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Clinical Factors and Expenditures Associated With ICD ‐9‐CM Coded Trauma for the U.S. Population: A Nationally Representative Study
ConclusionsTrauma results in a significant healthcare expenditure burden, both per person and on the U.S. population. Clinicians should be aware that individuals in the U.S. population with certain comorbidities such as stroke, joint pain, arthritis, and asthma are more likely to have trauma and that differences exist in expenditures for office‐based, outpatient, dental, and the ED.
Source: Academic Emergency Medicine - March 22, 2017 Category: Emergency Medicine Authors: Clara E. Dismuke, Kinfe G. Bishu, Samir Fakhry, Rebekah J. Walker, Leonard E. Egede Tags: Original Contribution Source Type: research

Clinical Factors and Expenditures Associated With ICD ‐9‐CM Coded Trauma for the US Population: A Nationally Representative Study
ConclusionsTrauma results in a significant health care expenditure burden, both per person and on the US population. Clinicians should be aware that individuals in the U.S. population with certain comorbidities such as stroke, joint pain, arthritis and asthma are more likely to have trauma, and that differences exist in expenditures for office‐based, outpatient, dental and the ER.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - December 14, 2016 Category: Emergency Medicine Authors: Clara E. Dismuke, Kinfe G. Bishu, Samir Fakhry, Rebekah J. Walker, Leonard E. Egede Tags: Original Contribution Source Type: research

Clinical Factors and Expenditures Associated With ICD-9-CM Coded Trauma for the US Population: A Nationally Representative Study.
CONCLUSIONS: Trauma results in a significant health care expenditure burden, both per person and on the US population. Clinicians should be aware that individuals in the U.S. population with certain comorbidities such as stroke, joint pain, arthritis and asthma are more likely to have trauma, and that differences exist in expenditures for office-based, outpatient, dental and the ER. This article is protected by copyright. All rights reserved. PMID: 27976494 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - December 14, 2016 Category: Emergency Medicine Authors: Dismuke CE, Bishu KG, Fakhry S, Walker RJ, Egede LE Tags: Acad Emerg Med Source Type: research

A Paramedic's Repeated Encounters with Sepsis
Sepsis is a disease process that has been on the forefront lately, especially in the EMS community. Prehospital professionals are trained to recognize the symptoms, such as tachypnea above 22 breaths per minute, fever, tachycardia above 90bpm, and a possible source of infection. Thanks to special emphasis by JEMS in a far-reaching special sepsis section in September that points out how effectively prehospital providers are able to identify sepsis in the field, hospitals around the U.S. are now developing sepsis protocols and working with EMS providers to institute prehospital alerts to join the ranks of trauma, STEMI and s...
Source: JEMS Patient Care - November 29, 2016 Category: Emergency Medicine Authors: Jessica Edwards, NRP Tags: Patient Care Source Type: news

The Fault in our (Three) Stars
Conclusions Like it or not (I think only a minority of CEOs will be happy with their star rating and many physicians will chafe at the ED metrics being used) CMS has started rating your hospital on a five star scale. All of the ED metrics used in the star rating system are typically followed by the ED medical director and nursing leaders, but now you may notice hospital administration is more interested in your performance. The good news is that with added visibility, hospital admin may provide more support in helping to improve performance. We need to know which of our metrics are involved and how we’re contributing to ...
Source: EPMonthly.com - September 27, 2016 Category: Emergency Medicine Authors: Matt McGahen Tags: Uncategorized Source Type: news

South Carolina EMS Integrates In-Hospital Sepsis Care into Protocols
Medic 29 is dispatched to a college dorm for a female with chief complaint of lower abdominal and flank pain for the past five days. The dorm room appears clean and well kept. The patient appears to be a typical 18-year-old college student. She's lying on her bed and is responsive to verbal stimuli, hot to touch, and tachycardic with weak and thready radial pulses at 128. She reports painful urinating for the past 48 hours, general malaise, weakness and nausea. She appears to have labored respirations with a room air SpO2 reading of 95% and is hypotensive with a systolic blood pressure of 88 mmHg that remains low during tr...
Source: JEMS Patient Care - September 1, 2016 Category: Emergency Medicine Authors: Jason G. Walchok, NRP, FP-C Tags: Patient Care Source Type: news

Refractory thrombotic thrombocytopenic purpura following acute pancreatitis
Publication date: Available online 11 August 2016 Source:Journal of Acute Disease Author(s): Ebisa Bekele, Bethel Shiferaw, Alexandra Sokolova, Arpan Shah, Phillip Saunders, Alida Podrumar, Javed Iqbal Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder with an estimated incidence of 4–5 cases per million people per year. It is characterized by small-vessel platelet-rich thrombi that cause thrombocytopenia, microangiopathic hemolytic anemia and organ damage. There are reports in literature that TTP and acute pancreatitis are associated, indicating each can be the cause of the other. However, acute pancrea...
Source: Journal of Acute Disease - August 11, 2016 Category: Emergency Medicine Source Type: research

