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Other documented pharmacological causes of anisocoria include nebulized ipratropium bromide and scopolamine (14-19). Pecha JD, Yen KG, Moisiuc A, et al. Chabicovsky M, Winkler S, Soeberdt M, et al. Pashaei-Marandi A, Assam JH, Arnold A, et al. Al-Holou SN, Lipsky SN, Wasserman BN. 2022;26(1):42-3. 2019;370:154-69.
Commentary on an article by Marc Schnetzke, MD, et al.: “Determination of Elbow Laxity in a Sequential Soft-Tissue Injury Model. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28846302 O’Driscoll SW. How Do Elbows Dislocate?: A Cadaveric Study” J Bone Joint Surg Am. 17.01448.
Photographic documentation of the wound is helpful to enhance continuity of care. References Nussbaum SR, Carter MJ, Fife CE, et al. The ED case manager arranged follow up in the wound care clinic in two days. An economic evaluation of the impact, cost, and Medicare policy implications of chronic nonhealing wounds.
A draft guidance document was developed after the completion of a national consultation process though an electronic survey with EMTs. Topics were selected by using section titles from the guidance document with a view to seeking further feedback and subsequent refinement of the proposals for CPD. MethodsWillis, et al.
References Dyson K, Bray JE, Smith K, et al. Wang HE, Schmicker RH, Daya MR, et al. Benger JR, Kirby K, Black S, et al. Benger JR, Lazaroo MJ, Crout M, et al. Lyng J, Baldino KT, Braude D, et al. Prehospital supraglottic airways: an NAEMSP position statement and resource document. Ann Emerg Med.
11,12 There is a well-documented decrease in empathy during medical school. Howick J, Moscrop A, Mebius A, et al. Crawford MJ, Rutter D, Manley C, et al. Kelley JM, Kraft-Todd G, Schapira L, et al. Haverfield MC, Tierney A, Schwartz R, et al. Wang H, Kline JA, Jackson BE, et al. J R Soc Med. Health Commun.
Posterior – Shortened, adducted, internally rotated 5,6 Anterior – Shortened, abducted, externally rotated 5,6 As with all dislocations, perform and document distal neurovascular exam before and after management. 8 Perform and document distal neurovascular exam. Parvizi J, Tan TL, Goswami K, et al. Zalikha, A.K.
When interpreting the patient’s ECG, be mindful and document the presence or lack of conduction and interval abnormalities, ischemia, arrhythmias, delta waves to suggest Wolff-Parkinson-White, Brugada sign, and evidence of hypertrophic obstructive cardiomyopathy (HOCM). Evans, et al., Gausche-Hill M, et al. 18 percent).
Perkins ZB, Greenhalgh R, Avest E, et al. Sutori D, Erdelyi LS, Uri I, et al. Dorsett M, Allen H, Garbacz H, et al. Baker PO, Karim SR, Smith SW, et al. Perkins ZB, Greenhalgh R, Avest E, et al. Sutori D, Erdelyi LS, Uri I, et al. Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest.
Each case requires a member of the team to review the prehospital and emergency department documentation, identify key learning points, and craft tailored feedback, often supplemented with relevant educational resources. Proctor A, Billing J, Lyttle M, et al. Australasian Journal of Paramedicine [Internet]. Pollard J, Black S.
Communicability Marin et al. Burden of Chickenpox on the Health Service Bernal et al. Complications of varicella are well-documented in the NICE guidelines and include secondary bacterial infections, neurological complications, and other rarer complications. Bernal et al. , Bozzola et al. Eurosurveillance.
It is essential to ensure that cost reports are meticulously documented, auditable, and aligned with allowable cost definitions under federal law. Cost shifting has been well-documented in health policy literature and poses a significant threat to the sustainability of both EMS systems and broader healthcare markets.
3 Simulation training in healthcare is documented to have been in practice for more than 50 years with implementation in the 1960s to teach medical students bedside diagnosis. 15 Moreover, the role of resilience as a buffer against burnout has been well-documented in the literature. Abelsson et al., Bienstock et al. (16
Manual for the laboratory diagnosis of measles and rubella infection Geneva: WHO Documents Production Services, 2007 Available from: [link] [Accessed 4 Oct 2024] Government of the United Kingdom. 2014;142(4):685-94 Crowcroft NS, Booy R, Harrison T et al. 2024 Ghanaie RM, Karimi A, Sadeghi H, et al. Measles facts [Internet].
