ACEP Now

MARCH 10, 2025

At your monthly meeting with the chief medical officer (CMO) and chief nursing officer (CNO), they inform you of the hospitals plan to start a Sexual Assault Nurse Examiner (SANE) Program. 1 There are many program models including ED-based, non-ED hospital-based, hospital, and community-based programs. You accept the position.

Sexual Assault 52

Sexual Assault Forensics Leadership Pediatrics 52

ACEP Now

MARCH 11, 2025

2-4 A study in Annals of Emergency Medicine of almost 300,000 patients hospitalized with acute PE between 2011-2020 found that the use of UFH increased from 41.9 no increase in vasopressor use, mechanical ventilation, admission to an intensive care unit, in-hospital mortality). percent to 56.3 percent despite guideline recommendations.

Hospitals 52

Hospitals Administration Outcomes Stroke 52

Sensible Medicine

AUGUST 12, 2024

Surely you do as well. You can improve your chances by eating well, exercising, avoiding smoking and too much alcohol. Cancer researchers recently quantified the costs of (initial) cancer screening in one year in the US. But first we should set out, as the researchers did, that this is an underestimate of the costs.

Outcomes 133

Outcomes Research Wellness Hospitals 133

The Skeptics' Guide to EM

JULY 2, 2023

He is the Creator and founder of REBEL EM, a free, critical appraisal blog that tries to cut down knowledge translation gaps of research to bedside clinical practice ( [link] ). His Glasgow Coma Scale (GCS) score is 13 with obvious head trauma as well. Salim Rezaie is a community emergency physician in San Antonio, TX.

EMS 140

EMS Outcomes Hospitals Research 140

EMDocs

NOVEMBER 19, 2024

1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. He was extubated on hospital day 2 and was able to be discharged to psychiatry on hospital day 5.

Poisoning 108

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 108

RebelEM

JUNE 1, 2023

Background: Achieving ROSC in out of hospital cardiac arrest (OHCA) is no easy feat but, care doesn’t end with ROSC. Excluded: Obvious cause for OHCA prior to SDCT or on hospital arrival. The cost difference may be modest here as many of the patients in the standard care cohort were getting CTs as well. IQR 2.2 – 69.5)

Outcomes 144

Outcomes Resuscitation Hospitals CPR 144

The Trauma Pro

APRIL 30, 2024

In the next post, I’ll look at a brand new paper that includes a cost analysis as well. They performed a systematic search of the literature, analyzing the impact of each procedure on in-hospital mortality. Until we have better research to learn from, I suggest the following: Time is of the essence.

Radiology 113

Radiology Radiology Research Fractures 113

Sensible Medicine

NOVEMBER 14, 2023

Stefan Kertesz is Professor of Medicine at the Heersink School of Medicine at the University of Alabama at Birmingham where his work includes leading VA and non-VA supported research focused on homeless healthcare and issues related to pain and opioids. Criticism of these programs is both well-deserved and unfair.

Research 133

Research Psychiatric CDC Best Practices 133

ACEP Now

MARCH 10, 2025

A sense of purpose is an integral part of well-being. Passion for womens health may lead one to research and advocate for more effective emergency contraceptive options in your department. Dr. Koo is faculty and an emergency physician at MedStar Washington Hospital Center in Washington, D.C., They celebrate his sense of ikigai.

Academics 52

Academics Wellness CPR Hospitals 52

ACEP Now

MARCH 6, 2024

Every year, the volume of published research continues to outpace capacity to consume. Many clinicians staffing emergency departments intubate infrequently, as well, and these results are likely applicable to a wide scope of practice. Survival to hospital discharge favored the “standard care” group, 47.9 Gotta catch ‘em all!”

Research 52

Research Airway Management Stroke Outcomes 52

The Trauma Pro

OCTOBER 4, 2024

And unfortunately, I’m not able to guess the numbers well enough to do the power calculation for this study. This was reduced based on our experience of no delayed complications and guidance from our sister pediatric trauma center at Children’s Hospital in Minneapolis. ” This means they probably did not.

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

RebelEM

OCTOBER 30, 2023

Cryoprecipitate Group: 25.3% OR 0.96; 95% CI 0.75 to 1.23; p = 0.74 vs 10%; OR 1.74; 95% CI 1.20 Cryoprecipitate Group: 25.3% OR 0.96; 95% CI 0.75 to 1.23; p = 0.74 vs 10%; OR 1.74; 95% CI 1.20 Cryoprecipitate Group: 25.3% OR 0.96; 95% CI 0.75 to 1.23; p = 0.74 vs 10%; OR 1.74; 95% CI 1.20 Cryoprecipitate Group: 25.3% OR 0.96; 95% CI 0.75

Administration 125

Administration Blood Transfusions Outcomes Hospitals 125

The Skeptics' Guide to EM

JULY 29, 2023

Another core element of emergency department (ED) and pre-hospital care is the assessment for potential spinal injuries [1,2]. This has evolved due to recognition of some of the adverse effects of immobilization as well as limitations to its benefits. We have also covered concussions ( SGEM#112 , SGEM#331 , and SGEM#362 ).

