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EDs Are Seeking to Minimize Restraint Use
At Hennepin County Medical Center’s ED, quality improvement and quality assurance have been a long-term focus. “There was an interest, particularly in the wake of the local and national events of the summer of 2020, to reexamine our restraint practices and look for opportunities to minimize coercive care in our ED,” reports Aaron E. Robinson, MD, MPH, a faculty physician in the Department of Emergency Medicine at Hennepin County Medical Center and assistant medical director at Hennepin Emergency Medical Services.
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An Alternative Model for ECPR: Keeping the Pool of Physicians Skilled in the Procedure Small
Extracorporeal cardiopulmonary resuscitation, or ECPR, is relatively new to UF Health’s Shands Hospital in Gainesville, FL. Interestingly, unlike the model for ECPR being deployed by hospitals in San Diego, where dozens of emergency physicians are being trained in the technique, developers of the ECPR program at UF Health have decided that it is important to restrict the number of emergency physicians who perform ECPR.
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San Diego County EPs Making Sure Life-Saving Technique Is Available to Cardiac Arrest Patients
The Centers for Disease Control and Prevention notes that every year more than 365,000 people in the United States will experience an out-of-hospital cardiac arrest. However, even in cases where quick-thinking bystanders skillfully administer cardiopulmonary resuscitation before paramedics arrive to take over, the odds of surviving a cardiac arrest are bleak. But what if there was a way to improve the odds of survival in such cases?
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Delayed CT? ED Documentation Can Increase, or Mitigate, Risk
When CT scan delays occur, ED providers sometimes want to document in the chart all the factors beyond their control. “But trying to call out delays in the chart puts up a flag,” warns Bryan Baskin, DO, FACEP, vice chair of safety and quality at the Cleveland Clinic’s Department of Emergency Medicine and an assistant professor at Cleveland Clinic Lerner College of Medicine. Documenting objectively, such as stating, “The CT scanner was down for two hours,” is probably appropriate, he says.
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Pediatric Hematologic Emergencies
Hematology is a challenging area in pediatrics, with unique diseases that do not occur commonly. The authors review critical pediatric hematologic conditions that the acute care provider may encounter and provide a concise guide to diagnosis, stabilization, and management.
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Teen Pregnancies in the ED Part 2: Handling Complications
Teenage pregnancies have a higher incidence of adverse medical outcomes and obstetrical complications that are critical for providers to recognize and manage in a timely manner. The author provides a succinct, comprehensive review of the critical aspects of trauma in pregnancy; preeclampsia; hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome; venous thromboembolism; as well as precipitous delivery and postpartum hemorrhage.
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Teen Pregnancies in the ED Part 1: First Trimester
This article is the first of a two-part series that focuses on an important emergency medicine topic — teenage pregnancy. In this first part, the author focuses on the unique features that affect diagnosis and management of pregnancy in adolescence. Part two will focus on obstetrical emergencies in pregnant teenagers.
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Preparing for Pediatric Asthma Exacerbations in the ED
Asthma is a common disease in pediatrics, with exacerbations occurring frequently. Every clinician who cares for children must be familiar with recognition and timely management to optimize each child's outcome.
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Pediatric Burn Care: Strategies for Identification and Treatment
Pediatric burn injuries, especially minor, are an essential part of caring for children. Classification of the depth of injury, recognition of nonaccidental trauma, and appropriate care are all critical aspects of management. The authors comprehensively review pediatric burn care.
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Calling ED Boarding a Public Health Crisis, ACEP Pushes Policymakers to Act
Although there are many possible solutions, both legislative and administrative, the industry continues searching for the right formula to solve the problem.