The Trauma Pro

JUNE 14, 2024

Patients with no other injuries could potentially be discharged from the hospital before they become overtly symptomatic, leading to delayed treatment. But without a more convincing exam, it is difficult to convince yourself to operate immediately on these patients. If the exam worsens, operate.

Operations 147

Operations Radiology Radiology Hospitals 147

Pediatric EM Morsels

JULY 19, 2024

If bleeding has completely stopped, most of these children still come into the hospital for observation so access will likely be necessary and helpful should patient have rebleed event. Even those that are no longer bleeding on arrival, will often require observation in the hospital. Is there active bleeding, clot, or no bleeding ?

Airway Management 286

Airway Management Pediatrics Wellness Operations 286

Don't Forget the Bubbles

JUNE 12, 2023

I first watched “ Just a Routine Operation “, – the story of the events that led to the tragic death of Elaine Bromiley. Elaine Bromiley went into hospital for a routine operation. I remember how I felt when. When Max entered the healthcare system, he was alert and could ask for help.

Resuscitation 145

Resuscitation Anaphylaxis Best Practices Operations 145

The Trauma Pro

OCTOBER 3, 2023

Many vertebral fractures can be treated non-operatively. I have seen several patients in follow-up who basically stopped wearing their brace as soon as they were out of the hospital. Post-operative bracing after pedicle screw fixation for thoracolumbar burst fractures: A cost-effectiveness study. J Clin Neurosci 45:33-39, 2017.

Fractures 203

Fractures Dislocations Operations Burns 203

American Medical Compliance

FEBRUARY 26, 2023

The Orientation to the Operating Room for Sales Professionals course is designed to educate sales professionals on proper operating room practices. There are several benefits and risks of healthcare industry representatives (HCIRs) being in the operating room. Reach out for other courses by visiting the AMC Course Library.

Operations 52

Operations Best Practices Administration Hospitals 52

Don't Forget the Bubbles

JANUARY 31, 2024

As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties. Two really important patient groups were excluded – those who were admitted to hospital and families who were not fluent in English. How sick the child was did not appear to play a role.

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

Pediatric EM Morsels

NOVEMBER 3, 2023

This allowed US hospitals to stock the drug to ensure quick treatment of suspected severe cases, rather than having to ship it from the CDC under the prior expanded-access protocol (Thomas 2023). Both have a range of detection limits, which can be greatly dependent on operator. Treatment of Malaria: Guidelines for Clinicians.

Seizures 278

Seizures Pediatrics CDC Infectious Diseases 278

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. The primary outcome was in-hospital mortality. Patients discharged home, including from the ED, were regarded as having survived to hospital discharge.

Hospitals 86

Hospitals Emergency Department EMS Outcomes 86

The Trauma Pro

DECEMBER 12, 2023

This necessitates an inter-hospital transfer that is subject to scrutiny by the trauma performance improvement program of both trauma centers. The work-up from the referring hospital can be re-evaluated. In some hospitals, orthopedics may choose to place a traction pin to provide initial fracture management.

Emergency Department 124

Emergency Department Operations Hospitals Radiology 124

Pediatric EM Morsels

MARCH 1, 2024

Chest CT Demonstrates parenchymal disease better Allows for operative planning (if needed) Lung Abscess in Children: Management Rarity of the condition affects what is known (no randomized control trials on therapeutic options). Lung abscess: 14 years of experience in a tertiary paediatric hospital. Pediatr Pulmonol. 2024 Jan 11.

Ultrasounds 169

Ultrasounds Pediatrics Operations Hospitals 169

American Medical Compliance

AUGUST 10, 2023

A California-based healthcare provider was the target of a cyberattack that led to hospital closures and redirected ambulance services in various states. Additionally, hospitals in Rhode Island faced severe negative effects due to this breach. Cyberattacks cause multiple hospitals to shut emergency rooms and divert ambulances.

Hospitals 52

Hospitals Ambulance Services Administration Operations 52

The Trauma Pro

AUGUST 20, 2024

This is especially true now in the COVID age with hospitals decreasing their OR capabilities. Too often, we look at them and delay because “they are too sick to operate.” Healthcare is a complex affair, and sometimes things don’t go entirely as planned. Occasionally, an elective OR may not be available the next day.

