Core EM

JANUARY 25, 2024

Renal injury: isolated proteinuria or hematuria, moderate acute kidney injury with serum creatinine levels <2 mg/dL Skin: petechiae and purpura Despite severe thrombocytopenia, clinically significant bleeding is rare Figure 1.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

EMDocs

AUGUST 22, 2024

You may be more familiar with the term “limited English proficiency” (LEP), defined as: someone who does not speak English as their primary language and has a limited ability to read, speak, write, or understand English. For instance, displaying posters in multiple languages that explain the language services patients are entitled to.

Emergency Department 82

Emergency Department ALS E-9-1-1 ED 82

Core EM

JULY 23, 2024

Author: Mallika Singh, MD Editor: Jonathan Kobles, MD Background Unintentional or intentional exposure to radiological material represents a potential threat to human health on the individual to mass-casualty scale. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. 10-Hour Flight: 0.03

ALS 130

ALS OR Emergency Department ED 130

The Skeptics' Guide to EM

AUGUST 17, 2019

Date: August 9th, 2019 Reference: Daoust et al. Date: August 9th, 2019 Reference: Daoust et al. Volkow et al. Platts-Mills TF, et al. Pain 2012). ACEP has a clinical policy regarding prescribing of opioids for adult ED patients that was published in 2012 ( Cantrill et al ). Reference: Daoust et al.

Emergency Department 130

Emergency Department ALS ED OR 130

Dr. Smith's ECG Blog

JUNE 5, 2024

Uncontrolled coronary spasm may be associated with serious arrhythmias , including cardiac arrest ( Looi et al — Postgrad Med, 2012 ; Tan et al — Eur Heart J Case Rep, 2018 ; Chevalier et al — JACC, 1998 ; Rodriguez-Manero — EP Europace, 2018 ). It is unclear if the patient was pain free at this time.

Coronary 101

Coronary ACS ALS OR 101

This Podcast Will Kill You

MAY 7, 2024

Health Canada, 2012. Djaoudene, Ouarda, et al. Herasimenka, Aliaksandr, et al. Does it seem like the supplement section of your grocery store gets bigger every time you go in? You’re not imagining things. Label Claims for Conventional Foods and Dietary Supplements.”. link] Bekker, Jessie L., Alex Flores, and Michael S.

ALS 98

ALS OR 98

REBEL EM

APRIL 29, 2024

A study by Lee et al ( 7) compared femoral CVC placement to IO and demonstrated a first-pass success pass rate with IO of 90.3% Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line. compared to only 37.5% in the CVC group.

Epinephrine 104

Epinephrine ALS Critical Care Emergency Department 104

Don't Forget the Bubbles

AUGUST 9, 2023

References Cerbone M, Capalbo D, Wasniewska M, Mattace Raso G, Alfano S, Meli R, et al. We’ll use some cases to think about the different causes of subacute hypothyroidism, but first, let’s explore what it is. Hypothyroidism can be classified by lab values. A TSH between 4.5 It is soft, cystic, and not tender. Source: Salerno, M. Endocrinol.

ALS 98

ALS OR 98

Don't Forget the Bubbles

JANUARY 17, 2024

After Meshram et al, 2020 When Orbeez are exposed to water, the water molecules diffuse into the polymer network through osmosis. Image adapted from Mullens et al., After Darracq et al., A recent literature review by Caré et al. Zamora et al., From Mullens et al., Here, a water bead had been aspirated.

E-9-1-1 111

E-9-1-1 ALS Emergency Department OR 111

Don't Forget the Bubbles

AUGUST 23, 2023

Kapoor et al. 2012) “Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue”. 2012) “Implementation of a Rapid Post-Code Debrief Quality Improvement Project in a Community Emergency Department Setting”. That piercing parental cry rips through the room. Our bodies primed for the fight.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

Core EM

MARCH 12, 2024

Author: Mallika Singh, MD Editor: Jonathan Kobles, MD Background Unintentional or intentional exposure to radiological material represents a potential threat to human health on the individual to mass-casualty scale. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. 10-Hour Flight: 0.03

ALS 130

ALS OR Emergency Department ED 130

EMDocs

NOVEMBER 7, 2023

2012 Apr;99(4):532-9. The DIABLO trial: Daniels L, Ünlü Ç, de Korte N, et al; Dutch Diverticular Disease (3D) Collaborative Study Group. Randomized van Dijk ST, Daniels L, Ünlü Ç, et al; Dutch Diverticular Disease (3D) Collaborative Study Group. The STAND trial: Jaung R, Nisbet S, Gosselink MP, et al. Antibiotics

ACPE 88

ACPE ALS OR ED 88

FOAMfrat

MAY 19, 2024

The patient will thank you for it; we are only human. References 1. Ostergaard E, Moller LB, Kalkanoglu-Sivri HS, et al. 2012 Jan. After learning this, medical control is consulted for additional treatment recommendations. Think about the man who wrote the book, bound it, and sold it. Knowledge is power. Mol Genet Metab.

