Two Midnights, One New Challenge
This report stated: “Medicare beneficiaries had 1.5 million (limited?) observation stays in 2012; an additional 1.4 million long outpatient stays, and 1.1 million short inpatient stays”. Beneficiaries had over 600,000 hospital stays that lasted 3 nights or more but did not qualify them for SNF services.” Clearly a lot of money is on the table here. The report also noted wide variation and inconsistency in hospitals’ use of inpatient and observation/outpatient designation for similar diagnostic groupings. According to the OIG, many beneficiaries treated with observation stays incurred huge bills from SNFs because th...
Source: EPMonthly.com - December 28, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

Rethink the Salter-Harris I Fracture
The last 50 years of pediatric fracture management may have included a substantial misunderstanding of Salter and Harris’s original findings. In a recent issue of SMART EM we went under the evidence sea and into the depths of pediatric orthopedics, where there is a question trainees (and parents) with overdeveloped common sense have been asking for a half century: why do we immobilize bones that are clinically and radiographically normal? The infamous Salter-Harris type I fracture has, in many settings, become the most common type of pediatric ‘fracture’. And yet the diagnosis is, in the overwhelming majority of case...
Source: EPMonthly.com - December 28, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

When a “ Fall ” Isn ’ t a Fall: Screening for Elder Mistreatment
Up to 1 in 10 elders experience abuse, but most cases are missed during visits to the ED. by Chloe Sidley, MD and Lauren T. Southerland, MD Emergency departments are exceptional at detecting child abuse and they’ve trained SANE forensic nurses to assist with sexual abuse cases. So why aren’t we better at detecting elder abuse? During a shift on a bitterly cold winter day, a 76-year-old man is brought in by paramedics. He is disheveled and the medic team says that the home health aide found him in a freezing apartment with the heat off. The home health aide called 911 because the patient was confused and “not a...
Source: EPMonthly.com - December 28, 2016 Category: Emergency Medicine Authors: Taja Whitted Tags: Uncategorized Source Type: news

When a “ Fall ” Isn ’ t a Fall: Screening for Elder Mistreatment
Up to 1 in 10 elders experience abuse, but most cases are missed during visits to the ED. by Chloe Sidley, MD and Lauren T. Southerland, MD Emergency departments are exceptional at detecting child abuse and they’ve trained SANE forensic nurses to assist with sexual abuse cases. So why aren’t we better at detecting elder abuse? During a shift on a bitterly cold winter day, a 76-year-old man is brought in by paramedics. He is disheveled and the medic team says that the home health aide found him in a freezing apartment with the heat off. The home health aide called 911 because the patient was confused and “not a...
Source: EPMonthly.com - December 28, 2016 Category: Emergency Medicine Authors: Taja Whitted Tags: Uncategorized Source Type: news

How to Confirm Ankle Joint Penetration
Suspicious lacerations should be investigated, even if the X-ray is normal. A step-by-step pictorial guide. It is a busy Friday evening in the emergency department when you get called to the resuscitation bay for a 14-year-old female who was the restrained back seat passenger in a rollover motor vehicle crash. After a quick call to your significant other to ensure that your daughter is safe in bed, you proceed to evaluate this young patient. You are once again amazed by modern safety technology with the minimal amount of head, torso and abdominal trauma on this patient. After a thorough initial inspection you find that the...
Source: EPMonthly.com - December 28, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

Opening the Book on ED Metrics
Conclusions Medical directors are generally under pressure to improve some aspect of the department’s performance. While we always have to keep the overall operation of the department in mind, we are also at the mercy of how individuals perform. We can’t control every aspect of the ED visit. But things that we can control and things we can measure, we need to take advantage of. Start with awareness of the key metrics and then add in transparency. Be sure to establish goals and work with your under-performers on improvement strategies. As I’ve heard ACEP President Jay Kaplan say many times, “If you want to improve p...
Source: EPMonthly.com - December 28, 2016 Category: Emergency Medicine Authors: Matt McGahen Tags: Uncategorized Source Type: news

Do It Yourselfer
I’m proud of the fact that I’m self sufficient in the emergency department. And it irritates the fire out of me to see prima donnas (read surgeons) come into the department and require the entire staff to follow them around to do little things they could do for themselves. I guess you could say that I was trained well by a charge nurse by the name of Beatrix where I did my residency. Miss Bea, as she called herself, or Miss Behemoth as the interns called her under their breath, was a heavy set matronly type with a ruddy complexion. Her upper arms had extra fat that sagged and waved when she pointed to something. Tough ...
Source: EPMonthly.com - December 28, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

Steps to Start An Investigation Report
Because you can observe, this really is an totally different procedure to compose an essay. Create a summary initially before you compose an essay. For me, composing documents isn’t a simple task. Yet another indicates to do so would be to take an completely diverse innovative approach to writing an essay. You don’t require to compose an essay for your blog posts, a few of paragraphs will do fine. You are able to be as imaginative as you need to be, so long as your composition expresses the appropriate info to the reader. These documents have to be composed completely by you, but be certain that the authorship ...
Source: EPMonthly.com - December 27, 2016 Category: Emergency Medicine Authors: TJ Hume Tags: Education Source Type: news

Is Physician Oz right about avocado oil
Authorship shouldn’t be an daunting occupation, actually when you’re writing a college essay. You can find several sorts of essays and each one of these includes a special structure. Your satirical article may make additional brownie points with a suitable name. If you are intending to put on such documents for all of us to examine, be sure your words tend not to lead every one to follow the incorrect route of therapy, medicine or exercise. The initial tip to take into consideration when learning how to compose essays is that you would like to have the ability to consider http://essayswriting.org/ the complete ...
Source: EPMonthly.com - December 26, 2016 Category: Emergency Medicine Authors: TJ Hume Tags: Education Source Type: news

How To Become A Fearless Leader
The essays may cover every prospective matter below sunlight. Do you really desire to get documents essays online. Each of the descriptive composition issues have their special one of a kind article issues. There are a few great matters for this sort of composition. An composition isn’t about fiction, is about the truth. For some thing to become a adequate convincing article matter, it must be an controversial problem. The more passion you’ve got for a creating issue, the simpler it’ll really be to carry that feeling to your own audience and generate a great descriptive article. Usually, you will contend ...
Source: EPMonthly.com - December 22, 2016 Category: Emergency Medicine Authors: TJ Hume Tags: Top News Source Type: news

Scholarships with March 2015 deadlines
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Source: EPMonthly.com - December 21, 2016 Category: Emergency Medicine Authors: TJ Hume Tags: Uncategorized Source Type: news