The Skeptics' Guide to EM

AUGUST 5, 2023

Reference: Easter JS et al. Annals of Emergency Medicine 2014. Reference: Easter JS et al. Annals of Emergency Medicine 2014. Reference: Easter JS et al. Annals of Emergency Medicine 2014. Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study.

ALS 100

ALS Emergency Department OR 100

Dr. Smith's ECG Blog

DECEMBER 27, 2023

The note also says "slight lateral ST elevations noted, likely early repolarization since unchanged compared to 2014." The original term " benign early repolarization" has fallen out of favor since the seminal paper by Haïssaguerre et al. (This patient was not one of the lucky 6.4% per 100,000 to 11 per 100,000 [Rosso].

E-9-1-1 116

E-9-1-1 OR Coronary ACS 116

The Skeptics' Guide to EM

MAY 14, 2022

Date: May 13th, 2022 Reference: Abril et al. Date: May 13th, 2022 Reference: Abril et al. These include: acetaminophen ( Williams et al Lancet 2014), steroids ( Balakrishnamoorthy et al Emerg Med J 2014) and benzodiazepines ( Friedman et al Ann Emerg Med 2017).

ALS 130

ALS Emergency Department ED OR 130

The Skeptics' Guide to EM

OCTOBER 14, 2023

Reference: Brennan L et al. Reference: Brennan L et al. Background: We have looked at pediatric vital signs on the SGEM back in 2014 with PedEM superhero Dr. Anthony Crocco ( SGEM#98 ). That episode reviewed the 2011 Fleming et al systematic review for the normal ranges of HR and RR in children from birth to 18 years of age.

Life Support 221

Life Support Advanced Life Support Emergency Department ALS 221

ACEP Now

AUGUST 14, 2024

This recommendation is a departure from the 2014 guideline iteration that only recommended against CCBs in patients with decompensated heart failure. The American Heart Association and American College of Cardiology released a comprehensive guideline on the management of atrial fibrillation (AF). based care of ED patients with AFRVR.

ALS 105

ALS Emergency Department ED OR 105

REBEL EM

JANUARY 9, 2024

This finding persists when looking at a number of other infections including skin and soft tissue infections (SSTI) ( First10EM ), pyelonephritis ( Strohmeier 2014 ) and even bone and joint infections ( Li 2019 ). This feels intuitive as the IV route seems like it would be stronger, faster, and fix the patient better than the oral route.

ALS 100

ALS ICU ED OR 100

ALiEM

MARCH 7, 2024

Transvere ultrasound views of the bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.) The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. 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

JUNE 17, 2023

Date: June 15, 2023 Reference: Rees CA et al. Date: June 15, 2023 Reference: Rees CA et al. The National Heart, Lung, and Blood Institute (NHLBI) released an expert panel report in 2014 with evidence-based guidelines for management of sickle cell disease recommending timely administration of parenteral opioids for VOE. [7]

Emergency Department 182

Emergency Department ALS ED OR 182

ALiEM

SEPTEMBER 27, 2023

Hoffman et al. Koppaka V, Thompson DC, Chen Y, et al. 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.

ALS 169

ALS OR ED 169

This Podcast Will Kill You

SEPTEMBER 3, 2024

” Applied and environmental microbiology 80.12 (2014): 3552-3561. Dolin, Raphael, et al. Al-Hello, H., Al-Hello, H., Dolin, Raphael, et al. “Is it gonna be poop or is it gonna be barf?” Often, the germ forcing this question upon us is none other than the dreaded norovirus. Campos, Carlos JA, and David N.

ALS 52

ALS OR 52

Pediatric EM Morsels

AUGUST 18, 2023

Rose 2014) They are the most frequently prescribed class of medications in adults; however, in children they are the least frequently prescribed class , <2% of antibiotics. Hersh 2014) Another study looked at all MAEs in juvenile beagles given either low dose or high dose fluoroquinolone. Which is a risk of 1 event for 62.5

E-9-1-1 130

E-9-1-1 ACS OR ALS 130

ALiEM

NOVEMBER 29, 2023

PMID: 34529640 Ayub S, Parnia S, Poddar K, et al. Published 2014 Mar 26. PMID: 24769343 Ehrman-Dupre R, Kaigh C, Salzman M et al. PMID: 36148197 Love JS, Levine M, Aldy K, et al. PMID: 37014353 Ball NS, Knable BM, Relich TA et al. MMWR Morb Mortal Wkly Rep. 2021;70(37):1300-1302. Published 2021 Sep 17.

