This Podcast Will Kill You

FEBRUARY 11, 2025

” International Journal for Parasitology: Parasites and Wildlife 2 (2013): 222-227. Now imagine that your tongue suddenly shriveled up and fell off and that in its place is a tongue-sized isopod aka rollie pollie aka pillbug. Just there, hanging out, forever. How are you feeling? Hey, we get it. But at least youll never be alone again.

E-9-1-1 97

E-9-1-1 ALS OR 97

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-9-1-1 114

E-9-1-1 ACS OR Emergency Department 114

Pediatric EM Morsels

JULY 26, 2024

Epub 2013 Dec 18. While it is important for us to maintain a safe work environment for our patients and our team, managing the agitated patient requires more of us than administering Droperidol or Ketamine. Make sure to consult your friendly neighborhood pediatric neurologist and/or rheumatologist! The prevalence ranges from 12.5%-61%

Plasma 271

Plasma OR ED Critical Care 271

Pediatric EM Morsels

APRIL 7, 2023

Observation, interaction with patient, as well as parent information is key to bring the whole picture together!

ALS 130

ALS OR EMS Critical Care 130

ALiEM

NOVEMBER 10, 2023

2013 Apr;168(4):726-32. Epub 2013 Feb 16. Management of FDE anchors on identification and discontinuation of the causative agent. Topical or systemic steroids are common adjuncts and there is limited evidence suggesting the utility of systemic cyclosporine for severe cases [1]. Br J Dermatol. doi: 10.1111/bjd.12133. PMID: 23413807.

Emergency Department 161

Emergency Department OR 161

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. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019.

Emergency Department 130

Emergency Department ALS ED EMS 130

NAEMSP

APRIL 18, 2025

2013 Jun;19(6):370-80. Epub 2013 Apr 10. However, this theory has not been shown to be true in the literature and Ketamine can be an excellent form of anesthesia for combative patients such as in this case. Ketamine is thought to work as an antagonist at the NMDA receptor and has a dose dependent response [1]. CNS Neurosci Ther.

Ambulance 52

Ambulance EMS EMT EMT 52

Core EM

JANUARY 25, 2024

Background: The lumbar puncture (LP or spinal tap) is a procedure that has been in the medical arsenal since first described in 1891 by German physician Heinrich Quincke. Technique: Probe selection: The linear probe is more ideal for pediatric patients and adults with a leaner body habitus. High-quality images obtained in <1 minute in 87.9%

ALS 246

ALS Critical Care OR 246

Emergency Medicine Cases

NOVEMBER 7, 2017

Yet according to a 2013 Medscape survey, 40% of physicians reported burnout in U.S. Burnout – it’s the elephant in the room that we all know about but prefer not to discuss. They explain why wellness matters, how you can strive to achieve it and how to recognize when you or a colleague are unwell so that you can get the help you need.

OR 130

OR EMS 130

ALiEM

DECEMBER 18, 2023

2013 Jun;6(6):31-7. The patient specifically denied mucous membrane involvement (mouth, eyes, genitalia), vomiting, diarrhea, dysuria, hematuria, neck stiffness, cough, dyspnea, chest pain, or exposure to ticks or exotic animals. Additional Images Physical Exam Vitals : T 39.6°C; Additional Images Physical Exam Vitals : T 39.6°C;

Emergency Department 177

Emergency Department OR 177

ALiEM

AUGUST 30, 2024

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. She denied difficulty swallowing, fatigue, cold intolerance, or hair and nail changes. Physical Exam Vitals : BP 87/62; Pulse 80; Temp 36°C (96.8°F); Abdominal : Soft.

ACS 161

ACS Emergency Department ED OR 161

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 98

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

Pediatric EM Morsels

MAY 5, 2023

2013 Aug;110(4):755-73. Epub 2013 Jan 14. Supplementation is key! Key nutrients and vitamins are not always found in specialized diets (or picky children) and adherence to multivitamins is a must! Look out for nutritional deficiencies ! References: Alexy U, Fischer M, Weder S, Längler A, Michalsen A, Sputtek A, Keller M.

E-9-1-1 130

E-9-1-1 OR EMS 130

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). Most EM physicians shared the frustration and made positive comments. Some neurologists disagreed with the premise of the tweet and challenged it.

EMS 186

EMS ALS Emergency Department OR 186

Pediatric EM Morsels

OCTOBER 27, 2023

PAWPER [Wells 2013, Silvagni 2022] Takes into account body habitus. Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. Krug 2007] What If the Child is Obese or Emaciated? x exp[0.02

E-9-1-1 271

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

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

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% Lacerations are a common presenting complaint to emergency department. of ED visits(1).

Emergency Department 93

Emergency Department ED OR 93

The Skeptics' Guide to EM

DECEMBER 7, 2019

The Journal of Pediatrics published a systematic review of literature regarding the Management of ALTE in 2013 and one of the findings was that there was very little agreement in the literature on how to apply the definition. It is a diagnosis of exclusion that applies to infants under the age of 12 months. . *

CPR 130

CPR ALS 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. Reference: Martel et al.

Emergency Department 100

Emergency Department ALS Ambulance ED 100

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 is a RANThony on pediatric pain control and one of the interesting treatments was sucrose. Sweet Solutions to Reduce Procedural Pain in Neonates: A Meta-analysis.

ALS 130

ALS Emergency Department OR ED 130

REBEL EM

SEPTEMBER 13, 2023

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 ). Typically involves the mouth, larynx, pharynx, and subglottic tissue ( Kostis 2005 ).

