Core EM

OCTOBER 16, 2024

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?

ED 100

ED EMS Critical Care OR 100

Core EM

SEPTEMBER 24, 2024

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?

ED 100

ED EMS Critical Care OR 100

EMDocs

AUGUST 22, 2024

6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. 6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. One cohort study in a public ED found that 84.5%

Emergency Department 104

Emergency Department ALS E-9-1-1 ED 104

ACEP Now

JUNE 7, 2023

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. Commercial payers aggressively abused the No Surprises Act as a method to delay, downcode, and deny payment for emergency services.

Emergency Department 52

Emergency Department ED EMS Ambulance 52

EMDocs

SEPTEMBER 26, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. Patient not informed of enlarged heart, dies 3 weeks post ED visit Miscommunicated radiology findings are a hot topic. Someone should have – either the first ED doc, the second ED doc, or my PCP.

Emergency Department 97

Emergency Department ED Coronary ALS 97

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. Future articles will highlight solutions and success stories. Patients with sepsis get antibiotics.

Emergency Department 52

Emergency Department ED Naloxone ALS 52

The Skeptics' Guide to EM

JANUARY 23, 2021

Emergency Physician and Advanced Practice Provider Diagnostic Testing and Admission Decisions in Chest Pain and Abdominal Pain. AEM January 2021 Case: A 50-year-old male presents to the Emergency Department (ED) with left lower quadrant abdominal pain. The patient is seen by an advanced practice provider (APP).

ED 130

ED ALS Emergency Department OR 130

ACEP Now

NOVEMBER 14, 2023

The emergency department (ED) at UVA was rebuilt in 2019 and the department had not fully optimized its operations when COVID-19 hit. Following the pandemic, the ED saw a surge in its volume as it raced through 60,000 to 80,000 visits per year. They also developed standard work documents for each role.

Emergency Department 52

Emergency Department Operating Room ED OR 52

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The result of this ED capacity strain and less than ideal patient to staff ratios has led to delays in interventions, treatments and care adjustments. Paper: Owyang CG, et al. J Crit Care. J Crit Care.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

Critical Care Scenarios

NOVEMBER 15, 2020

A few rapid-fire cases from the emergency department, with Dr. Seth Trueger (@mdaware), emergency physician at Northwestern University and digital media editor for JAMA Network Open. Takeaway lessons Many decisions in the ED are less about what to do, and more about when to do it. ICU time and ED time are different.

ICU 100

ICU Life Support Emergency Department ED 100

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. ED crowding impairs this mission. 2 This article discusses the practical and ethical issues of interhospital transfer of these patients.

Emergency Department 52

Emergency Department ED ALS ICU 52

Don't Forget the Bubbles

OCTOBER 10, 2024

This time the team from Bristol Royal Children’s Hospital ED tell us what is new in the world of paediatric literature… Led by Dr John Coveney a Paediatric Emergency Medicine Trainee in Bristol who has revived The Journal Club at Bristol Royal Children’s Hospital ED on a monthly basis. Arch Dis Child.

ED 75

ED Emergency Department OR ALS 75

The Skeptics' Guide to EM

OCTOBER 28, 2017

Stevens and colleagues updated their review in 2016 and concluded “sucrose is effective for reducing procedural pain” and “no serious side effects or harms have been documented with this intervention”. There are certain patient populations who are at risk for in adequate pain management.

ALS 130

ALS Emergency Department OR ED 130

REBEL EM

SEPTEMBER 11, 2023

1 It is a quickly deployable and easily interpreted study that can be done in real time to guide decisions in the Emergency Department. 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.

ED 68

ED ACS Emergency Department OR 68

The Skeptics' Guide to EM

APRIL 24, 2021

Randomized Double-blind Trial Intramuscular Droperidol, Ziprasidone and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. Randomized Double-blind Trial Intramuscular Droperidol, Ziprasidone and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. Reference: Martel et al.

Emergency Department 100

Emergency Department ALS Ambulance ED 100

EMDocs

JUNE 13, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. difficile enterocolitis post antibiotic treatment Facts : An adult female presents to the ED with dental pain. We just don’t document it. Documenting our warnings should be standard care.

Emergency Department 98

Emergency Department ED EMS OR 98

EMDocs

OCTOBER 3, 2023

Emergency Physician and founder of Orman Physician Coaching Host of the Stimulus Podcast Learn more at roborman.com If you want to hear the coaching session where Brit and Rob deconstructed his shift and came up with this strategy, it’s here. Episode 87: Conquering Mid-Shift Overwhelm Mid-shift in an emergency department is a special beast.

EMR 122

EMR EMS OR Emergency Department 122

The Skeptics' Guide to EM

JANUARY 16, 2021

In the emergency department (ED), tetracaine drops are applied prior to slit lamp examination and the pain is completely resolved. The first documented use of topical ophthalmologic anesthetics was in 1818. His visual acuity is 20/20 bilaterally and he doesn’t wear corrective lenses or contact lenses.

