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 #208: Vocal Cord Dysfunction

Podcast #208: Vocal Cord Dysfunction

Author: Martin O'Bryan M.D. Educational Pearls: Vocal cord dysfunction can mimic other causes of stridor, such as asthma and upper airway obstruction. Patients are often very anxious because of the d...

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Podcast #207: Boxer's Fracture

Podcast #207: Boxer's Fracture

Author: Sam Killian, M.D. Educational Pearls: Defined as fracture of neck (distal segment) of 5th metacarpal. Intrinsic muscles of hand pull segment to palmar aspect of hand. 30 degrees of angulation...

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Podcast #206: Urethral Injuries

Podcast #206: Urethral Injuries

Author: Jared Scott, M.D. Educational Pearls: DDx for blood at urethral meatus includes: pelvic fracture, ruptured bladder, kidney laceration, penile trauma. Retrograde Urethrogram (RUG) must be perf...

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Podcast #205: Post Cardiac Arrest Temperature Control

Podcast #205: Post Cardiac Arrest Temperature Control

Author: Michael Hunt, M.D. Educational Pearls: Research has shown that the higher temperatures post-cardiac arrests may lead to poorer outcomes. Initially, 33 deg C was the target temp. However, more...

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Deep Dive #3: The New Standard in Stroke Treatment

Deep Dive #3: The New Standard in Stroke Treatment

Authors: Rebecca van Vliet MS, APN; Michelle Whaley MSN, CNS, CCNS, ANVP-VC The Stroke Team at Swedish Medical Center gives us a taste of how they are breaking records with door-to-needle time in man...

16 Touko 201738min

Podcast #204: Thoracotomy

Podcast #204: Thoracotomy

Author: Aaron Lessen M.D. Educational Pearls: Thoracotomy is a potentially life-saving procedure. However, outcomes are often poor and the procedure itself poses many risks to provider and patient....

14 Touko 20172min

Podcast #203: Wine, Milk and… Vaccines!?

Podcast #203: Wine, Milk and… Vaccines!?

Author: Dave Rosenberg M.D. Educational Pearls: Louis Pasteur developed the technique that is now known as pasteurization. It was first used in the wine-producing regions of France, and eventually in...

12 Touko 20174min

Podcast #202: Tide Pods

Podcast #202: Tide Pods

Author: Susan Brion M.D. Educational Pearls: Laundry and dishwasher detergent pods resemble candy and can be ingested by children. These tide pods are very highly concentrated and can cause chemical ...

10 Touko 20173min

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