RebelEM

AUGUST 21, 2023

Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest. PMID: 37318140 Clinical Question: Does mild hypercapnia in adults with coma who have been resuscitated following out-of-hospital cardiac arrest provide favorable neurological outcomes in 6 months compared to normocapnia? Paper: Eastwood G, et al. N Engl J Med.

Hospitals 77

Hospitals Resuscitation Outcomes CPR 77

Total Medical ComplianceHIPAA

JULY 6, 2023

A recent settlement between the Office for Civil Rights (OCR) and Yakima Valley Memorial Hospital in Washington state highlights the importance of safeguarding sensitive data. Department of Health and Human Services, reached a $240,000 settlement with Yakima Valley Memorial Hospital following an investigation into a privacy breach.

Hospitals 52

Hospitals Best Practices Emergency Department Wellness 52

The Trauma Pro

NOVEMBER 17, 2023

Well, it’s not supposed to be that way. The whole point of adhering to the usual ATLS protocol is to ensure that the patient stays alive through and well after your exam. My previous statements were based on the way that we organize our trauma team and trauma activations at this hospital. In principle, I agree.

Resuscitation 278

Resuscitation Ultrasounds Hospitals Wellness 278

The Skeptics' Guide to EM

APRIL 22, 2023

Effect of early high-flow nasal oxygen vs standard oxygen therapy on length of hospital stay in hospitalized children with acute hypoxemic respiratory failure: the PARIS-2 randomized clinical trial. He is drinking well, and parents report normal urine output. Date: April 20, 2023 Reference: Franklin D, et al.

Hospitals 52

Hospitals Pediatrics Emergency Department Outcomes 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Case: A 6-month-old boy presents to […] The post SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Method and Design Data was obtained from 20 EDs and associated acute hospitals from 1/11/20201-31/10/2022. Hospitals may already be accounting well for increased seasonal demand, moderating any observed effect of season.

Emergency Department 40

Emergency Department Hospitals Outcomes Research 40

PHARM

SEPTEMBER 21, 2023

We studied the quality of prehospital care in severe TBI patients by analyzing adherence to recommended target ranges for ventilation and blood pressure, prehospital time expenditure, and their effect on mortality, as well as quality of prehospital ventilation assessed by arterial partial pressure of CO2 (PaCO2) at hospital admission.

Hospitals 40

Hospitals Resuscitation Wellness Outcomes 40

The Skeptics' Guide to EM

AUGUST 21, 2021

Evaluation and management of well-appearing febrile infants 8 to 60 days old. Pediatrics 2021 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Evaluation and management of well-appearing febrile infants 8 to 60 days old.

Wellness 52

Wellness Pediatrics Emergency Department Hospitals 52

The Trauma Pro

SEPTEMBER 1, 2023

more likely In-hospital cardiac arrest – 5x The authors concluded that even if your patient does not have injuries that might limit their daily activities, it is still important to discuss goals of care with our elderly trauma patients. The point is that injuries limiting daily activities are a predictable factor for withdrawal of care.

Hospitals 198

Hospitals Wellness 198

Greater Sydney Area HEMS

MARCH 17, 2024

This feasibility trial – a first for Sydney – concerns placing patients suffering out of hospital cardiac arrest onto potentially life-saving extracorporeal membrane oxygenation (ECMO) therapy in the field, before transporting them to definitive care. I hope you enjoy it!

Hospitals 52

Hospitals Wellness 52

The Trauma Pro

AUGUST 8, 2023

The patient was oxygenated well and the “outside” ET tube was removed. A well-positioned ET tube was then reinserted. The patient did well afterwards. Not treated at Regions Hospital or even in Minnesota. This explained the shallow position of the tube. ” And if you need more hands, ask for assistance!

Wellness 130

Wellness Hospitals 130

American Medical Compliance

MARCH 18, 2024

Although anyone working at a hospital can be a victim of violence, nurses and aides who have the most direct contact with patients are especially vulnerable. To become certified, please visit us at: American Medical Compliance (AMC). Reach out for other courses by visiting the AMC Course Library. Who is at Risk for Workplace Violence?

Psychiatric 105

Psychiatric Operations Hospitals Wellness 105

ER Nurses

OCTOBER 29, 2018

Some coloring books are marketed with 'art therapy' label suggesting coloring is a viable means to not only calm the mind, but offer therapeutic benefits as well. The current rage in art therapy models is the coloring book craze, particularly the adult coloring book market, which has exploded over the past couple of years with new titles.