E-9-1-1 97

E-9-1-1 ALS Emergency Department EMT 97

Don't Forget the Bubbles

MARCH 18, 2024

Typical HUS has a diarrheal prodrome, usually caused by an infection with a Shiga-toxin-producing E. coli (STEC). Children can acquire STEC from contaminated food or water, through person-to-person contact or from contact with animals/ Only 6-14% of cases of STEC go on to develop HUS, so how does infection with STEC lead to HUS?

E-9-1-1 59

E-9-1-1 ALS OR 59

REBEL EM

FEBRUARY 8, 2023

Surv Ophthalmol 2012; 57(5):448-462. PMID: 3652623 Wilhelmus KR et al. PMID: 4739528 Weiner et al. Link McDonald et al. Link Welder et al. Link Wilhelmus KR et al. PMID: 7997324 Chan RV et al. Link White et al. Herpes simplex epithelial and stromal keratitis: an epidemiologic update.

ALS 52

ALS OR EMS ED 52

The Skeptics' Guide to EM

APRIL 8, 2023

John Brown PhD is a Professor of Health Services Research in Ireland who has been studying rural healthcare issues since 2012. Louella Vaugh is an internist practising as a hospitalist physician at an academic centre in London, UK with a special interest in smaller, rural and remote healthcare. Her main job is working for a think tank.

Emergency Department 139

Emergency Department ED Ambulance ALS 139

The Skeptics' Guide to EM

JANUARY 14, 2018

[display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. A study from Bindman et al.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

OCTOBER 3, 2020

Reference: Claiborne Johnston S et al. Reference: Claiborne Johnston S et al. SGEM#24 reviewed a randomized controlled trial (RCT) of aspirin vs. aspirin + clopidogrel in patients with recent symptomatic lacunar infarcts identified by MRI ( Benavente et al NEJM 2012 ).

Emergency Department 100

Emergency Department ALS OR 100

This Podcast Will Kill You

SEPTEMBER 3, 2024

Dolin, Raphael, et al. Al-Hello, H., Dolin, Raphael, et al. Hellysaz, Arash, et al. “Is it gonna be poop or is it gonna be barf?” It’s the question we all fear during a bout of food poisoning when time is of the essence and a decision has to be made before it’s made for us. Gastanaduy, P., Parashar, U.D. and Vinjé, J.,

ALS 52

ALS OR 52

This Podcast Will Kill You

FEBRUARY 13, 2024

and STRAW+ 10 Collaborative Group, 2012. Ellis, Samuel, et al. “That time of the month”, “Aunt Flo”, “the red wave”, “period”, the list goes on. But what about euphemisms for menopause? We’ve got “the change” or “change of life”, “climacteric”, and… that’s it? There may be more out there, but the comparison is revealing. Harlow, S.D.,

ALS 98

ALS OR 98

REBEL EM

JULY 20, 2022

References: Frappe P, et al the STEPH Study Group. Take Home Points SVT >5cm or <3 cm from the SFJ should be treated with anti-coagulation. The rate of concurrent DVT and PE in patients with SVT is 25% and 5%, respectively. This treatment is still recommended by most for SVT’s <5cm in length and >3cm from the SFJ.

ALS 52

ALS OR ED EMS 52

REBEL EM

AUGUST 30, 2023

REBEL Core Cast 107.0 – Vertebral Osteomyelitis Click here for Direct Download of the Podcast Definition Inflammation of the vertebrae due to a pyogenic, fungal or mycobacterial organism. Classified as either acute (days), subacute (weeks) or chronic (months) Spondylodiscitis: a term encompassing osteomyelitis, spondylitis and discitis.

E-9-1-1 102

E-9-1-1 ALS ED OR 102

EMDocs

MAY 11, 2024

A) Basilar artery stroke B) Cavernous sinus syndrome C) Lateral medullary infarction D) Multiple sclerosis Answer: C Vertigo , or the internal sensation of motion when no motion exists, is often classified as either peripheral or central depending on the origin of the pathology. loss of pain and temperature sensation).

EMS 89

EMS E-9-1-1 ALS OR 89

EMDocs

OCTOBER 5, 2024

4 The incidence of ESBL-E identified in bacterial cultures in the United States increased by 53% from 2012 to 2017. They are found primarily in hospital specimens but are increasing in frequency in samples from the community. Increased incidence is largely due to increasing community spread. IV fluid resuscitation as needed.

E-9-1-1 74

E-9-1-1 EMS ALS OR 74

The Skeptics' Guide to EM

DECEMBER 7, 2018

Date: December 6th , 2018 Reference: Perkins et al. Date: December 6th , 2018 Reference: Perkins et al. There have been a number of papers published since OPALS that support the findings of not using ACLS drugs like epinephrine for OHCA ( Olavseengen et al. JAMA 2009, Hagihara et al. JAMA 2012 and Cournoyer et al.