Frozen Plasma 104

Frozen Plasma Allergic Reaction FFP Plasma 104

The Skeptics' Guide to EM

MAY 14, 2022

They include: CBT and mindfulness ( Cherkin et al JAMA 2016), chiropractic ( Paige et al JAMA 2017), physical therapy ( Paolucci et al J Pain Research 2018) and acupuncture (Colquhoun and Novella Anesthesia and Analgesia 2013 ). The pain is 10/10 in intensity, gets worse with bending, turning, and prolonged walking.

ALS 130

ALS Emergency Department ED OR 130

Don't Forget the Bubbles

OCTOBER 25, 2023

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. It is often difficult to do this in an ED setting. How is IIH diagnosed? Manometer three-way tap.

ALS 124

ALS OR ED 124

EMDocs

APRIL 6, 2024

Source Adverse Tracheal Intubation Events in Critically Ill Underweight and Obese Children: Retrospective Study of the National Emergency Airway for Children Registry (2013-2020). We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Pediatr Crit Care Med. 2024 Feb 1;25(2):147-158.

OR 98

OR 98

Pediatric EM Morsels

JUNE 16, 2023

Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

Overdose 154

Overdose OR Critical Care ALS 154

The Skeptics' Guide to EM

AUGUST 28, 2021

They include: Cognitive Behavioural Therapy and mindfulness ( Cherkin et al JAMA 2016), chiropractic ( Paige et al JAMA 2017), physical therapy ( Paolucci et al J Pain Research 2018) and acupuncture (Colquhoun and Novella Anesthesia and Analgesia 2013 ). Background: Acute and chronic back pain has been covered many times on the SGEM.

ED 130

ED Emergency Department ALS OR 130

The Skeptics' Guide to EM

JULY 3, 2021

This is the original Target Temperature Management (TTM) trial by Nielson et al NEJM 2013. The trial was not truly randomized, as the groups were based on the day of the month, and they also weren’t blinded. The results of this Australian trial seemed too good to be true. This gives a NNT of 4.

Paramedic 130

Paramedic Defibrillator ALS OR 130

Dr. Smith's ECG Blog

DECEMBER 12, 2022

This " imbalance of precordial T waves" is not seen very often — and in the “right” clinical setting, has been associated with recent OMI from a LCx culprit artery ( See Manno et al: JACC 1:1213, 1983 — and the July 17, 2013 post by Salim Rezaie in ALiEM ). This is termed " pseudo-normalization."

OR 52

OR ACS STEMI Coronary 52

REBEL EM

MAY 29, 2024

Laryngoscope 2013; 123: 2928-9. Take Home Points: Posterior epistaxis is a rare, life-threatning presentation. The key is in identifying and rapidly gaining control with a posterior pack or foley catheter. These patients often require surgical intervention so get ENT to the bedside and admit to a place with a higher level of monitoring.

ICU 102

ICU ALS ACS EMS 102

EMDocs

NOVEMBER 21, 2023

Denied weakness of his upper extremities, paresthesias, vision changes, trouble swallowing or speaking, and drug or alcohol use. Exam: 2/5 strength when attempting to flex his bilateral thighs. Could not ambulate. Otherwise normal CN’s, sensation, upper extremity motor exam. HypoPP only impacts skeletal muscles, NOT smooth or cardiac muscle.

E-9-1-1 95

E-9-1-1 ALS ED OR 95

Broome Docs

MAY 31, 2024

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! Do we need to intubate French drunkards in ED? Psychol Sci.

E-9-1-1 82

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

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. Also, start a hazmat company and engine company as quickly as possible. Be prepared to take an advanced airway early.

Life Support 105

Life Support ALS Emergency Response OR 105

First Responders Foundation

AUGUST 26, 2024

Her research and advocacy led to the implementation of OPD’s Peer Support Team (PST) in 2013, under the leadership of Omaha Police Chief Todd Schmaderer. After years of serving in Uniform Patrol, including a specialized assignment in the Weed and Seed Unit focusing on gang and narcotics activity, Mary was promoted to Sergeant in 1998.

First Responder 98

First Responder Public Safety Paramedic OR 98

The Skeptics' Guide to EM

MARCH 13, 2021

Jeff was actually on the SGEM as the guest skeptic discussing this clinical decision instrument way back in 2013 ( SGEM#48 ). Date: March 11th, 2021 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Ohio. Reference: Post et al. Reference: Post et al.

ALS 100

ALS Emergency Department ED OR 100

The Skeptics' Guide to EM

JUNE 24, 2017

Then came the Targeted Temperature Management (TTM) Trial ( Nielsen et al NEJM 2013 ). Both papers showed no patient oriented benefit to pre-hospital cooling in patients with OHCA and return of spontaneous circulation (ROSC). Intervention: Rapid infusion of 30ml/kg IV cold saline (maximum two litres).

CPR 100

CPR Epinephrine ALS Paramedic 100

EMDocs

AUGUST 13, 2024

From 2006-2013, HTN emergencies occurred in approximately 2 of every 1000 adult ED visits. Background Hypertension (HTN) is significant issue globally and a leading risk factor for cardiovascular disease. 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.

ED 98

ED OR 98

REBEL EM

MAY 11, 2023

Background: The emergency department is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines. 5 Paper: Lebin J et al. 11 of those were admitted to the hospital.

Emergency Department 95

Emergency Department ED EMR OR 95