Pediatric EM Morsels

JULY 19, 2024

If bleeding, the only lab that is needed in the Emergency Department is a type and cross. If bleeding has completely stopped, most of these children still come into the hospital for observation so access will likely be necessary and helpful should patient have rebleed event. Well… sometimes it starts again.

Airway Management 286

Airway Management Pediatrics Wellness Administration 286

The Trauma Pro

AUGUST 20, 2024

But here is something to keep at top of mind: Your patient is at their healthiest as they roll in through the emergency department door Yes, major trauma patients are sick, but they are going to get sicker over the next few hours to days. Too often, we look at them and delay because “they are too sick to operate.”

Operations 113

Operations Emergency Department Hospitals 113

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. 1 The Rise of the Miami BBL An entire industry has emerged around gluteal AFTs in Miami. units per patient.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

The Skeptics' Guide to EM

DECEMBER 10, 2022

Bone Joint J 2022 Guest Skeptic: Dr.Matt Schmitz is an Orthopaedic Surgeon specializing in Adolescent Sports Medicine and Young Adult Hip Preservation. […] The post SGEM#385: If the Bones are Good, the Rest Don’t Matter – Operative vs Non-Operative Management of Scaphoid Fractures first appeared on The Skeptics Guide to Emergency Medicine.

Operations 52

Operations Fractures Military Emergency Department 52

ACEP Now

DECEMBER 11, 2023

The Emergency Department Benchmarking Alliance (EDBA) is a membership organization composed of high-performance emergency departments (EDs) that share a commitment to quality. Patients who require inpatient boarding remain a significant challenge to ed operations. American College of Emergency Physicians.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

Emergency Medicine Journal

AUGUST 23, 2023

Participants reported local triage/streaming systems predating 111 First continued to operate so that, despite prebooked arrival slots at the ED, all attendances were funnelled into a single queue. This was described by participants as a source of frustration for staff and patients.

Urgent Care 75

Urgent Care Emergency Department Documentation/Coding Patient Safety 75

RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. More pertinent and relevant takeaway messages have to do with staffing and operations.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. 0.41), p < 0.001.

Pediatrics 183

Pediatrics Emergency Department Outcomes Sepsis 183

The Skeptics' Guide to EM

MARCH 2, 2024

Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Case: A 59-year-old man walks into your community emergency department (ED) complaining of chest pain.

Emergency Department 119

Emergency Department Stroke Operations Hospitals 119

Taming the SRU

SEPTEMBER 22, 2023

million adults undergo tracheal intubation outside of the operating room each year in the United States. The operator reported a subjective assessment of the anticipated difficulty. Most intubations (69.7%) were performed in the emergency department, with the remainder occurring in an intensive care unit.

Operations 103

Operations Outcomes Emergency Department Academics 103

Don't Forget the Bubbles

NOVEMBER 29, 2023

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. Pediatric Endotracheal Intubations for Airway Management in the Emergency Department.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

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% An abnormal ABI (<0.9) No open wound. ABI’s were 1.1

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

Taming the SRU

SEPTEMBER 25, 2023

Musculoskeletal injuries are a common occurrence, representing a substantial number of Emergency Department visits on an annual basis. 1) Oftentimes, Emergency Physicians are the first provider patients encounter after an injury. Thus, treatment of Maisonneuve fractures often involves operative repair. (5) References 1.

Fractures 100

Fractures Operations Emergency Department EMS 100

Emergency Medicine Journal

FEBRUARY 20, 2024

Reference standard was radiological or operative confirmation of AAS. Clinicians treating prospectively identified patients were asked to record their perceived likelihood of AAS, prior to any confirmatory testing. 30-day electronic patient record follow-up evaluated whether a subsequent diagnosis of AAS had been made and mortality.

Emergency Department 52

Emergency Department Operations Radiology Radiology 52

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Secondary hemorrhage occurs between days five and 14 post-operatively, peaking around days five to seven. and youre three hours from the nearest tertiary care center. CREDIT: Dr. P.

Airway Management 90

Airway Management Operations Resuscitation Pediatrics 90

Emergency Medicine Journal

FEBRUARY 20, 2024

The Chief Coroner’s annual report details the operation of the coroner’s service and does not collate PFD findings. 4 We identified and analysed PFD reports relating to emergency departments (EDs), aiming to identify common themes in coroners’ concerns.

Emergency Department 40

Emergency Department Operations 40

Emergency Medicine Journal

NOVEMBER 28, 2023

Introduction Most Irish emergency departments (EDs) do not record diagnosis in a standardised way at the conclusion of each patient care episode. This lack of data hampers service planning and the transformation of ED funding from a block grant system to one based on activity.

