PulmCCM

APRIL 18, 2024

The real world success rates by operators experienced with intubation remained unknown. In the relatively few studies comparing video to direct laryngoscopy, intubations were usually performed by inexperienced trainees, and sample sizes were small. The results seem to hold for both major video laryngoscopes (GlideScope and McGrath).

Operations 98

Operations Airway Management EMS Research 98

Taming the SRU

MAY 23, 2023

weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge Counsel on expected course of injury, supportive care (e.g., 2015 Apr 28]. 2015 Dec;8(1):76. Epub 2015 Jul 25. RICE), and symptomatic management (e.g., Calcaneus fractures. What's in a name?

Fractures 55

Fractures Dislocations Operations EMS 55

EMDocs

DECEMBER 14, 2023

If a physician is allowed to be on call for more than one hospital – or to be in the OR when on call – define the procedure for simultaneous calls as well as when a surgeon is operating. Reference : See similar case in “ Where ’ s all that blood coming from” in the November 2015 issue of MMI-LFL. Patient dies in ED.

Hospitals 71

Hospitals Patient Safety Operations Wellness 71

EMDocs

NOVEMBER 1, 2023

McGraw-Hill Education; 2015. Answer : Esophageal Perforation 1-6 Epidemiology : Most frequent etiology is iatrogenic injury from instrumentation accounting for 60% of cases (e.g. upper endoscopy, transesophageal echo, etc.). 2 Additional etiologies include caustic ingestion, trauma, foreign body, or malignancy. Am J Emerg Med. 2022;53:29-36.

Operations 66

Operations Radiology Radiology Fluid Resuscitation 66

ACEP Now

MARCH 13, 2024

Unfortunately, many tertiary hospitals routinely operate at censuses of greater than 100 percent capacity, due to factors including insufficient acute care bed capacity, a shortage of nursing care, and misaligned incentive structures for health care more generally. 2015):157-165. Click to enlarge. Critical care medicine 40.8

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

Taming the SRU

MAY 22, 2023

weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge: Counsel on expected course of injury, supportive care (e.g., A comparison between pre-operative ultrasonography and surgical findings. 2015 Dec;8(1):76. Epub 2015 Jul 25. 2001;220:406-12.

Fractures 69

Fractures Dislocations Operations Radiology 69

Taming the SRU

OCTOBER 23, 2023

At this point, the patient is taken to the operating room for a diagnostic laparoscopy. She was taken to the operating room and found to have a right tubal ectopic pregnancy with a pseudogestational sac. 2007), Free Fluid in Morison's Pouch on Bedside Ultrasound Predicts Need for Operative Intervention in Suspected Ectopic Pregnancy.

Ultrasounds 87

Ultrasounds Operations Radiology Radiology 87

Ziqitza HealthCare Ltd

JULY 14, 2023

For starters, several states have launched and currently operate the 181 and 112 emergency helpline numbers to provide relief to women in distress, whether it is in a public place, at home or even at their workplace. Ziqitza Healthcare Limited has also operated 181 Police Helpline in Punjab to provide timely assistance to the caller in need.

Domestic Violence 52

Domestic Violence Documentation/Coding Operations Ambulance Services 52

PulmCCM

APRIL 1, 2024

Authors included 130 studies published 2015-2023, “to ensure that included studies were representative of current medical practices, including ultrasonography guidance.” Authors also had no information on operators’ experience levels. In skilled hands using ultrasound, CVC complications are much lower than 3%.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

Emergency Medicine Journal

MAY 23, 2023

Methods In this retrospective study, we included all adult patients who visited the ED of a single urban academic tertiary-care university hospital in South Korea for five consecutive years (1 January 2015 to 31 December 2019). The data set was randomly split into train and test sets (1:1) for internal validation.

Outcomes 40

Outcomes Emergency Department Academics Hospitals 40

EMDocs

OCTOBER 23, 2023

Operative complications requiring surgical intervention or hospitalization occur in about 3-6% of all hysterectomies (5). difficile infection, and post-operative hemorrhage. Abscess and Infected Hematoma : This condition is typically delayed, occurring most commonly 10-14 days post-operatively.

OB/GYN 66

OB/GYN Operations EMS Ultrasounds 66

Don't Forget the Bubbles

JANUARY 17, 2024

2015 But we all know that what happens in the lab does not always mirror what happens in real life. They passed away a few days after a second operation. The liquids were chosen to “approximate a pediatric digestive environment.” ” ( Ed. – Very few three-year-olds drink 210mls of vodka in one sitting ).

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

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. 2015 Nov 25;351. Retrieved from www.sciencedaily.com/releases/2015/11/151125233018.htm 5 Quality : Results on quality impacts are mixed. ” ScienceDaily.

