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Search Results for Emergency
Abstract Number: 438
SHM Converge 2024
Background: Hospital bed capacity is limited across the nation due to increased demand and staffing shortages. Capacity shortages result in hospital diversion and therefore impact Emergency Department (ED) length of stay and ED medical boarding. A large tertiary hospital typically serves as the referral hub for many smaller hospitals in the region, and optimizing bed […]
Abstract Number: 439
SHM Converge 2024
Background: In 2006, the Institute of Medicine issued a report on the state of emergency care, which identified overcrowding and patient boarding as major concerns. Subsequent research has confirmed that boarding in the emergency department (ED) leads to adverse events including medication errors, higher mortality, and lower patient satisfaction. In answer to this, hospitalist groups […]
Abstract Number: 444
Hospital Medicine 2019, March 24-27, National Harbor, Md.
Background: The burden of acute care among cancer patients, estimated to exceed $70B by 2020, represents ~50% of all costs of advanced cancer care and accounts for 70% of nationwide regional variation in these costs. The Centers for Medicare and Medicaid Services proposed value-driven Rule OP-35 includes a mandate to reduce acute care use among […]
Abstract Number: 470
Hospital Medicine 2020, Virtual Competition
Background: While rapid response teams are well established for inpatient emergencies, outpatient emergency response on large medical campuses is much more variable. At our institution, this need for outpatient emergency response is particularly acute. As a tertiary referral center, cancer treatment center, and the largest transplant center in the state, our clinics provide 1.4 million […]
Abstract Number: 473
Hospital Medicine 2020, Virtual Competition
Background: In many urban hospitals, Emergency Department (ED) crowding and patient boarding is an increasing challenge. Admitted patients often spend prolonged periods of time in the ED while waiting for an inpatient bed. These ED boarded patients can have delayed or inadequate care, increased adverse events and increased mortality. Furthermore, these ED boarded patients place […]
Abstract Number: 504
Hospital Medicine 2020, Virtual Competition
Case Presentation: A 22-year-old male with a history of atopic dermatitis presented with worsening of eczema lesions around his eyes and mouth with blurring of vision bilaterally despite being on oral antibiotics. 2 weeks ago he was treated with a steroid taper for eczema flare in his forearms. Patient reported that he has always had eczema patches around his […]
Abstract Number: 506
SHM Converge 2024
Case Presentation: A 64-year-old female with past medical history of seizures, breast cancer s/p bilateral mastectomy, hypothyroidism, anxiety and agoraphobia on Xanax, tobacco abuse presents to ED after husband found her unresponsive, with agonal breathing, slurred speech, and oral secretions. Last admission in 2019 was significant for Xanax and Benadryl overdose. On admission, vitals were […]
Abstract Number: 555
SHM Converge 2024
Case Presentation: A 55-year-old female with a past medical history of seizure disorder and prior opioid use presented to an outside emergency department with a 1-day history of expressive aphasia and headache. Her NIH Stroke Scale was 4. CT head w/o contrast demonstrated a subacute infarct within the left middle cerebral artery (MCA) territory and […]
Abstract Number: 608
Hospital Medicine 2020, Virtual Competition
Case Presentation: A 63-year-old man with lung adenocarcinoma with multiple rib metastases and lytic spinal lesions was receiving palliative radiation treatment when computed tomography (CT) incidentally revealed a fluid collection along the anterior cecum with pneumatosis. Cultures taken during CT-guided abscess drainage were positive for piperacillin-tazobactam-sensitive enterococcus, and the patient was started on antibiotics. His […]
Abstract Number: 669
SHM Converge 2024
Case Presentation: 48-year-old man with past medical history of AIDS, unknown recent CD4 count presented to the ED complaining of slurred speech and disorientation for 3 days associated with fever and generalized body ache. Patient was admitted for stroke workup (CTH, CTA head/neck, and MRI brain) which resulted negative and there were also concerns for […]