Documentation/Coding 40

Documentation/Coding Emergency Department Administration Operations 40

EB Medicine

OCTOBER 21, 2024

Eckler, MD discuss the October 2024 Pediatric Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Departmen t 00:00 Welcome and Introduction 00:13 Free Subscription for Emergency Medicine Residents 01:05 Introduction to Pediatric Emergency Medicine Practice 01:37 Discussion (..)

Pediatrics 59

Pediatrics Elder Abuse Risk Management Emergency Department 59

Taming the SRU

JULY 24, 2024

Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med 2024 Background Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world.

Sepsis 88

Sepsis Resuscitation Emergency Department Wellness 88

Taming the SRU

MARCH 12, 2024

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. Acad Emerg Med 2023;30(8):800–8. The study’s primary outcomes were the operational impacts of the SQuID protocol on EDLOS and ICU admission rates. Acad Emerg Med 2023;30(8):800–8. Acad Emerg Med 2023;30(8):800–8.

Operations 96

Operations Hospitals Best Practices Wellness 96

PulmCCM

NOVEMBER 6, 2023

The intervention took place in the emergency department, with device placement by ED physicians. It was hypothesized that performing REBOA in the emergency department (as opposed to operating rooms or interventional suites) may have led to delays in definitive surgical procedures to control hemorrhage.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Don't Forget the Bubbles

JUNE 30, 2023

These procedures require an experienced operator. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this. These procedures require an experienced operator. c) Or, do both?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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

EM Literature of Note

OCTOBER 1, 2023

Prior to ChatGPT, clinicians did not operate in an information resource vacuum, as is frequently the case in these contrived situations. “ ChatGPT and Generating a Differential Diagnosis Early in an Emergency Department Presentation “ Tweet However, what is lacking from these studies are any sort of comparison.

Documentation/Coding 88

Documentation/Coding Operations Emergency Department Wellness 88

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Chest drains are commonly inserted in the Emergency Department (ED) with a complication rate of 30-40%. Training in chest drain insertion is essential in Emergency Medicine (EM) as approximately 25,000 patients undergo in England and Wales undergo this procedure annually.

Emergency Department 40

Emergency Department EMS Research Operations 40

ACEP Now

NOVEMBER 7, 2023

And in our comment letter responding to the FTC and Department of Justice’s proposed updates to health care merger guidelines, ACEP urged the agencies to finalize these changes that would bring more scrutiny to health care mergers and slow down consolidation. Learn more at openbook.acep.org.

Leadership 98

Leadership Administration Research Risk Management 98

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. The data is strong that in the hands of trained Emergency Clinicians, when parasternal, apical, and subcostal views are obtained, US has an accuracy of 97.5%

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EMDocs

DECEMBER 11, 2023

In October 2022, the American College of Cardiology released an updated expert consensus decision regarding the evaluation of chest pain in the emergency department. This included the addition several new STEMI equivalents [4] on ECG that warrant “prompt evaluation for emergency coronary angiography.” J Am Coll Cardiol.

EKG/ECG 110

EKG/ECG Emergency Department Academics Operations 110

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. At this point, the patient is taken to the operating room for a diagnostic laparoscopy. Diagnosing ectopic pregnancy in the emergency setting.

Ultrasounds 97

Ultrasounds Operations Radiology Radiology 97

Don't Forget the Bubbles

OCTOBER 10, 2024

Ten thousand children in the UK are operated on a year for fingertip injuries, and 96% of surgeons currently report replacing the nail plate intra-operatively. Exploring communication preferences and risk thresholds of clinicians and parents of febrile infants under 90 days presenting to the emergency department: a qualitative study.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. One operator should perform defibrillation in the anterolateral position, followed by another operator providing a second shock in the anteroposterior position after a delay of less than one second.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

The Skeptics' Guide to EM

JUNE 15, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. Enhanced Operative Strategies - Damage control surgery with truncated interventions, energy devices, hemostatic foams/gels/packs, etc. Reference: Jansen et al.

Resuscitation 89

Resuscitation Patient Safety Operations Emergency Department 89

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. Crit Care Med.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Jeff: Even more shockingly, some series showed a 52% repeat operation rate. These patients often require emergent operative intervention.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ACEP Now

APRIL 5, 2024

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. There was no analysis of operator experience or expertise. As with any procedural device, operator expertise is an important component of its successful use. Ann Emerg Med. Vital signs on arrival are: Temperature: 38.8

Airway Management 73

Airway Management Operations Emergency Department Research 73

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

SEPTEMBER 2, 2023

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. Date: August 30, 2023 Reference: Griffey et al. He is otherwise healthy.

Operations 79

Operations Diabetic Emergencies Hospitals Research 79