Hospitals 76

Hospitals Research Wellness Patient Safety 76

PHEM Cast

JULY 6, 2017

Anatomy The Guidelines Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. British Journal of Anaesthesia, 115 (6): 827–848 (2015) doi:10.1093/bja/aev371 For more information, have a look at the Difficult Airway Society website. Click here to go straight to their page. Frerk et al.

Airway Management 52

Airway Management Academics Operations Resuscitation 52

Don't Forget the Bubbles

JUNE 30, 2023

These procedures require an experienced operator. A joint statement released by the American College of Surgeons/American College of Emergency Physicians recommends that zone 1 REBOA should only be performed if the anticipated time to start the operation is less than 15 minutes. These procedures require an experienced operator.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

RebelEM

APRIL 17, 2023

While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage. 2015 May;204(5):1064-8. Additionally, potential increases in resource utilization, healthcare expense, and ED length of stay are also essential considerations. Ultrasound has become an extended part of our physical exam.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

Don't Forget the Bubbles

JANUARY 8, 2024

O ral sedation if the patient will co-operate Diazepam 0.2mg/kg up to 10mg orally – up to two doses OR Olanzapine 5mg (if <40kg) and 10mg (if >40kg) – one dose only – acts within 20 minutes OR Risperidone 0.02-0.04mg/kg Recent studies have indicated a significant rise in mental health disorders among young people.

Research 105

Research Emergency Department Psychiatric Outcomes 105

Taming the SRU

AUGUST 30, 2023

A 2015 prospective, cross-sectional study of 78 Thai patients published in the International Journal of Rheumatic Disease demonstrated a sensitivity of 59% and specificity of 84% for PCT with a cut-off of 0.5 This finding was not significantly different among operators with different levels of experience, or between adults and children.

Infectious Diseases 78

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 78

PHEM Cast

DECEMBER 12, 2016

For an entertaining and insightful discussion about the impact of undertaking thoracotomy, listen to Dr John Hinds talk from SMACC 2015. Journal of the Royal Society of Medicine 2015. Highly recommended. Traumatic Cardiac Arrest. 108(1): 11-16. Wise et al. Emergency thoracotomy: “how to do it”.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

SheMD

NOVEMBER 27, 2023

As physicians, we cannot leave our office, clinic or operating room at 1030am to attend a school event in our child’s classroom—it just doesn’t work that way. In 2015, I took my children with me to a meeting in Washington DC where I was presenting my research. Unconditional love—it’s all about quality, not necessarily quantity.

Pediatrics 98

Pediatrics Research Operations 98

The Skeptics' Guide to EM

NOVEMBER 20, 2021

Background: We looked at geriatric falls on an SGEM Xtra in 2015. Case: Mid-shift, you realise that the next patient you are about to see is the third in a row aged over 70 who has fallen at home, and that this is her third attendance for a fall in the last two months. Reference: Hammouda et al.

Geriatric Emergencies 52

Geriatric Emergencies Elder Abuse Research Academics 52

RebelEM

JANUARY 25, 2024

Point-of-care ultrasound (PoCUS) is inherently operator-dependent, which may have led to inconsistencies in the quality and findings of the ultrasound exams across different operators. 2015 Oct;50(4):480-7. Epub 2015 May 22. J Pain Symptom Manage. PMID: 26004401.

Ultrasounds 114

Ultrasounds Outcomes COPD Hospitals 114

ACEP Now

NOVEMBER 7, 2023

The 2015 Edition Cures Act sought to promote “transparency, modern standards, and enhanced health IT capabilities by fostering innovation in the health care technology ecosystem to deliver better information to patients, clinicians, and other users.” 2015 Edition Cures Update fact sheet. HealthIT.gov website. Public law 114–255—Dec.

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

ALiEM

MAY 13, 2024

63M with an Erythematous Abdomen Limitations of POCUS As with all ultrasound applications, soft tissue POCUS is operator dependent. J Pediatr 2015 [8] 151 Prospective cohort study of patients 3mo-21yrs comparing clinical assessment to POCUS 96% (90-99%) 87% (74-95%) POCUS changed management in 27% of cases.** Epub 2015 Nov 10.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

EMDocs

SEPTEMBER 25, 2023

Improved Visualization: Video laryngoscopes allow for the use of standard or hyperangulated geometry, essentially allowing the operator to “look around the corner” on an anterior airway. Operators can manipulate the blade with less force to optimize the view, making it easier to identify and navigate the endotracheal tube into the trachea.

