Don't Forget the Bubbles

MAY 10, 2023

You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. Promoting hot debriefing in an emergency department. Scand J Trauma Resusc Emerg Med. Emergency Medicine Residents Experience Acute Stress While Working in the Emergency Department.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. Clinical Policy: Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the Emergency Department.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Emergency Department (ED) crowding has dominated discourse around Emergency Medicine (EM) in recent years and is now well recognised as contributing towards patient harm. Less is known about the implications of crowded departments on staff. Because you’ve got patients in, well, everywhere.’

Emergency Department 40

Emergency Department Wellness EMS Patient Safety 40

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

Taming the SRU

JANUARY 1, 2024

For laboratory testing, it is important to be aware that not all values obtained via an intraosseous line correlate well with peripheral venous samples (11). Additional Resources Please see a previous Taming the SRU post for extra tips and trouble-shooting tricks, as well as a video demonstration for IO access. Ann Emerg Med.

Emergency Department 91

Emergency Department Ultrasounds Administration Burns 91

RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. Paper: Owyang CG, et al. J Crit Care. N Engl J Med. 2000 May 4; PMID: 10793162 Harvey CE, et al.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Emergency Medicine Journal

MARCH 21, 2024

Background Staff retention in Emergency Medicine (EM) is at crisis level and could be attributed in some part to adverse working conditions. This study aimed to better understand current concerns relating to working conditions and working practices in Emergency Departments (EDs).

Emergency Department 52

Emergency Department Leadership EMS Wellness 52

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

Ultrasound Gel

JUNE 18, 2018

Well, wipe the smile from your face validity because it is not that simple. This article takes an interesting approach in performing a rather complex "focused" echo in the emergency department and uses it to determine the patient's disposition. Well, wipe the smile from your face validity because it is not that simple.

Emergency Department 52

Emergency Department Ultrasounds Wellness 52

SheMD

OCTOBER 15, 2023

Yes, I am a woman, yes I am a feminist, yes I am a physician, yes I am in academic leadership for a well-known emergency department… The yes’s are many, but what do I have to say that is so meaningful or useful that people would want to publish it? Well first of all, I didn’t do it in my 20’s, and I didn’t do it in residency.

Emergency Department 52

Emergency Department EMS Leadership Academics 52

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

Pediatric EM Morsels

JUNE 7, 2024

Lucky for us, in 2020 there were some updates made to the NIH Asthma Management Guidelines and we’re going to discuss which ones can help us in the Emergency Department! For children at least 4 years of age who are not well controlled on ICS alone. No more SABA ! Isn’t this more relevant for the outpatient pediatricians?

Pediatrics 268

Pediatrics Emergency Department Wellness EMS 268

Emergency Medicine Journal

OCTOBER 26, 2023

Cauda equina syndrome (CES) is a spinal emergency that can be challenging to identify from among the many patients presenting to EDs with low back and/or radicular leg pain.

Emergency Department 40

Emergency Department Wellness 40

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

Emergency Medicine Journal

JULY 22, 2024

Introduction Episodes of physical and verbal violence, as well as psychological humiliation, are experienced daily by ED staff. 1 These incidents are increasing exponentially and can cause workplace disaffection contributing to severe burnout of ED healthcare personnel.

Emergency Department 52

Emergency Department Hospitals Wellness 52

Emergency Medicine Cases

NOVEMBER 5, 2019

Gaibrie Stephen, we discover the evidence supporting a more rigorous and professional approach to language translation services as well as some practical available options. The post WTBS 19 Does Poor Access to Language Services Leave Emergency Departments Primed for Tragedy? appeared first on Emergency Medicine Cases.

Emergency Department 52

Emergency Department Wellness EMS 52

EM Literature of Note

SEPTEMBER 13, 2024

These are each awful, of course, in their own way from a patient- and parent-oriented standpoint, but they’re also quite awful at the population level, overburdening limited pediatric and emergency department resources. “Nirsevimab and Acute Bronchiolitis Episodes in Pediatric Emergency Departments” [link] Tweet

Emergency Department 85

Emergency Department Pediatrics Administration Wellness 85

Emergency Medicine Journal

JULY 24, 2023

Introduction Pain is the most common presenting feature within the ED, yet undertreatment of pain in the ED is a well-documented problem worldwide. Despite the development of interventions to address this problem, there is still limited understanding of how pain management can be improved within the ED.

