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)

Deep Dive #6: Bacteriuria and the Elderly

Deep Dive #6: Bacteriuria and the Elderly

Author: Heidi Wald, MD, MSPH Associate Professor of Medicine - University of Colorado School of Medicine, Physician Advisor - Colorado Hospital Association Dr. Heidi Wald explains common misconceptio...

25 Syys 201729min

Podcast #255: Posterior Vitreous Detachment

Podcast #255: Posterior Vitreous Detachment

Author: Erik Verzemnieks, M.D. Educational Pearls Posterior vitreous detachment is the tearing of the lining in the back of of the eye. Patients often present with loss of vision and floaters. Diagno...

22 Syys 20171min

Podcast #254: Myths About Antibiotic Course Length

Podcast #254: Myths About Antibiotic Course Length

Author: Chris Holmes, M.D. Educational Pearls There's little/no data about the necessary length of an antibiotic course, nor has it proven that stopping a course of antibiotics early selects for the ...

20 Syys 20174min

Podcast #253: Total Eclipse of the Eye - Solar Retinopathy

Podcast #253: Total Eclipse of the Eye - Solar Retinopathy

Author: Nick Hatch, M.D. Educational Pearls Photic or solar retinitis occurs when you stare at the sun. The refractive power of the lens of the eye concentrates the light of the sun on the retina, st...

18 Syys 20173min

Podcast #252: Mandible Fractures

Podcast #252: Mandible Fractures

Author: Sam Killian, M.D. Educational Pearls The tongue blade test is done for mandible fractures, which make up 40-60% of facial fractures. The test is done by having the patient bite down on a tong...

15 Syys 20174min

Podcast #251: Cyanide Poisoning

Podcast #251: Cyanide Poisoning

Author: Rachel Beham, PharmD, Advanced Clinical Pharmacist – Emergency Medicine Educational Pearls Cyanide poisoning is suspected in patients who present with lactic acidosis after being trapped arou...

13 Syys 20174min

Podcast #250: Desmopressin

Podcast #250: Desmopressin

Author: Rachael Duncan, PharmD BCPS BCCCP Educational Pearls Desmopressin is an ADH mimetic and helps retain water, release von Willibrand Factor (in high doses), and treat diabetes insipidus (in low...

11 Syys 20173min

Podcast #249: Detecting Pulses

Podcast #249: Detecting Pulses

Author: Jared Scott, M.D. Educational Pearls Overall, medical providers are bad at detecting pulses. However, only 2% of patients do not have a detectable DP pulse. In one study, for patients with l...

10 Syys 20173min

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