ALiEM

NOVEMBER 10, 2023

A 33-year-old male presented to the emergency department with a diffuse pruritic rash that appeared several days after starting Trimethoprim/Sulfamethoxazole (TMP-SMX) for a dental infection. 2013 Apr;168(4):726-32. Epub 2013 Feb 16. Progression stopped after discontinuing TMP-SMX. Br J Dermatol. doi: 10.1111/bjd.12133.

Emergency Department 161

Emergency Department OR 161

ALiEM

DECEMBER 18, 2023

A 19-year-old female with a past medical history of epilepsy presented to the emergency department for evaluation of rash and fever. 2013 Jun;6(6):31-7. Two days prior to presentation she began to experience fevers with a Tmax of 103°F. The patient endorsed associated pruritus and cervical lymphadenopathy with the rash.

Emergency Department 177

Emergency Department OR 177

Pediatric EM Morsels

OCTOBER 27, 2023

Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. PAWPER [Wells 2013, Silvagni 2022] Takes into account body habitus. Int J Emerg Med. J Emerg Med.

E-9-1-1 271

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

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. 2013 Mar;34(3):115-24; quiz 125. The patient had no significant past medical history. She also endorsed three weeks of cough and congestion, and one day of muffled voice. Abdominal : Soft.

ACS 161

ACS Emergency Department ED OR 161

The Skeptics' Guide to EM

AUGUST 28, 2021

Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. Case: A forty-year-old woman presents to the emergency department […] The post SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED?

ED 130

ED Emergency Department ALS OR 130

EMDocs

JANUARY 11, 2025

2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation.

E-9-1-1 98

E-9-1-1 EMS Emergency Department OR 98

The Skeptics' Guide to EM

AUGUST 19, 2023

I responded by posting the 2013 SGEM episode on INTERACT-2 ( SGEM#73 ) which showed no statistical difference between intensive (<140 mmHg) and guideline directed (<180 mmHg). Case: A 67-year-old male presents to the emergency department obtunded with left hemiplegia. Symptoms began just prior to presentation.

EMS 186

EMS ALS Emergency Department OR 186

EMOttawa

FEBRUARY 22, 2024

Lacerations are a common presenting complaint to emergency department. 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).

Emergency Department 93

Emergency Department ED OR 93

ACEP Now

DECEMBER 11, 2023

The Emergency Department Benchmarking Alliance (EDBA) is a membership organization composed of high-performance emergency departments (EDs) that share a commitment to quality. The time interval referred to as ED boarding time has been part of the hospital’s required data submission to CMS since 2013. ACEP website.

Emergency Department 52

Emergency Department ED EMS ALS 52

The Skeptics' Guide to EM

MAY 14, 2022

Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. His twitter handle is @PainFreeED.

ALS 130

ALS Emergency Department ED OR 130

The Skeptics' Guide to EM

APRIL 24, 2021

Randomized Double-blind Trial Intramuscular Droperidol, Ziprasidone and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. 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.

Emergency Department 100

Emergency Department ALS Ambulance ED 100

ALiEM

MARCH 7, 2024

The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Her mother denies any fevers, upper respiratory symptoms, sore throat, or diarrhea. She adds that her daughter has complained of 2-3 episodes of dysuria and gross hematuria over the last few days. Lay the patient supine when possible.

E-9-1-1 177

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

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. There are certain patient populations who are at risk for in adequate pain management. The pediatric age group represents one of the populations at risk for oligoanalgesia.

ALS 130

ALS Emergency Department OR ED 130

REBEL EM

SEPTEMBER 13, 2023

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 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

Frozen Plasma 104

Frozen Plasma Allergic Reaction FFP Plasma 104

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? 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.

Emergency Department 105

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

Don't Forget the Bubbles

SEPTEMBER 30, 2024

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. Emergency department overcrowding is a complex issue with multiple contributing factors. Learning about international trends sparked our curiosity about our own department.

Emergency Department 89

Emergency Department ALS ED OR 89

The Skeptics' Guide to EM

MARCH 10, 2018

We will summarize some of the recommendations for emergent anticoagulation reversal in the emergency department in the show notes. Zahed et al did a randomized control trial (RCT) in 2013 on using TXA for the treatment of anterior epistaxis [2]. It made sense to look at it for the treatment of epistaxis.

Emergency Department 100

Emergency Department ALS Coronary OR 100

The Skeptics' Guide to EM

MARCH 13, 2021

Date: March 11th, 2021 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Ohio. Lancet 2021 Case: You’re […] The post SGEM#322: TXA for SAH – Won’t Stop Me Now first appeared on The Skeptics Guide to Emergency Medicine. Reference: Post et al. Reference: Post et al.

ALS 100

ALS Emergency Department ED OR 100

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.

ED 108

ED Life Support Advanced Life Support CPR 108

Don't Forget the Bubbles

SEPTEMBER 27, 2023

The parents of two-year-old, previously healthy, Jamie bring him to the Emergency Department with coryzal symptoms, wheezing and difficulty breathing. Do not obtain comprehensive viral panel testing for patients who have suspected respiratory viral illnesses. SpO2 is 88%. If both answers are the same, don’t take the test.”