Head Injuries 95

Head Injuries EMS Research Emergency Department 95

Sensible Medicine

JUNE 8, 2024

Access to clinical trials might be an advantage to a subspecialist, but a recent— well done— study in JAMA shows that at least for cancer medicine, access to trial does not mean you live longer, probably because most investigational agents are b t. I.e. a true sub sub specialist. It would be rare to be great at all these domains.

Research 122

Research Outcomes Hospitals Wellness 122

Sensible Medicine

JULY 29, 2024

Yet the failure of the hospital readmission penalty policy and sepsis protocols expose the risks of implementing a policy because it sounds good. Dr. Sarah Miller, an economist in the University Michigan business school, led the second trial, named the Open Research Unconditional Income Study or ORUS study.

Outcomes 118

Outcomes Research Sepsis Emergency Department 118

ACEP Now

SEPTEMBER 6, 2024

The hypothesis tested in INTERACT-4 is whether antihypertensive treatment might be started even earlier, in the pre-hospital setting, reducing any time-dependent negative effects. A greater number of patients randomized to “standard of care” attained modified Rankin scores of 0 to 3 than the Andexxa cohort, as well. N Engl J Med.

Research 49

Research Stroke Outcomes Sepsis 49

EMDocs

FEBRUARY 7, 2024

3 Increasing Strikes and Unions Labor actions in healthcare can disrupt normal hospital operations, potentially impacting costs and threatening patient quality of care. One study from the National Bureau of Economic Research on nursing strikes in New York State from 1984 to 2004 found that hospital mortality increased by 19.4%

Hospitals 95

Hospitals Research Patient Safety Wellness 95

The Trauma Pro

DECEMBER 26, 2023

Everyone knows that venous thromboembolism (VTE) is a potential problem in hospitalized patients, and especially so in trauma patients. Screening looks at patient factors such as age, obesity, and previous VTE, as well as injury risk factors like spine and pelvic fractures and decreased mobility. And we probably won’t, ever.

Fractures 124

Fractures Documentation/Coding Hospitals Research 124

Pediatric EM Morsels

JULY 21, 2023

Borgialli DA, Mahajan P, Hoyle JD Jr, Powell EC, Nadel FM, Tunik MG, Foerster A, Dong L, Miskin M, Dayan PS, Holmes JF, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN). PMID: 1933914. Performance of the Pediatric Glasgow Coma Scale Score in the Evaluation of Children With Blunt Head Trauma. Acad Emerg Med.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Don't Forget the Bubbles

DECEMBER 25, 2023

Interpreting Research Outcomes with a Little Bathroom Humour You have learned a method for how to read a research paper , and now you are faced with a bunch of outcomes. The researchers should have specified a clear research question or aim. How well a patient can use their arm matters greatly to the patient!

Research 83

Research Outcomes Fractures Pediatrics 83

Don't Forget the Bubbles

MARCH 19, 2024

This has coincided with a widespread shortage of specialist placements for children facing behavioural, psychiatric, and child protection challenges, leading to an over-reliance on the placement of these children in hospitals. A paediatric social admission is one where a child is admitted to the hospital but not for a medical reason.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

Sensible Medicine

AUGUST 21, 2023

On yesterday’s podcast , I talked with Bobby Yeh, an academic cardiologist who made a compelling case for enhancing credibility of observational research. The reasons are multiple, but I will articulate a few: Most epidemiological studies are done from large data sets that are not collected for the purpose of research.

Administration 98

Administration Outcomes Research COPD 98

Don't Forget the Bubbles

JUNE 26, 2023

Too much pulmonary blood flow and we will see well-oxygenated blood ( SpO2 >85% ) but insufficient systemic blood flow (pallor/mottling, cool peripheries, delayed capillary refill time, weak pulses, hypotension, narrow pulse pressure) and hypoxia (lactic acidosis). Stage 1 is performed in the first days of life.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

EMDocs

SEPTEMBER 14, 2024

2: Human, Take this Patient to the Cath Lab – AI and STEMI Detection Spoon Feed These researchers developed and trained a deep ensemble artificial intelligence (AI) model to classify ECGs as STEMI versus non-STEMI. The AI performed well in both accuracy and in improving sensitivity. PMID: 39032988. #2: Resuscitation. 2024;201:110286.