Emergency Department 74

Emergency Department Documentation/Coding Research Wellness 74

The Skeptics' Guide to EM

APRIL 11, 2020

Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com Case: It has been a hard shift. You wish you […] The post SGEM#289: I Want a Dog to Relieve My Stress in the Emergency Department first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 52

Emergency Department Resuscitation 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. 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 Skeptics' Guide to EM

OCTOBER 12, 2024

A national survey of children’s experiences and needs when attending Canadian pediatric emergency departments. June 2024 Date: Oct 1, 2024 Guest Skeptic: Dr. Andrew (Andy) Tagg is an Emergency Physician with a special interest in education and lifelong learning. Reference: Ma K et al. He is accompanied by his worried parents.

Emergency Department 91

Emergency Department Pediatrics Outcomes EMS 91

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

EM Literature of Note

AUGUST 25, 2024

Move over ketamine and TXA, there’s another medication gradually approaching do-it-all darling status in Emergency Medicine: dexamethasone. Well, yes to all of the above, in the appropriate clinical context – But, most prominently, as featured in this brief report, for asthma – particularly childhood asthma. Sore throats?

Administration 92

Administration Emergency Department Wellness Pediatrics 92

EM Ottawa

NOVEMBER 2, 2023

Introduction Frostbite is a frequent presenting complaint to emergency departments (EDs) in cold climates. It is more common among those without housing, those with mental health disorders as well as those who work or engage in outdoor activities.(1)

Emergency Department 118

Emergency Department Wellness Hospitals Resuscitation 118

Emergency Medicine Journal

OCTOBER 23, 2024

The use of dock leaves to ease the discomfort of nettle stings is a well-known folk remedy in the British Isles, yet has never been tested in a clinical trial.

Research 52

Research Emergency Department Wellness 52

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

Emergency Medicine Journal

NOVEMBER 21, 2024

I read with interest the frailty practice review by Van Oppen et al in which they suggest that existing emergency department (ED) guidelines and protocols poorly represent older people living with frailty.

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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

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

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

The Skeptics' Guide to EM

FEBRUARY 22, 2020

Maia Dorsett is an Emergency and EMS Physician at the University of Rochester Medical Center. Date: January 27th, 2020 Guest Skeptics: Dr. Bringing value, balance and humanity to the emergency department: The Right Care Top 10 for emergency medicine. ” Where does emergency medicine fit into the RCA initiative?

Wellness 52

Wellness Emergency Department EMS 52

Pediatric EM Morsels

OCTOBER 27, 2023

Taking care of a critically ill child can be nerve-racking to say the least, and downright petrifying for those who don’t do it frequently, even if they are well-trained and brilliant clinicians. Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Prehosp Emerg Care.

Pediatrics 269

Pediatrics Resuscitation Documentation/Coding Wellness 269

Pediatric EM Morsels

JULY 19, 2024

DON’T forget to put on your Personal Protective Equipment as well! If bleeding, the only lab that is needed in the Emergency Department is a type and cross. Have traditional, direct laryngoscopes available as well. This is worth a shot in a well appearing child that is old enough to gargle and spit.

Pediatrics 286

Pediatrics Airway Management Wellness Administration 286

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

AUGUST 21, 2021

Evaluation and management of well-appearing febrile infants 8 to 60 days old. Pediatrics 2021 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Case: A 25-day-old, full-term boy presents to the emergency department with fever.

Wellness 52

Wellness Pediatrics Emergency Department Hospitals 52

Pediatric EM Morsels

JUNE 2, 2023

Our patients have varied past medical histories that require us to be well-versed in even the most uncommon disorders (or know where to look things up in a pinch)! You may not make the diagnosis, but detecting the clues is important for the family!

Dehydration 189

Dehydration Shock Pediatrics Emergency Department 189