ACEP Now

OCTOBER 29, 2024

On a busy day shift in the emergency department, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? This is the essence of emergency medicine. 4 However, emergency physicians rely on gestalt to predict outcomes well.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

Taming the SRU

JUNE 11, 2023

End-tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in-hospital mortality and intensive care unit admission. Acad Emerg Med 2023; 10.1111/acem.14703 Acad Emerg Med 2023; 10.1111/acem.14703 The primary outcome was in-hospital mortality.

Hospitals 86

Hospitals Emergency Department EMS Outcomes 86

Don't Forget the Bubbles

JANUARY 31, 2024

As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties. Article 1: What predicts parental anxiety in the Paediatric Emergency Department? Predictors of parental anxiety in a paediatric emergency department. Martin, S.R.,

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. ED crowding impairs this mission.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. are caused by a behavioral crisis.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

The Trauma Pro

JULY 5, 2024

But under-prescribing can create problems as well. Uncontrolled pain is a huge patient dissatisfier, and can lead to unwelcome complications as well (think pneumonia after rib fractures). Make sure all is documented well on the consent or in the EHR.

Documentation/Coding 113

Documentation/Coding Fractures Emergency Department Wellness 113

Downeast Emergency Medicine

DECEMBER 1, 2021

While the ongoing COVID-19 pandemic has contributed to overdose deaths and taxed constrained Emergency Department (ED) resources, it has also clarified the important role that emergency physicians have in expanding access to life-saving medications to treat opioid use disorder. Annals of Emergency Medicine. Hawk, et al.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Administration 52

EM Ottawa

NOVEMBER 2, 2023

Introduction Frostbite is a frequent presenting complaint to emergency departments (EDs) in cold climates. It is more common among those without housing, those with mental health disorders as well as those who work or engage in outdoor activities.(1)

Emergency Department 117

Emergency Department Wellness Hospitals Resuscitation 117

Emergency Medicine Journal

AUGUST 21, 2024

The Clinical Frailty Scale (CFS) is a 9-point frailty assessment instrument that has shown promise to identify frail emergency department (ED) patients at increased risk of adverse outcomes. Background Older patients living with frailty have an increased risk for adverse events. Logistic regression was used to adjust for confounders.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

RebelEM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

ACEP Now

DECEMBER 17, 2024

But we should not have to sacrifice our own well-being in the process. We deal with difficult and traumatizing situations daily, and nowhere is this more apparent than in the emergency department, where sickness, violence, and death are routine. Elmhurst doctors’ strike ends as hospital, union reach deal.

Burns 105

Burns Hospitals Documentation/Coding Emergency Department 105

Taming the SRU

MARCH 11, 2024

Acute knee dislocations are rare orthopedic injuries that have high morbidity and need to be recognized quickly by the emergency physician; if unrecognized or inadequately treated, these injuries can lead to vascular and limb compromise (1,2). Knee dislocations make up less than 0.5%

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

Taming the SRU

DECEMBER 17, 2024

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. compared the effects of these two among the acute gastroenteritis children and reported that the use of ORT was associated with shorter hospital stay and increased patient satisfaction.

Dehydration 82

Dehydration Fluid Resuscitation Administration Resuscitation 82

Pediatric EM Morsels

FEBRUARY 2, 2024

Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries. Internationally Acquired Severe Systemic Infections in Febrile Pediatric Travelers Presenting to the Emergency Department. Pediatr Emerg Care.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

EMDocs

DECEMBER 18, 2024

A 36-year-old male presents to the emergency department after being found down at home by his spouse. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

Seizures 88

Seizures Hyperthermia / Hypothermia Emergency Department EMS 88

ACEP Now

DECEMBER 6, 2024

His health care focus included hospital efficiency, physician and patient satisfaction, and emergency department (ED) wait times, as well as a host of nonhealth issues. That changed when, as a college student, he joined a friend on a volunteer shift at Highland Hospital in Oakland, Calif. Click to enlarge.)

Emergency Department 98

Emergency Department Hospitals Wellness 98

ACEP Now

OCTOBER 10, 2024

He completed residency in emergency medicine through Emory while training at Grady Hospital in Atlanta. Most recently, Dr. McCormick served as an emergency physician at Northside Hospital. In the Atlanta region, we had AMC, one of the largest hospitals in the region closed. Overburden the other hospital systems.

Telemedicine 105

Telemedicine Critical Access Hospitals Administration 105

The Trauma Pro

OCTOBER 4, 2024

Clinical outcomes assessed at 60 days included an unplanned return to the emergency department (ED), re-admission, complications, and development of new bleeding confirmed by surgery, ultrasound, or computed tomography (CT) at 60 days post-injury. Adherence to guidelines was assessed by a follow-up phone call two months after injury.

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

Emergency Medicine Journal

NOVEMBER 28, 2023

This study utilised 12 months’ of routinely collected data from Emergency Departments (EDs) and acute Admitted Patient Care Episodes (APCs) to understand trends in demand for emergency care. Specifically, we examined factors associated with seasonal variation in overall demand and avoidable usage of emergency care.

