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

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

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 Trauma Pro

JULY 5, 2024

But under-prescribing can create problems as well. Uncontrolled pain is a huge patient dissatisfier, and can lead to unwelcome complications as well (think pneumonia after rib fractures). Make sure all is documented well on the consent or in the EHR.

Documentation/Coding 113

Documentation/Coding Fractures Emergency Department Wellness 113

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

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

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

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. Did they have the statistical power to show such a difference?

Pediatrics 147

Pediatrics Outcomes Operations Emergency Department 147

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

JULY 1, 2024

Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. AVAPS may be useful, but we still need a well conducted RCT to find out if it is (i.e Paper: Goren NZ et al. Balkan Med J 2021. AVAPS: 0.07 AVAPS: 10.20

COPD 133

COPD Emergency Department Outcomes EMS 133

Emergency Medicine Journal

MAY 23, 2023

Background Upper gastrointestinal bleeding (UGIB) is a medical emergency with an approximate mortality of 10%, which results in a high hospitalisation rate. The Glasgow-Blatchford score (GBS) is recommended to identify low-risk patients who can be discharged from the emergency department (ED).

Emergency Department 40

Emergency Department Blood Transfusions Hospitals Wellness 40

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

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

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 93

COPD Outcomes Emergency Department Wellness 93

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

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

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

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 84

Pediatrics EMS Emergency Department Research 84

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 81

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 81

ACEP Now

OCTOBER 15, 2023

1 The emergency department remains an important frontier for work in judicious prescribing, but opiate analgesia remains a valuable tool for the initial treatment of a variety of presentations. The treatment response for any six-week program is of limited relevance to the acute treatment provided in the emergency department.

Emergency Department 52

Emergency Department Outcomes CDC Research 52

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 91

COPD Patient Safety Administration Emergency Department 91

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

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

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 114

Outcomes Research Sepsis Emergency Department 114

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 130

Ultrasounds Outcomes COPD Hospitals 130

Mind The Bleep

OCTOBER 17, 2024

I am a GP at a large practice based in a town in southwest Scotland, and I also work as a doctor in the Emergency Department in our local district general hospital. BASICS responders have additional skills and can provide pre-hospital emergency care to patients delivering time-critical interventions to improve outcomes.

Ambulance Services 52

Ambulance Services Hospitals Anaphylaxis Wellness 52

RCEM Learning

APRIL 9, 2024

The MRCEM OSCE assesses the common competences and clinical competences required for the evaluation and immediate management of common clinical conditions seen in the Emergency Department in adults and children. Seek feedback from peers, instructors, or mentors to gain different perspectives and refine your approach.

Emergency Department 52

Emergency Department Outcomes Wellness 52

ACEP Now

AUGUST 14, 2024

4 The 2023 recommendation is based on consensus and two retrospective studies demonstrating some negative outcomes with exposure to diltiazem (acute kidney injury, worsening HF symptoms); however, diltiazem was not associated with mortality and hypotension. as well as conversion to sinus rhythm (OR 1.75; 95 percent CI 1.08-2.84).7

Emergency Department 105

Emergency Department Outcomes Research Wellness 105

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 98

Outcomes Administration Emergency Department Resuscitation 98

Pediatric EM Morsels

JULY 21, 2023

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. A practical scale. PMID: 4136544.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

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

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 98

Administration Outcomes Documentation/Coding Emergency Department 98

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

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. Nachi: This month’s team parsed through roughly 1200 articles as well as guidelines from the eastern association for surgery in trauma also known as EAST.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

The Skeptics' Guide to EM

APRIL 29, 2023

The effect of telemental versus in-person mental health consults in the emergency department on 30-day utilization and processes of care. AEM April 2023 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine.

Psychiatric 40

Psychiatric Emergency Department Urgent Care Academics 40

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting." Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients With Myocardial Infarction With Nonobstructive Coronary Artery Disease. References: 1. Lindahl B, Baron T, Erlinge D, et al.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

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 107

EKG/ECG Documentation/Coding Patient Safety Outcomes 107