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Case: The Chief of Emergency Medicine (EM) at a large urban hospital recently approached the AI Committee at Unity Health, intrigued by the CMAJ article describing the apparent success of CHARTWatch in detecting early signs of patient deterioration. Reference: Verma et al.
On a busy day shift in the emergencydepartment, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? This is the essence of emergency medicine. The post Putting Clinical Gestalt to Work in the EmergencyDepartment appeared first on ACEP Now.
With increasing forest fires, heat waves, floods, storms, vector-borne illnesses and heat waves, the emergencydepartment is uniquely positioned to declare sentinel events, advocate on behalf of vulnerable populations and lead by example.
Bupe Allergy Buprenorphine induction has been the mainstay of emergencydepartment treatment of opioid use disorder for more than a decade [11, 12]. That discussion can be deferred until the patient is stable, the risk of such an event is mitigated, and other medications can be given for their withdrawal symptoms and pain.
Intimate partner violence (IPV) in the EmergencyDepartment (ED). 2022 Nov Guest Skeptics: Dr. Nour Khatib is an emergency physician in Toronto working in community sites Markham Stouffville Hospital and Lakeridge health. Intimate partner violence (IPV) in the EmergencyDepartment (ED).
The emergencydepartment (ED) evaluation reveals an unremarkable chemistry panel with normal renal function and a white blood cell count of 10,000. Conflicts in the ED often stem from clinical decision-making and actions, leading to potential adverse patient events and exacerbating access block issues.
If bleeding has completely stopped, most of these children still come into the hospital for observation so access will likely be necessary and helpful should patient have rebleed event. If bleeding, the only lab that is needed in the EmergencyDepartment is a type and cross.
In this issue, we collaborated with the CJEM team to present “Hypotension and respiratory events related to electrical cardioversion for atrial fibrillation or atrial flutter in the emergencydepartment” in a visual abstract format1.
Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in EmergencyDepartment Patients With … Continue reading →
Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk EmergencyDepartment Patients: The PROPER Randomized Clinical Trial. Case: A 47-year-old woman presents to the emergencydepartment with a 24-hour history of chest pain and shortness of breath. JAMA February 2018.
Consider these medications if there are signs of end-organ dysfunction, there is a considerable delta in baseline BP, systolic is less than 90 and/or MAP is less than 65 Norepinephrine is a good pressor for a lot of the situations that we encounter in the emergencydepartment, such as septic shock, undifferentiated shock and hypovolemic shock.
A 32-year-old male with no significant past medical history presented to the emergencydepartment (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work.
As Pinellas Countys only Level II trauma center,Orlando Health Bayfront Hospitalwould be the main destination for ambulances in a major emergencyevent like a hurricane.
Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergencydepartment. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. Of course we were skeptical and wanted to review the evidence.
Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergencydepartment, specifically the use of ketamine. His twitter handle is @PainFreeED.
Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergencydepartment. AEM March 2022 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Reference: Butt et al.
A 42-year old Bengali man with a history of hyperlipidemia presented to the EmergencyDepartment with facial swelling, diffuse rash, renal insufficiency and proteinuria after receiving his COVID-19 vaccine (Moderna) booster dose. He was advised to go to the EmergencyDepartment. 2020 Feb 11;38(7):1746-1752. 2019.12.028.
A Multifaceted Intervention Improves Prescribing for Acute Respiratory Infection for Adults and Children in EmergencyDepartment and Urgent Care Settings. AEM July 2019 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and clinical lecturer in Calgary. Date: July 22nd, 2019 Reference: Yadav et al.
Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia. Case: The emergencydepartment is backing up. Your medical team is great, but you […] The post SGEM#250: Scribes – I Want to Break Free (from the EMR) first appeared on The Skeptics Guide to Emergency Medicine.
Physicians, nurses, and staff in emergencydepartments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. J Emerg Nurs. J Am Coll Emerg Physicians Open. J Emerg Nurs.
Major adverse cardiac events 40 minutes after giving the antiarrhythmic. The following table shows their results, take a look: Note that procainamide leads with less adverse cardiac events. Procainamide therapy was associated with less major cardiac adverse events and a higher proportion of tachycardia termination within 40 min.
Case: A 34-year-old male presents to the emergencydepartment with burning epigastric pain after eating two hours ago. Background: Patients presenting to emergencydepartments (EDs) with epigastric pain are typically treated with an antacid, either alone or combined with other medications. AEM Sept 2020. AEM Sept 2020.
