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

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 Documentation/Coding Academics 52

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. days versus 2.7 days, a difference of 2.2

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

EMDocs

DECEMBER 18, 2024

A 36-year-old male presents to the emergency department after being found down at home by his spouse. Alcohol withdrawal syndrome: improving outcomes through early identification and aggressive treatment strategies. Emerg Med Pract. Acad Emerg Med. 2015; 17(6): 1-19. Borgundvaag B, Bellolio F, Miles I, et al.

Seizures 99

Seizures Hyperthermia / Hypothermia Emergency Department EMS 99

ACEP Now

JULY 11, 2024

2 Although the opiate epidemic is certainly worthy of attention, it accounts for only about half of the number of deaths annually and only around a quarter of the number of emergency department visits annually relative to alcohol use. This medication has limited outcomes data and multiple contraindications. West J Emerg Med.

Emergency Department 98

Emergency Department Psychiatric Outcomes Wellness 98

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

The Skeptics' Guide to EM

AUGUST 17, 2019

Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain.

Emergency Department 52

Emergency Department Academics Fractures Outcomes 52

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

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 27, 2024

The primary outcome was cumulative norepinephrine use during the first 48 hours of admission. Secondary outcomes included mean arterial pressure (MAP), heart rate, vasoactive inotropic score (VIS) – a weighted score of different cardiovascular active agents, VIS/MAP, and pulmonary artery catheter (PAC) monitoring. Hill, J.

Resuscitation 98

Resuscitation Outcomes CPR Hospitals 98

Dr. Smith's ECG Blog

MARCH 14, 2024

Written by Jesse McLaren Three patients presented with acute chest pain and ECGs that were labeled by the computer as completely normal, and which was confirmed by the final cardiology interpretation (which is blinded to patient outcome) also as completely normal. It is well known that NOMI usually has a normal ECG or nonspecific ECG.

EKG/ECG 122

EKG/ECG Documentation/Coding Patient Safety Outcomes 122

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Certified interpreter use can improve communication and patient outcomes. One cohort study in a public ED found that 84.5% 45:446-458. 23:1214-1222.

Documentation/Coding 94

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 94

AENJ: Current Issue

SEPTEMBER 30, 2023

The overuse of computed tomographic (CT) scans for patients who present to the emergency department (ED) after mild traumatic brain injury (mTBI) has been well-documented. The Canadian Computed Tomography Head Rule (CCHR) is a validated tool to guide ED providers in determining the need for emergent CT of mTBI patients.

Emergency Department 52

Emergency Department Documentation/Coding Outcomes Wellness 52

The Skeptics' Guide to EM

FEBRUARY 15, 2020

Case: A 32-year-old woman with no previous medical history calls you while a passenger on a […] The post SGEM#284: Might as Well Jump, but We would Recommend a Parachute first appeared on The Skeptics Guide to Emergency Medicine. Guest Skeptic: Marcus Prescott is a nurse in Norway. He is also now a third-year medical student.

Wellness 52

Wellness Outcomes Emergency Department Research 52

Sensible Medicine

JULY 29, 2024

The background for cash giveaways stem from the association of low income and worse health outcomes. Their primary endpoint was emergency department visits. The primary outcome was positive but there were caveats. And, I am not against improving disparities in outcomes between richer and poorer citizens.

Outcomes 110

Outcomes Research Sepsis Emergency Department 110

EM Literature of Note

SEPTEMBER 24, 2024

Among the ~150 patients in each arm, those randomized to “high-intensity” NIPPV improved their primary outcome of “need for endotracheal intubation” – 4.8% These observations were durable in both unadjusted and adjusted results, as well as across most pre-specified subgroups. in each group.

COPD 95

COPD Outcomes Emergency Department Wellness 95

The Skeptics' Guide to EM

JUNE 1, 2024

He is the principal investigator for EMSC State Partnership in Washington, DC and is also involved in various multi-center EMS studies with the Pediatric Emergency Care Applied Research Network (PECARN). Population: Children (aged 0 to <18 years) who underwent blunt trauma evaluation in emergency departments. (ED)

Pediatrics 83

Pediatrics EMS Emergency Department Research 83

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department.

EKG/ECG 122

EKG/ECG Documentation/Coding Emergency Department Outcomes 122

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

The Skeptics' Guide to EM

JULY 20, 2024

Case: A 70-year-old man presents to the emergency department (ED) with an exacerbation of COPD. They do not provide positive pressure or ventilatory support, and the actual FiO2 delivered can be significantly lower than expected if the mask does not fit well. He is hypoxic on arrival with an oxygen saturation of 80% on room air.

