EMDocs

DECEMBER 18, 2024

fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

E-9-1-1 105

E-9-1-1 Emergency Department ICU ED 105

EMDocs

OCTOBER 9, 2023

Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. He states that he recently moved to Texas from Colorado. Which one do you select?

ED 105

ED Life Support Advanced Life Support CPR 105

The Skeptics' Guide to EM

JULY 8, 2023

Case: A 57-year-old woman with hypertension, hyperlipidemia and type-2 diabetes mellitus presents to the emergency department (ED) with fever, cough, myalgias, headache and congestion. Managing editor of EM:RAP and Associate Editor at REBEL EM. It’s flu season and you’ve already seen 15 people with the same symptoms.

ALS 270

ALS Emergency Department EMS ED 270

EMDocs

DECEMBER 1, 2024

A 52-year-old male with a history of essential hypertension presents to your South Texas ED for his second visit this week complaining of indolent fever, shortness of breath, pleuritic chest pain, and a rash on his trunk and extremities. Flea-Borne Typhus: Epidemiology Summary 2013-2019. Flea-Borne Typhus. Accessed August 19, 2024.

EMS 103

EMS E-9-1-1 OR ED 103

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. The SGEM has done two previous podcasts on APPs in the ED. Date: February 17, 2023 Reference: Gettel et al.

Emergency Department 130

Emergency Department ALS ED EMS 130

REBEL EM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. US, compared with CXR and CT, offers the absence of ionizing radiation and high reproducibility. Emerg Med J. 2023;40(10):700-707.

ED 125

ED E-9-1-1 Emergency Department ALS 125

Core EM

JANUARY 25, 2024

More than 1/3 of geriatric trauma patients presenting to the ED after a fall return to the ED or die within one year of initial evaluation. 4 Elderly patients, who comprise only 8-12% of total ED major trauma cases, represent a disproportionate 15-30% of trauma mortalities and costs. Int J Emerg Med 2013; 6:12.

ALS 246

ALS ED ICU OR 246

EMDocs

JULY 25, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Editor, Med Mal Insights The challenge of suicide evaluation in the ED “I’ve changed my mind. Blogpost, June 2013.

ED 103

ED ALS Emergency Department OR 103

ALiEM

FEBRUARY 20, 2024

2013 Dec;15(4):90-2. Epub 2013 Nov 7. Successful treatment of flecainide-induced cardiac arrest with extracorporeal membrane oxygenation in the ED. Sivalingam SK, Gadiraju VT, Hariharan MV, Atreya AR, Flack JE, Aziz H. Flecainide toxicity–treatment with intravenous fat emulsion and extra corporeal life support.

Overdose 183

Overdose Life Support ED 183

EMergucate

MAY 30, 2013

A mid fifties male presents to your ED with 2 hours of chest pain and this ECG

ED 100

ED EMS 100

Pediatric EM Morsels

JULY 26, 2024

It is commonly missed during the first few ED visits. Keep a high index of suspicion for anti-NMDAr encephalitis in children and adolescents who have had multiple ED visits for new and worsening psych/behavioral concerns, seizures, and/or movement disorders over several months. Epub 2013 Dec 18. Serum AND CSF antibody titers!

Plasma 271

Plasma OR ED Critical Care 271

Core EM

JANUARY 25, 2024

One week prior to ED arrival, the patient was becoming progressively despondent, less interactive with peers, exhibiting slow speech and movements, and was not eating. In Diagnostic and statistical manual of mental disorders (5th ed.). Catatonia: a case report by Brown Emergency Medicine. Burrow JP, Spurling BC, Marwaha R.

MICU 246

MICU Emergency Department ED OR 246

ALiEM

NOVEMBER 15, 2023

2013 ;2013:610648. PMID: 17079589 Chaouali N, Gana I, Dorra A, Khelifi F, Nouioui A, Masri W, Belwaer I, Ghorbel H, Hedhili A. Potential Toxic Levels of Cyanide in Almonds (Prunus amygdalus), Apricot Kernels (Prunus armeniaca), and Almond Syrup. ISRN Toxicol. PMID: 24171123 Suchard JR, Wallace KL, Gerkin RD. Ann Emerg Med.

OR 169

OR ED 169

Pediatric EM Morsels

AUGUST 9, 2024

Foles, 2024 ] In the US, from 2013-2018, cases increased from 362 to 1,306. Congenital Syphilis may still occur in patients presenting to your ED! 2013 Aug;20(4):337-9. Epub 2013 Feb 27. Worldwide, congenital syphilis complicates about 1 million pregnancies / year. Rates of congenital syphilis are increasing.