Operations 113

Operations Emergency Department Hospitals 113

Emergency Live

MAY 2, 2024

The Adaptability of Advanced Medical Posts (AMPs) in the Emergency Medical Plan: An Anticipation of the Modern Out-of-Hospital Medical Rescue System Having solved the problem of medical responders, about 280 (doctors, nurses, rescue volunteers, military stretcher bearers, radio operators) and the 18 ambulances, it was necessary to identify places to (..)

Military 97

Military Operations Hospitals 97

The Trauma Pro

APRIL 5, 2024

.” Frequently, it is possible to have a resident (at an appropriate training level) or advanced practice provider (APP) see the new patient while the surgeon is tied up, say in the operating room. They just can’t operate on them. What if the surgeon is in the OR? mangled extremity).

Operations 113

Operations Resuscitation Hospitals 113

The Skeptics' Guide to EM

SEPTEMBER 18, 2021

His practice is in trauma, […] The post SGEM#345: Checking In, Checking Out for Non-Operative Treatment of Appendicitis first appeared on The Skeptics Guide to Emergency Medicine. The patient is recommended to undergo admission to hospital for serial observation and intravenous antibiotics.

Operations 52

Operations Academics Ultrasounds Hospitals 52

American Medical Compliance

JUNE 12, 2024

These goals provide a framework for hospitals to identify and mitigate risks, ensuring that patients receive the safest care possible. This course equips hospital staff to enhance safety protocols, reduce errors, and improve patient outcomes. Ensuring patient safety is a cornerstone of high-quality healthcare.

Patient Safety 52

Patient Safety Hospitals Best Practices Outcomes 52

The Trauma Pro

MAY 14, 2024

Many of these issues are due to operator unfamiliarity or equipment availability. These instruments are expensive, so your hospital may not be excited about purchasing new ones just for the trauma bay. ” One of the most essential components of the resuscitative thoracotomy is rapid access to the chest.

Resuscitation 162

Resuscitation Operations Hospitals 162

Taming the SRU

MARCH 12, 2024

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. ED visits per 1000 adults with diabetes based on 2018 data resulting in over 500,000 annual hospital days. This amounts to annual hospital costs of $5.1 Griffey RT, Schneider RM, Girardi M, et al. 10.1111/acem.14685

Operations 96

Operations Hospitals Best Practices Wellness 96

American Medical Compliance

MARCH 18, 2024

Although anyone working at a hospital can be a victim of violence, nurses and aides who have the most direct contact with patients are especially vulnerable. To become certified, please visit us at: American Medical Compliance (AMC). Reach out for other courses by visiting the AMC Course Library. Who is at Risk for Workplace Violence?

Psychiatric 90

Psychiatric Operations Hospitals Wellness 90

The Trauma Pro

APRIL 26, 2024

In the last post in the series, I’ll discuss a paper in press that compares the efficacy and hospital charges of the two techniques. Unfortunately, it’s generally not feasible to operatively fix the pelvis acutely, and external fixation has limited impact on ongoing hemorrhage.

Fractures 147

Fractures Head Injuries Radiology Radiology 147

The Trauma Pro

JUNE 13, 2023

Ever wonder why your hospital won’t let pharma representatives sponsor lunches anymore? And even if you firmly believe you can’t be swayed, you can’t change the basic operating system in your brain. Or even give you a pen? Believe it or not, these little things can change your attitude regarding their product.

Research 189

Research Academics Operations Hospitals 189

Emergency Medicine Journal

NOVEMBER 28, 2023

Background The regional emergency medical service (EMS) in Lombardy (Italy) developed clinical algorithms based on operator-based interviews to detect patients with COVID-19 and refer them to the most appropriate hospitals. Results The training set includes 264 976 patients, median age 74 (IQR 55–84).

Operations 52

Operations EMS Hospitals Outcomes 52

Don't Forget the Bubbles

JUNE 26, 2023

Whilst waiting for an operation, they need to be managed medically. Staged reconstructions are a topic in itself (click here for a nice summary by Children’s Hospital of Philadelphia), but here we focus on Stage 1. Six hours post-operatively, they become more mottled, with weak pulses – signs of poor systemic perfusion.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

RebelEM

OCTOBER 2, 2023

Mild to moderate DKA represents a subgroup of patients that often require admission to the ICU due to hospital policies not allowing insulin infusions outside of this clinical setting. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. Paper: Griffey RT et al. Acad Emerg Med 2023.