Hospitals 52

Hospitals Wellness 52

The Trauma Pro

OCTOBER 6, 2023

At the time, there was a debate about whether the procedure should be done immediately versus waiting until the patient was well-resuscitated. This was a big procedure, with the possibility of several major complications, with postop paraplegia being one of them. The concern was that death was nearly certain if the aortic lesion progressed.

Head Injuries 147

Head Injuries Research Hospitals Resuscitation 147

The Trauma Pro

APRIL 26, 2024

In the last post in the series, I’ll discuss a paper in press that compares the efficacy and hospital charges of the two techniques. Years ago, we tried to pack the pelvis from the inside (peritoneal cavity), but it never worked very well. As I continue to preach, going anywhere but the OR is dangerous for the patient.

Fractures 147

Fractures Head Injuries Radiology Radiology 147

Dr. Mike Sevilla

APRIL 15, 2024

As our name describes, Salem Family Care is centered around the health and wellness of our patients and their families. Salem Family Care is an independently owned small business and not owned by any hospital or health care system. It is a specialty that integrates the biological, clinical, and behavioral sciences.

Hospitals 98

Hospitals Wellness 98

The Trauma Pro

APRIL 30, 2024

In the next post, I’ll look at a brand new paper that includes a cost analysis as well. They performed a systematic search of the literature, analyzing the impact of each procedure on in-hospital mortality. Today, I’ll look at an earlier review article summarizing some smaller studies comparing it to angioembolization.

Radiology 147

Radiology Radiology Research Fractures 147

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. One study from the National Bureau of Economic Research on nursing strikes in New York State from 1984 to 2004 found that hospital mortality increased by 19.4%

Hospitals 75

Hospitals Research Wellness Patient Safety 75

Taming the SRU

MAY 13, 2024

The patient is a well-appearing male who is awake, alert, and oriented. There is also a well-appearing, healed surgical scar. There is also a well-appearing, healed surgical scar. The skin is warm and well perfused with brisk capillary refill. The patient was discharged on hospital day 5. BMP : Na 136, K 4.3,

Ultrasounds 87

Ultrasounds Emergency Department Wellness Operations 87

The Skeptics' Guide to EM

JULY 8, 2023

Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Date: July 6, 2023 Reference: Hanula R et al. JAMA Int Med 2023. JAMA Int Med 2023.

CDC 102

CDC Hospitals EMS Emergency Department 102

PulmCCM

SEPTEMBER 28, 2023

There was a strong trend toward reduction in the combined endpoint of hospitalization or death, among patients randomized to inhaled budesonide. Outcomes tested were the time to sustained recovery (three days symptom-free, hazard ratio 1.01), hospitalizations (three in each group), or death by day 28 (there were none).

COPD 95

COPD Stroke Academics Hospitals 95

The Trauma Pro

OCTOBER 10, 2023

To expedite care, most hospitals developed a system of pseudo-names to be used until the patient can be identified. The use of Doe names in electronic health records is rapidly fading as well. The best practice for this varies by electronic record system and hospital. Originally, these names were often “Doe” names.

Blood Transfusions 113

Blood Transfusions Best Practices Hospitals Wellness 113

Sensible Medicine

APRIL 12, 2024

For probably the twelfth time on Sensible Medicine, I’ll reference Lisa Rosenbaum’s essay, Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training which brought some of the current inter-generational angst to the fore. That 95-hour work week was not all work.

Radiology 74

Radiology Radiology Hospitals Documentation/Coding 74

Taming the SRU

MARCH 10, 2024

There are also many costs to hypoglycemia, both in terms of financial burdens on hospitals/caretakers/patients, and in terms of morbidity and mortality. There are many medical and pharmacologic causes of hypoglycemia (see the upcoming approved pathway for more!). 2) If you’re concerned for sulfonylurea use, consider octreotide.

EKG/ECG 86

EKG/ECG Shock Wellness EMS 86

AENJ: Current Issue

SEPTEMBER 30, 2023

The patient was referred to the cardiothoracic team and was admitted to the hospital. Postdecortication, the left-sided lung re-expanded well, and the patient was discharged home. A nonrebreathable mask with high-flow oxygen was given to the patient to maintain his oxygen saturation.

