ALiEM

SEPTEMBER 27, 2023

Hoffman et al. Koppaka V, Thompson DC, Chen Y, et al. 2012 Jul;64(3):520-39. Disulfiram-like reaction with ethanol consumption Coprinus atramentarius or Ink Cap mushroom is well known to cause a disulfiram-like reaction when it is consumed prior to ethanol. In: Goldfrank’ s Toxicologic Emergencies. New York, NY. McGraw-Hill.

ALS 169

ALS OR ED 169

The Skeptics' Guide to EM

JUNE 4, 2017

[display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. Huber-Wagner et al ( Lancet 2009 ) showed a mortality reduction in a retrospective database study of patients who have had a pan scan. Reference: Sierink et al. Lancet August 2016.

OR 130

OR ALS CPR ICU 130

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 81

Emergency Department ALS E-9-1-1 ED 81

The Skeptics' Guide to EM

AUGUST 5, 2023

Reference: Easter JS et al. Reference: Easter JS et al. Reference: Easter JS et al. Population: Children less than 18 years of age presenting with head injury to a level 2 pediatric trauma center in the United States between 2012-2013. Annals of Emergency Medicine 2014. Annals of Emergency Medicine 2014.

ALS 100

ALS Emergency Department OR 100

EMDocs

NOVEMBER 13, 2024

Literature concerning risk with PPIs is controversial. Presentation: Classic presentation is abdominal pain or tenderness, fever, and altered mental status. Literature suggests 10-33% of patients are asymptomatic or only have mild symptoms. Clinician sensitivity for SBP based on bedside assessment is between 40-75%. increase in mortality.

E-9-1-1 72

E-9-1-1 ALS OR ED 72

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 107

Coronary ACS ALS OR 107

REBEL EM

NOVEMBER 6, 2024

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)

E-9-1-1 59

E-9-1-1 ACS OR Emergency Department 59

REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. Richards JE et al. NEJM 1994. [2]

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

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

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.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

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

The Skeptics' Guide to EM

DECEMBER 17, 2022

Date: December 16th, 2022 Reference: Hohle et al. Date: December 16th, 2022 Reference: Hohle et al. Background: Major trauma in older patients is increasing in frequency (1), with the median age of major trauma patients in the UK from 2012-2017 being 63.6 years ( 2 ).

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

The Skeptics' Guide to EM

DECEMBER 12, 2020

Date: December 10th, 2020 Reference: Ladde et al. Date: December 10th, 2020 Reference: Ladde et al. Way back in 2012 we looked at packing after incision and drainage (I&D) on SGEM#13 and concluded routine packing might not be necessary. Reference: Ladde et al. This is done by making a couple of small incisions.

ALS 130

ALS ED Emergency Department OR 130

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

Don't Forget the Bubbles

SEPTEMBER 30, 2024

Simpson et al. A 2011-2012 Australian study by Blake et al. There was a disproportionate number of DNWs on Sundays, and if they presented between 4 pm and midnight, A 2002 Canadian study by Goldman et al., Gaucher et al. Gaucher et al. Similarly, a study by Suastegui et al., What is happening locally?

Emergency Department 89

Emergency Department ALS ED OR 89

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

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

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

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

REBEL EM

NOVEMBER 30, 2022

Perform manual detorsion after diagnosis Read More: Video: The New Testicular Torsion Traction Technique Ben-Israel T et al. PMID: 20837255 Sidler D et al. Pediatric Emer Care 2012; 28: 80-6. Epidemiology: Most common cause of acute scrotal pain in prepubertal boys Torsion present in 3.2% OR = 58.8 (Ben-Israel OR = 58.8 (Ben-Israel

ALS 52

ALS ED OR EMS 52

REBEL EM

NOVEMBER 2, 2022

grams/kg on day 3 of treatment Patients with a single episode of SBP should be considered for antibiotic prophylaxis (with norfloxacin, ciprofloxacin or TMP/SMX) ( Runyon 2012 ) Take Home Points SBP is a difficult diagnosis to make because presentations are variable. grams/kg within 6 hours 1.0 grams/kg within 6 hours 1.0

ALS 52

ALS ED EMS 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

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-9-1-1 104

E-9-1-1 ALS ED OR 104

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

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

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

The Skeptics' Guide to EM

MARCH 6, 2021

Reference: Reuben A et al. Reference: Reuben A et al. The episode included the Dundee protocol for adult epistaxis management from 2012. Anand Swaminathan is an Assistant Professor of Emergency Medicine at St. Joseph’s Regional Medical Center in Paterson, NJ. Managing editor of EM:RAP and Associate Editor at REBEL EM.

ALS 130

ALS Emergency Department EMS ED 130

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 88

EMS E-9-1-1 ALS OR 88

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