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.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

The Skeptics' Guide to EM

DECEMBER 10, 2022

One-year outcome of surgery compared with immobilization in a cast for adults with an undisplaced or minimally displaced scaphoid fracture: A meta-analysis of randomized controlled trials. Case: A 32-year-old male construction worker presents to the emergency department (ED) after falling on his right dominant hand.

Operations 52

Operations Fractures Military Emergency Department 52

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

ALiEM

OCTOBER 30, 2024

Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. Your patient ultimately is diagnosed with a spinal epidural abscess requiring operative care. PMID 35774687 D’Onofrio G, Chawarski MC, O’Connor PG, et al. 2017 Jun;32:660-6.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. This is a critical error that leads to poorer outcomes for patients in need of critical care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

EMDocs

DECEMBER 6, 2024

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Antiemetics as needed. 2 L/hr in adults.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

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)

Fractures 101

Fractures Operations Emergency Department EMS 101

The Skeptics' Guide to EM

DECEMBER 14, 2024

He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate of FOAMed. Dr. Damian Roland Case: A 3-year-old boy arrives at the emergency department (ED) with a high fever, rapid breathing, and lethargy. Damian is also part of theDont Forget the Bubbles Team.

Sepsis 103

Sepsis Pediatrics Shock Hospitals 103

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 129

Ultrasounds Outcomes COPD Hospitals 129

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. J Ped Surg 54:335-339, 2019.

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

PulmCCM

NOVEMBER 6, 2023

TEG or ROTEM) is becoming a more widely used tool to help guide the administration of blood products in hemorrhage from trauma, although its effects on meaningful clinical outcomes remain uncertain. The intervention took place in the emergency department, with device placement by ED physicians. Thromboelastometry (e.g.,

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. They stratified patients according to the ratio of FFP: PRBC received (1:1, 1:2, 1:3 and 1:3+) and performed logistic regression analyses for various outcomes. These procedures require an experienced operator.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Don't Forget the Bubbles

OCTOBER 10, 2024

Reviewed by: Isabella Davenport Article 2: Does it improve outcomes if you replace the nail in nail bed repair? Children with nail bed injuries were randomly assigned to nail replacement or discarding , with the primary outcomes being secondary infection in 7 days and cosmetic outcome in four months.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

ACEP Now

JANUARY 5, 2025

The PREOXI trial compared oxygen mask pre-oxygenation versus noninvasive positive-pressure ventilation (NIPPV) in patients requiring intubation in emergency departments (EDs) and intensive care units. 1 The primary outcome was the frequency of observed hypoxemia, defined as any pulse oximetry reading below 85 percent.

Sepsis 40

Sepsis Research Airway Management Stroke 40

Emergency Medicine Journal

MAY 23, 2023

We validated the score in a large patient data set and constructed a model that allows early prediction of the probability of clinical outcomes based on the individual’s NEWS+L Score. The outcomes were hospital death or a composite of hospital death and intensive care unit admission at 24 hours, 48 hours and 72 hours.

Outcomes 40

Outcomes Emergency Department Academics Operations 40

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 2,3 In general, patients who develop cardiac arrest with an initial rhythm of VT or VF tend to have favorable outcomes compared to patients who develop cardiac arrest from either asystole or pulseless electrical activity.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

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. Secondary outcomes included fidelity to and safety of the intervention.

Operations 97

Operations Hospitals Best Practices Wellness 97

RebelEM

JUNE 8, 2023

Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

RebelEM

NOVEMBER 20, 2023

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12]. Outcome: Primary Outcome: All-cause mortality at 90 days. Paper: Jansen JO, Hudson J, Cochran C, et al.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Don't Forget the Bubbles

JUNE 19, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort.

CPR 124

CPR Research Documentation/Coding Outcomes 124

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

Don't Forget the Bubbles

JANUARY 8, 2024

Dr Bourke’s work is not only about deepening academic understanding but also about forging practical approaches to help healthcare professionals navigate the nuanced and often uncertain waters of adolescent care in emergency settings. Mulraney, M., Coghill, D., Sciberras, E., and Sawyer, M.,

Research 105

Research Emergency Department Psychiatric Academics 105

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Emerg Med J. Paediatr Int Child Health. 2024 Jan 11:1-7.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

EMDocs

SEPTEMBER 25, 2023

Still, there are those that believe that FPS is more of a physician-centered endpoint that does not fully reflect important patient-centric outcomes (16). Improved Visualization: Video laryngoscopes allow for the use of standard or hyperangulated geometry, essentially allowing the operator to “look around the corner” on an anterior airway.

Emergency Department 93

Emergency Department Soft Tissue Injuries Airway Management Operations 93

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

The Skeptics' Guide to EM

NOVEMBER 21, 2020

Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. The impact of advanced practice provider staffing on emergency department care: productivity, flow, safety, and experience. He is also the CME editor for Academic Emergency Medicine.

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 52

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.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. Under standard operating protocols, residual contrast materials are usually wasted, according to current CDC and JC standards.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

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

Emergency Medicine Journal

JULY 22, 2024

This retrospective study compared the performance of 21 EWS scores to predict clinical deterioration using vital signs (VS) measured in the prehospital or emergency department (ED) setting. The discriminative ability of the EWS scores was assessed using the area under the receiver operating characteristic curve (AUROC).

Ambulance Services 52

Ambulance Services Hospitals Operations Emergency Department 52

Emergency Medicine Journal

NOVEMBER 28, 2023

The primary outcome was the proportion of patients requiring more than one reduction attempt. The secondary outcomes were time to complete reduction and treatment plan at ED discharge (conservative or operative repair).

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. How do you manage this situation?

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

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 The primary outcome was in-hospital mortality. The secondary outcome focused on ICU admissions.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

The Skeptics' Guide to EM

SEPTEMBER 3, 2017

EmergeNcy Department use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). He writes an excellent […] The post SGEM#186: Apneic and the O, O, O2 for Rapid Sequence Intubation first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 52

Emergency Department Resuscitation Operations EMS 52

PHEM Cast

DECEMBER 12, 2016

Emergency thoracotomy in thoracic trauma: a review. Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World Journal of Emergency Surgery; 2006: 1:4. Survival after Emergency Department thoracotomy: review of published data for last 25 years.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

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

OCTOBER 15, 2023

Additionally, in the current era of ubiquitous emergency department (ED) boarding, ED length of stay is of critical importance. Evaluation of outcomes following hospital-wide implementation of a subcutaneous insulin protocol for diabetic ketoacidosis. Acad Emerg Med. Rao P, Jiang SF, Kipnis P, et al. JAMA Netw Open.

Hospitals 80

Hospitals Operations Emergency Department Research 80