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https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#1
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431869/the-diagnostic-and-prognostic-value-of-the-optic-nerve-sheath-diameter-on-ct-for-diagnosis-spontaneous-subarachnoid-hemorrhage
#2
Murat Yesilaras, Turgay Yilmaz Kilic, Suveyda Yesilaras, Ozge Duman Atilla, Dilek Öncel, Mahmut Çamlar
INTRODUCTION: The aim of this study was to investigate the relationship between the optic nerve sheath diameter (ONSD) measured on non-contrast head computed tomography (CT) and the diagnosis and prognosis of spontaneous subarachnoid hemorrhage (SAH) on emergency department (ED) patients. METHOD: We used a matched control group of patients with the same age and gender who were diagnosed in the ED with spontaneous SAH and who admitted to the ED with headache. Four emergency medicine attending physicians made the ONSD measurements...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28430550/round-table-on-malignant-hyperthermia-in-physically-active-populations-meeting-proceedings
#3
Yuri Hosokawa, Douglas J Casa, Henry Rosenberg, John F Capacchione, Emmanuel Sagui, Sheila Riazi, Luke N Belval, Patricia A Deuster, John F Jardine, Stavros A Kavouras, Elaine C Lee, Kevin C Miller, Sheila M Muldoon, Francis G O'Connor, Scott R Sailor, Nyamkhishig Sambuughin, Rebecca L Stearns, William M Adams, Robert A Huggins, Lesley W Vandermark
CONTEXT:   Recent case reports on malignant hyperthermia (MH)-like syndrome in physically active populations indicate potential associations among MH, exertional heat stroke (EHS), and exertional rhabdomyolysis (ER). However, an expert consensus for clinicians working with these populations is lacking. OBJECTIVE:   To provide current expert consensus on the (1) definition of MH; (2) history, etiology, and pathophysiology of MH; (3) epidemiology of MH; (4) association of MH with EHS and ER; (5) identification of an MH-like syndrome; (6) recommendations for acute management of an MH-like syndrome; (7) special considerations for physically active populations; and (8) future directions for research...
April 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28428438/global-emergency-medicine-highlights
#4
EDITORIAL
Ellen J Weber
No abstract text is available yet for this article.
May 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28424835/-future-of-emergency-medicine-in-germany-2-0
#5
REVIEW
A Gries, M Bernhard, M Helm, J Brokmann, J-T Gräsner
In 2003 an article on the future of prehospital emergency medicine in Germany was published in the journal Der Anaesthesist. Emergency medicine in Germany, which at that time was almost exclusively defined as prehospital emergency rescue, has evolved and now in-hospital domains have increasingly moved into the focus. At that time, the primary goal was to connect prehospital management with a smooth transition to hospital admission and further care in the hospital and to further optimize the rescue chain from the actual emergency through to causative treatment...
April 19, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28421650/keeping-up-with-the-kids-diffusion-of-innovation-in-pediatric-emergency-medicine-among-emergency-physicians
#6
Robert L Cloutier, Rakesh D Mistry, Stephen Cico, Chris Merritt, Samuel H F Lam, Marc Auerbach, L Melissa Skaugset, Jean Klig, Meg Wolff, Myto Duong, Jennifer Walthall
With 30,000,000 emergency department (ED) visits annually, children account for nearly one fourth of all ED visits in the United States. Despite these statistics, EDs across the country remain underprepared to care for pediatric patients [1, 2]. Based on published data, only 45% of EDs report having a pediatric quality improvement plan in place, one third of hospitals do not weigh children in kilograms, less than half have disaster plans in place for pediatric patients and more than 15% are missing critical pediatric emergency equipment [1]...
