2 View: Emergency Medicine PAs & NPs

Welcome to Episode 32 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!

Show Notes for Episode 32 of “The 2 View” – EMTALA, provider-in-triage positions, head injuries, appendicitis

EMTALA / Head Injuries / Provider In Triage

Latner A. Man Escorted Out of Hospital Without Being Seen: Is This an EMTALA Violation? Clinicaladvisor.com. Published April 11, 2023. Accessed January 21, 2024. https://www.clinicaladvisor.com/home/my-practice/legal-advisor/man-escorted-out-of-hospital-emtala-violation/

Centers for Medicare and Medicaid Services. Emergency Medical Treatment & Labor Act (EMTALA). Cms.gov. Accessed January 21, 2024. https://www.cms.gov/medicare/regulations-guidance/legislation/emergency-medical-treatment-labor-act

MDCalc. Canadian CT Head Injury/Trauma Rule. Mdcalc.com. Accessed January 21, 2024. https://www.mdcalc.com/calc/608/canadian-ct-head-injury-trauma-rule

Appendicitis

Latner A. PA and NP Fail to Diagnose Appendicitis. Clinicaladvisor.com. Published December 6, 2023. Accessed January 21, 2024.
https://www.clinicaladvisor.com/home/my-practice/legal-advisor/pa-np-fail-appendicitis/

Roberts M, Sharma M. 29 - Toxoplasmosis, the OPAL trial, medical marijuana, appendicitis, and colchicine. The 2 View: EM PA & NP Podcast. Published November 20, 2023. Published October 13, 2023. Accessed January 21, 2024. https://2view.fireside.fm/29

Recurring Sources

Center for Medical Education. Ccme.org. http://ccme.org

The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org

The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx

The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com

Trivia Questions: Send answers to [email protected]

Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at [email protected] and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!

Welcome to Episode 25 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!

Show Notes for Episode 25 of “The 2 View”

Pediatric Nurse Practitioners Are Not Okay

Della Volpe K. We Are Not Ok, Say Pediatric NPs. Clinical Advisor. Published March 17, 2023. Accessed March 27, 2023. https://www.clinicaladvisor.com/home/meeting-coverage/napnap-2023/pediatric-nps-not-ok/?utm_source=newsletter&utm_medium=email&utm_campaign=NWLTR_CAD_CONF_NAPNAP_MODERNA_032023_RM&hmEmail=1f%2FJfEV7hN5vJr6vg%2FQRqK0NA6IXtyO3&sha256email=092493d8223fdfa40d9e995176d13e5fc5b5211674db9deb440c025fd462c80c&hmSubId=&NID=1639413404&elqTrackId=31abe541d69a4ca587368d18c07e2aeb&elq=24134fa5abd64addafddd14ad54e8f8d&elqaid=13088&elqat=1&elqCampaignId=10964&fbclid=IwAR2YZErTgA9ET7Yzib3bPYuhD68VDtGA_ayIfQ2bu398LBTX6xEmLjZX3EY

Sarjoo A. Pediatricians: We Can’t Bear the Burden of Teen Angst. Medscape. Published March 13, 2023. Accessed March 27, 2023. https://www.medscape.com/viewarticle/989552

New TASER

Bleetman A, Hepper AE, Sheridan RD. The use of TASER devices in UK policing: an update for clinicians following the recent introduction of the TASER 7. BMJ Journals. Emerg Med J. Published 2023. Accessed March 27, 2023. https://emj.bmj.com/content/40/2/147.long

Taser Injuries. Emergency Central. Unboundmedicine.com. Accessed March 27, 2023. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307682/all/Taser_Injuries

Vilke G, Chan T, Bozeman WP, Childers R. Emergency Department Evaluation After Conducted Energy Weapon Use: Review of the Literature for the Clinician. NIH National Library of Medicine: National Center for Biotechnology Information. PubMed. J Emerg Med. Published September 26, 2019. Accessed March 27, 2023. https://pubmed.ncbi.nlm.nih.gov/31500994/

Hyperacute T-Waves

Dr. Smith’s ECG blog. Blogspot.com. Published March 2023. Accessed March 27, 2023. http://hqmeded-ecg.blogspot.com/search/label/hyperacute%20T-waves

