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

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Podcast #220: A-Fib Cardioversion

Podcast #220: A-Fib Cardioversion

Author: Aaron Lessen, M.D. Educational Pearls Atrial fibrillation is common. One of the best treatments for a fib is cardioversion back into sinus rhythm. Cardioversion may increase stroke risk if A-...

23 Kesä 20172min

Podcast #219: History of Sepsis

Podcast #219: History of Sepsis

Author: Chris Holmes, M.D. Educational Pearls "Sepo' is a term from Homer (author of The Iliad and The Odyssey), and means "I rot". Hippocrates in 400 BC identified sepsis as a "dangerous decay withi...

21 Kesä 20176min

Podcast #218: Estimating Pediatric Weight

Podcast #218: Estimating Pediatric Weight

Author: Aaron Lessen, M.D. Educational Pearls Asking parents and Broselow Tape are common options for estimating pediatric weight. Equipment sizes should not be adjusted for under/overweight kids bas...

19 Kesä 20172min

Podcast #217: Designer Drugs

Podcast #217: Designer Drugs

Author: John Winkler, M.D. Educational Pearls: Designer, or "synthetic" drugs include bath salts, synthetic THC, and many others. Many of these drugs are originally manufactured in China and are ship...

17 Kesä 20173min

Podcast #216: Roller Coasters and Kidney Stones

Podcast #216: Roller Coasters and Kidney Stones

Author: Aaron Lessen, M.D. Educational Pearls: Anecdotal evidence suggests that roller coasters may help with kidney stones. A recent study used a model of a kidney and ureter with different sized s...

13 Kesä 20171min

Opioid MIniseries Part IV: Harm Reduction

Opioid MIniseries Part IV: Harm Reduction

PRACTICE RECOMMENDATIONS 1. Patients who abuse opioids should be managed without judgement; addiction is a medical condition and not a moral failing. Caregivers should endeavor to meet patients "where...

8 Kesä 201748min

Opioid Miniseries Part III: Alternative to Opioids

Opioid Miniseries Part III: Alternative to Opioids

PRACTICE RECOMMENDATIONS 1. All emergency departments should implement ALTO programs and provide opioid-free pain treatment pathways for the following conditions: a. Acute on chronic opioid-tolerant r...

8 Kesä 201749min

Opioid Miniseries Part II: Limiting Opioids in the Emergency Department

Opioid Miniseries Part II: Limiting Opioids in the Emergency Department

RACTICE RECOMMENDATIONS 1. Opioids are inherently dangerous, highly addictive drugs with significant abuse potential, numerous side effects, lethality in overdose, rapid development of tolerance, and ...

8 Kesä 20171h 8min

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