Emergency Department 92

Emergency Department Hospitals Wellness 92

The Trauma Pro

OCTOBER 31, 2023

If you believe that harm will occur, here are your options, from least to most damaging to your professional status at the hospital: Contact another consultant in the same or overlapping specialty (if there is one). Contact the trauma medical director, service chief, or hospital administrator and see if they can intervene.

Risk Management 113

Risk Management Documentation/Coding Hospitals Fractures 113

EMDocs

DECEMBER 14, 2023

A lawsuit is filed against the hospital (including the ED physician) the surgeon, his surgical group, the hospital ’ s trauma service director, and the hospital ’ s chief medical officer. Takeaways : Be certain that your emergency call schedule responsibilities are clearly defined in hospital policy.

Hospitals 71

Hospitals Patient Safety Operations Wellness 71

University of Maryland CC Project

JUNE 16, 2023

The first annual Mid-Atlantic Neurocritical Care Symposium will bring together experts from The University of Maryland/Shock Trauma Hospital, Johns Hopkins University, INOVA, Christiana Care, and beyond to discuss the basics of caring for critically ill neurological patients, as well as highlight recent innovations in the field.

Shock 70

Shock Hospitals Wellness Stroke 70

Pediatric EM Morsels

FEBRUARY 2, 2024

Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries. Infectious Disease Acquisition in Pediatric International Travelers: A 10-Year Review at a Canadian Tertiary Care Hospital. Pediatr Emerg Care.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

Maria Yang, MD

MARCH 18, 2024

Maybe “well” versus “unwell”? It is more common to hear “I’m physically doing well,” rather than “My physical health is high.”) Consider the person with a diagnosis of schizophrenia who has been hospitalized multiple times in the past. 2 Then there are people with no diagnosable mental illness who have “low mental health”.

Psychiatric 52

Psychiatric Hospitals Wellness 52

Ziqitza HealthCare Ltd

MAY 14, 2024

Ambulance services staff highly qualified and well-trained medical professionals, paramedics and emergency medical technicians, especially educated to provide trauma aid. Dedicated Care: Ambulances have medical personnel trained to provide immediate care and treatment on the emergency scene, as well as advanced medical assistance if required.

Ambulance Services 52

Ambulance Services Hospitals CPR EKG/ECG 52

EM Literature of Note

APRIL 11, 2024

Each of these disease states has well-defined pathways for “optimal” therapy and escalation. “Pragmatic Trial of Hospitalization Rate in Chronic Kidney Disease” [link] Tweet In this specific study, the underlying disease state was the triad of chronic kidney disease, hypertension, and type II diabetes.

Outcomes 101

Outcomes Administration Hospitals Wellness 101

PEMBlog

SEPTEMBER 20, 2023

The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Kelly Levasseur, DO Children’s Hospital of Michigan Detroit, MI, USA docklevasseur@gmail.com Jennifer Thull-Freedman, MD Alberta Children’s Hospital Calgary, Alberta, Canada Jennifer.Thull-Freedman@albertahealthservices.ca

Pediatrics 123

Pediatrics Emergency Department Hospitals Ultrasounds 123

Sensible Medicine

MARCH 28, 2024

Just 3 examples: #1 #2 #3 Here is the problem: Adjuvant chemotherapy is a well described medical term, but preventive chemotherapy is a colloquialism. When dignitaries, celebrities or other VIPs are admitted to the hospital, extreme protections are placed to ensure privacy.

Hospitals 92

Hospitals Outcomes Wellness 92

ACEP Now

MARCH 13, 2024

Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. 1 Hospital boarding is the main driver of ED crowding, with patients nearly always awaiting transfer to inpatient beds and now more commonly, to other hospitals.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

Taming the SRU

MARCH 27, 2024

Effect of prehospital high-dose glucocorticoid on hemodynamics in patients resuscitated from out-of-hospital cardiac arrest: a sub-study of the STEROHCA trial. Crit Care 2024;28(1):28. In this study, the authors aim to assess the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose OHCA patients.

Resuscitation 87

Resuscitation Outcomes CPR Hospitals 87

The Trauma Pro

DECEMBER 26, 2023

Everyone knows that venous thromboembolism (VTE) is a potential problem in hospitalized patients, and especially so in trauma patients. Screening looks at patient factors such as age, obesity, and previous VTE, as well as injury risk factors like spine and pelvic fractures and decreased mobility. And we probably won’t, ever.

Documentation/Coding 162

Documentation/Coding Fractures Hospitals Research 162