ACEP Now

SEPTEMBER 3, 2024

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. Christopher’s Hospital for Children by private equity (PE) firm Paladin Healthcare Capital for 170 million dollars. 14 Dr. Stinson remembers what it was like to work for a PE-owned hospital early in her career. “I

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

RebelEM

NOVEMBER 20, 2023

Patients with torso hemorrhage present a clinical conundrum often requiring interventional radiology or surgery, both of which take time to mobilize. Patients in the standard care alone group had more intensive care unit-free and hospital-free days. Outcome: Primary Outcome: All-cause mortality at 90 days.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Taming the SRU

OCTOBER 23, 2023

A radiology performed ultrasound is ordered and has similar findings– Impression: no definitive IUP with a small amount of free fluid within physiologic limits. At this point, the patient is taken to the operating room for a diagnostic laparoscopy. Given these findings along with her history, there is concern for ectopic pregnancy.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

The Skeptics' Guide to EM

JUNE 4, 2017

However, when we assess major trauma that includes chest, abdominal and pelvic trauma, the initial radiologic evaluation is left to the treating physician’s judgement. Many studies (most retrospective) have assessed the use of pan scanning as an initial radiologic evaluation.

Radiology 52

Radiology Radiology CPR Hospitals 52

Don't Forget the Bubbles

MAY 22, 2023

Robin is an LTV patient and will likely need some extra planning should he need to be admitted to hospital. These can be operated and maintained by patients and their families at home. Gemma responds, ‘Ask the hospital physio to come and see him?’ What is long-term ventilation (LTV)? You go to see Robin. You think fast.

Radiology 98

Radiology Radiology Hospitals Wellness 98

Intensive Blog

MARCH 11, 2024

Current ventilator settings Recent pathology, radiology and ABG results What central access does the patient have? Mildura is one of the furthest hospitals from Melbourne. They are staffed by Ambulance attendants to help operate specialized bariatric equipment. What has been the patient’s trajectory?

Hospitals 69

Hospitals Radiology Radiology Sepsis 69

Northwestern EM Blog

MAY 16, 2022

were hospitalizations during f/u period; 26.4% were hospitalizations during f/u period; 26.4% were hospitalizations during f/u period; 26.4% There also were no significant differences in pain scores, hospitalizations, ED readmissions among the groups. Follow up CT should depend on the patient and ultrasound operator.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Total Medical ComplianceHIPAA

OCTOBER 9, 2024

Mold buildup, sanitary sewer systems operating correctly, surfaces being free of microorganisms, equipment being cleaned/disinfected/sterilized properly, and supplies being free of damage are just a few other issues to look out for. Clean and disinfect surfaces with an EPA registered hospital level disinfectant.

Hazardous Materials 59

Hazardous Materials Infectious Diseases PPE Shock 59

The Skeptics' Guide to EM

MARCH 25, 2023

Casey currently splits his time between Broome, a small rural hospital in the remote Kimberley region of Western Australia, and a large tertiary ED in sunny Perth. Do they need surgery, an ERCP or just analgesia and non-operative care? He is also now a fully-fledged “sonologist”. He has been on the SGEM#369 , SGEM#326 and SGEM#217.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

ACEP Now

MAY 4, 2023

On hospital day 2, he was taken to the operating room for surgical rib fixation. The direct movement of air into the chest wall was improved with the placement of a pigtail catheter and ultimately treated with operative repair. The patient continued to have an oxygen requirement and significant pain.

EMS 52

EMS Fractures Operations Ultrasounds 52

ALiEM

SEPTEMBER 9, 2024

General surgery and neurosurgery should be consulted emergently for further operative interventions. Author information Benjamin Deschner, MD Resident Physician Emergency Medicine HCA Kendall Florida Hospital | The post SAEM Clinical Images Series: An Unusual Foreign Body appeared first on ALiEM.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

Advanced Emergency Nursing from AENJ

DECEMBER 18, 2014

Clinical Chemistry and Laboratory Medicine , 52 (2), 183-187. Teaching in accident and emergency medicine: 10 commandments of accident and emergency radiology. Teaching in accident and emergency medicine: 10 commandments of accident and emergency radiology. Touquet, R., Driscoll, P., & Nicholson, D.

Mass Casualty Incidents 40

Mass Casualty Incidents Burns Urgent Care Pediatrics 40

Taming the SRU

APRIL 5, 2023

Outside hospital records were obtained and upon review, it was noted that the patient had recently been diagnosed with a horseshoe kidney on CT imaging. Operators should take care to obtain clear images of the upper renal poles with the understanding that inferior pole evaluation will be limited from the isthmus. 2017;27(2):133-140.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Still, except for the public hospital, other hospitals did little emergency work and would have unattended first aid or treatment room in which one could meet one's physician or have an intern provide care in the meanwhile. ." Rebuilding of EDs in proximity to Radiology, Blood Bank, OR, and ICU, becoming organic to the hospital.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

PEMBlog

JUNE 5, 2024

It’s a highly sensitive rule that is designed to prevent missing cervical spine injuries while limiting the amount of unnecessary radiologic examinations. Or patients with a substantial head or torso injury and substantial means that they’re going to require an intervention or observation in the hospital. 2 percent or less.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Northwestern EM Blog

DECEMBER 20, 2021

Commonly hematogenous spread from bacteremia; clinical suspicion should prompt radiologic evaluation. Management is orthopedic consultation for operative stabilization [12]. X-rays may be likely to be normal/inconclusive early in the disease course and MRI may be often indicated. References Smith E, Anderson M, Foster H. 2021, Dec 20).