Koechlin L, Strebel I, Zimmermann T, et al. Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction. Ann Emerg Med. PubMed. NIH: National Library of Medicine. National Center for Biotechnology Information. Published online February 9, 2023. Accessed March 27, 2023. https://pubmed.ncbi.nlm.nih.gov/36774205/

Writing Committee, Kontos MC, de Lemos JA, et al. 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. Published November 2022. Accessed March 27, 2023. https://www.jacc.org/doi/10.1016/j.jacc.2022.08.750

DEA Updates – Segment with Dr. Rick Bukata

Criteria for Furnishing Number Utilization by Nurse Practitioners. State of California, DCA (Department of Consumer Affairs). Board of Registered Nursing. Rn.ca.gov. Accessed March 27, 2023. https://www.rn.ca.gov/pdfs/regulations/npr-i-16.pdf

DEA Announces Proposed Rules for Permanent Telemedicine Flexibilities. Drug Enforcement Administration (DEA). Published February 24, 2023. Accessed March 27, 2023. https://www.dea.gov/press-releases/2023/02/24/dea-announces-proposed-rules-permanent-telemedicine-flexibilities

Mid-Level Practitioners Authorization by State. US Department of Justice. Drug Enforcement Administration. Diversion Control Division. Usdoj.gov. Accessed March 27, 20...

Welcome to Episode 14 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!

Show Notes for Episode 14 of “The 2 View” – Urticaria, Foreign Bodies, and a Special Interview

Urticaria

Bernstein JA, Lang DM, Khan DA, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol. Published 2014. Accessed February 11, 2022. https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/Urticaria-2014.pdf

Radecki RP, MS. Does New IV Urticaria Medication Offer Benefits Over Current Treatments? ACEP Now. Published June 15, 2021. Accessed February 11, 2022. https://www.acepnow.com/article/does-new-iv-urticaria-medication-offer-benefits-over-current-treatments/

Safety of use of high dose antihistamines in difficult-to-control chronic urticaria patients. J Am Acad Dermatol. Published May 1, 2015. Accessed February 11, 2022. https://www.jaad.org/article/S0190-9622(15)00371-0/fulltext

Sarti L, Barni S, Giovannini M, Liccioli G, Novembre E, Mori F. Efficacy and tolerability of the updosing of second-generation non-sedating H1 antihistamines in children with chronic spontaneous urticaria. Pediatr Allergy Immunol. Wiley Online Library. Published August 3, 2020. Accessed February 11, 2022. https://onlinelibrary.wiley.com/doi/10.1111/pai.13325

Schaefer P. Acute and Chronic Urticaria: Evaluation and Treatment. Am Fam Physician. Published June 2017. Accessed February 11, 2022. https://www.aafp.org/afp/2017/0601/p717.html

Winters M. Clinical Practice Guideline: Initial Evaluation and Management of Patients Presenting with Acute Urticaria or Angioedema. AAEM - American Academy of Emergency Medicine. Published July 10, 2006. Accessed February 11, 2022. https://www.aaem.org/resources/statements/position/clinical-practice-guideline-initial-evaluation-and-management-of-patients-presenting-with-acute-urticaria-or-angioedema

Foreign Bodies & Toxic Shock Syndrome

Cone LA, Woodard DR, Byrd RG, Schulz K, Kopp SM, Schlievert PM. A recalcitrant, erythematous, desquamating disorder associated with toxin-producing staphylococci in patients with AIDS. J Infect Dis. NIH. PubMed.gov. Published April 1992. Accessed February 11, 2022. https://pubmed.ncbi.nlm.nih.gov/1552193/

Contou D, Colin G, Travert B, et al. Menstrual Toxic Shock Syndrome: A French Nationwide Multicenter Retrospective Study. Clin Infect Dis. Oxford Academic. Published January 15, 2022. Accessed February 11, 2022. https://academic.oup.com/cid/article-abstract/74/2/246/6255963

Parsonnet J, Hansmann MA, Delaney ML, et al. Prevalence of Toxic Shock Syndrome Toxin 1-Producing Staphylococcus aureus and the Presence of Antibodies to This Superantigen in Menstruating Women. J Clin Microbiol. NCBI. Published September 2005. Accessed February 11, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1234102/

