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. Learn more at acep.org/PracticeEssentials.

Leadership 98

Leadership Administration Research Risk Management 98

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 89

Sepsis Resuscitation Emergency Department Wellness 89

Don't Forget the Bubbles

JANUARY 8, 2024

In paediatric emergency care, addressing the challenge of adolescent agitation is a complex and evolving task. Dr Elyssia Bourke, based at Ballarat Base Hospital, is actively engaged in this area through her ongoing PhD research. Organic Illnesses : Often overlooked, these can manifest as behavioural changes. Mulraney, M., Coghill, D.,

Research 105

Research Emergency Department Psychiatric Academics 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

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

Don't Forget the Bubbles

JUNE 19, 2024

In adult trauma cases, there has been significant research to help decide which patients require X-ray or CT imaging for possible cervical spine injuries, leading to the development of the National Emergency X-Ray (NEXUS) prediction rule and the Canadian C-Spine Rule (CCR). Why is this study needed? Lancet Child Adolesc Health.

CPR 124

CPR Research Documentation/Coding Outcomes 124

ACEP Now

MARCH 6, 2024

Every year, the volume of published research continues to outpace capacity to consume. The Sisyphean task remains to try to keep up—and, in that vein—here is a light round of the emergency medicine literature from 2023. The post Fourteen Emergency Medicine Research Gems from 2023 appeared first on ACEP Now.

Research 52

Research Airway Management Stroke Outcomes 52

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

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 97

Operations Hospitals Best Practices Wellness 97

Greater Sydney Area HEMS

FEBRUARY 20, 2024

This would therefore remove some of the limitations (perceived or real) around time delays associated with using ultrasound for central access as there would be no need for probe covers and positioning of the portable ultrasound (which often needs the help of a second operator, a significant limitation in a small prehospital medical team).

Ultrasounds 98

Ultrasounds Shock Research Operations 98

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. Without a clear definition, tailoring research and audit is difficult.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

SheMD

JULY 23, 2023

Talk about your major extra-curricular activities and research in the department. For example, one medical school student I recently interviewed who was applying for internal medicine – primary care spoke about her research with transgender individuals and their perceptions of sexual health. These reasons are TOO common.

Research 98

Research Academics Hospitals Operations 98

ACEP Now

APRIL 5, 2024

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. Is the Evidence from This Research Sufficient to Change Practice? There was no analysis of operator experience or expertise. As with any procedural device, operator expertise is an important component of its successful use.

Airway Management 73

Airway Management Operations Emergency Department Research 73

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. Am J Emerg Med. 2021 Nov;49:226-232. 2021.05.071.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

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

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]. Researchers randomly assigned 90 eligible patients over ≈ 4.5 Paper: Jansen JO, Hudson J, Cochran C, et al.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

ACEP Now

OCTOBER 15, 2023

Additionally, in the current era of ubiquitous emergency department (ED) boarding, ED length of stay is of critical importance. Dr. Westafer (@Lwestafer) is an attending physician and research fellow at Baystate Medical Center, clinical instructor at the University of Massachusetts Medical School in Worcester, and co-host of FOAMcast.

Hospitals 80

Hospitals Operations Emergency Department Research 80

The Skeptics' Guide to EM

NOVEMBER 20, 2021

Moving the Needle on Fall Prevention: A Geriatric Emergency Care Applied Research (GEAR) Network Scoping Review and Consensus Statement. She […] The post SGEM#351: How to Stop Geriatrics from Free Fallin’ first appeared on The Skeptics Guide to Emergency Medicine. Date: November 16th, 2021 Reference: Hammouda et al.

Geriatric Emergencies 52

Geriatric Emergencies Elder Abuse Research Academics 52

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. Retrospective study done by Monash University in Melbourne (largest radiology department in Australia) (Average daily scans plotted).

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

The Skeptics' Guide to EM

DECEMBER 12, 2020

AEM December 2020 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). 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

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

The fire department, who operate at an EMT level in this municipality, arrived before us and administered 324 mg of baby aspirin to the patient due to concern for ACS. Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

The Skeptics' Guide to EM

JANUARY 23, 2021

Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She is the cofounder of FOAMcast and a pulmonary embolism and implementation science researcher. and Physicians first appeared on The Skeptics Guide to Emergency Medicine.

