The Trauma Pro

JUNE 14, 2024

But without a more convincing exam, it is difficult to convince yourself to operate immediately on these patients. With newer scanners, radiologists are better able to detect subtle areas of hypoperfusion as well. If the exam worsens, operate. A paper was published by a group of radiologists at Duke University.

Operations 147

Operations Radiology Radiology Hospitals 147

The Skeptics' Guide to EM

DECEMBER 10, 2022

Bone Joint J 2022 Guest Skeptic: Dr.Matt Schmitz is an Orthopaedic Surgeon specializing in Adolescent Sports Medicine and Young Adult Hip Preservation. […] The post SGEM#385: If the Bones are Good, the Rest Don’t Matter – Operative vs Non-Operative Management of Scaphoid Fractures first appeared on The Skeptics Guide to Emergency Medicine.

Operations 52

Operations Fractures Military Emergency Department 52

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. It is a good, and generally very safe operation, with a high rate of patient satisfaction. Date: September 16th, 2021 Reference: Sippola et al.

Operations 52

Operations Academics Ultrasounds Hospitals 52

Pediatric EM Morsels

AUGUST 4, 2023

Oka, 2023) A systematic review linked SMA syndrome to the immediate post-operative period after surgery for scoliosis in pediatric patients, and found the mean days to onset of symptoms was 9. Positional changes after intake can also be helpful including the lateral decubitus position as well as knee to chest.

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

The Trauma Pro

APRIL 26, 2024

Unfortunately, it’s generally not feasible to operatively fix the pelvis acutely, and external fixation has limited impact on ongoing hemorrhage. Years ago, we tried to pack the pelvis from the inside (peritoneal cavity), but it never worked very well. Preperitoneal packing of the pelvis (PPP) has now become popular.

Fractures 147

Fractures Head Injuries Radiology Radiology 147

Taming the SRU

MARCH 12, 2024

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. as well as patients less than 18 years old were excluded from analysis. The study’s primary outcomes were the operational impacts of the SQuID protocol on EDLOS and ICU admission rates. Acad Emerg Med 2023;30(8):800–8.

Operations 96

Operations Hospitals Best Practices Wellness 96

NIOSH Science Blog

MAY 14, 2020

This year has seen nurses all over the world step up and battle coronavirus disease 2019 (COVID-19) fearlessly, often while navigating evolving guidance and operating under difficult conditions with strained resources. None of us could have anticipated how prescient that would be.

Wellness 52

Wellness Operations 52

Don't Forget the Bubbles

JUNE 26, 2023

Whilst waiting for an operation, they need to be managed medically. 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).

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Pediatric EM Morsels

APRIL 28, 2023

Has undergone many modifications as well to include up to 5 types. In general, non-operative treatment is reserved for Type I fractures and type II. The Athlete is at risk of both Osgood Schlatter’s disease as well as Tibial Tubercle Avulsion Fracture. Anterior knee pain is not always Osgood Schlatter’s.

Fractures 130

Fractures Pediatrics Operations Wellness 130

The Trauma Pro

OCTOBER 25, 2024

This is probably because there is no need to perform repeated operations to insert and remove the preperitoneal packs when angiography is used. Authors from several well-known trauma centers collaborated to re-analyze data from the CLOTT study. But what about venous thromboembolism risk?

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

The Trauma Pro

SEPTEMBER 13, 2023

Unfortunately, losing any limb has a significant psychological impact on our patients’ physical and mental well-being. It does take some extra effort to apply a well-fitted early prosthesis. The conventional treatment is to protect the amputation incision, provide physical therapy, and fit a prosthesis once the stump is mature.

Soft Tissue Injuries 113

Soft Tissue Injuries Operations Wellness 113

Emergency Medicine Cases

FEBRUARY 13, 2024

How can we utilize virtual care to make it work for us and our patients well? How can we integrate systems thinking into the daily operations of EDs to improve patient flow and outcomes? They answer questions such as: What can we glean from how EM has evolved in the last few decades to help shape the future? and many more.