Emergency Department 65

Emergency Department Operations Soft Tissue Injuries Airway Management 65

Medical Law

FEBRUARY 4, 2021

Santa Barbara also continues to move forward on implementing its 2015 Bicycle Master Plan Update, which will include the construction of several new multiuse bike pathways for bicyclists and pedestrians. In 2015, California updated its bicycle laws to accommodate E-bikes. See www.sbbike.org/sb for more detailed information).

Documentation/Coding 52

Documentation/Coding Legal Issues Operations 52

Don't Forget the Bubbles

MARCH 11, 2024

Craniosynostosis needs urgent referral and is usually corrected operatively before a child’s first birthday. Craniosynostosis can lead to raised intracranial pressure and failure to thrive. and can worsen and become harder to correct over time. This can lead to intracranial hypertension and neurodevelopmental delay. Purnell, C. Santiago, C.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

The Skeptics' Guide to EM

NOVEMBER 28, 2020

It was surgeons in the late 1890’s that began wearing masks in the operating theaters. There was one recent cluster randomized control trial looking at surgical masks, cloth masks or a control group in healthcare workers ( MacIntyre et al BMJ 2015 ).

Infectious Diseases 52

Infectious Diseases Outcomes Wellness Operations 52

Don't Forget the Bubbles

MAY 24, 2023

Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. The Difficult Airway Society (DAS) published guidelines for difficult pediatric airways in children age one to eight back in 2015. difficult intubations in neonates and infants. Unanticipated difficult tracheal intubation.

Airway Management 98

Airway Management Teamwork Pediatrics Emergency Department 98

Dr. No

DECEMBER 1, 2021

Nonetheless, by summing the narrow bands used in 2020 and 2021 to the broader bands used in previous years, we can get comparable weekly data going back to 2015, and could even go back further, but Dr No needs to get out more often. Figures 1 to 6: weekly deaths over summer and autumn from 2015 to date, all ages and by age band.

Forensics 52

Forensics Wellness Operations 52

EMDocs

MARCH 2, 2024

2015 Sep 29;6:155. The most common causes include trauma and cranial surgeries, but there are other etiological factors, and in rare cases, it can also be spontaneous. [1-3] 1-3] The most common location is the frontal region, followed by the occipital and temporal regions. [4]  Korean J Anesthesiol. 2010  2010 Dec;59 Suppl(Suppl):S183-6.

EMS 113

EMS Fractures Seizures Head Injuries 113

Taming the SRU

SEPTEMBER 1, 2023

2015) reported a sensitivity of 98.9% to divert the plane). for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al.,

Sepsis 84

Sepsis Administration Documentation/Coding Fractures 84

The Skeptics' Guide to EM

JUNE 9, 2018

A new Cochrane Review by Hines et al published in 2018 looked at aromatherapy for post-operative nausea and vomiting. There’s some data supporting the use of an inhalation of isopropyl alcohol in emergency department patients (Beadle, et al Ann Emerg Med 2015 ). We covered that paper on the SGEM in Episode #144.

Emergency Department 52

Emergency Department Academics Operations Administration 52

Taming the SRU

MAY 27, 2024

This often is seen in trauma, cancer, post-operatively, and end-stage metabolic conditions with excessive colloid or protein leak. If the volume of fluid is anticipated to re-accumulate quickly, a drain should be placed. a) left image: normal pleural cavity, image accessed from 2313 The Lung Pleurea - Pleural cavity - Wikipedia ; under CC 3.0

Emergency Department 76

Emergency Department Ultrasounds Radiology Radiology 76

RebelEM

MARCH 9, 2023

Barr 2016 , Trevejo-Nunez 2015) Patients are at high risk of bleeding from the GI tract due to clotting factor impairment or devastating hemorrhage from esophageal varices in the setting of portal hypertension. Epub 2015 Sep 14. Osteopathic Family Physician. 2014 Mar;6(2). Barr T, Helms C, Grant K, Messaoudi I. 2016 Feb 4;65:242-51.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

ALiEM

AUGUST 9, 2023

The lung POCUS is also operator-dependent, and it has a steep learning curve. Pediatrics 2015 8 studies; 765 patients 96% 93% Evidence supports lung POCUS as an alternative for diagnosis of pneumonia in children. 2015 Apr;135(4):714-22. A lung consolidation needs to extend to the pleural surface to be visualized on lung POCUS.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

EMDocs

JUNE 3, 2023

4 This is the framework the ED resuscitationist should be operating under, as hemodynamically unstable pelvic trauma patients require a different approach compared to stable patients who will undergo CT, routine pelvic fixation, and definitive surgical repair. An x-ray in the trauma bay demonstrated an AP grade III fracture.

Fractures 54

Fractures Resuscitation Operations EMS 54