Poisoning 52

Poisoning Research Documentation/Coding Operations 52

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 Operations Emergency Department Outcomes 40

ACEP Now

JULY 8, 2024

Recently published experiments with LLMs in the emergency department fall into a handful of primary areas of interest. In this case, the LLM lacks specific domain training on the CTAS score, and the predictions do not have the appropriate foundational training to operate accurately. J Am Coll Emerg Physicians Open.

Emergency Department 52

Emergency Department Operations Documentation/Coding EKG/ECG 52

Taming the SRU

AUGUST 4, 2024

to teach you and your learner something new on shift skin adhesives WITH dr. hill Dermabond is a polymer (octyl cyanoacrylate) that can be used to repair lacerations in the Emergency Department faster than sutures, allowing the ED physician to be more efficient. The largest retrospective cohort study to date (Beyde et al.)

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). For example, other modes of EEG monitoring may be used in the operative setting, including bispectral index monitoring (BIS) and SEDline device, to monitor depth of sedation. Ann Emerg Med. Am J Emerg Med.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

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. Dr. Charles Brower is a second-year resident training in Emergency Medicine at the University of Cincinnati.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

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 ). Nonetheless, research has consistently shown that healthcare environments demonstrate higher-than-average levels of workplace incivility.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

ACEP Now

SEPTEMBER 3, 2024

Still, this wave of private equity acquisitions in emergency medicine has come crashing down on the heads of many early-career physicians. As of 2022, 1 in 4 emergency departments in the United States were staffed by a private equity-owned physician group. Center for Economic and Policy Research (CEPR). The New Yorker.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

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

ACEP Now

SEPTEMBER 5, 2024

While some issues are handled locally, many issues cannot be solved in our emergency department or hospital. As a community “pit doctor,” I believe I have a good understanding of the needs of emergency physicians. Emergency physicians that seek a network of colleagues may be inclined to join ACEP.

Leadership 98

Leadership PPE EMS Wellness 98

Don't Forget the Bubbles

MAY 17, 2023

We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Post-operative pain in children: Comparison of pain scores between parents and children. J Pediatr Gastroenterol Nutr. 2023 Apr 24. Cetinkaya PG, et al. 2023 Apr 12.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

ACEP Now

JUNE 14, 2024

Nick Vasquez, MD, FACEP, gets to see the impact of social determinants of health every day in the emergency department. He said emergency physicians often care for those who did not develop agency, and it’s led them to believe the world has power and they do not. Like most in our specialty, he wants to help solve problems.

Operations 52

Operations Emergency Department Research 52

The Skeptics' Guide to EM

FEBRUARY 2, 2018

Guest Skeptic: Dr. Melissa Langhan is an Associate Professor of Pediatric Emergency Medicine at Yale University in New Haven, CT. Melissa is passionate about clinical and translational research and focuses most of her work […] The post SGEM#205: Twist & Shout – Testicular Torsion first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 40

Pediatrics Ultrasounds Emergency Department Research 40

ACEP Now

DECEMBER 10, 2023

Today Dr. Calderon is known for her research into HIV and Hepatitis C prevention, but she didn’t start off on an academic track. She was 10 years into being an attending physician when she realized that to make an impact on the problems she was seeing in her ED, she would need a better understanding of how to do research. “I

Research 52

Research Point-of-Care Testing Burns Academics 52

The Skeptics' Guide to EM

NOVEMBER 25, 2017

While inwardly wishing you worked in a country where droperidol was available, you wonder whether there is any new research to guide your management. It has been used for years to treat nausea and vomiting in post-operative patients and cancer patients. You know her well, and none of the usual anti-emetics seem to help her symptoms.

Psychiatric 40

Psychiatric Emergency Department Operations Hospitals 40

Don't Forget the Bubbles

MAY 3, 2023

Every month we ask some of our friends from PERUKI (Paediatric Emergency Research in the UK and Ireland) to point out something that has caught their eye. Because of the retrospective nature of the study, the decision to use the bougie was operator-dependent. 468 paediatric patients were intubated in this timeframe.

CPR 52

CPR Airway Management Emergency Department Resuscitation 52