Emergency Medicine Cases

JUNE 7, 2022

In this part 2 of our 2-part podcast series on Cardiac Arrest - The When, Why & How, we discuss some of the finer art of cardiac arrest care and answer questions such as: how should we best communicate to EMS, the ED team and the family of the patient to keep the team focused, garner the most important info and keep the flow of the code going?

CPR 52

CPR Documentation/Coding Resuscitation EMS 52

Dr. Smith's ECG Blog

NOVEMBER 27, 2023

Written by Jesse McLaren A 45 year old presented with two weeks of recurring non-exertional chest pain, now constant for an hour. Below is old and then new ECG (old on top; new below). What do you think? Both ECGs have normal sinus rhythm, normal conduction and normal voltages.

EKG/ECG 78

EKG/ECG Documentation/Coding Wellness 78

Emergency Medicine Cases

JULY 31, 2018

In anticipation of EM Cases Episode 113 Diagnosis an Workup of Pulmonary Embolism with Dr. Kerstin DeWit and Dr. Eddy Lang, we have Dr. Peter Reardon telling us his Best Case Ever (Coding in the Scanner) of a young woman who presents with a seizure followed by hemodynamic instability, who codes while in the CT scanner.

Documentation/Coding 52

Documentation/Coding Seizures EMS Resuscitation 52

Sensible Medicine

OCTOBER 19, 2023

We wrote this letter and submitted it to the journal, documenting that the trial violated ethical codes. Kids are a vulnerable population— subject to teasing and bullying— and frankly the dogs were not that good at sniffing COVID19. Lots of false positives and negatives. Yet the journal refuses to print it.

Pediatrics 110

Pediatrics Documentation/Coding Outcomes Research 110

Emergency Medicine Cases

MARCH 26, 2020

We touch on PPE conservation strategies as we struggle with supplies, give you the bottom line on donning/doffing sequencing, and discuss the core principles of the protected code blue. The post Ep 139 COVID-19 Part 3 – PPE: What We Know, Conservation Strategies and Protected Code Blue appeared first on Emergency Medicine Cases.

PPE 52

PPE Resuscitation Documentation/Coding Wellness 52

The Trauma Pro

AUGUST 15, 2023

MTP logistics include details such as who will be delivering the blood, what actually goes in each cooler, what ratios should be used, limitations imposed by the use of frozen plasma, and documentation. Documentation is critically important, both in the trauma bay and the blood bank. And there are plenty around all the time!

Resuscitation 130

Resuscitation Documentation/Coding Emergency Department Hospitals 130

Sensible Medicine

OCTOBER 19, 2023

We wrote this letter and submitted it to the journal, documenting that the trial violated ethical codes. Kids are a vulnerable population— subject to teasing and bullying— and frankly the dogs were not that good at sniffing COVID19. Lots of false positives and negatives. Yet the journal refuses to print it.

Pediatrics 66

Pediatrics Documentation/Coding Outcomes Research 66

Science Based Medicine

OCTOBER 16, 2023

This is an old finding that needs to be documented periodically and shows why the acceptance of non-science-based treatments by physicians endangers vaccination efforts. A recent study reaffirms the high degree of correlation among physicians between antivax views and an embrace of quackery.

Documentation/Coding 121

Documentation/Coding 121

Resus Review

FEBRUARY 12, 2015

Part of performing a bedside percutaneous tracheostomy is the procedural documentation. Given that this is a surgical procedure, the documentation should be more thorough than you may be accustomed to doing for an arterial line or central line. I have included a sample procedure note below.

Documentation/Coding 40

Documentation/Coding 40

Ken Grauer, MD

FEBRUARY 28, 2023

Figure-2: I've color-coded P waves from Figure-1 according to P wave morphology ( See text ). NOTE: For clarity — I've color-coded P waves in the long lead II rhythm strip according to morphology. Microvascular dysfunction — cardiac vasculitis — intravascular thrombosis.

EKG/ECG 195

EKG/ECG Sepsis COPD Documentation/Coding 195

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Early identification of patients at higher risk of death and hospital admission is an important problem in emergency departments. Most triage scales were developed before current electronic healthcare records were developed.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Documentation/Coding Sexual Assault Hospitals 40

Emergency Medicine Cases

AUGUST 28, 2017

The post Best Case Ever 61 Biohazard Preparedness: The Protected Code Blue appeared first on Emergency Medicine Cases. If you were faced with a patient with suspected Ebola or drug resistant TB or any other biohazard patient who required intubation, would you know how to handle the situation so that you and your colleagues were safe.