ALS 130

ALS Emergency Department EMS ED 130

The Skeptics' Guide to EM

DECEMBER 18, 2021

Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: At the completion of her 1-month elective in your rural emergency department […] The post SGEM#352: Amendment – Addressing Gender Inequities in Academic Emergency Medicine first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 100

Emergency Department ALS ED OR 100

EM Literature of Note

OCTOBER 9, 2024

This exploration of LLMs in the emergency department is a bit unique in its conceptualization. While most demonstrations of generative AI applied to the ED involve summarization of records, digital scribing, or composing discharge letters, this attempts clinical decision-support. For what its worth, of course, U.S.

Emergency Department 86

Emergency Department OR ED 86

EMDocs

JUNE 9, 2023

We’re defining “protocol” here as a written document that provides oversight from the medical director about how to assess and treat patients. Reassessment and Documentation After any type of restraint is instituted, careful assessment, re-assessment, and documentation is required. Was the documentation complete?

Emergency Medical Services 98

Emergency Medical Services EMS Emergency Department Ambulance 98

Pediatric EM Morsels

JULY 5, 2024

Using this decision rule would have cut down on ED CT C-spine ordering by >50% in this derivation cohort. I am hopeful it will also improve the flow in the ED.” While plain films for C-spine injury had previously fallen out of routine ED practice, we now have more evidence to support their use in intermediate risk patients.

ALS 164

ALS OR ED Emergency Department 164

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. What do you think?

E-9-1-1 138

E-9-1-1 ACS Emergency Department Coronary 138

EMDocs

JUNE 16, 2023

Podcast: Play in new window | Download (Duration: 13:57 — 19.2MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Management of the child with mental health problems who is boarding in the ED In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

ED 52

ED Mental Health Services Emergency Department Emergency Medical Services 52

ACEP Now

DECEMBER 6, 2024

This case report documents the first known instance of using NTG during an emergency department resuscitation to treat a patient in cardiac arrest due to severe coronary artery vasospasm. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented.

Coronary 98

Coronary Life Support ALS Emergency Department 98

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. Am J Emerg Med.

STEMI 119

STEMI Emergency Department Coronary OR 119

The Skeptics' Guide to EM

DECEMBER 5, 2020

Case: A 50-year-old female presents to your community emergency department in the middle of the night with new-onset constant but mild vertigo and nausea. Over the past decade, some emergency physicians have adopted this examination into their own bedside clinical assessment and documentation. How hard can it be?”

ALS 100

ALS Emergency Department ED OR 100

EMDocs

JUNE 2, 2023

Document what you gave and why, as well as the impact. The fourth episode in this series will shift gears and talk about safely transporting children to the ED via prehospital services. Erratum in: West J Emerg Med. Pediatric Agitation in the Emergency Department: A Survey of Pediatric Emergency Care Coordinators.

Emergency Department 93

Emergency Department Emergency Medical Services Overdose ED 93

EMDocs

SEPTEMBER 19, 2023

On ED arrival GCS is 3, there are rapid eye movements to the right but no other apparent seizure activity. Official diagnosis requires EEG, which is not something we can typically obtain in the ED. This document covers high sensitivity troponin, risk disposition pathways, and STEMI equivalents. J Am Coll Cardiol.

STEMI 98

STEMI Coronary Emergency Department ICU 98

REBEL EM

JUNE 8, 2023

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 emergency department pharmacist. Am J Emerg Med.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

ALS 96

ALS Emergency Department ED OR 96

REBEL EM

JULY 3, 2023

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 emergency department. Am J Emerg Med.

E-9-1-1 98

E-9-1-1 EMR Emergency Department ED 98

EMDocs

MAY 26, 2023

But what about the patient who is agitated, and is a potential danger to themselves or to the ED staff? This need for 1-on-1 observation is a major challenge for EDs and health care systems from a staffing standpoint. Do we Redirect? Patient that are agitated should always be treated with dignity and respect. Dtsch Arztebl Int.

Emergency Medical Services 98

Emergency Medical Services Emergency Department OR ED 98

Don't Forget the Bubbles

JUNE 19, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. A proportion of the patients who were initially missed using the CDR were found to actually have risk factors documented in EMS reports or the medical record.

CPR 124

CPR Operating Room OR Emergency Department 124

Dr. Smith's ECG Blog

OCTOBER 12, 2024

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. Vital signs were within normal limits on arrival to the Emergency Department. EKG on arrival to the ED is shown below: What do you think? Blood glucose was not low at 162 mg/dL.

STEMI 115

STEMI Coronary Emergency Department ACS 115

Don't Forget the Bubbles

JANUARY 22, 2024

Choosing Wisely in Paediatric Car e A trainee-led project in a UK tertiary paediatric emergency department looked at the usefulness of blood tests in 101 children. You receive a referral for a 7-year-old Josh, who presented to the emergency department (ED) with a 5-day history of fever, cough, and borderline oxygen saturation.

Emergency Department 90

Emergency Department ALS ED OR 90

ACEP Now

JUNE 14, 2024

Transferring patients from one ED to another hospital is an established part of emergency medicine practice. 1 As fresh challenges of the pandemic and hospital operations changed emergency medicine practice, one of the more challenging areas was the movement of admitted patients out of the first emergency department (ED).

Emergency Department 52

Emergency Department ED Ambulance OR 52