E-9-1-1 154

E-9-1-1 Plasma Emergency Department OR 154

ALiEM

AUGUST 30, 2024

A 5-year-old female presented to the emergency department (ED) with a one-year history of gradually increasing anterior neck swelling. She was discharged from the ED on levothyroxine 25 mcg daily with endocrinology outpatient follow-up. 2013 Mar;34(3):115-24; quiz 125. The patient had no significant past medical history.

ACS 161

ACS Emergency Department ED OR 161

EMDocs

NOVEMBER 13, 2024

Major takeaway: Consider SBP in any patient who comes into the ED with ascites. A 2013 meta-analysis found IV albumin was associated with 22.3% 2013 May;44(5):903-9. Patients can also present with GI bleeding, AKI. Critically ill: hypotensive, tachycardic, may be hypothermic, may have paralytic ileus. IV albumin is essential.

E-9-1-1 105

E-9-1-1 ALS OR ED 105

EMDocs

SEPTEMBER 25, 2023

However, RSI has never been shown to reduce the risk of aspiration in the ED (13) or during emergent OR cases (14). While RSI should remain the gold standard in the vast majority of patients in the ED, FI presents an additional technique to mitigate anatomic or physiologic risk. To date, ketamine has been the agent of choice (12).

ED 88

ED Emergency Department ALS Paramedic 88

EMOttawa

FEBRUARY 22, 2024

In 2013, in the United States there were 7 million visits to the emergency department (ED) for lacerations making up a total of 5.2% of ED visits(1). Lacerations are a common presenting complaint to emergency department.

Emergency Department 93

Emergency Department ED OR 93

Core EM

OCTOBER 16, 2024

In: Marx J, ed. In: Wolfson A, ed. 2013 Feb;160(4):434-44. Br J Haematol. 2009 Nov;147(4):431-43. link] Emery, M. Blood and blood components. Rosen’s emergency medicine. Philadelphia, PA: Elsevier; 2014:75-80. Transfusion Reactions and Complications. Harwood-Nuss’ Clinical Practice of Emergency Medicine. Hirayama F.

Allergic Reaction 188

Allergic Reaction Plasma ED Epinephrine 188

The Skeptics' Guide to EM

MAY 14, 2022

Case: A 45-year-old man without a significant past medical history presents to your emergency department (ED) with two days of severe lower back pain after shoveling some dirt. EDs annually (1). He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine.

ALS 130

ALS Emergency Department ED OR 130

The Skeptics' Guide to EM

APRIL 24, 2021

Way back in 2013 we looked at haloperidol for agitation due to psychosis ( SGEM#45 ) and concluded that it was an effective treatment but had common side effects. Droperidol has been used widely, particularly in Australasia, for acute severe agitation. Droperidol has been used widely, particularly in Australasia, for acute severe agitation.

Emergency Department 100

Emergency Department ALS Ambulance ED 100

EMDocs

JANUARY 11, 2025

A 75-year-old woman who is bedridden after a stroke presents to the ED from a nursing facility with abdominal pain and constipation. Therefore, discharging the patient on lactulose (C) would not be recommended without additional treatment in the ED. Low threshold for antibiotics and escalation of care with surgery consultation.

E-9-1-1 97

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

The Skeptics' Guide to EM

OCTOBER 28, 2017

That rant relied upon a Cochrane SRMA by Stevens B et al 2013 and a randomized clinical trail published in Pediatrics by Gray L et al 2015. One medication that should not be use in children under 12 years of age is codeine. There is a RANThony on pediatric pain control and one of the interesting treatments was sucrose.

ALS 130

ALS Emergency Department OR ED 130

Don't Forget the Bubbles

NOVEMBER 29, 2023

Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED). 2013 Jan;31(1):222-6. What are the only exceptions? Br J Anaesth.

E-9-1-1 135

E-9-1-1 Emergency Department ED CPR 135

Broome Docs

MAY 31, 2024

Do we need to intubate French drunkards in ED? 2013 Sep;24(9):1848-53. Epub 2013 Jul 17. Justin and I discuss 7 papers covering a range of topics from securing IVCs in kids to intubating in space and the use of religious sham artifacts in middle-age, French “psychiatry” Yep, it was a strange month on the pod!

E-9-1-1 82

E-9-1-1 ED Critical Care ICU 82

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. PAWPER [Wells 2013, Silvagni 2022] Takes into account body habitus. Good correlation to bed scale weight in trauma patients (Pearson coefficient 0.86), but there was some error in the highest weight category.

