Podcast #235: ER Discharge and Mortality

Podcast #235: ER Discharge and Mortality

Author: Pete Bakes, M.D.

Educational Pearls

  • One of the roles of the ER provider is to discharge patients only after life-threatening conditions have been ruled out. However, some patients that are discharged from the ED die within days of their discharge. One recent study sought to investigate the factors and diagnoses associated with death within 7 days of discharge.
  • This study was a retrospective study in 10 million medicare recipients that presented to the ER over 10 years. They excluded palliative, hospice and SNF patients.
  • 0.12% of these patients died within 7 days of ER discharge. Signs and symptoms such as altered mental status, general malaise and fatigue, and nonspecific dyspnea had relative risks of 3-5 for death following discharge.
  • Think carefully before discharge in patients with the signs/symptoms above.

References: Obermeyer Ziad, Cohn Brent, Wilson Michael, JenaAnupam B, Cutler David M. Early death after discharge from emergency departments: analysis of national US insurance claims data BMJ 2017;356 :j239

Jaksot(1145)

Podcast #270: Wound Botulism

Podcast #270: Wound Botulism

Author: Don Stader, M.D. Educational Pearls Wound botulism should be considered in patients with cutaneous lesions and neuromuscular weakness. The toxin produced by clostridium botulinum is the c...

10 Marras 20173min

Podcast #269: Tattoo Ink Complications

Podcast #269: Tattoo Ink Complications

Author: Michael Hunt, M.D. Educational Pearls Tattoo ink is applied below the skin, and because of this, they can lead to keloids, granulomas, tetanus, hepatitis B and C, and skin infections. Tattoo...

8 Marras 20174min

Podcast #268: Poiseuille's Law

Podcast #268: Poiseuille's Law

Author: Dave Rosenberg, M.D. Educational Pearls Poiseuille's Law addresses the flow of a fluid through a tube. Many common ED presentations involve alterations in flow: asthma, MI, ischemic stroke, ...

6 Marras 20176min

Podcast #267: Causes of Very High Lactate

Podcast #267: Causes of Very High Lactate

Author: Dylan Luyten, M.D. Educational Pearls Lactate is a byproduct of anaerobic metabolism, a sign of dying tissue. Dangerous causes of high lactates will not normalize with repeat labs. Crush inju...

3 Marras 20173min

Podcast #266: MI in Young Patients

Podcast #266: MI in Young Patients

Author: John Winkler, M.D. Educational Pearls Some risk factors for MI in the young are history of CAD, stimulant drug use, coronary spasm and diabetes. In those with diffuse ST elevations on EKG, th...

1 Marras 20171min

Podcast #265: The 2017 Flu Vaccine

Podcast #265: The 2017 Flu Vaccine

Author: Rachel Beham, PharmD, Advanced Clinical Pharmacist - Emergency Medicine Educational Pearls CDC recommends using the inactivated, injectable flu vaccine in those 6 months and older. The live a...

30 Loka 20174min

Podcast #264: Witnessed Cardiac Arrest

Podcast #264: Witnessed Cardiac Arrest

Author: Aaron Lessen, M.D. Educational Pearls For patients with in-hospital cardiac arrest, intubation in the 1st 15 minutes of resuscitation was associated with worse outcomes (mortality, neurologic...

27 Loka 20172min

Podcast #263: Early Antibiotics in Sepsis

Podcast #263: Early Antibiotics in Sepsis

Educational Pearls After the first hour, every 1 hour delay in antibiotics in a patient with septic shock patient is associated with a 4% increase in mortality. In patients with high suspicion for se...

25 Loka 20172min

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