He is a GP by training but works in EmergencyDepartment, Anaesthesia, Internal Medicine and Paediatrics. He has a wonderful #FOAMed blog and podcast called Broomedocs and also work […] The post SGEM#326: The SALSA Study: Hypertonic Saline to Treat Hyponatremia first appeared on The Skeptics Guide to Emergency Medicine.
Offer advice and guidance to emergency medicine practitioners worldwide in the formation of national associations and training and certification programs. Provide a network system of centers to facilitate international cooperation in the event of national or manmade disasters. It is helpful to know that you are not alone.
Cuffed Endotracheal Tubes show no difference in immediate post-extubation adverse events (i.e Differences in intubation outcomes for pediatric patients between pediatric and general EmergencyDepartments. Acad Emerg Med. – Cuffed Endotracheal Tubes offer multiple advantages over uncuffed ETTs. Risk was Overstated!
Polypharmacy and medication side effects are a common, and generally under-recognized, reason for patients to present to the emergencydepartment. Adverse events and drug interactions should almost always be […] The post Beers criteria for potentially inappropriate medication use in older adults appeared first on First10EM.
The Learners The target learners were EM residents and physicians practicing in the emergencydepartment. In order to avoid connectivity issues with Wifi, the event administrators broadcasted from an ethernet-connected computer. Internet connection: A stable internet connection is a must. Read more publications from the series.
Date: June 14th, 2017 I had the pleasure of presenting at the Intra America Emergency Medicine Conference (#IAEMC17) held in Costa Rica last month. Thank you to Dr. Manrique Umana for inviting me and the conference organizers for putting on such an amazing and educational event.
However, ketamine may be associated with adverse clinical events including a higher intubation rate. The primary endpoint was incidence of endotracheal intubation occurring during transportation and within one hour after arrival to the emergencydepartment (ED).
Overnight Stay in the EmergencyDepartment and Mortality in Older Patients. Metronidazole-associated Neurologic Events: A Nested Case-control Study. Risk of Radiation Exposure to EmergencyDepartment Personnel From Portable Radiographs. J Emerg Med. J Emerg Med. Emerg Med Australas. 2023 Nov 6.
The parents of 9-month-old Josie bring her into the EmergencyDepartment with coryzal symptoms and difficulty breathing. A secondary analysis of a nationwide study of EmergencyDepartment attendance in America from 2006 to 2008 found that CXRs increase the average length of stay by 27 minutes. Am J Emerg Med.
Background: Patients present commonly to their primary care providers (PCPs) and to the emergencydepartment (ED) with complaints of a sore throat. The ibuprofen did not help and he is requesting antibiotics so he can get back to work sooner. In the US, adults accounted for 6.6 million visits annually to PCPs and EDs for sore throat.
Spoon Feed This was a multi-hospital retrospective study of patients who presented to the emergencydepartment with severe hypertension without end organ damage. The authors found that the 1 year rate of major adverse cardiovascular events (MACE) was 15.5%.
Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.
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.
From a safety standpoint this is a great thing, but also could be the reason we see such few adverse events Discussion: There is a recent “push” to utilize “Push dose pressors” as the correction of acute hypotension in a variety of clinical scenarios. In other words these were pre-made syringes and not mixed at the bedside.
A 41-year-old male who presents to the emergencydepartment with chest pain. I do not think it is possible for a 2nd trop to remain undetectable in a patient then goes on to rule in for acute MI, unless there is a 2nd event. I know of no data on unstable angina/30-day adverse events/acute MI after 2 serial undetectable trops.
Case: You are working in the emergencydepartment (ED) and have just been involved in a difficult case in the resuscitation room. During the resuscitation, a relative of the patient you have been treating named Rudy makes a derogatory/rude comment about Emergency Medicine (EM) staff.
Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the EmergencyDepartment: Consensus Statement of the American Association for Emergency Psychiatry. Erratum in: West J Emerg Med. Pediatric Agitation in the EmergencyDepartment: A Survey of Pediatric Emergency Care Coordinators.
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. Emerg Med J. Paediatr Int Child Health. 2024 Jan 11:1-7.
As hospital boarding, increased emergencydepartment (ED) volumes, and complexity of patients have increased, so have wait times. Some physicians now coin themselves waiting room medicine specialists as departments schedule a physician in triage or attempt to evaluate patients in whatever spaces might be available. J Emerg Med.
Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergencydepartment (ED) with acute onset shortness of breath. He states that he recently moved to Texas from Colorado. 2013;9(1):30.
Source Intranasal fentanyl and discharge from the emergencydepartment among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. . #3: 3: High or Low Fluid Volume in Sepsis?
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