Emergency Medicine - Adult and Pediatric
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Diagnosing and Managing Pediatric Foreign Body Ingestions: Part I
Pediatric foreign body ingestion comes with a dichotomous presentation to the ED — the child in extremis with a clear need for immediate intervention vs. the well-appearing child with unknown ingestion. This creates a challenge for the emergency medicine provider to use a combination of history, physical examination, different imaging modalities, and overall clinical picture to verify ingestion over aspiration and, furthermore, to determine whether there is any need for immediate intervention. The decision-making tree surrounding foreign body ingestion changes based on time course, type of object, location in the gastrointestinal tract, and size. Therefore, a regimented and practical approach to foreign body ingestions is warranted.
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The Latest on COVID-19 Vaccination
The COVID-19 pandemic has led to an infodemic of misinformation affecting the ability of the general public to make good decisions about vaccination. Vaccine hesitancy is a byproduct of this infodemic. After reviewing the current available data, the vaccines have an excellent risk/benefit ratio.
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Artificial Intelligence Documentation Assistant Shows Promise for Healthcare Charting
Advocates are seeking relief for physicians overburdened with too many administrative tasks.
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ED Is Focus of Reduction in Sepsis-Related Mortality
Using a sepsis alert, combined with nursing protocols and physician order set usage, can improve core measure compliance and related mortality rates.
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Rapid-Access Psychiatry Encounter Might Reduce ED Use Rate
The lack of access to outpatient psychiatric care could contribute to the medical emergencies seen in EDs. Most emergency providers are well aware of the shortage of available mental healthcare providers in both inpatient and outpatient settings.
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Damages, Causation Are Obstacles in Abdominal Pain Med/Mal Cases
Many older ED patients are living with a host of preexisting conditions, which, coupled with the patient’s age, argue against investing the needed time and money to pursue a malpractice claim. Even if there is clear liability and causation, the case of misdiagnosed abdominal pain still might not be worth pursuing from a financial standpoint.
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Older Adults with Abdominal Pain Risk Mistriage, Inadequate Diagnostic Tests
ED providers should not think of abdominal pain in older adults as the same as abdominal pain in younger patients. At the department level, consider adding abdominal pain in older patients to the list of automatic ECG criteria.
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CT Scans Rarely Change Management of Acute Pancreatitis
For acute pancreatitis patients, efficient and clinically accurate triage is the singular most vital function to help eliminate potential claims — but more importantly, to provide safe and effective treatment to ED patients.
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Stroke Patients Visit EDs Often After Discharge from Hospital
Repeat visits to the ED are quite common, even for patients who experienced mild or moderate strokes and are managing their conditions at home. This suggests home care models for these complex patients are important to evaluate and modify, if needed, to improve long-term care outcomes.
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Unexpected Gaps in Opioid Overdose Treatments
Patients presenting to EDs for opioid overdose should go home with a naloxone prescription or a naloxone take-home kit. Alternatively, these patients could start buprenorphine when it is clinically feasible, or they could be connected directly to outpatient treatment for opioid use disorder.