April 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28421563/the-current-utilization-and-perceptions-of-prescription-drug-monitoring-programs-among-emergency-medicine-providers-in-florida
#7
Henry W Young, Joseph A Tyndall, Linda B Cottler
BACKGROUND: Pain is among the most commonly treated symptoms in the emergency department, and opioids are commonly prescribed from the emergency department to treat moderate to severe pain. Prescription drug monitoring programs (PDMP) can be used to assist physicians identify individuals at increased risk to misuse or abuse opioids. While the use of the PDMP has been shown useful among clinicians, in the past, utilization of the PDMP has been less than optimal. The objective of this study was to assess the current utilization and perceptions of the prescription drug monitoring program among emergency medicine providers in Florida...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28420603/the-coags-uncomplicated-app-fulfilling-educational-gaps-around-diagnosis-and-laboratory-testing-of-coagulation-disorders
#8
Craig Kessler, Ellinor I Peerschke, Meera B Chitlur, Roshni Kulkarni, Natalia Holot, David L Cooper
BACKGROUND: Patients with coagulation disorders may present to a variety of physician specialties; however, accurate and efficient diagnosis can be challenging for physicians not specialized in hematology, due to identified gaps in knowledge around appropriate laboratory assays and interpretation of test results. Coags Uncomplicated was developed to fill this unmet educational need by increasing practical knowledge of coagulation disorders among nonexpert physicians and other health care professionals (HCPs) in a point-of-care (POC) setting...
April 18, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28419618/correspondence-response-to-letter-to-the-editor-ultrasound-assisted-lumbar-puncture-on-infants-in-the-pediatric-emergency-department
#9
Michael Gorn
We would like to thank our reader for his/her interest in our work and continuing support of point-of-care ultrasound in pediatric emergency medicine. Our study was conducted at a large academic emergency department with pediatrics and emergency medicine residents, nurse practitioners who function at or above the level of a senior resident (PGY-3 and 4), and pediatric emergency fellows who function as attending physicians. As a routine, all initial lumbar puncture (LP) attempts are made by learners. This article is protected by copyright...
April 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28419016/an-evaluation-of-a-new-debriefing-framework-reflect
#10
Lauren E Zinns, Paul C Mullan, Karen J OʼConnell, Leticia M Ryan, Angela T Wratney
BACKGROUND: Postresuscitation debriefing (PRD) is recommended by the American Heart Association guidelines but is infrequently performed. Prior studies have identified barriers for pediatric emergency medicine (PEM) fellows including lack of a standardized curriculum. OBJECTIVE: Our objective was to create and assess the feasibility of a time-limited, structured PRD framework entitled REFLECT: Review the event, Encourage team participation, Focused feedback, Listen to each other, Emphasize key points, Communicate clearly, and Transform the future...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28412073/pediatric-acute-flaccid-paralysis-enterovirus-d68-associated-anterior-myelitis
#11
James A Yoder, Michael Lloyd, Luke Zabrocki, Jonathan Auten
BACKGROUND: Enteroviral infections can cause acute flaccid paralysis secondary to anterior myelitis. Magnetic resonance imaging (MRI) is important in the diagnosis of this potentially devastating pediatric disease. Before the 2014 outbreak of Enterovirus D68 (EV-D68), the virus was considered a relatively benign disease. CASE REPORT: A fully immunized 8-year-old boy was brought to the emergency department complaining of a cough, headache, neck pain, and right arm pain and weakness...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412072/do-slow-and-steady-residents-win-the-race-modeling-the-effects-of-peak-and-overall-resident-productivity-in-the-emergency-department
#12
Joshua W Joseph, Victor Novack, Matthew L Wong, Larry A Nathanson, Leon D Sanchez
BACKGROUND: Emergency medicine residents need to be staffed in a way that balances operational needs with their educational experience. Key to developing an optimal schedule is knowing a resident's expected productivity, a poorly understood metric. OBJECTIVE: We sought to measure how a resident's busiest (peak) workload affects their overall productivity for the shift. METHODS: We conducted a retrospective, observational study of resident productivity at an urban, tertiary care center with a 3-year Accreditation Council for Graduate Medical Education-approved emergency medicine training program, with 55,000 visits annually...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412071/emergency-medicine-myths-cerebral-edema-in-pediatric-diabetic-ketoacidosis-and-intravenous-fluids
#13
Brit Long, Alex Koyfman
BACKGROUND: Pediatric diabetic ketoacidosis (DKA) is a disease associated with several complications that can be severe. One complication includes cerebral edema (CE), and patients may experience significant morbidity with this disease. OBJECTIVE: This review evaluates the myths concerning CE in pediatric DKA including mechanism, presentation of edema, clinical assessment of dehydration, and association with intravenous (i.v.) fluids. DISCUSSION: Multiple complications may occur in pediatric DKA...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28410792/accuracy-of-pecarn-catch-and-chalice-head-injury-decision-rules-in-children-a-prospective-cohort-study
#14
Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis, Louise Crowe, Ed Oakley, Stuart R Dalziel
BACKGROUND: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. METHODS: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively)...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28409293/defining-the-need-for-surgery-in-small-bowel-obstruction
#15
Florian Kuehn, Malte Weinrich, Sarah Ehmann, Katja Kloker, Ilaria Pergolini, Ernst Klar
BACKGROUND: Small-bowel obstruction is a frequent disorder in emergency medicine and represents a major burden for patients and health care systems worldwide. Within the past years, progress has been made regarding the management of small-bowel obstructions, including the use of contrast agent swallow as a tool in the decision-making process. OBJECTIVES: This is a prospective controlled study investigating the central role of contrast agent swallow in the diagnostic and treatment algorithm for small-bowel obstruction at a university department of surgery...
