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 #375: Retrograde Urethrogram

Podcast #375: Retrograde Urethrogram

Author: Jared Scott, MD Educational Pearls: Blood at urethral meatus in trauma can be a sign of bladder/urethral injury Blind placement of a Foley catheter can make an undiagnosed urethral injur...

6 Syys 20185min

Podcast #374:  Iliac Artery Endofibrosis

Podcast #374: Iliac Artery Endofibrosis

Author:  Sue Chilton, MD Educational Pearls:   An unusual cause of leg pain that can mimic sciatica/claudication Predominantly occurring in high endurance athletes, particularly cyclists and runner...

4 Syys 20183min

Podcast # 373: Legionnaires Disease

Podcast # 373: Legionnaires Disease

Author: Gretchen Hinson, MD Educational Pearls: Legionnaires disease refers to a severe pneumonia caused by Legionella pneumophilia and occurs typically at the extremes of age Associated gastroi...

1 Syys 20183min

Podcast # 372:  The Latest on Epinephrine in Cardiac Arrest

Podcast # 372: The Latest on Epinephrine in Cardiac Arrest

Author: Don Stader, MD Educational Pearls: 8014 patients with out-of-hospital cardiac arrest randomized to epinephrine vs placebo 30-day survival was not dramatically better between groups (3.2%...

30 Elo 20183min

Podcast # 371: EKG changes of Hyperkalemia

Podcast # 371: EKG changes of Hyperkalemia

Author: Jared Scott, MD Educational Pearls: EKG changes do not necessarily correlate to degree of hyperkalemia Traditional progression through peaked T-waves, flattened p-waves, QRS widening, an...

28 Elo 20183min

Podcast # 370:  Rapid Fire Neonatal Resuscitation

Podcast # 370: Rapid Fire Neonatal Resuscitation

Author:  Erik Verzemnieks, MD Educational Pearls:   In the panic of a precipitous ED delivery, remember: Warm. Dry. Stim.  It will solve most of your problems in most scenarios Start compressions i...

24 Elo 20181min

Podcast # 369:  Five powerful toxins - the definitive list?

Podcast # 369: Five powerful toxins - the definitive list?

Author: Michael Hunt, MD Educational Pearls: Here is a list of some very toxic natural substances:     #5: Tetrodotoxin: Found in pufferfish and other aquatic species #4: Ricin: made from castor beans...

22 Elo 20183min

Podcast # 368: Prehospital Plasma

Podcast # 368: Prehospital Plasma

Author: Aaron Lessen, MD Educational Pearls: Non-blinded randomized study assessing 30-day mortality benefit from plasma-first resuscitation in patients at risk hemorrhagic shock Study involved a...

20 Elo 20182min

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