Operations 99

Operations Academics Outcomes Fluid Resuscitation 99

ACEP Now

JANUARY 5, 2025

Secondary hemorrhage occurs between days five and 14 post-operatively, peaking around days five to seven. The literature suggests that approximately 85 percent of these cases require procedural source control in the operating room, highlighting the importance of expediting transport arrangements. CREDIT: Dr. P.

Airway Management 90

Airway Management Operations Resuscitation Pediatrics 90

The Trauma Pro

OCTOBER 25, 2024

To sum up, both are equally effective in controlling hemorrhage, but the hospital costs for patients undergoing angioembolization are significantly less. This is probably because there is no need to perform repeated operations to insert and remove the preperitoneal packs when angiography is used.

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

Greater Sydney Area HEMS

NOVEMBER 4, 2023

In 2022, we achieved: 95% overall first pass success rate (first pass of laryngoscope into mouth results in successful intubation, from both prehospital and inter hospital cases, including cold tube and RSI. A change of operator or removal of the blade from the mouth ends the attempt). first pass success rate from RSI.

Airway Management 144

Airway Management Burns Operations Resuscitation 144

The Trauma Pro

JUNE 20, 2023

The exact duties may vary somewhat geographically and even between individual hospitals. For example, wound infections occur after a given percentage of operations, and it varies based on the wound classification. There must be a departure from what is called “good and accepted practice.”

Documentation/Coding 130

Documentation/Coding Operations Hospitals 130

Emergency Medicine Journal

JULY 22, 2024

Methods Adult patients transported to a single ED by ambulances and subsequently admitted to the hospital between 1 January 2019 and 18 April 2019 were eligible for inclusion. The discriminative ability of the EWS scores was assessed using the area under the receiver operating characteristic curve (AUROC). male, mean age 68.7±17.5

Ambulance Services 52

Ambulance Services Hospitals Operations Emergency Department 52

The Skeptics' Guide to EM

MARCH 2, 2024

He is the Vice Chair of the Emergency Department at Nassau University Medical Center in East Meadow, NY, the safety net hospital for Nassau County. Arrangements are made for him to be transferred stat to the tertiary hospital while he is still stable. It is described as a ripping sensation that radiates to his back.

Emergency Department 119

Emergency Department Stroke Operations Hospitals 119

EM Literature of Note

JANUARY 21, 2025

Approximately half of the failures occurred at the index hospitalization, whereas the remainder occurred over the one year of follow-up. These children spent less time in the hospital, were back to normal activity sooner, and required less analgesia. Adverse events were low and similar across each group.

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60

Emergency Medicine Journal

SEPTEMBER 25, 2024

The primary end point was the hospital diagnosis of NSTE-ACS. The diagnostic performance was expressed as area under the receiver operating characteristic (AUROC), sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV).

EMS 97

EMS EKG/ECG Operations Hospitals 97

ACEP Now

JULY 7, 2023

Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Incidence and outcomes of out-of-hospital cardiac arrest with shock-resistant ventricular fibrillation: Data from a large population-based cohort.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

ACEP Now

DECEMBER 7, 2024

As emergency departments (EDs) have become the focus of bottlenecks in the entire health care systemfrom insufficient inpatient beds leading to hospital boarding to dwindling access to primary carea siege atmosphere has developed. Strategies to Reduce Delays It doesnt have to be this way.

EMS 98

EMS Hospitals Operations Emergency Department 98

The Trauma Pro

JANUARY 3, 2024

They designed a prehospital study that used end-tidal CO2 monitoring in the ambulance and correlated results with a TEG reading upon arrival at the hospital. The study was prospective and observational and involved two Level I trauma centers. End-tidal CO2 was measured from the ventilator circuit or via nasal cannula capnography.

Shock 113

Shock Operations Administration Hospitals 113

The Trauma Pro

MARCH 5, 2024

Here are some tips: Do not rely on the medical record and previous operative note. If the surgery occurred at an outside hospital and was then transferred, you must call the initial surgeon to have this discussion before going to the OR! How can this be accomplished? Don’t believe it. The discussion is exactly the same.

Leadership 113

Leadership Operations Hospitals Wellness 113

Don't Forget the Bubbles

NOVEMBER 29, 2023

A retrospective cohort analysis of the ED portion of the National Hospital Ambulatory Medical Care Survey from 2006 to 2009 in the US revealed that less than one-half of patients undergoing ETI in the ED received sedative drugs while in the ED. When there is an immediate threat to life (e.g., What are the potential physiological sequelae?

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135