Documentation/Coding 52

Documentation/Coding EMS 52

Mind The Bleep

NOVEMBER 21, 2023

Unless you’re documenting something hilarious, please keep it brief and to the point. History of Presenting Complaint In this section use SOCRATES to document the pain. Drugs/Allergies When documenting drugs – try to get the dose and frequency (this can be found on Summary Care Records from the GP if you have access).

EKG/ECG 52

EKG/ECG Documentation/Coding COPD Ultrasounds 52

Total Medical ComplianceHIPAA

DECEMBER 7, 2023

Secure Physical Documents: With increased holiday traffic in workplaces, it’s important to secure physical documents containing patient information. Implement measures such as locking file cabinets and guaranteeing documents are not left unattended in public spaces.

52

52

EM Ottawa

SEPTEMBER 28, 2023

You are treating a 43-year-old male with two days of left lower quadrant abdominal pain, a documented fever of 38.4 and malaise. He has no urinary or bowel symptoms. His past medical history is unremarkable. He looks well by ED standards. After a focused history and physical examination, you narrow the differential to diverticulitis.

Documentation/Coding 92

Documentation/Coding Wellness Infectious Diseases EMS 92

Dr. Smith's ECG Blog

OCTOBER 18, 2023

4,5] We have now formally studied this question: Emergency department Code STEMI patients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review.[6] have published a number of warnings about the previous reassuring studies.[4,5] Am J Emerg Med. 2022 ; 55 : 180 - 182 6.

EKG/ECG 109

EKG/ECG Emergency Department Documentation/Coding Ultrasounds 109

Emergency Medicine Journal

NOVEMBER 28, 2023

Measures of time taken (mins : secs), number information technology (IT) support calls, quality of documentation (using a visual analogue scale), and cognitive load (NASA Task Load Index) were recorded and analysed. Quality of documentation improved with OSLER 4.3 ± 0.3 vs 2.7 ± 0.9 (p p < 0.001). 95% CI 2.3 – 3.5

Emergency Department 40

Emergency Department Documentation/Coding 40

EMDocs

OCTOBER 3, 2023

This is also where keeping up with documentation starts to slip. You’ll need to put the following tasks in a rank order list: new patient evaluations, dispositions, managing critical or potentially critical patients, results review, team huddle, running the board, calling consults, doing procedures, and documentation. It’s up to you.

EMS 105

EMS Documentation/Coding Emergency Department Operations 105

EMDocs

OCTOBER 11, 2023

.” The tech cleans the wound and documents it as 2cm long and “ dirty.” The ED physician documents suturing a 3 cm laceration in a single layer, omitting any reference to any wound exploration, cleansing or debridement. I thought they were incidental “ bone islands” so I didn ’ t document them. Negligence was present.

Radiology 74

Radiology Radiology Patient Safety EMS 74

PulmCCM

SEPTEMBER 17, 2023

Fully implemented, CDC’s toolkit would promote sepsis into the major leagues of “code strokes” and “code STEMIs” — highly prioritized system-wide operational programs enjoying executive sponsorship and significant financial and human resources.

Sepsis 98

Sepsis CDC Hospitals Stroke 98

Science Based Medicine

AUGUST 17, 2023

A new paper documents COVID-19 medical misinformation shared by US physicians on social media The post Examining COVID-19 misinformation propagated by US physicians first appeared on Science-Based Medicine.

Documentation/Coding 81

Documentation/Coding 81

Emergency Medicine Journal

AUGUST 23, 2023

Interviews were transcribed verbatim and coded inductively by the primary researcher. We coded all items to capture experiences of 111 First within the full project coding tree and from this constructed two explanatory themes which were refined by the wider research team.

Emergency Department 75

Emergency Department Urgent Care Patient Safety Documentation/Coding 75

EMDocs

JUNE 28, 2023

EMS report includes concern for CVA, with variable documentation of face and extremity weakness. Nursing documentation includes the presence of a facial droop. There, his initial neuro exam is documented as normal, but a head CT reveals evidence of a possible acute CVA in the right hemisphere.

EMS 75

EMS Stroke Patient Safety Fractures 75

ACEP Now

NOVEMBER 7, 2023

3 These regulations have led to widespread practices of EHI, such as test results and clinical documentation, being shared with patients in real time. Training opportunities for documentation best practices should be employed. Code of federal regulations eCFR website. substance use disorder” rather than “drug addict”).

Documentation/Coding 52

Documentation/Coding Ethical Issues Best Practices EMS 52

Total Medical ComplianceHIPAA

NOVEMBER 13, 2023

Develop a documented process for managing exceptions to information requests, aligning them with consent, privacy, and regulatory requirements. Create clear documentation for exceptions on a case-by-case basis for records management purposes. This process should encompass the eight exceptions mentioned here: [link].