Shands KN, Schmid GP, Dan BB, et al. Toxic-Shock Syndrome in Menstruating Women: Association with Tampon Use and Staphylococcus aureus and Clinical Features in 52 cases. N Engl J Med. Published December 18, 1980. Accessed February 11, 2022. https://www.nejm.org/doi/full/10.1056/nejm198012183032502?casa_token=GVNPVVA8uB4AAAAA:LQTf1B8PlxwffYbLmuOeWnteCLdkKtwEydZDKn2lYW-NoNe8953D58cgSMnWVnwbN136BWtd23zr

Streptococcal Toxic Shock Syndrome: All You Need to Know. Cdc.gov. Published November 23, 2021. Accessed February 11, 2022. https://www.cdc.gov/groupastrep/diseases-public/streptococcal-toxic-shock-syndrome.html

Toxic Shock Syndrome (Other Than Streptococcal) (TSS) 2011 case definition. Cdc.gov. Reviewed April 16, 2...

Welcome to Episode 5 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!

Full show notes for Episode 5 of “The 2 View” can also be found here:
https://docs.google.com/document/d/1zcY2AKac2_5xxSwwubIgkypWkRI-uRit9zuIvqDpPLY/edit?usp=sharing

Needle Sticks

Needlestick Helpline: If you have questions about appropriate medical treatment for occupational exposures, assistance is available from the Clinicians’ Post Exposure Prophylaxis (PEP) Line at 1-888-448-4911.

National Clinician Consultation Center. Ucsf.edu. Accessed April 22, 2021. https://nccc.ucsf.edu/

Moayedi, Siamak MD, Torres, Mercedes MD. HIV Post-Exposure Prophylaxis. EM:RAP CorePendium. Emrap.org. Updated October 5, 2020. Accessed April 22, 2021. https://www.emrap.org/corependium/chapter/rech6mbrZTyKtAIqw/HIV-Post-Exposure-Prophylaxis

Roberts, Martha ACNP, CEN. Viewpoint: A Needle Stick and a Life Lesson. Emergency Medicine News. Lww.com. Updated December 2015. Accessed April 22, 2021. https://journals.lww.com/em-news/Fulltext/2015/12000/Viewpoint__A_Needle_Stick_and_a_Life_Lesson.19.aspx

Announcement: Updated Guidelines for Antiretroviral Postexposure Prophylaxis after Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV — United States, 2016. Morbidity and Mortality Weekly Report (MMWR). Cdc.gov. Updated May 6, 2016. Accessed April 22, 2021. https://www.cdc.gov/mmwr/volumes/65/wr/mm6517a5.htm

U.S. Public Health Service. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis. MMWR Recomm Rep. 2001;50(RR-11):1-52. Cdc.gov. Updated June 29, 2001. Accessed April 22, 2021. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm

Dominguez KL, Smith DK, Thomas V, et al. Updated guidelines for antiretroviral postexposure prophylaxis after sexual, injection drug use, or other nonoccupational exposure to HIV—United States, 2016. Cdc.gov. Updated May 23, 2018. Accessed April 22, 2021. https://stacks.cdc.gov/view/cdc/38856
Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2018;67(1):1-31. Cdc.gov. Updated January 12, 2018. Accessed April 22, 2021. https://www.cdc.gov/mmwr/volumes/67/rr/rr6701a1.htm

CDC - Bloodborne Infectious Diseases: HIV/AIDS, Hepatitis B, Hepatitis C - Emergency Needlestick Information - NIOSH Workplace Safety and Health Topic. Cdc.gov. Published November 21, 2018. Accessed April 22, 2021. https://www.cdc.gov/niosh/topics/bbp/emergnedl.html

Hepatitis C Questions and Answers for Health Professionals. Cdc.gov. Published April 9, 2021. Accessed April 22, 2021. https://www.cdc.gov/hepatitis/hcv/hcvfaq.htm

Hepatitis B Foundation: Understanding Your Hepatitis B Test Results. Hepb.org. Accessed April 22, 2021. https://www.hepb.org/prevention-and-diagnosis/diagnosis/understanding-your-test-results/

Procedures: The Top Ten in EM Right Now

Roberts M, Roberts JR. The Proceduralist. Accessed April 22, 2021. https://www.theproceduralist.org/

The Proceduralist. Youtube.com. Accessed April 22, 2021. https://www.youtube.com/channel/UCQtZPVvIl2tCJdNrslXcCww

Back Pain Featuring W. Richard Bukata, M.D.
Motov, Sergey. Faculty Forum: A Practical Approach to Pain Management. YouTube. https://www.youtube.com/watch?v=lJSioPsGw3A. The Center for Medical Education. Published December 2, 2020. Accessed April 22, 2021.
@painfreeED
LaFollette R. Back to Basics: Treatment of Acute Low Back Pain in the ED — Tamin...