COPD 93

COPD Patient Safety Administration Emergency Department 93

AENJ: Current Issue

SEPTEMBER 30, 2023

Managing agitation in pregnancy is a challenging dilemma due to the fear of adverse maternal and neonatal outcomes as well as the legal risk involved. Should medication be necessary, first-generation antipsychotics, second-generation antipsychotics, antihistamines, or benzodiazepines may be considered.

Psychiatric 52

Psychiatric Emergency Department Outcomes Wellness 52

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. Arch Dis Child.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

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 ). The enrollment was multicenter, large, and adequately powered for clinically meaningful changes in outcome.

Fluid Resuscitation 121

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 121

Don't Forget the Bubbles

JUNE 19, 2024

Well-designed multicentre large studies in children were warranted; cue Leonard et al. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. 2024 Jun 3:S2352-4642(24)00104-4.

CPR 124

CPR Research Outcomes Documentation/Coding 124

Emergency Medicine Journal

MAY 28, 2024

The SNNOOP10 criteria, which incorporates red and orange flags for serious causes, has been proposed but not well studied. The outcome of interest was serious secondary headache. Objectives Only a small proportion of patients presenting to an ED with headache have a serious cause.

Emergency Department 52

Emergency Department Outcomes Wellness 52

Don't Forget the Bubbles

NOVEMBER 25, 2024

A 7-week-old baby presents to the Emergency Department (ED) with a one-day history of coryza and cough. In triage, she is noted to be alert and feeding well. Primary outcome A total of 1821 infants were recruited for the FIDO study, of which 1395 ( 77% ) underwent respiratory viral testing at presentation and were included.

Point-of-Care Testing 69

Point-of-Care Testing Outcomes Wellness Emergency Department 69

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives In recent years there has been a large increase in demand for emergency care across the country, particularly during winter. 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.

Emergency Department 40

Emergency Department Hospitals Outcomes Research 40

ACEP Now

NOVEMBER 7, 2024

About three percent of emergency department (ED) visits are due to skin and soft tissue infections, but data are lacking on the contribution of chronic wounds to this number. Wound management in the ED is only a starting point, and appropriate referral and follow-up are key to an improved outcome. Back to the patient.

Burns 97

Burns Documentation/Coding Outcomes Emergency Department 97

ACEP Now

DECEMBER 6, 2024

1 Relatively little literature on the clinical characteristics and outcomes of out-of-hospital cardiac arrest (OHCA) patients complicated by coronary vasospasm exists beyond anecdotal reports, however. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

RebelEM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. Got FDA exemption as well as went to the community and made sure their community was ok with the trial).

Outcomes 90

Outcomes Administration Emergency Department Resuscitation 90

The Skeptics' Guide to EM

JULY 8, 2023

Case: A 57-year-old woman with hypertension, hyperlipidemia and type-2 diabetes mellitus presents to the emergency department (ED) with fever, cough, myalgias, headache and congestion. Managing editor of EM:RAP and Associate Editor at REBEL EM. It’s flu season and you’ve already seen 15 people with the same symptoms.

CDC 96

CDC Hospitals EMS Emergency Department 96

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

JULY 3, 2023

Currently, the infusion of IV calcium before diltiazem is not well understood, and more studies have focused on administering IV calcium prior to verapamil than diltiazem. Impact of intravenous calcium with diltiazem for atrial fibrillation/flutter in the emergency department. Am J Emerg Med. Article: Rossi N et al.

Administration 88

Administration Outcomes Documentation/Coding Emergency Department 88

PulmCCM

NOVEMBER 6, 2023

Intuitively, plasma seemed even less likely to help the very sickest of the sick— those mechanically ventilated with ARDS from Covid-19, whose mortality rate was well over 50% at many centers. The intervention took place in the emergency department, with device placement by ED physicians. Only it turns out, it did help.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Don't Forget the Bubbles

NOVEMBER 27, 2024

C presents to your emergency department. They look well and, apart from fever, have no other symptoms. Although they look well, you don’t want to miss a serious diagnosis, so what do you do? The AAP guideline is not alone in using PCT – several other, well-validated tools use PCT, including StepByStep and PECARN.

Outcomes 81

Outcomes Wellness Hospitals Emergency Department 81

Emergency Medicine Journal

SEPTEMBER 25, 2024

Being a trauma team leader, emergency physician in charge or clinical lead all look very different and require a range of skills, but are all certainly forms of leadership that have a significant impact on the running of an emergency department, patient outcomes and, as is increasingly being recognised, staff well-being.

Leadership 52

Leadership Emergency Department Outcomes Wellness 52

Taming the SRU

MARCH 12, 2024

In the context of increasing ED and hospital crowding as well as limited ICU availability, this study aimed to evaluate the impact of a subcutaneous insulin (SQuID) protocol in the treatment of DKA on emergency department length-of-stay (EDLOS) and ICU admissions.

Operations 96

Operations Hospitals Best Practices Wellness 96