Naloxone 169

Naloxone Overdose ALS Epinephrine 169

ALiEM

NOVEMBER 1, 2023

In: Nelson LS, Goldfrank LR et al (eds): Goldfrank’s Toxicologic Emergencies. Intensive Care Med 2014; 40(1):104. PMID As ferrioxamine is excreted, the patient’s urine becomes an orange or brown rusty hue, classically referred to as vin rosé urine [1,2]. For iron toxicity, what are the indications for deferoxamine?

E-9-1-1 161

E-9-1-1 ALS OR ED 161

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 71

E-9-1-1 ALS OR ED 71

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 152

Overdose OR Critical Care ALS 152

The Skeptics' Guide to EM

FEBRUARY 26, 2022

Date: February 21st 2022 Reference: Kim et al. Date: February 21st 2022 Reference: Kim et al. ED visits in the US for mental health conditions has increased by 44% from 2006 to 2014. Reference: Kim et al. AEM February 2022. AEM February 2022. AEM February 2022.

ED 130

ED ALS Emergency Department OR 130

REBEL EM

DECEMBER 5, 2023

up to 23% ( Lieberman 2005 , Rohacek 2014 , Tole 2007 , Grunau 2014 ). Since half of biphasic reactions occur within the first 6-12 hrs ( Lee 2014 ) physicians often choose an observation time of 4-6 hrs. Biphasic anaphylactic reactions: occurrence and mortality Allergy 2014 Jun;69(6):791-7 Tole JW, Lieberman P.

Epinephrine 81

Epinephrine Allergic Reaction Emergency Department Emergency Management 81

Don't Forget the Bubbles

OCTOBER 21, 2024

Available at: The DSM‐5: Classification and criteria changes – Regier – 2013 – World Psychiatry – Wiley Online Library Szejko N, Robinson S, Hartmann A, Ganos C, Debes NM, Skov L et al. Tics are the most common type of paediatric movement disorder. The first three always start before 18 years of age.

ALS 59

ALS Emergency Department OR 59

The Skeptics' Guide to EM

NOVEMBER 20, 2021

Date: November 16th, 2021 Reference: Hammouda et al. Date: November 16th, 2021 Reference: Hammouda et al. In 2014 the SGEM looked at a systematic review by Dr. Chris Carpenter , which concluded that there wasn’t a good tool to help us predict which ED patients are at risk of recurrent falls ( SGEM #89 ).

ALS 130

ALS ED Emergency Department OR 130

The Skeptics' Guide to EM

OCTOBER 10, 2020

Reference: Friedman et al. Reference: Friedman et al. million visits each year in the USA ( Friedman et al Spine 2010 ). These include: acetaminophen ( Williams et al Lancet 2014), muscle relaxants ( Friedman et al JAMA 2015), NSAIDs ( Machado et al

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

DECEMBER 17, 2022

Date: December 16th, 2022 Reference: Hohle et al. Date: December 16th, 2022 Reference: Hohle et al. Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality. AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. years ( 2 ).

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

EMDocs

JUNE 22, 2024

A) Amniotic fluid embolism B) Eclampsia C) Placental abruption D) Pulmonary embolism Answer: A Amniotic fluid embolism (AFE) is a rare but potentially fatal complication of pregnancy. AFE should be considered in a patient who experiences cardiorespiratory collapse during labor or shortly thereafter.

EMS 95

EMS Ambulance FFP ICU 95

Emergency Medicine Ireland

OCTOBER 14, 2024

This has been moderately well studied with MIST-2 2011 and the Picollo trial (2014) being commonly quoted trials suggesting benefit. 11, 1419–1425 (2014). While perhaps obvious, the clinical features we’ll be looking for are fever and pleural effusion either on CXR, CT or US. LDH>1000 Sugar <2.2 What are your options?

Critical Care 52

Critical Care ICU ALS OR 52

FOAMcast

SEPTEMBER 6, 2023

However, recent studies have demonstrated the feasibility of ED-initiated medication for AUD, specifically naltrexone (Anderson ES et al. Murphy et al. Jonas DE et al. 2014 May 14;311(18):1889-900. Example emergency department algorithm below, also see UCSF protocol Anderson ES et al. Ann Emerg Med. PMID: 34353648.

Emergency Department 52

Emergency Department ALS ED OR 52

The Skeptics' Guide to EM

MAY 1, 2021

Reference: Donaldson et al. Reference: Donaldson et al. The Donaldson et al SRMA included 10,431 patients in 26 randomized trials comparing intravenous thrombolysis with placebo or standard care in acute ischemic stroke [1]. He is also one of the SGEM Hot Off the Press Faculty. A systematic review and meta-analysis.