April 13, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28408233/securing-a-chest-tube-properly-a-simple-framework-for-teaching-emergency-medicine-residents-and-assessing-their-technical-abilities
#16
Raaj K Ruparel, Torrey A Laack, Rushin D Brahmbhatt, Phillip G Rowse, Johnathon M Aho, Yazan N AlJamal, Brian D Kim, David S Morris, David R Farley, Ronna L Campbell
BACKGROUND: Quality-improvement efforts at our institution have identified chest tube dislodgement as a preventable complication of tube thoracostomy. Because proper fixation techniques are not well described in the literature and are seldom formally taught, techniques vary among residents. OBJECTIVE: Our aim was to develop and test a framework for teaching and assessing chest tube securement. METHODS: A repeated-measures study design was used...
April 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28406552/auckland-regional-emergency-medicine-trainee-mentoring-uptake-survey
#17
Gordon Michael Mike Nicholls, Emma Lawrey, Peter Jones
OBJECTIVE: The primary objective of this study is to quantify how many Auckland region emergency medicine (EM) trainees would like a formal mentoring programme. The secondary objectives were to quantify how many Auckland region EM trainees would like to participate in a formal mentoring programme; to determine trainees' current understanding of mentoring; how trainees prefer mentors to be allocated; why trainees may want a mentor; what mentees perceive would be good qualities in a mentor; and trainees' prior experience with mentoring...
April 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28406108/specialty-preferences-and-motivating-factors-a-national-survey-on-medical-students-from-five-uae-medical-schools
#18
Mahera Abdulrahman, Maryam Makki, Sami Shaaban, Maryam Al Shamsi, Manda Venkatramana, Nabil Sulaiman, Manal M Sami, Dima K Abdelmannan, AbdulJabbar M A Salih, Laila AlShaer
BACKGROUND: Workforce planning is critical for being able to deliver appropriate health service and thus is relevant to medical education. It is, therefore, important to understand medical students' future specialty choices and the factors that influence them. This study was conducted to identify, explore, and analyze the factors influencing specialty preferences among medical students of the United Arab Emirates (UAE). METHODS: A multiyear, multicenter survey of medical student career choice was conducted with all five UAE medical schools...
September 2016: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/28405953/angioedema-in-the-emergency-department-a-practical-guide-to-differential-diagnosis-and-management
#19
REVIEW
Jonathan A Bernstein, Paolo Cremonesi, Thomas K Hoffmann, John Hollingsworth
BACKGROUND: Angioedema is a common presentation in the emergency department (ED). Airway angioedema can be fatal; therefore, prompt diagnosis and correct treatment are vital. OBJECTIVE OF THE REVIEW: Based on the findings of two expert panels attended by international experts in angioedema and emergency medicine, this review aims to provide practical guidance on the diagnosis, differentiation, and management of histamine- and bradykinin-mediated angioedema in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28405061/emergency-department-discharge-prescription-errors-in-an-academic-medical-center
#20
Kelly A Murray, April Belanger, Lauren T Devine, Aaron Lane, Michelle E Condren
This study described discharge prescription medication errors written for emergency department patients. This study used content analysis in a cross-sectional design to systematically categorize prescription errors found in a report of 1000 discharge prescriptions submitted in the electronic medical record in February 2015. Two pharmacy team members reviewed the discharge prescription list for errors. Open-ended data were coded by an additional rater for agreement on coding categories. Coding was based upon majority rule...
April 2017: Proceedings of the Baylor University Medical Center
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