EMS 82

EMS Operations Outcomes Wellness 82

American Medical Compliance

MARCH 18, 2024

Requirements Specific to Missouri By August 28, 2021, any hospital licensed under the Missouri chapter, excluding any department of mental health-operated psychiatric hospital, must implement a workplace violence prevention plan to protect healthcare employees and other hospital personnel from aggressive and violent behavior.

Psychiatric 91

Psychiatric Operations Hospitals Wellness 91

Taming the SRU

MARCH 11, 2024

It is also important for the emergency physician to ask about previous surgeries on the affected knee, as well as anticoagulation status. She continues to do well post operatively with her rehabilitation program. He works in both the emergency department as well as the sports medicine clinic. An abnormal ABI (<0.9)

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

The Trauma Pro

MARCH 5, 2024

Here are some tips: Do not rely on the medical record and previous operative note. Applying these concepts will decrease the possibility of error, as well as the likelihood of any iatrogenic harm to these complex patients. How can this be accomplished? Don’t believe it. Ideally, meet face to face with the previous surgeon(s).

Leadership 113

Leadership Operations Hospitals Wellness 113

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. Be sure to follow with your performance improvement program to make sure that they actually do work as well as you think! Did they have the statistical power to show such a difference? I am still intrigued by this study!

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

Sensible Medicine

NOVEMBER 23, 2023

Some of the people who underwent lung transplant for lung cancer may have done well, but all the selection pressures to decide who to operate on select for people who will do better than average. The question is whether they did well because of the surgery, or in spite of it. What type of study is ideal for this?

Operations 130

Operations Research Wellness 130

Ken Grauer, MD

SEPTEMBER 6, 2024

Depending on which of above considerations is operative — the differential diagnosis of the rhythm in ECG #1 will be between: i ) A reentry SVT rhythm with retrograde atrial conduction; ii ) ATach ( A trial T achycardia ) ; — or — iii ) Junctional Tachycardia. What is happening in today's case is different.

EKG/ECG 248

EKG/ECG Administration Wellness Operations 248

Total Medical ComplianceHIPAA

JANUARY 12, 2023

Many comments to the NPRM noted that this would be an operational and compliance risk issue for providers. As the new year progresses and new requirements are announced and clarified, count on TMC to keep you informed and well within the compliance timeframe after the final rule is published.

Operations 104

Operations Best Practices Documentation/Coding Administration 104

Taming the SRU

JULY 24, 2024

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. They also developed a machine learning model using Least Absolute Shrinkage and Selection Operator (LASSO) using 80% of the available data.

Sepsis 89

Sepsis Resuscitation Emergency Department Wellness 89

RebelEM

APRIL 17, 2023

However, It is unclear how well POCUS performs in ruling in or ruling out the diagnosis of PTA. Question: How well does the US perform in diagnosing PTA compared to CT, needle aspiration, or Incision and Drainage? While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

Pediatric EM Morsels

NOVEMBER 3, 2023

Both have a range of detection limits, which can be greatly dependent on operator. With concern for malaria, it is very important to identify who is non-immune and semi-immune as this can affect both the timeframe for illness after departure from the endemic country as well as severity of illness. Third times the charm!

Seizures 278

Seizures Pediatrics CDC Infectious Diseases 278

PulmCCM

NOVEMBER 6, 2023

Intuitively, plasma seemed even less likely to help the very sickest of the sick— those mechanically ventilated with ARDS from Covid-19, whose mortality rate was well over 50% at many centers. Convalescent plasma, it was concluded, didn’t help patients with severe Covid-19 as a general group. Only it turns out, it did help.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

American Medical Compliance

OCTOBER 3, 2024

As dental professionals, it’s crucial to understand and adhere to OSHA dental compliance standards to ensure the well-being of both staff and patients. Dental practices must maintain radiation safety protocols and provide radiation safety training for staff operating radiographic equipment.

PPE 95

PPE Hazardous Materials Documentation/Coding Operations 95

The Trauma Pro

AUGUST 18, 2023

Presentation at your transfusion committee is fine, but this data is most suitable for presentation at the trauma operations committee. product ratios are way off) then it should also be discussed at your multidisciplinary trauma PI committee as well. And if significant variances are present (e.g.