Muhammed Ali's Death Underscores Importance of Prehospital Sepsis Detection
Muhammad Ali, one of the greatest athletes of all times and a world-class treasure, passed away on Friday, June 3, 2016, as result of sepsis. Imagine if an EMS crew could have detected that he was becoming septic and was able to treat him in the field, helping the hospital attack this deadly condition before it attacked his vital organs? Soon, crews all over the world will be capable of doing so. Severe sepsis is caused by overwhelming infection, and is responsible for significant morbidity and mortality among hospitalized patients. Clinical identification of sepsis includes two or more of the systemic inflammatory respons...
Source: JEMS Patient Care - June 6, 2016 Category: Emergency Medicine Authors: A.J. Heightman, MPA, EMT-P Tags: Patient Care Source Type: news

Analgesia in Neurocritical Care: An International Survey and Practice Audit*
Conclusions: Opiates and acetaminophen are preferred analgesic agents, and gabapentin is a contextual third choice, in neurocritically ill patients. Other agents are rarely prescribed. The discordance in physician self-reports and objective audits suggest that pain management optimization studies are warranted.
Source: Critical Care Medicine - April 16, 2016 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Perceived Appropriateness of Shared Decision‐Making in the Emergency Department: A Survey Study
ConclusionsAcceptance of SDM among emergency physicians appears to be strong across management categories (diagnostic testing, treatment, and disposition) and in a variety of clinical scenarios. SDM is perceived by most EPs to be medicolegally protective.This article is protected by copyright. All rights reserved.
Source: Academic Emergency Medicine - January 25, 2016 Category: Emergency Medicine Authors: Marc A. Probst, Hemal K. Kanzaria, Dominick L. Frosch, Erik P. Hess, Gary Winkel, Ka Ming Ngai, Lynne D. Richardson Tags: Original Contribution Source Type: research

Perceived Appropriateness of Shared Decision-Making in the Emergency Department: A Survey Study.
CONCLUSIONS: Acceptance of SDM among emergency physicians appears to be strong across management categories (diagnostic testing, treatment, and disposition) and in a variety of clinical scenarios. SDM is perceived by most EPs to be medicolegally protective. This article is protected by copyright. All rights reserved. PMID: 26806170 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - January 25, 2016 Category: Emergency Medicine Authors: Probst MA, Kanzaria HK, Frosch DL, Hess EP, Winkel G, Ngai KM, Richardson LD Tags: Acad Emerg Med Source Type: research

Short answer question: a distracting ECG
Part 1 A 76-year-old man with a past medical history of chronic obstructive pulmonary disease is brought to the emergency department (ED) with suspected sepsis. He is a smoker of 15 cigarettes per day who has an exercise tolerance of approximately 30 m. He saw his general practitioner who treated him with antibiotics and steroids. He has rung for an ambulance complaining of increasing shortness of breath and back pain. His initial vital signs were: BP 100/87 mm Hg, HR 120 bpm, RR 24 breaths per minute, oxygen saturations 100% on room air and normal temperature. He appeared sweaty and clammy, but his hea...
Source: Emergency Medicine Journal - December 23, 2015 Category: Emergency Medicine Authors: Lyddon, K., Thevendra, M., Jang Tags: Tachyarrhythmias, Cardiomyopathy, Drugs: infectious diseases, Pneumonia (infectious disease), TB and other respiratory infections, Echocardiography, Pain (neurology), Stroke, Hypertension, Acute coronary syndromes, Percutaneous intervention, Pain (palliat Source Type: research

Pediatric Homonymous Superior Quadrantanopia in the Presence of Acute Vertebral Artery Dissection
Conclusions: Most patients with vertebral artery dissection present with signs of posterior circulation ischemia consisting of neurological deficits, headaches, or neck pain. This case report highlights the unique clinical features and diagnostic imaging seen in the work-up of this rare disease process and exemplifies the importance of identifying acute visual symptoms in an emergency situation.
Source: Pediatric Emergency Care - December 1, 2015 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Prehospital Helicopter Air Ambulances Part 1: Access, Protocols, and Utilization
Conclusion Most nationally certified EMS professionals had access to a medical helicopter service and used these resources mainly for trauma patients. About one third reported they did not have or were unsure if their agency had written protocols for HAA use.
Source: Air Medical Journal - November 24, 2015 Category: Emergency Medicine Source Type: research

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