ALiEM

OCTOBER 16, 2023

2012 Oct;12(10):808-15. Epub 2012 May 25. He has no history of immunocompromise and denies any drug or alcohol use. Of note, he has not seen a dentist in many years. No gingival inflammation or swelling or induration to suggest abscess. The floor of the mouth is unremarkable. References Kuppalli K, Livorsi D, Talati NJ, Osborn M.

Emergency Department 152

Emergency Department OR 152

ALiEM

JANUARY 29, 2024

2012 Dec;33(7):E263-E267. Epub 2012 Sep 21. At the time of presentation, he only sees a speck of light from that eye. He denied associated pain, flashes, floaters, jaw claudication, the sensation of a “curtain falling”, prior vision problems, or a history of blood clots. Visual acuity: 20/30 OD, Light Perception OS. Ultraschall Med.

ALS 161

ALS ED OR 161

ALiEM

SEPTEMBER 13, 2024

2012 Feb;26(2):212-7. On arrival to our emergency department, the patient expressed continued eye pain with bloody discharge as well as blurry vision from his right eye. He had no other complaints and denied any other trauma or loss of consciousness during the event. Extraocular movements intact. Ocular pressure deferred. Absent right lens.

Emergency Department 161

Emergency Department OR ED 161

ALiEM

MAY 19, 2023

2012 Feb;33(1):46-54. Another minor difference is that the gastric balloon in the Minnesota tube holds 450-500 ccs of air, while the SB gastric balloon holds 250 ccs of air [2]. If bleeding persists, you can go to a maximum of 45 mmHg. What is this “manometer” typically used for the esophageal balloon? Deranged Physiology. EM:RAP HD Videos.

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245

ALiEM

SEPTEMBER 27, 2023

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. This results in significant nausea and vomiting and can lead to tachycardia and hypotension. Koppaka V, Thompson DC, Chen Y, et al.

ALS 169

ALS OR ED 169

The Skeptics' Guide to EM

JANUARY 14, 2018

Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. One issue that has been to use CT or ultrasound for the diagnosis.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

AUGUST 17, 2019

Pain 2012). ACEP has a clinical policy regarding prescribing of opioids for adult ED patients that was published in 2012 ( Cantrill et al ). ACEP has a clinical policy regarding prescribing of opioids for adult ED patients that was published in 2012 ( Cantrill et al ). Platts-Mills TF, et al.

Emergency Department 130

Emergency Department ALS ED OR 130

ALiEM

MARCH 1, 2024

link] Published November 19, 2012. Resp : Clear to auscultation bilaterally. Abd : Soft, non-tender, non-distended. Neuro : Alert. Motor and sensation grossly intact. MSK : Moves all extremities, no joint pain or tenderness. Skin : No obvious rashes or skin lesions. This is traumatic iridodialysis. The Atlas of Emergency Medicine, 5e.

ED 152

ED OR 152

ALiEM

JANUARY 8, 2024

2012 Jul;51(7):1278-84. Epub 2012 Feb 29. References Huang K, Levy RD, Avina-Zubieta JA. The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM. Rheumatology (Oxford). doi: 10.1093/rheumatology/ker518. PMID: 22378718.

ED 152

ED OR 152

EMDocs

JANUARY 11, 2025

Up to 1/3 of adults over 60 suffer from chronic constipation. Evaluation: A good history and a high index of clinical suspicion is paramount, especially in high-risk patient populations 4 CT of the abdomen and pelvis with contrast is the best choice for diagnosis. Enemas (some studies show this may be associated with perforation risk).

E-9-1-1 97

E-9-1-1 EMS Emergency Department OR 97

Core EM

OCTOBER 16, 2024

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 188

Allergic Reaction Plasma ED Epinephrine 188

REBEL EM

SEPTEMBER 13, 2023

Both conditions can range in severity from benign to life threatening (Wilkerson 2012). of people who take NSAIDs ( Nzeako 2010 ). patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 of people who take NSAIDs ( Nzeako 2010 ).

Frozen Plasma 104

Frozen Plasma Allergic Reaction FFP Plasma 104

ALiEM

OCTOBER 20, 2023

2012 Jul;16(4):614-20. Necrobiosis lipoidica is a rare, chronic, idiopathic, granulomatous disease of collagen degeneration classically associated with type 1 diabetes (with a prevalence of 0.3 Available from: [link] PMID:29083569. Kota SK, Jammula S, Kota SK, Meher LK, Modi KD. Indian J Endocrinol Metab. doi: 10.4103/2230-8210.98023.

Plasma 161

Plasma Coronary Emergency Department OR 161

The Skeptics' Guide to EM

DECEMBER 12, 2020

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. When you ask your nursing colleague to set up the equipment, he wants to know if you will be using standard packing or a vessel loop drainage technique.

ALS 130

ALS ED Emergency Department OR 130

NVFC

JANUARY 16, 2024

Since the program began in 2012, a total of 715 sets of gear and 260 helmets have been donated to 160 departments. In 2023, 13 volunteer fire departments across the U.S. and Canada each received four new turnout jackets, four new turnout pants, and four helmets.

Firefighter 115

Firefighter First Responder OR EMS 115

The Good, The Bad & The Ugly Paramedic

JULY 1, 2020

As paramedics, whilst we often take great offence at being called ambulance drivers, the question is, when it’s our turn to drive, what exactly is it that we are providing? Do we fully engage in shared patient care with our attending partner, or do we switch off so that we can simply drive the ambulance and take it easy?

