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With emergencydepartment (ED) volumes rising, administrators are eager to explore AI-driven solutions to improve patient safety and reduce staff burnout. Their hospital has struggled with a growing number of adverse events that often occur without warning. Background: There are many ways to define artificial intelligence.
A 10-year-old boy presents to the emergencydepartment (ED) after a high-speed motor vehicle collision. The study enrolled 22,430 children, aged 0–17 years, presenting with blunt trauma across 18 PECARN-affiliated ED in the US. Case Scenario: What would you do? He complains of neck pain and is reluctant to move his head.
A young woman, 13 days post-tonsillectomy, comes into your rural emergencydepartment (ED) coughing up blood. Managing post-tonsillectomy hemorrhage in the ED can be challenging, especially in rural or resource-limited settings. Clin Pract Cases Emerg Med. Hemoptysis ED approach and management.
Darnall Army Medical Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, (@long_brit) Disclaimer: The views expressed in this post are those of the authors and do not reflect the official policy or position of the Department of the Army, DoD, or the US Government.
One week prior to ED arrival, the patient was becoming progressively despondent, less interactive with peers, exhibiting slow speech and movements, and was not eating. An estimated 7% to 15% of acutely hospitalized psychiatric patients and psychiatric emergencydepartment patients exhibit catatonia [4].
The Case A 41-year-old male presents to the ED with constant palpitations for one day. Differentiating between the two is difficult as multiple proposed diagnostic criteria have yet to demonstrate sufficient sensitivity or specificity for a definitive diagnosis. Discussion Fascicular VT is a distinct subgroup of idiopathic VT.
Concussions are commonly encountered in the EmergencyDepartment. Concussion – Presentation [ Silverberg, 2023 ] There is no definitive test to diagnose concussion in the ED. We have previously discussed an approach to the question of when a patient “ can return to sport.”
First, research suggests a higher number of emergencydepartment visits among individuals with ASD. About 30 percent of children with ASD need treatment in an emergencydepartment, and this number increases to nearly 70 percent for those aged 15–18.
Annie: I developed an interest in EM while working as a scribe in the ED during college. In addition to what Charlotte and Nick said, I can envision myself staying calm in the stressful situations that come up in the ED. How does your medical school support interest in emergency medicine careers?
Annie: I developed an interest in EM while working as a scribe in the ED during college. In addition to what Charlotte and Nick said, I can envision myself staying calm in the stressful situations that come up in the ED. How does your medical school support interest in emergency medicine careers?
While in the ED, patient developed acute dyspnea while at rest, initially not associated with chest pain. The patient had no chest symptoms until he had been in the ED for many hours and had been undergoing management of his DKA. The patient was under the care of another ED physician. Another ECG was recorded: What do you think?
The role of emergency physicians has been made dramatically more important due to the pandemic. The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. EDs weathered attacks from a variety of sources in recent years. This necessarily increased ED walkaway rates.
Children presenting with diabetes and diabetic ketoacidosis to EmergencyDepartments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the EmergencyDepartment. Arch Dis Child.
Also known as Facilitated intubation (FI), the use of intubating with only a sedative was an accepted alternative intubation technique prior to those definitive studies in the late 1990s but quickly was abandoned for RSI in all emergent endotracheal intubations (ETI) (8,9). To date, ketamine has been the agent of choice (12).
14-year-old Katy presents to the paediatric EmergencyDepartment (ED), alone, complaining of suicidal ideation. Mental health-related ED visits for children and young people are common and have been on the rise during the last decade. What is the problem? hours earlier had these not been undertaken.
Background Information: Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. Over the past few years, there has been an increase in emergencydepartment (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care.
Complications of Gluteal AFT The pale, prone patient with multiple surgical drains and a constrictive faja has become a common site in the Jackson Memorial Hospital EmergencyDepartment. 9 PFE is only definitively diagnosed on autopsy and a high clinical suspicion must be maintained in high-risk patients. units per patient.
By some definitions, you could call former Maryland state legislator Dan Morhaim, MD, FACEP, a retired emergency physician. His health care focus included hospital efficiency, physician and patient satisfaction, and emergencydepartment (ED) wait times, as well as a host of nonhealth issues. The effort paid off.
1 It is a quickly deployable and easily interpreted study that can be done in real time to guide decisions in the EmergencyDepartment. However, many institutions’ surgical teams still require or request a formal study over a bedside exam, likely due to a lack of confidence in the accuracy of POCUS, resulting in longer ED stays.
Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the EmergencyDepartment (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergencydepartment. Am J Emerg Med. Paper: Mason JM, et al.
The ED clinician should inquire about a relevant history of HIV infection, malignancy, high-dose corticosteroid use, chemotherapy, organ transplant, or use of immunosuppressive drugs for other indications. Am J Emerg Med. She reports occasional central chest pain exacerbated by coughing. Int J STD AIDS. 2019;30(2):188-193.
, tells us that we physicians do not need to even look at this ECG until the patient is placed in a room because the computer says it is normal: Validity of Computer-interpreted “Normal” and “Otherwise Normal” ECG in EmergencyDepartment Triage Patients I reviewed this article for a different journal and recommended rejection and it was rejected.
AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergencydepartment (ED) with his first time anterior should dislocation after trying to recreate one of his favourite scenes in the movie Lethal Weapon.
In her spare time, Melissa also enjoys being the fellowship director to an amazing group of PEM trainees. Case: Brian is a 14-year-old male who presents to the emergencydepartment (ED) complaining of acute onset testicular pain. He has vomited twice, but there is no history of any fever or trauma. AEM Dec 2017.
In most EmergencyDepartments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. Definitive emotional support is critical to our emotional and psychological well-being. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. Psychological harm occurs.
Rate Versus Rhythm in the ED The 2023 AHA/ACC guideline doesn’t give explicit recommendations or preference regarding initial rate or rhythm control strategy for new-onset AF patients who are hemodynamically stable. based care of ED patients with AFRVR. J Emerg Med. The study compared four grams and 9.5 Circulation. Circulation.
We have teamed up with the team from the EmergencyDepartment at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergencydepartment sees approximately 50,000 presentations per year. Children were included if they had a malaria screen in ED.
This study chose a relevant topic to analyze that could influence acute management in the ED and has a fairly larger sample size of patients to do so. If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergencydepartment pharmacist. Am J Emerg Med.
He presented to the emergencydepartment because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. The Atlas of Emergency Medicine, 5e. Ann Emerg Med. Emergency Medicine Residents’ Association; 2022:10-11. Tendon Lacerations. Open Fracture.
emergencydepartments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. emergencydepartments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Adult cardiac arrest in the emergencydepartment – A Swedish cohort study.
Key Secondary Endpoints: 5 (3.9%) patients in the IV cetirizine group returned to any ED or clinic within 24 hours compared to 15 (11.1%) in the IV diphenhydramine group; P=0.04 7 (5.5%) patients in the IV cetirizine group returned to any ED or clinic within 48 hours compared to 19 (14.1%) in the IV diphenhydramine group; P=0.02
Fundamentally, I believe every patient coming to an emergencydepartment is best served by care delivered by board certified emergency physicians. So, to that end, I don’t believe there is a “balance” when it comes to board certified emergency physician anything and scope of practice for non-physicians anything.
A 50 year old presented to the emergencydepartment of a remote rural community (where the nearest cath lab is a plane ride away) with one hour of mild chest pain radiating to the back and jaw, and an ECG labeled ‘normal’ by the computer interpretation. Figure-1: The first 2 tracings in today's case.
PMID: 36946338 Bottom line: This is a well done RCT that demonstrates pretty convincingly that you should not bother trying to but fingernails back on after nail bed repair (and my guess is you definitely shouldn’t be removing them either). Carson JL, Brooks MM, Hébert PC, et al; MINT Investigators. JAMA Psychiatry. 2023 Sep 27:e233582.
This was sent by anonymous The patient is a 55-year-old male who presented to the emergencydepartment after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.
REBEL Core Cast 107.0 – Vertebral Osteomyelitis Click here for Direct Download of the Podcast Definition Inflammation of the vertebrae due to a pyogenic, fungal or mycobacterial organism. Evaluation and Treatment of Acute Back Pain in the EmergencyDepartment. Orthopedic Emergencies 2015 May; 33(2) 311-26.
By Sofiya Diurba MD, reviewed by Meyers, Grauer A woman in her 50s with PMH known RBBB and prior syncopal events presents to the ED for five syncopal events over the last 24 hours. This is her first ECG in the ED: What do you see? Each event is associated with a prodrome of mild substernal CP, SOB, and “brain fog.”
The risk of a biphasic reaction is what keeps patients in the ED while being observed for a set period of time. This varied incidence can be due to inconsistent definitions or inclusion of mild reactions. Incidence of clinically important biphasic reactions in emergencydepartment patients with allergic reactions or anaphylaxis.
Upon arrival to the emergencydepartment, a senior emergency physician looked at the ECG and said "Nothing too exciting." To Emphasize: The reason definitive diagnosis is important in today's case — is that the senior ED physician interpreted ECG #1 as "nothing too exciting".
Emergencydepartment Code STEMI patients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review. Acad Emerg Med 2024;31:296-300 == MY Comment , by K EN G RAUER, MD ( 6/6 /2024 ): == Recognition of repolarization variants can be challenging.
All you know, back in ED, is that the ETA is 10 minutes, and there is a single stab wound to the chest. The ODP is caught up leaving theatres and has not yet made it down to ED. Back in ED with Ranulf, and pack two has gone through. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this.
Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergencydepartment at around 3 AM complaining of chest pain onset around 9 PM the evening prior. ECG 2 What do you think?
Background: Atrial fibrillation and atrial flutter with rapid ventricular rate (AF/AFL with RVR) are the most common subtypes of SVT, comprising a large number of ED visits in aging populations. Impact of intravenous calcium with diltiazem for atrial fibrillation/flutter in the emergencydepartment. Am J Emerg Med.
A 68-year-old male with a history of poorly controlled diabetes presents to the ED with increasing right-sided ear and facial pain, swelling, and difficulty hearing for two weeks. CT and MRI can be synergistic in diagnosis of management, though CT is the ideal imaging modality in the ED. What is the diagnosis?
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