Emergency Department 40

Emergency Department Hospitals Outcomes Research 40

ACEP Now

AUGUST 22, 2023

Regardless of the domain, somewhere an expert panel has convened to issue a pronouncement informing all of the ideal care of patients under their specialty umbrella, indirectly extending to their care in the emergency department. 1 To date, there have been three GRACE publications. 1 To date, there have been three GRACE publications.

Emergency Department 98

Emergency Department Academics Critical Access Research 98

Don't Forget the Bubbles

OCTOBER 12, 2024

doi: 10.1136/archdischild-2023-326773 Two-year-old Moyo is brought to the emergency department because her parents were concerned about noisy breathing. Most children can be discharged from the emergency department after a dose of corticosteroids and an appropriate safety net. Published Online First: 15 April 2024.

Airway Management 85

Airway Management Emergency Department Administration Hospitals 85

RebelEM

JULY 1, 2024

Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. AVAPS may be useful, but we still need a well conducted RCT to find out if it is (i.e Paper: Goren NZ et al. Balkan Med J 2021. AVAPS: 0.07 AVAPS: 10.20

COPD 131

COPD Emergency Department Outcomes EMS 131

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

RebelEM

DECEMBER 23, 2024

There has been ongoing study about the clinical significance of these effects, as well as whether and for whom LR might provide meaningfully better clinical outcomes ( Myburgh 2013 , Self 2018 , Semler 2018 , Self 2020 ). saline affect hospital-free days by day 30?

Fluid Resuscitation 124

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 124

The Skeptics' Guide to EM

JULY 8, 2023

Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Date: July 6, 2023 Reference: Hanula R et al. JAMA Int Med 2023.

CDC 94

CDC Hospitals EMS Emergency Department 94

RebelEM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

Ultrasounds 127

Ultrasounds Outcomes COPD Hospitals 127

The Skeptics' Guide to EM

AUGUST 21, 2021

Evaluation and management of well-appearing febrile infants 8 to 60 days old. Pediatrics 2021 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Case: A 25-day-old, full-term boy presents to the emergency department with fever.

Wellness 52

Wellness Pediatrics Emergency Department Hospitals 52

ACEP Now

MAY 10, 2024

Patients often seek care in the emergency department (ED) setting when flares of pain affect their ability to ambulate, climb stairs, or even stand up from sitting. We prefer an in-plane, superior to inferior approach, but an out-of-plane technique can be performed, as well. J Emerg Med. Surg Technol Int. Ragab, A.R.,

Ultrasounds 92

Ultrasounds Emergency Department Hospitals Wellness 92

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. There are well preserved R-waves in Wellens waves. What do you think? ng/mL, BNP 2790, and lactate 3.7.

EKG/ECG 136

EKG/ECG Emergency Department Shock Ultrasounds 136

Emergency Medicine Journal

JULY 22, 2024

Introduction Episodes of physical and verbal violence, as well as psychological humiliation, are experienced daily by ED staff. Methods We conducted a prospective observational study in the ED of Merano Hospital, Italy (52 000 ED admission in 2022) from 1 January 2022 to 31 August 2023. The ED staff include 38 nurses and 11 physicians.

Emergency Department 52

Emergency Department Hospitals Wellness 52

ACEP Now

JULY 7, 2023

Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. Circulation. 2018;137(12). Kimblad H, et al.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Pediatric EM Morsels

JULY 21, 2023

Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. J Surg Res. 2019 Sep;241:112-118. doi: 10.1016/j.jss.2019.03.038. 2019.03.038. Epub 2019 Apr 22. PMID: 31022676. Gill MR, Reiley DG, Green SM. 2004;43:215-223. Rowley G, Fielding K. 1991;337:535-538.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

The Skeptics' Guide to EM

APRIL 22, 2023

Effect of early high-flow nasal oxygen vs standard oxygen therapy on length of hospital stay in hospitalized children with acute hypoxemic respiratory failure: the PARIS-2 randomized clinical trial. Case: A 14-month-old boy presents to the emergency department (ED) with two days of upper respiratory symptoms and respiratory distress.

Hospitals 52

Hospitals Pediatrics Emergency Department Outcomes 52

Taming the SRU

MAY 13, 2024

The patient is a well-appearing male who is awake, alert, and oriented. There is also a well-appearing, healed surgical scar. There is also a well-appearing, healed surgical scar. The skin is warm and well perfused with brisk capillary refill. The patient was discharged on hospital day 5. BMP : Na 136, K 4.3,

Ultrasounds 96

Ultrasounds Emergency Department Wellness Operations 96

The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. It did not perform as well which is not unusual for a clinical decision instrument [5].

Fractures 82

Fractures Ultrasounds Emergency Department CDC 82

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. The IO can actually be your “GO-TO” emergency line or your second choice after failed PIV access.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Taming the SRU

MARCH 12, 2024

ED visits per 1000 adults with diabetes based on 2018 data resulting in over 500,000 annual hospital days. This amounts to annual hospital costs of $5.1 as well as patients less than 18 years old were excluded from analysis. DKA accounts for approximately 223,000 ED visits annually or 8.9

Operations 96

Operations Hospitals Best Practices Wellness 96