Welcome to Episode 4 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants!

Full show Notes for Episode 4 of “The 2 View” can be found here: https://docs.google.com/document/d/1Awc9VPm2igzhKwNoDO07eq269bZTgrPtfSCJVVCvu6U/edit?usp=sharing

Sickle Cell

Brandow AM, Carroll CP, Creary S, et al. American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain. Blood Adv. 2020;4(12):2656-2701. Accessed April 5, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322963/

Della-Moretta S, Delatore L, Purcell M, et al. The Effect of Use of Individualized Pain Plans in Sickle Cell Patients Presenting to the Emergency Department. Ann Emerg Med.
Published September 2020. Accessed March 17, 2021. https://www.sciencedirect.com/science/article/pii/S019606442030648X

Table from Cisewski D. ED Management of Sickle Cell Vaso-occlusive Crises: Myths, Facts, and A Novel Approach to Acute Pain Management. emDocs. Updated April 15, 2019. Accessed April 5, 2021. https://www.emdocs.net/ed-management-of-sickle-cell-vaso-occlusive-crises-myths-facts-and-a-novel-approach-to-acute-pain-management/
A Practical Approach to Pain Management in the Acute Care Setting with Dr. Sergey Motov, MD / EM Boot Camp Faculty Forum #2. Updated December 2, 2020. Accessed April 5, 2021. https://youtu.be/lJSioPsGw3A

Sickle Cell Disease. CorePendium. EM:RAP.org, 2020. Updated December 7, 2020. Accessed April 5, 2021. https://www.emrap.org/corependium/chapter/recZWicqx0K20uwsz/Sickle-Cell-Disease

Procedure IM Shots

Roberts M, Roberts JR. Intramuscular Injections: 101 — The Proceduralist. The Proceduralist. Accessed March 17, 2021. https://www.theproceduralist.org/thecases/intramusclar-injections-101

You Call the Shots – Vaccine Administration: Intramuscular (IM) Injection Adults 19 years of age and older. Cdc.gov. Published November 16, 2020. Accessed March 17, 2021. https://www.cdc.gov/vaccines/hcp/admin/downloads/IM-Injection-adult.pdf

Documentation

Henry, Greg, MD. What You Must Know to Avoid Being Sued. Original Emergency Medicine Boot Camp. December 2019. Las Vegas. Accessed March 17, 2021.

Risk Management Monthly. The Center for Medical Education. Accessed March 17, 2021. https://www.ccme.org/riskmgmt/

Weinstock MB; Longstreth R; Henry GL. Bouncebacks! Emergency Department Cases: ED Returns. 2nd ed. Anadem; 2018.

First Time Seizures

Epilepsy. American Association of Neurological Surgeons. Accessed March 17, 2021. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Epilepsy

Types of Seizures. Johns Hopkins Medicine. Accessed March 17, 2021. https://www.hopkinsmedicine.org/health/conditions-and-diseases/epilepsy/types-of-seizures

Billet, M MD, Khouja, D MBBS. Seizures in Adults. EM:RAP CorePendium. Emrap.org. Updated September 15, 2020. Accessed March 17, 2021. https://www.emrap.org/corependium/chapter/recLTpXKGatE7jq2r/Seizures-in-Adults

Pohlmann-Eden B, Beghi E, Camfield C, Camfield P. The first seizure and its management in adults and children. BMJ. Published February 11, 2006. Accessed March 17, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1363913/

Adamolekun, B MD. Seizure Disorders. Merck Manuals. Content last modified July 2020. Accessed March 17, 2021. https://www.merckmanuals.com/professional/neurologic-disorders/seizure-disorders/seizure-disorders

Neurology. Ame...