Ambulance Driver 52

Ambulance Driver Paramedic Ambulance OR 52

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

Emlyn’s blog and podcast since 2012. She’s been there for the last 18 months working in prehospital and retrieval medicine and then in Emergency Medicine. She is a medical education enthusiast and has been an editor and regular contributor to the St. Case: You are working the afternoon shift in the paediatric emergency department.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

FEBRUARY 26, 2019

Hoffman and Cooper provided commentary on some of the limitations of IST-3 ( EMA 2012 ). The SGEM has summarized the dozen major RCTs looking at the issue of thrombolytics for acute ischemic strokes ( SGEM Xtra ). 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

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 122

Coronary ACS ALS OR 122

REBEL EM

JANUARY 24, 2024

You will notice the squeeze will cause no motion if there is a full rupture/tear, and diminished motion if there is a partial tear Performance Characteristics ( Garras 2012 ) Sensitivity Specificity (+) LR (-) LR 96-100% 93-100% 13.7 Take Home Points Achilles tendon rupture is a clinical diagnosis. Weakness with plantar flexion.

ALS 98

ALS ED OR EMS 98

The Skeptics' Guide to EM

DECEMBER 7, 2018

JAMA 2012 and Cournoyer 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. We reviewed the Cournoyer et al cohort study as part of the #SGEMHOP series with Academic Emergency Medicine ( AEM ).

Epinephrine 130

Epinephrine Life Support Advanced Life Support Defibrillator 130

The Skeptics' Guide to EM

MARCH 6, 2021

The episode included the Dundee protocol for adult epistaxis management from 2012. I searched and could not find an updated version. ED patients with epistaxis often fail conservative management and end up with anterior nasal packs which are uncomfortable.

ALS 130

ALS Emergency Department EMS ED 130

Don't Forget the Bubbles

AUGUST 9, 2023

2012 Aug;97(8):2732-40. Epub 2012 Jun 20. 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. Subclinical hypothyroidism can be defined as either mild or severe, depending on the degree of TSH elevation. 99:2697–703.

ALS 98

ALS OR 98

Don't Forget the Bubbles

AUGUST 2, 2023

What is Complex Regional Pain Syndrome? Complex regional pain syndrome (CRPS) is a chronic neuropathic pain condition characterized by spontaneous and evoked regional pain disproportionate in magnitude or duration to the typical course of pain after similar tissue trauma. Making the diagnosis relies on observable signs and reported symptoms.

MPD 98

MPD ALS Plasma OR 98

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 104

Emergency Department ALS E-9-1-1 ED 104

The Skeptics' Guide to EM

JUNE 24, 2017

The Cochrane Collaboration updated their review on hypothermia for neuroprotection in adults after CPR in 2012. Two relatively small randomized control trials published in the NEJM showed that hypothermia post cardiac arrest resuscitation was neuroprotective ( Bernard et al and The Hypothermia after Cardiac Arrest Study Group ).

CPR 100

CPR Epinephrine ALS Paramedic 100

EMDocs

JULY 13, 2024

Evaluate for retained products of conception as etiology Diagnosis Diagnosis of endometritis with at least two of the following: 8 Fever >100.4F Evaluate for retained products of conception as etiology Diagnosis Diagnosis of endometritis with at least two of the following: 8 Fever >100.4F

EMS 88

EMS E-9-1-1 Plasma OR 88

ACEP Now

NOVEMBER 7, 2024

To begin, a 2012 prospective pediatric study found a failure rate of 16.9 Children with and without VP shunts get sick. When a child with a VP shunt develops a fever or feels unwell, the voice in the back of our heads asks, “Is it the shunt?” Sometimes it is; most often it’s not. percent) required shunt revision.

ALS 59

ALS OR 59

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

MARCH 10, 2018

The American College of Chest Physicians published some evidence-based recommendations in 2012 on anticoagulation therapy [1]. For the adult management of epistaxis there is something called the Dundee Protocol. We will put a link in the show notes to the protocol. shock, a bleeding visible vessel, renal disease, or lack of consent.

Emergency Department 100

Emergency Department ALS Coronary OR 100

REBEL EM

APRIL 29, 2024

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. If you are not familiar with this term, it’s the act of rapidly trying to place a central line (usually femoral), placing the needle for access over strict sterile precautions.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

EMDocs

DECEMBER 11, 2023

2012 Dec;60(6):766-76. Traditionally, emergency providers looked for signs of ST-segment elevation myocardial infarction (STEMI) to indicate the need for intervention. This included the addition several new STEMI equivalents [4] on ECG that warrant “prompt evaluation for emergency coronary angiography.” Ann Emerg Med. N Engl J Med.

STEMI 120

STEMI Coronary Emergency Department OR 120

Core EM

OCTOBER 2, 2024

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 100

Allergic Reaction Plasma ED Epinephrine 100

The Overrun Podcast

JULY 21, 2019

2008 JAMA article on fluid resuscitation: Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults R Bellomo, C Hegarty, D Story , L Ho, M Bailey – Jama , 2012 – jamanetwork.com… “Normal” 0.9 per cent salt solution is neither “normal” nor physiological.

ED 52

ED OR 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 96

E-9-1-1 ALS ED OR 96

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, of the patients received vasopressors through a peripheral IV.

Overdose 92

Overdose ACS Critical Care OR 92

Dr. Smith's ECG Blog

MAY 21, 2023

Excessive Flecainide may result in the following ( Levis — Permanente Journal 16(4): 53, 2012 ) ( Strangio et al — Eur Heart J, 2022 ) ( Andrikopoulos et al — World J Cardiol, 2015 ) ( Dardas and Khan — Eur Soc Cardiol, 2021 ) : Depressed contractility; hypotension ( negative inotropic effect ). This one is 320 ms !!

ALS 94

ALS OR ED 94