Emergency Department 84

Emergency Department ALS ED OR 84

Don't Forget the Bubbles

AUGUST 7, 2023

This prospective cohort study included patients between 0-16 years old, who presented to one of four NHS hospital sites in Greater Manchester (a large metropolitan area in the North of England), consisting of an Urgent Care Centre and three Emergency Departments. What did previous studies show? and one in the US by Bonafide et al.

Life Support 98

Life Support Advanced Life Support ALS Emergency Department 98

ACEP Now

AUGUST 1, 2023

How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. When those same fundamentals done right achieve great success, they aren’t little at all.

Emergency Department 98

Emergency Department EMS ED OR 98

Don't Forget the Bubbles

OCTOBER 2, 2023

mmol/L) with acute illness between 2013 and 2018. The reported prevalence of undiagnosed hypoglycaemia disorders among children seen in the emergency department (ED) for any reason ranges between 10% and 28%. The high proportion of hyperinsulinism may have been influenced by including neonates in the study population.

ALS 138

ALS OR ED Emergency Department 138

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. The patient states they were cutting an avocado when the knife pierced through and punctured his hand. Examination reveals the following: What is the diagnosis?

EMS 95

EMS ALS Emergency Department ED 95

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. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

ED 128

ED E-9-1-1 Emergency Department ALS 128

EMDocs

AUGUST 8, 2023

However, patients remain concerned about losing a testicle, and there is high medicolegal risk. Pain can be intermittent. 84-90% have testicular pain. May start within a few hours of a minor trauma or wake them from sleep. Abdominal/flank pain – 20% ONLY have this complaint (check this testicles in a male patient with abdominal/flank pain).

ALS 94

ALS OR Emergency Department 94

EMDocs

FEBRUARY 22, 2024

2013; 7362. He reports onset of his symptoms while mowing his lawn just prior to arrival and reports that he was not wearing eye protection. The man does not use glasses or contact lenses. He denies known ocular trauma or ocular surgical history. Triage VS: BP 136/86 mm Hg, HR 110 bpm, T 98.6 F oral, RR 14 bpm, SpO2 98% on room air.

ALS 98

ALS ED EMS OR 98

EMDocs

MAY 11, 2024

Emergent MRI and neurology consultation are required for diagnosis and management. Central causes of vertigo include ischemic stroke, demyelinating conditions, cerebellar hemorrhage, vertebrobasilar insufficiency, vertebral artery dissection, multiple sclerosis, malignancy, and vestibular migraine. loss of pain and temperature sensation).

EMS 111

EMS E-9-1-1 ALS OR 111

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. hypertensive emergency, need for thrombolytic administration) [1]. His blood pressure (BP) is 220/120 mmHg. What are the next best steps in BP management for this patient?

ALS 99

ALS Critical Care OR EMS 99

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. 3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013.

E-9-1-1 100

E-9-1-1 Emergency Department ALS CCT 100

Don't Forget the Bubbles

OCTOBER 21, 2024

Olivia, 7, has been brought to the emergency department. Her mother has brought her to the emergency department because she is worried that Olivia is doing the movements more frequently and would like a brain scan. Over the last couple of weeks, Olivia has been having episodes of rapid blinking and grimacing.

ALS 59

ALS Emergency Department OR 59

REBEL EM

AUGUST 18, 2022

Fletcher, MD, FACEP and Nicholas Slattery, MD Background: Diverticulitis is a common finding amongst Emergency Department patients, accounting for more than 360,000 visits in 2013 alone 1. Once appropriate symptom control was achieved, patients were discharged home with medical treatment and diet recommendations.

Emergency Department 52

Emergency Department ALS ED OR 52

ACEP Now

JULY 7, 2024

Should emergency physicians rely on standard textbooks for diagnostic and treatment regimens? 1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). 1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED).

Emergency Department 52

Emergency Department Critical Care ALS ICU 52

REBEL EM

MARCH 8, 2023

Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. Emergency Department Management: Emergency ophthalmology consultation. Emergency surgical management indicated if concomitant retinal tear, vitreous hemorrhage, or retinal detachment. >10 floaters, (+) LR 8.1-36

Emergency Department 52

Emergency Department ALS ED OR 52

AAEM RSA

MAY 7, 2021

Schreyer, MD CMQ FAAE Originally published: Common Sense January/February 2021 The advent and broad availability of ridesharing services, such as Lyft and Uber, are changing the way patients access medical services, and emergency departments (EDs) are taking notice. The American Journal of Emergency Medicine. doi:10.1016/j.ajem.2019.10.013.

EMR 52

EMR Emergency Medical Services Ambulance Emergency Department 52

REBEL EM

MARCH 23, 2023

The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores. Treatment options for alcohol withdrawal include benzodiazepines such as lorazepam, diazepam, or chlordiazepoxide, gabapentin, and phenobarbital (Buell et al.).

ICU 52

ICU Emergency Department ALS OR 52

Dr. Smith's ECG Blog

MAY 23, 2023

Am J Emerg Med. Written by Pendell Meyers A man in his early 40s experienced acute onset chest pain. The chest pain started about 24 hours ago, but there was no detailed information available about whether his pain had come and gone, or what prompted him to be evaluated 24 hours after onset. by being interrupted??? 2022 Jan;51:384-387.

STEMI 98

STEMI Coronary Paramedic OR 98