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 #242: Pott's Puffy Tumor

Podcast #242: Pott's Puffy Tumor

Author: Suzanne Chilton, M.D. Educational Pearls Pott's puffy tumor is a subperiosteal abscess of the frontal bone that arises from hematologic spread or direct infection via the frontal sinuses. The...

23 Elo 20173min

Podcast #241: GERD vs. MI

Podcast #241: GERD vs. MI

Author: Dave Rosenberg, M.D. Educational Pearls MI and GERD can present similarly. For example, 47% with angina report increased belching with an anginal attack, and 20% of people with an MI describe...

21 Elo 20173min

Podcast #240: Honey and Burns

Podcast #240: Honey and Burns

Podcast #240: Honey and Burns Author: Nick Hatch, M.D. Educational Pearls Honey can be used to treat burns because it has antibacterial properties. In one study, honey outperformed silver sulfadiazin...

19 Elo 20172min

Podcast #239: Tetanus in the ED

Podcast #239: Tetanus in the ED

Author: Rachel Beham, PharmD, Advanced Clinical Pharmacist - Emergency Medicine Educational Pearls Tetanus Ig is indicated in those who have no or unknown tetanus vaccination history who present with...

17 Elo 20173min

Podcast #238: Ultrasound in Cardiac Arrest

Podcast #238: Ultrasound in Cardiac Arrest

Author: Aaron Lessen M.D. Educational Pearls Ultrasound is helpful in the setting of cardiac arrest for finding a cause like cardiac tamponade or PE, but also for predicting outcomes for non-shockab...

15 Elo 20171min

Deep Dive #5: The Evolution of Sepsis Treatment

Deep Dive #5: The Evolution of Sepsis Treatment

Author: Susan Brion, M.D. Dr. Brion enlightens us on the ever-evolving standard of sepsis management.

11 Elo 201722min

Podcast #237: Phimosis vs. Paraphimosis

Podcast #237: Phimosis vs. Paraphimosis

Author: Sam Killian, M.D. Educational Pearls Phimosis refers to the inability to retract the distal foreskin over the glans penis in uncircumcised males. Paraphimosis is the entrapment of the foreski...

9 Elo 20174min

Podcast #236: Peripheral IJ Access

Podcast #236: Peripheral IJ Access

Author: Nick Hatch, M.D. Educational Pearls When peripheral or central IV access is difficult, sometimes providers will try to use a peripheral IV setup at an IJ site using US guidance. Case studies ...

7 Elo 20174min

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