E-9-1-1 271

E-9-1-1 Emergency Medical Services Life Support ALS 271

REBEL EM

SEPTEMBER 13, 2023

J Emerg Med 2013; 44 (4): 764-772. In: UptoDate, Feldweg AM (ed.) N Engl J Med. 2015; 372(5):418-25. PMID 25629740 Hassen GW et al. Fresh frozen plasma for progressive and refractory angiotensin-converting enzyme inhibitor-induced angioedema. PMID: 23114109 Hessert MJ and Bennett BL. Wilderness and Environmental Medicine. 2012; 14(11).

Frozen Plasma 101

Frozen Plasma Allergic Reaction FFP Plasma 101

The Skeptics' Guide to EM

JANUARY 19, 2019

Wave 3: Significant increase in overdose deaths involving synthetic opioids (like illicitly-manufactured or prescribed fentanyl) beginning in 2013 [4]. . * Wave 2: Rapid increase in overdose deaths involving heroin starting in 2010. Opioids depress the heart rate and breathing, and overdoses can result in death.

Naloxone 130

Naloxone Overdose Emergency Medical Services Emergency Department 130

ALiEM

MARCH 7, 2024

Ann Emer Med , 2005 [7] Prospective, blinded, observational study performed in the pediatric ED, 3 month period N=44, < 2 years of age Created a bladder urinary index by multiplying the AP and transverse bladder diameters. Author, Title, Journal, Publication Year Study Type, Location, Time Frame N, Ages Summary Milling et al., Chen et al.,

E-9-1-1 177

E-9-1-1 Emergency Department ALS ED 177

EMDocs

AUGUST 13, 2024

HTN was the primary diagnosis in over 1 million ED visits in 2023, and rates of HTN emergencies have increased over the past 20 years. From 2006-2013, HTN emergencies occurred in approximately 2 of every 1000 adult ED visits. In the ED setting, they recommend avoiding intensifying HTN medications.

ED 98

ED OR 98

REBEL EM

MAY 11, 2023

PMID: 34697777 Clinical Question: In patients with moderate to severe alcohol withdrawal being discharged from the emergency department (ED), does treatment with phenobarbital alone and phenobarbital plus benzodiazepines compared to benzodiazepines alone decrease the odds of returning to the ED within 3 days after initial discharge?

Emergency Department 89

Emergency Department ED EMR OR 89

The Skeptics' Guide to EM

MARCH 13, 2021

Lancet 2021 Case: You’re working a busy evening shift in your community emergency department (ED) when a 58 year old female presents with a rapid onset terrible intensity headache. Jeff was actually on the SGEM as the guest skeptic discussing this clinical decision instrument way back in 2013 ( SGEM#48 ).

ALS 100

ALS Emergency Department ED OR 100

Don't Forget the Bubbles

OCTOBER 25, 2023

It is often difficult to do this in an ED setting. 2013 Sep 24;81(13):1159-65. Epub 2013 Aug 21. Strabismus alone is a rare sign of a brain tumour in this age group; however, the associated papilloedema is concerning. The fact that fundoscopy has been carried out on this child is a feat. doi: 10.1212/WNL.0b013e3182a55f17.

ALS 124

ALS OR ED 124

EMDocs

NOVEMBER 21, 2023

In ED, repeat potassium level was 2.6 Permanent weakness usually affects the proximal lower extremities, happens in older patients, and develops late. Diagnosis: Can be made in the ED based on history, exam, lab testing. Consult neurology in the ED. ED workup should exclude alternate causes of symptoms. Muscle Nerve.

E-9-1-1 92

E-9-1-1 ALS ED OR 92

EMDocs

AUGUST 22, 2024

6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. 6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. One cohort study in a public ED found that 84.5%

Emergency Department 103

Emergency Department ALS E-9-1-1 ED 103

FOAMfrat

JULY 3, 2024

This is the mechanism that will eventually kill the patient as well with the high concentration (430 ppm+ exposure) Vajner JE 3rd (2013) references several studies on the inhalation of chlorine. Advanced Hazmat Life Support Provider Manual (4th ed.). (F. Thomas, Eds.) 2013, 9 9). Bronstein, A. Fernandez, M. Walter, J.

Life Support 105

Life Support ALS Emergency Response OR 105

EMDocs

FEBRUARY 22, 2024

A 43-year-old male, with no significant medical history, presents to the ED for right eye pain. 2013; 7362. In: Knoop KJ, Stack LB, Storrow AB, Thurman RJ, eds. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. Corneal Abrasion With Foreign Body Present.

ALS 97

ALS ED EMS OR 97