Emergency Department 90

Emergency Department Resuscitation Pediatrics EKG/ECG 90

The Skeptics' Guide to EM

JUNE 1, 2024

Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washington School of Medicine and Health Sciences in Washington, DC. His research focuses on the pre-hospital care of children by EMS. Well-designed,

Pediatrics 87

Pediatrics EMS Emergency Department Research 87

The Skeptics' Guide to EM

APRIL 22, 2023

Effect of early high-flow nasal oxygen vs standard oxygen therapy on length of hospital stay in hospitalized children with acute hypoxemic respiratory failure: the PARIS-2 randomized clinical trial. He is drinking well, and parents report normal urine output. Date: April 20, 2023 Reference: Franklin D, et al.

Hospitals 52

Hospitals Pediatrics Emergency Department Outcomes 52

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The cohort of patients that require this intervention in the pre-hospital setting are likely to be the most critically unwell patients we encounter. The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. i] Leibowitz A, Oren-Grinberg A, Matyal R.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

Sensible Medicine

SEPTEMBER 26, 2024

Employers will not hesitate to hire an applicant they discover has been hospitalized for 2 weeks with community acquired pneumonia or after a suicide attempt. Doctors need to be upfront about issues with their doctors and some well-chosen friends and colleagues. We have ongoing research on the topic).

Psychiatric 98

Psychiatric Research Operations Hospitals 98

Don't Forget the Bubbles

JUNE 19, 2024

In adult trauma cases, there has been significant research to help decide which patients require X-ray or CT imaging for possible cervical spine injuries, leading to the development of the National Emergency X-Ray (NEXUS) prediction rule and the Canadian C-Spine Rule (CCR). Why is this study needed? What were the limitations of the study?

CPR 124

CPR Research Documentation/Coding Outcomes 124

Sensible Medicine

SEPTEMBER 3, 2024

It is well-recognized that our commercial drug development process, a process that has led to so many nearly miraculous advancements, serves people with rare diseases poorly. Sensible Medicine readers appreciate a well-designed clinical trial. Here is a sample of what I have heard: “You don’t want to raise research funds?

Pediatrics 78

Pediatrics Poisoning Research Military 78

Taming the SRU

MARCH 12, 2024

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 as well as patients less than 18 years old were excluded from analysis. DKA accounts for approximately 223,000 ED visits annually or 8.9

Operations 97

Operations Hospitals Best Practices Wellness 97

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. 3, 4 It is the most common nosocomial infection in patients on mechanical ventilation, and one of the leading causes of nosocomial infection among all patients in the ICU. 4, 8 Paper: Dahyot-Fizelier, C.,

CDC 111

CDC Radiology Radiology Head Injuries 111

ACEP Now

SEPTEMBER 5, 2024

With elimination of CME funding in many of our hospitals and groups, it is crucial to continue to add value and communicate that value to residents before graduation. While some issues are handled locally, many issues cannot be solved in our emergency department or hospital. More members translate to more resources.

Leadership 98

Leadership PPE EMS Wellness 98

EMDocs

AUGUST 22, 2024

3,4 Notably, institutions receiving federal funding (such as hospitals receiving Medicare reimbursement) must abide by Title VI of the 1964 Civil Rights Act, which entitles persons with NELP to language assistance. Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Lion KC, et al.

Documentation/Coding 100

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 100

Medagadget

AUGUST 4, 2023

Researchers at Duke University have developed a gravity-powered microfluidic device that is intended for use as a diagnostic technology in low-resource areas. The researchers hope that the technology could unlock point-of-care diagnostics for those living in the most remote and low-resource areas.

Point-of-Care Testing 75

Point-of-Care Testing Research Operations Hospitals 75

RebelEM

JANUARY 25, 2024

CHF, in particular, lends itself well to diagnosis and treatment with PoCUS, as it readily reveals the presence of B lines. Interestingly, though not statistically significant, patients in the serial US group had a longer length of hospital stay compared to the control group (4d vs 3d). to −0.66) and −1.66 (95% CI −2.09 vs. 18.3%).

Ultrasounds 125

Ultrasounds Outcomes COPD Hospitals 125

Emergency Medicine Journal

NOVEMBER 28, 2023

Poor sonic environments in hospitals have been found to ‘impede the recovery process’ for patients and reduce staff performance. Sonic environments are often overlooked in hospital design, leading to spaces which are not supportive for care.

Emergency Department 74

Emergency Department Patient Safety Hospitals Research 74