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(1146)

Podcast # 457: Stroke Scores

Podcast # 457: Stroke Scores

Author: Jared Scott, MD Educational Pearls: Modified Rankin Score: measure of disability often used to qualify outcomes following stroke = no disability, 6=dead, 0-1 indicate good outcome) 0-6 S...

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Podcast # 456 Hypoglycemia: Not feeling so sweet

Podcast # 456 Hypoglycemia: Not feeling so sweet

Author: Jared Scott, MD Educational Pearls: Beta-blockers can mask the effects of hypoglycemia Prolonged/refractory hypoglycemia should raise a suspicion for sulfonylurea (or other oral hypoglycemi...

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Podcast # 455: Hunting for PeeCP

Podcast # 455: Hunting for PeeCP

Author: Michael Hunt, MD Educational Pearls: Like all tests, urine toxicology (utox) screens can have false positives Prescription medications such as demerol, antipsychotics, ketamine, and tramado...

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Podcast # 454: Tylenol Overdose

Podcast # 454: Tylenol Overdose

Educational Pearls: Acetaminophen overdose can also present in patients taking too much over the course of days to weeks - not just intentional ingestions If acute overdose is suspected, refer to t...

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Podcast # 453:  Headache Triggers

Podcast # 453: Headache Triggers

Author: Sam Killian, MD Educational Pearls:   Headache is a common complaint in the ED. It's plausible that headaches could be correlated with environmental factors A 2015 study ED visits for headach...

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Podcast # 452: CADASIL

Podcast # 452: CADASIL

Author: Sam Killian, MD Educational Pearls: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) occurs in 1:100000 individuals The disease is caused b...

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Podcast # 451: NSAIDs

Podcast # 451: NSAIDs

Author: Don Stader, MD Educational Pearls: Non-steroidal anti-inflammatory drugs (NSAIDs) are effective pain relievers but come with important side effects NSAIDs inhibit COX-1 and/or COX-2, which de...

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Podcast # 450: Probiotics in Gastroenteritis

Podcast # 450: Probiotics in Gastroenteritis

Author: Sam Killian, MD Educational Pearls: Viral gastroenteritis alters the gut microbiome and it is theorized that probiotics may help reduce the duration and severity of the disease. Double-blind ...

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