ALS 130

ALS OR 130

ALiEM

MAY 13, 2024

Scan the entirety of the affected area in 2 planes. Be aware of the patient’s comfort throughout the examination. A water bath may be helpful to visualize lesions in extremities such as the hands or feet. The probe sits just below the water’s surface and does not need to contact the skin. It may also aid in identifying nearby vasculature.

E-9-1-1 161

E-9-1-1 ALS Emergency Department OR 161

Don't Forget the Bubbles

SEPTEMBER 30, 2024

Simpson et al. examined 977,907 first-time ED presentations by children aged 0-15 across thirteen acute hospital trusts (between April 2014 and March 2017), trying to figure out how many were non-urgent. A 2011-2012 Australian study by Blake et al. Gaucher et al. Gaucher et al. What is happening internationally?

Emergency Department 89

Emergency Department ALS ED OR 89

Don't Forget the Bubbles

MAY 29, 2023

Explored in seminal research, incivility is described as “ behaviours or mistreatment which violate the workplace norms of mutual respect “ Incivility isn’t just about obvious aggression but can take the form of passive aggression, public beratement, intimidation or habitual interruption. link] Isn’t it just ‘part of the job?’

Critical Care 98

Critical Care E-9-1-1 Paramedicine Paramedicine 98

This Podcast Will Kill You

OCTOBER 22, 2024

” Orphan Drugs: Research and Reviews (2014): 19-27. ” (2014). Schieppati, Arrigo, et al. Stiff person syndrome, like many rare diseases, does not get nearly the same amount of screen time or name recognition that other, more common diseases do. Baizabal-Carvallo, J.F. and Jankovic, J., 840-848. . 1977): 363-371.

ALS 52

ALS OR 52

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. 2014 Feb. 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. Neuropediatrics.

E-9-1-1 97

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

Don't Forget the Bubbles

JANUARY 24, 2024

The first human trials for children with SRSE were conducted in 2014 where 2 patients responded well to the treatment and there have been encouraging results in open label adult trials more recently. Going beyond the algorithm, what can we do when a child is still fitting despite appropriate treatment? What is the problem with SRSE?

Critical Care 111

Critical Care ALS OR 111

REBEL EM

FEBRUARY 8, 2023

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 keratitis: A treatment guideline – 2014. Surv Ophthalmol 2012; 57(5):448-462. Herpes simplex keratitis.

ALS 52

ALS OR EMS ED 52

REBEL EM

JANUARY 29, 2024

Click here for Direct Download of the Podcast Paper: Aykan AC et al. Because the lungs receive 100% of cardiac output, it has been hypothesized that a lower dose of thrombolytic therapy may still be effective with a better safety profile [3][4]. REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

ALS 137

ALS ACS OR CPR 137

Don't Forget the Bubbles

OCTOBER 25, 2023

Image adapted by Holland JA et al. Image adapted by Holland JA et al. 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?

ALS 124

ALS OR ED 124

REBEL EM

FEBRUARY 29, 2024

Background: Ventilator-associated pneumonia (VAP), or what the CDC recently renamed infection-related ventilator-associated complication (IVAC), is defined as a nosocomial pneumonia occurring on day 3 of mechanical ventilation that was preceded by 2 days of stable or decreasing ventilator requirements. 4, 8 Paper: Dahyot-Fizelier, C.,

E-9-1-1 126

E-9-1-1 ICU OR ALS 126

Don't Forget the Bubbles

JULY 24, 2023

Kieu V, Palit S, Wilson G, Ditchfield M, Buttery J, Burgner D, et al. 2014 Jun;164. McNamara AL, Dickerson EC, Gomez-Hassan DM, Cinti SK, Srinivasan A. 2014 Mar;58. Modic MT, Feiglin DH, Piraino DW, Boumphrey F, Weinstein MA, Duchesneau PM, et al. A wide range of causative pathogens have been identified.

ALS 98

ALS OR 98

This Podcast Will Kill You

JANUARY 2, 2024

Devogelaer, Jean-Pierre, et al. Academic Press, 2014. Tsimicalis, Argerie, et al. . “Oldest medical description of osteogenesis imperfecta (17th Century, France).” ” Clinical Anatomy 30.2 2017): 128-129. Forlino, A., Bächinger, H. Osteogenesis imperfecta. Nat Rev Dis Primers 3(17052) Dahan‐Oliel, N.,

E-9-1-1 52

E-9-1-1 ALS OR 52