Hospitals 52

Hospitals Documentation/Coding 52

Taming the SRU

JULY 14, 2023

Hughes Pitfalls: We are not multitasking, we are task switching Instead of shotgun orders, do minimum workup for patients with a specific complaint Goal is disposition in the emergency department, so “hit the box” does not just include seeing patients but also their documentation and disposition On shift hacks: Documentation - start note with sign (..)

Emergency Department 58

Emergency Department Documentation/Coding 58

Emergency Medicine Journal

NOVEMBER 28, 2023

Age, Gender, Clinical Frailty Score (CFS) and documentation of ‘WMTY’ was analysed. 468 (79%) patients had documentation of WMTY. Data was routinely collected from Comprehensive Geriatric Assessments, and entered prospectively onto Excel by a trained administrator. Results 592 patient responses were analysed.

Emergency Department 40

Emergency Department Documentation/Coding Hospitals Administration 40

PHARM

JUNE 30, 2023

Visit the post for more.

Documentation/Coding 40

Documentation/Coding 40

Greater Sydney Area HEMS

AUGUST 1, 2023

When I found it, I felt the documentation (if done at all) largely tended to be the bare minimum, and certainly not reflective of the beautiful learning conversations happening in the room. We knew this would involve improving C+C learning summary documentation standards, and effectively disseminating content across the organisation.

Documentation/Coding 52

Documentation/Coding Outcomes Hospitals Administration 52

Pediatric EM Morsels

OCTOBER 27, 2023

He, along with Dr. Bob Luten, a PEM physician in Jacksonville, FL , designed the Broselow-Luten color-coded length-based system to help estimate a child’s weight, and thereby offload the cognitive burden of medication dosing and choice of equipment sizes in pediatric resuscitations. .”

Resuscitation 274

Resuscitation Pediatrics EMS Emergency Department 274

Dr. Smith's ECG Blog

DECEMBER 1, 2023

Watch how we do the coding fort he Queen: video1421687526 from Stephen Smith on Vimeo. These ones are EKG that the Queen's users uploaded, and on the comments and outcomes that they give. These EKGs are displayed on a platform with a pick list of diagnoses. If you are on your phone, use the VIMEO app to view this. The app is free: [link]

EKG/ECG 52

EKG/ECG Outcomes Documentation/Coding 52

AENJ: Current Issue

SEPTEMBER 30, 2023

A team at a Level 1 trauma center recognized the need for ED-friendly documentation and a validated ED skin risk assessment instrument. Emergency care professionals must be proactive about PI early identification and prevention strategies. The Bjorklund 25-item ED Skin/Risk Assessment Tool was selected.

Emergency Department 97

Emergency Department Patient Safety Documentation/Coding Research 97

EMDocs

SEPTEMBER 19, 2023

Reference: emDOCs – NCSE Journal of Emergency Medicine – Review Case 4: 52-year-0ld male brought in by EMS with “code STEMI” ECG demonstrates ST depressions with rocket like T waves in V2-V4. This document covers high sensitivity troponin, risk disposition pathways, and STEMI equivalents.

Seizures 79

Seizures EKG/ECG EMS Emergency Department 79

Emergency Medicine Journal

NOVEMBER 28, 2023

CT of the chest documented narrowing of the mid trachea ( figure 3 ). Pneumonia Central airway obstruction Pulmonary embolism Goodpasture syndrome Answer: B CXR demonstrated a pencil-tip configuration of the trachea ( figure 2 ). Findings were consistent with central airway obstruction (CAO).

Documentation/Coding 40

Documentation/Coding 40

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. 2019;154(7):e191152.

Resuscitation 98

Resuscitation Fluid Resuscitation EMS Pediatrics 98

PDC Healthcare

JANUARY 16, 2023

Thousands of healthcare facilities across the country have adopted standardized, color-coded alert wristbands […]. Being able to easily differentiate and identify these risks can be the difference in ensuring a patient’s safety and makes fulfilling a patient’s needs easier for healthcare workers.

Documentation/Coding 81

Documentation/Coding Patient Safety 81

Mind The Bleep

JULY 26, 2023

Good Medical Practice is the GMC’s core guidance document (a new version is out this year) and there are supporting documents covering important areas like consent , confidentiality , prescribing and treating children. Take care to document these discussions in the records. Most employers will have a chaperones policy too.

Patient Safety 52

Patient Safety Documentation/Coding Hospitals Wellness 52