Epinephrine 130

Epinephrine Life Support Advanced Life Support Defibrillator 130

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

The 2015 ACC/AHA/HRS Guidelines on SVT ( Page et al — Circulation 133(14):e506-e574, 2016 ) list the usual upper rate limit for ectopic ATach and AVNRT at ~250/minute — though other sources suggest occasional rates for these rhythms ( and for AVRT in patients with an accessory pathway ) that may attain up to 280/minute ( StatPearls, 2023 ).

E-9-1-1 66

E-9-1-1 ALS OR ED 66

The Skeptics' Guide to EM

FEBRUARY 26, 2019

Hoffman has published a graphic re-analysis of NINDS ( Annals EM 2009 ) and Sayer et al responded in print ( Annals EM 2010 ). Hoffman and Cooper provided commentary on some of the limitations of IST-3 ( EMA 2012 ). Six trials showed no benefit. Four trials were stopped early due to harm or futility and two trials reported benefit.

ALS 130

ALS EMS OR 130

EMS 12-Lead

JUNE 20, 2022

CASE 1 A 45 y/o Male called 911 for new onset central chest discomfort, non-radiating, 5/10 pain scale, and without any vomiting, diaphoresis, or pallor. Moreover, he had no pertinent medical history to report in terms of CAD, HTN, HLD, or DM, for example. A 12 Lead ECG was recorded. It’s important to stress the presence of a normal QRS (i.e.,

ACS 130

ACS Coronary STEMI CAD 130

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Date: September 20th, 2021 Reference: Litell et al. Date: September 20th, 2021 Reference: Litell et al. Background: We have covered sepsis many times on the SGEM since 2012. Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. mg/dl or 107 umol/L).

EMR 100

EMR Emergency Department ICU ALS 100

ACEP Now

JULY 7, 2023

Calming Measures Sometimes ED physicians are reluctant to initiate calming treatment in lower acuity patients, preferring to wait until more aggressive sedation is absolutely necessary. However, rapid initiation of treatment is actually patient-centered care that can both lead to better outcomes and limit ED boarding.

Emergency Department 52

Emergency Department ED Naloxone ALS 52

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

[display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. Emlyn’s blog and podcast since 2012. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ April 17. BMJ April 17.

Emergency Department 130

Emergency Department ALS OR 130

EMDocs

SEPTEMBER 23, 2023

On arrival, vital signs are stable with a HR of 71, BP of 121/71 mmHg, RR of 17 bpm, and SpO2 of 97% on room air. Physical exam reveals a well-appearing female in no acute distress. Cardiac exam is unremarkable with normal S1/S2 without rubs, gallops or murmurs. Neurological exam is also unremarkable. Her presenting EKG is shown below.

E-9-1-1 84

E-9-1-1 EMS ALS Defibrillator 84

EMDocs

JULY 25, 2024

Ronquillo L et al. Oct 04, 2012. Posner et al. Plaintiff Arguments : The patient lacked decisional capacity, being depressed and under the influence of both alcohol and benzos. He lacked insight and could not rationally consider the severity of his condition or the treatment options available to him. Applebaum PS.

ED 82

ED ALS Emergency Department OR 82

ACEP Now

FEBRUARY 13, 2024

In the January issue of Annals of Emergency Medicine , Merz-Herrara, et al., Trends in opioid prescriptions among part D medicare recipients from 2007 to 2012. Problem How should his pain be managed? LEARN MORE The most common nerve blocks in this study are shown in Table 1. J Gen Intern Med. 2016 May;31(5):478-85. Goodwin J.

E-9-1-1 52

E-9-1-1 Emergency Department ED ALS 52

The Skeptics' Guide to EM

JUNE 24, 2017

[display_podcast] Date: June 20th, 2017 Reference: Bernard et al. display_podcast] Date: June 20th, 2017 Reference: Bernard et al. The Cochrane Collaboration updated their review on hypothermia for neuroprotection in adults after CPR in 2012. Reference: Bernard et al. Circulation 2016. Circulation 2016.

CPR 100

CPR Epinephrine ALS Paramedic 100

ACEP Now

MARCH 15, 2024

He complains of pain both in the palm of his hand and in the wrist. Sound familiar? million hand and wrist injuries annually in the United States and when we miss an occult or subtle injury it can be very morbid for our patients and not uncommonly leads to litigation. The mechanism of injury may be a sudden supination or pronation force or a FOOSH.

ALS 52

ALS ED OR EMS 52

ACEP Now

OCTOBER 9, 2023

Clinical Case Your next patient is a Spanish-speaking 24-year-old female who begins by telling you that she is embarazada. Census Bureau, 60.6 million Americans (approximately 20.8 1,2 Medical interpreters (as opposed to translators who work with the written word), are essential to bridging the language gap. emergencies, patient’s request).

Emergency Department 64

Emergency Department E-9-1-1 ALS OR 64