Article: Chanderraj R, Admon AJ, He Y, et al. Reliance on Electronic Health Records Data : As with many retrospective studies, reliance on EHR data for identifying eligible patients and outcomes is prone to inaccuracies, missing data, and variability in clinical documentation practices. In 2021, Buckley et. 3 The same year, Ross et.
4,5 Of particular concern is the Sudanese conflict, which began in April 2023, and which has caused the largest internal displacement of a population in documented history. 57 Adapted from: Long B, MacDonald A, Liang SY, et al. link] Rother B, Pierre G, Lombardo D, et al. link] Franco JR, Cecchi G, Priotto G, et al.
2 Beginning in January 2023, the DRC documented a record number of annual suspected cases of clade 1 mpox, specifically classified as Clade 1b. By 2024, over 17,000 suspected cases (2,863 confirmed) were documented across Africa, with the majority in the DRC. Table adapted from: Long B, Liang SY, Carius BM, et al. 2024;32(3).
1,3 In Nudell et al. 5,6 The American College of Paramedics and American Paramedic Association founding document, “Manifesto; Paramedicine is Essential” defines and defends the unique role of paramedics as autonomous, highly skilled healthcare professionals. As Nudell et al. 11,12 In stark contrast to the U.S. system, the U.K.’s
With thousands of medications in use, it would be impractical to incorporate every potential prescription into protocol documents. Al Badawi, A. Today’s rapidly expanding pharmacologic landscape will likely amplify these factors. Journal of Medical Internet Research , 27, e58177. & Nashwan, A.
1,3 In Nudell et al. 5,6 The American College of Paramedics and American Paramedic Association founding document, “Manifesto; Paramedicine is Essential” defines and defends the unique role of paramedics as autonomous, highly skilled healthcare professionals. As Nudell et al. 11,12 In stark contrast to the U.S. system, the U.K.’s
Heidenreich PA, Bozkurt B, Aguilar D, et al. Collins S, Storrow AB, Albert NM, et al. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group. Yancy CW, Jessup M, Bozkurt B, et al. Yancy CW, Jessup M, Bozkurt B, et al. Am J Emerg Med.
Ralston survived this horrible ordeal and went on to document it in his book Between a Rock and a Hard Place. Kampden et al. Based on these concepts, Emmerlich et al. 1 Obviously, this is an extreme case; however, it illustrates that field amputations can be successful even in the most primitive conditions.
As frontline clinicians, emergency physicians play a crucial role not only in the diagnosis and management of TBI, but also in ensuring accurate documentation that supports vital epidemiological tracking and resource allocation. Use specific language about a TBI diagnosis in your documentation. Document how the injury occurred (e.g.,
that EMS providers are excellent at recognizing and documenting external signs of abuse, but they rarely document nonspecific signs such as seizures and vomiting (3). 2022.105604 Loos MHJ, van Rijn RR, Krug E, et al. Documentation of Child Maltreatment by Emergency Medical Services in a National Database. 2022;90:102386.
From VPS Connolly et al JACC, 1999 ) Major benefit to pacing! From VPS II Connolly et al JAMA, 2003 ) Answer: No significant reduction in syncope!! Because of its totally unexpected onset and propensity to result in sudden death PAVB is difficult to document and significantly underdiagnosed. What did they find?
One of the first documented strikes among house staff officers took place in 1974 at Howard University here in Washington, D.C., Ahmed AM, Kadakia K, Ahmed A, et al. Historically, labor unionization among health care workers is uncommon, 5 including among resident physicians, 6 and the prospect of striking even more so. Beresford L.
Transient STEMI was studied by Lemkes et al. Lemkes JS, Janssens GN, van der Hoeven NW, et al. Available from: [link] Lemkes et al. At time of cardiology evaluation, patient was chest pain free, according to documentation. Eur Heart J [Internet] 2019;40(3):283–91.
Some erroneously believe that merely documenting a patient leaving AMA, using an AMA form, is sufficient to meet legal and ethical standards. Proper documentation of AMA is essential to documentation, and also can confer medicolegal protection. Jeong J, Song KJ, Kim YJ, et al. Hoyer C, Stein P, Alonso A, et al.
2024.117470 Wang Y, Chen S, Bao S, et al. doi:10.3109/09553002.2013.765055 Shin JY, Yabroff KR, Keegan THM, et al. 2019.02.047 Fisher RF, Applegate KE, Berkowitz LK, et al. doi:10.1002/acm2.13526 Writing Committee Members, Hirshfeld JW Jr, Ferrari VA, et al. 27660 Waselenko JK, MacVittie TJ, Blakely WF, et al.