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. After balloon occlusion, blood pressure improved sufficiently to take the patient either to interventional radiology or to the OR.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

EB Medicine

JUNE 6, 2019

Taylor and Shaukat of Emory and Coney Island Hospital respectively for their efforts in peer reviewing this huge topic. CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Nachi: All valid points, but let’s dive in too some actual detail.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Dr. Smith's ECG Blog

DECEMBER 18, 2022

The operative report and radiology reads do not comment specifically as to whether the dissection flap was partially or fully obstructing coronary flow, or whether it was obstructing the left main or the RCA. Intraoperative TEE noted "Type A aortic dissection arising 1.0 cm distal to the non-coronary cusp of the aortic valve."

Ultrasounds 40

Ultrasounds EKG/ECG EMS Radiology 40

Pediatric Emergency Playbook

APRIL 1, 2017

16 found that of 142 patients evaluated at a single site university hospital, 61 had a foreign body. Steady the operating hand by placing your hypothenar eminence on the child’s zygoma or temporal scalp, to avoid jutting the instrument into the ear canal with sudden movement. Broncoscopy! Cohen et al.16 Otolaryngol Clin North Am.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

EMDocs

NOVEMBER 16, 2024

4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Hip flexion or adduction in the early post-operative period can cause atraumatic dislocations (typically avoided for 6 weeks post-op).

EMS 94

EMS Dislocations Fractures Operations 94

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 hospital is the Paediatric Major Trauma Centre for the South-West. It’s a great idea and maybe something for other centres to copy!) in lower-resource settings.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Don't Forget the Bubbles

FEBRUARY 7, 2024

My first real encounter with the healthcare system took place when I was about seven years old and had to go into hospital for an orchidopexy, so I can empathize with all the young people who come through our emergency department with acute testicular pain. Urgent senior review, decision making and operation 31.3%

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Don't Forget the Bubbles

JANUARY 27, 2025

However, the limitation with MRI scanning is the logistics of obtaining one in a busy hospital especially if it is an out-of-hours presentation of torsion. Hypointensity score of 2 or more, had the highest diagnostic accuracy in predicting necrosis [8]. How unstable is this patient?

Ultrasounds 76

Ultrasounds Emergency Department Pediatrics Dehydration 76

RebelEM

SEPTEMBER 11, 2023

Outcomes: Primary: Percent change in management decisions after introducing the Radiology Department RUQ US. A change in clinical course resulting from a discrepancy between POCUS and radiology department imaging only occurred in 2% of patients (not 10%). appeared first on REBEL EM - Emergency Medicine Blog.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68

EMDocs

OCTOBER 17, 2023

In patients with suspected ALCD, we suggest a complete assessment of the patients using clinical history, signs, laboratorial inflammation markers, and radiological findings (weak recommendation based on very low-quality evidence, 2D).” “In American College of Radiology ACR Appropriateness Criteria (2023) Left lower quadrant pain.

Radiology 87

Radiology Radiology Operations Best Practices 87

EMDocs

JUNE 3, 2023

Her Glasgow Coma Scale (GCS) is 14 (3E-5V-6M), and she arrives in a cervical collar placed pre-hospital. This is less critical in ED management of the unstable pelvic fracture, as the optimal site for identification of rectal or vaginal tears is the operating room. Her airway is intact, and she has equal bilateral breath sounds.

Fractures 60

Fractures Resuscitation Operations EMS 60

ACEP Now

JULY 7, 2023

Will this be enough for the general surgeon, or will they want an US performed by the radiology department to make their surgical decision? Clinical Question What is the value of radiology-performed US (RUS) compared to BUSED in terms of the surgical decision-making in acute biliary disease? Click to enlarge. Reference: Hilsden, et al.

Ultrasounds 52

Ultrasounds Radiology Radiology Emergency Department 52

Advanced Emergency Nursing from AENJ

MAY 27, 2015

and all start shooting the hospital staff. Little attention has been given to the Hospital as the target of terror. Other issues in hospital security have been dealing with assaultive behavior of patients; workplace violence; active killer scenarios. Attacks have occurred upon hospitals in other countries, notably Yemen.

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

ACEP Now

FEBRUARY 19, 2025

AI started to make its mark in the ED by maximizing the efficiency of certain tasks like patient triage, clinical presentation diagnosis, mortality prediction, clinical decision making, and operational workflow management (see Figure 1). Artificial intelligence in emergency radiology: where are we going? References Edmondson AC.

Teamwork 51

Teamwork Clinical Decision Support Systems Administration Radiology 51

Don't Forget the Bubbles

AUGUST 10, 2023

Non-operative approaches There is ongoing controversy regarding the best treatment of fingertip amputations, More extensive wounds are treated surgically. Operative approaches (from orthoinfo & the plasticsfella) More extensive wounds (often zone 2 & 3) are treated surgically. How would you manage this injury?

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. Infections are the most common reason for hospitalization within the first two years of transplant and are much more likely than rejection. Have there been any previous episodes of hospitalization since receiving the transplant?

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

PulmCCM

MARCH 7, 2025

Any self-respecting surgeon or anesthesiologist will tell you that patients undergoing surgery before the weekend receive just as high a quality of care as those operated on earlier in the week. Among almost 3 million patients at 28 hospitals in the U.S., Is it true? For elective surgeries at most U.S.

Outcomes 116

Outcomes Hospitals Operations Radiology 116