Administration 100

Administration Operations Hospitals Wellness 100

American Medical Compliance

FEBRUARY 17, 2024

Ensuring the safety and well-being of both patients and staff is paramount. By scrutinizing different facets of the work environment, including physical conditions and operational processes, organizations can comprehensively grasp potential risks and proactively address them.

Best Practices 89

Best Practices PPE Infectious Diseases Documentation/Coding 89

Sensible Medicine

MAY 31, 2024

Second guessing, also called post-call quarterbacking, is alive and well in medicine and, when done thoughtfully, can be a great way to teach and learn. Some of these disagreements will be critical: what drug needs to be given, does this person need to go the operating room, does JD need a chest tube? The patient did well.

Operations 66

Operations Wellness Academics Ultrasounds 66

The Trauma Pro

JULY 10, 2023

This stream of information continues after the patient leaves the trauma bay for CT, imaging, interventional radiology, operating room, ICU, or floor bed. During chart reviews, I have seen numerous examples of fluids, vital signs, and drug administration recorded well after the patient has been declared dead! Several are simultaneous.

Resuscitation 100

Resuscitation Radiology Radiology Administration 100

Ken Grauer, MD

FEBRUARY 9, 2024

Awareness of this common association made me instantly suspect that some type of Wenckebach conduction is probably operative in today's rhythm — even though I admittedly do not see any pattern of consistent group beating, or any repetitive PR intervals that typically clue me in to Mobitz I conduction defects.

EKG/ECG 266

EKG/ECG Operations Wellness 266

Medagadget

SEPTEMBER 14, 2023

Called “eAir”, the devices can also be highly miniaturized to just a few millimeters in size, making them well suited for inclusion in laparoscopic devices. Ultimately, these intra-operative benefits have the potential to translate into improved surgical and patient outcomes.”

Research 93

Research Operations Outcomes Wellness 93

EM Literature of Note

OCTOBER 1, 2023

Each case was tested both solely on the recorded narrative, as well as with laboratory results added. Prior to ChatGPT, clinicians did not operate in an information resource vacuum, as is frequently the case in these contrived situations. However, what is lacking from these studies are any sort of comparison. UpToDate) as augments.

Documentation/Coding 86

Documentation/Coding Operations Emergency Department Wellness 86

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. Its use in the prehospital environment is not well known or studied and may be an interesting area for future research. [i] i] Leibowitz A, Oren-Grinberg A, Matyal R.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

Taming the SRU

MAY 13, 2024

The patient is a well-appearing male who is awake, alert, and oriented. There is also a well-appearing, healed surgical scar. There is also a well-appearing, healed surgical scar. The skin is warm and well perfused with brisk capillary refill. Respiratory and cardiovascular exams are normal. BMP : Na 136, K 4.3,

Ultrasounds 97

Ultrasounds Emergency Department Wellness Operations 97

The Trauma Pro

MAY 26, 2023

Possible interventions were none, operation, angioembolization, or blood transfusion. The retrospectively reviewed patients with liver or spleen injury over five years. They examined how often serial hemoglobin determinations influenced management during the study period.

Blood Transfusions 100

Blood Transfusions Operations Pediatrics Hospitals 100

Don't Forget the Bubbles

JUNE 19, 2024

Well-designed multicentre large studies in children were warranted; cue Leonard et al. Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort. Were the predictor variables and the outcome evaluated in the initial sample?

CPR 124

CPR Research Outcomes Documentation/Coding 124

RebelEM

NOVEMBER 25, 2024

Included patients from out-of-hospital, emergency department, intensive care unit, and operating-room intubations. Intubation performed in all settings (out-of-hospital, emergency department, ICU, and operating room). Still, most patients undergoing intubation probably have well-visualized anatomy.

Outcomes 98

Outcomes Emergency Department Operations Hospitals 98

Emergency Live

AUGUST 22, 2024

The Bayesian shipwreck has caused the death of six people, including the well-known British magnate Mike Lynch The sinking of the luxurious sailing ship Bayesian off Porticello continues to hold a great hold on public opinion and cause debate among experts in the nautical sector.

Operations 52

Operations Wellness 52