Unexplained cardiac arrest or documented VF/polymorphic VT: +3 3. Brugada ECG Patterns: No matter how many times I have seen Brugada-1 and Brugada-2 ECG patterns I still find myself referring back to the images in Figure-1 : Figure-1: Review of ECG Patterns in Brugada Syndrome ( adapted from Brugada et al in JACC: Vol.
Intubated patients in the ED should have soft, wrist restraints places without the need for arduous, high-risk documentation or sitters Intubation Checklist EMCrit 176 – Updated EMCrit Rapid Sequence Intubation Checklist Awareness during Paralysis EMCrit 331 – Awareness after Resus RSI and ICU Paralysis – It is Unacceptable!!!
Singh K, Jain A, Panchal I, et al. Cole JB, Lee SC, Martel ML, et al. Nuttall GA, Malone AM, Michels CA, et al. Martel ML, Driver BE, Miner JR, et al. Roppolo LP, Morris DW, Khan F, et al. Droperidol and the black box warning. Ann Emerg Med. 2004;43(1):139-40. Egypt Heart J. 2023;75(1):56. West J Emerg Med.
Background document for the food advisory committee: certified color additives in food and possible association with attention deficit hyperactivity disorder in children. .” Heliyon (2024). From FDA News release “HHS, FDA to phase out petroleum-based synthetic dyes in nation’s food supply” released April 22,2025 [link]. 2017): 524-548.
Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Editor, Med Mal Insights Excellent documentation supports standard of care, avoids lawsuit Vertebral artery CVA leaves patient disabled. Result : Based on excellent documentation of thoughtful medical decision making, the case was found to be defensible. UpToDate Online.
Reference: Knack et al. That document tells us “Before widespread implementation, CDRs should be compared to clinical judgement.” [3] A similar review by Sanders et al 2015 concludes that clinica. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients.
Date: September 12, 2024 Reference: Anderson et al. These “allergies” are often poorly documented and could potentially be more accurately described as intolerance [1]. A pivotal study by Raja et al. Koo et al showed that offering amoxicillin oral challenges to ICU patients with low-risk penicillin allergies.
[display_podcast] Date: October 24th, 2017 Reference: Harrison et al. display_podcast] Date: October 24th, 2017 Reference: Harrison et al. That rant relied upon a Cochrane SRMA by Stevens B et al 2013 and a randomized clinical trail published in Pediatrics by Gray L et al 2015. Reference: Harrison et al.
Date: September 28th, 2022 Reference: Hartford et al. Date: September 28th, 2022 Reference: Hartford et al. Brown et al , Selbst and Clark ). It is not well documented, whether gaps in pain assessment and treatment exist in conditions in which opioids are not indicated, such as migraine headaches. AEM September 2022.
13 Interventions may include: Ascertaining a patient’s preferred language early in the clinical encounter (during registration, for instance), and clearly documenting this preference in a place that is visible to all providers. Utilizing certified interpreters and documenting their use. Lion KC, et al. Regenstein M, et al.
Reference: Pines et al. Reference: Pines et al. The American College of Emergency Physicians ( ACEP ) has a number of documents discussing APPs in the ED. Reference: Pines et al. Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. AEM November 2020. AEM November 2020.
Date: January 5th, 2021 Reference: Shipman et al. Date: January 5th, 2021 Reference: Shipman et al. The first documented use of topical ophthalmologic anesthetics was in 1818. We covered and randomized control trial by Waldman et al on topical tetracaine for simple corneal abrasions on SGEM#83.
The EMR tasks we undertake are expanding rapidly, far beyond simply documenting history and physical examination and every implementation slows us down. Research by Hill et al (1) demonstrated that an ED shift can have 4,000 clicks. Most emergency physicians use some form of electronic medical records (EMRs) when seeing patients.
Date: March 28, 2023 Reference: Fowler et al. Date: March 28, 2023 Reference: Fowler et al. You find her at the desk, asleep with her face on the keyboard, patient documentation half finished. Reference: Fowler et al. Objective assessment of sleep and fatigue risk in emergency medicine physicians.
We collected data directly from the bedside clinician which enabled us to gather pertinent patient symptoms and physical examination findings that may not be well documented in the medical record, but more accurately identify the child’s injuries.” Baumann F, Ernstberger T, Neumann C, et al. Leonard JC, Harding M, Cook LJ, et al.
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