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

RebelEM

NOVEMBER 25, 2024

Included patients from out-of-hospital, emergency department, intensive care unit, and operating-room intubations. Intubation performed in all settings (out-of-hospital, emergency department, ICU, and operating room). Secondary Outcomes: First-attempt success without clinically important complications (e.g.,

Outcomes 93

Outcomes Emergency Department Operations Hospitals 93

Taming the SRU

MARCH 11, 2024

of all orthopedic injuries and may be difficult to recognize if the dislocation spontaneously reduces prior to care in the Emergency Department, which may occur in upwards of 50% of cases (3). 4) This classification system is more specific but may be impractical to use in an Emergency Department setting. No open wound.

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

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 122

Ultrasounds Outcomes COPD Hospitals 122

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 96

Operations Hospitals Best Practices Wellness 96

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

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

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 85

Sepsis Pediatrics Shock Hospitals 85

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

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 97

Administration Emergency Department Outcomes Documentation/Coding 97

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 Outcomes Documentation/Coding 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

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

RebelEM

NOVEMBER 6, 2024

Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. J Emerg Med. Anatomy, Shoulder and Upper Limb, Radial Nerve. 2023 Nov 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30521261 Gottlieb M, Schiebout J. 2018 Jun;54(6):849-854. doi: 10.1016/j.jemermed.2018.02.011.

Dislocations 103

Dislocations Fractures Soft Tissue Injuries Outcomes 103

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

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

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 87

Hospitals Emergency Department EMS Outcomes 87

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

EMDocs

JANUARY 11, 2025

Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation.

EMS 88

EMS Sepsis Shock Fluid Resuscitation 88

The Skeptics' Guide to EM

DECEMBER 12, 2020

She is Chair of the Royal College of Emergency Medicine Women in Emergency Medicine group and involved with the RCEM Public Health and Informatics groups. Case: A 52-year-old previously healthy woman presents to your emergency department (ED) with an abscess on her left forearm.

Operations 52

Operations Outcomes Research Academics 52

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

The Skeptics' Guide to EM

JULY 30, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 63-year-old woman presents to your emergency department (ED) with two-day history of nausea, vomiting and constipation. Charles Brower is a second-year resident training in Emergency Medicine at the University of Cincinnati.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

Taming the SRU

MAY 22, 2023

Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. Most frequent reasons for emergency department visits, 2018. A comparison between pre-operative ultrasonography and surgical findings. 9(1):31-36.

Fractures 77

Fractures Dislocations Operations Radiology 77

Cook County EM Blog

JUNE 2, 2022

The Case: A 40-year-old male with no past medical history presented to the emergency department after he was assaulted with closed fists just prior to arrival. If there are no indications for surgery, the patient can be immobilized in a cast for four weeks with good outcomes.

Fractures 52

Fractures Soft Tissue Injuries Operations Emergency Department 52

SheMD

MAY 4, 2023

Article Summary What they looked at: This article aimed to look at career trajectory differences between genders in faculty who have attained academic chair roles in emergency medicine. What were their outcomes: The median number of years to first appointment to a chair position was 7 years after graduation. vs 31.6%, p=0.12).

Leadership 52

Leadership Academics Operations Administration 52

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). Although they may not appear as physically injurious as convulsive seizures, nonconvulsive seizures can significantly impact the neurological outcomes and overall prognosis of patients in critical care settings.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

Critical Care Now

JULY 7, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. Methodological challenges, such as extended prehospital transport times, limited operator experience, and small sample size, introduce uncertainty to these findings.

Resuscitation 52

Resuscitation Military Outcomes Hospitals 52

The Skeptics' Guide to EM

APRIL 16, 2022

Case: A 55-year-old man comes into the emergency department (ED) for increasing knee pain and decrease in function. Background: Musculoskeletal complaints are one of the most common presentations to emergency departments. He’s had an anterior cruciate ligament (ACL) repair and used to run marathons. Tricoci et al.

Military 40

Military Operations Emergency Department Pediatrics 40

Emergency Medicine Journal

NOVEMBER 28, 2023

Background Innovations in models of care for older adults living with frailty presenting to the emergency department (ED) have become a key priority for clinicians and researchers given the deleterious outcomes older adults experience due to prolonged exposure to such an environment.

Research 40

Research Outcomes Operations Emergency Department 40

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane). for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? 1 Low-dose non-contrast abdominal CT has become the gold standard for diagnosis as it has become readily available in emergency departments nationwide, with some studies touting sensitivity and specificity of 97% and 95%, respectively.2

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52