Pediatric EM Morsels

FEBRUARY 2, 2024

In one ED study, ALL cases of missed travel-related illness did not have a documented travel history in their ED note , whereas 90% of the identified travel-related illnesses had a provider documented travel history (Greenky 2022) Those who are visiting friends and relatives (VFR) are typically at highest risk. Am J Emerg Med.

E-9-1-1 161

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

The Skeptics' Guide to EM

MAY 14, 2022

He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. 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.

ALS 130

ALS Emergency Department ED OR 130

ALiEM

APRIL 12, 2023

20 – Local Anesthetics, Ed(s): Hugh C. Hynynen, 10.08 – Ultrasound Therapy, Editor(s): Anders Brahme, Comprehensive Biomedical Physics, Elsevier, 2014, Pages 153-168, ISBN 9780444536334. emDOCs.net – Emergency Medicine Education. PMID: 35049577 ; PMCID: PMC8774352 Suzuko S, Peter G, Philipp L.

Emergency Department 258

Emergency Department ALS ED 258

The Skeptics' Guide to EM

OCTOBER 10, 2020

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, specifically the use of ketamine. of all ED visits resulting in 2.6

Emergency Department 130

Emergency Department ALS ED OR 130

ALiEM

SEPTEMBER 11, 2023

A 29-year-old female with a past medical history of migraine headaches presented to the emergency department (ED) for several hours of bilateral eye pain, redness, and decreased visual acuity. Contact Lens Wearer Demographics and Risk Behaviors for Contact Lens-Related Eye Infections–United States, 2014.

Emergency Department 152

Emergency Department ED OR 152

REBEL EM

DECEMBER 5, 2023

The risk of a biphasic reaction is what keeps patients in the ED while being observed for a set period of time. 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.

Epinephrine 80

Epinephrine Allergic Reaction Emergency Department Emergency Management 80

ACEP Now

AUGUST 25, 2023

Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain Case A 15-year-old female with sickle cell disease (SCD) presents to your emergency department (ED) with a vaso-occlusive pain episode (VOE) of her legs and back. Children with SCD often present to the ED in pain due to VOE. She has a history of similar episodes.

Emergency Department 97

Emergency Department ED ALS OR 97

FOAMcast

SEPTEMBER 6, 2023

Apple Podcasts , Spotify , Listen Here Alcohol-related emergency department (ED) visits are common – estimated to be comprise nearly 4% of all ED visits and up to 6% of hospitalizations. Ann Emerg Med. Ann Emerg Med. 2014 May 14;311(18):1889-900. Ann Emerg Med. 2021 Dec;78(6):752-758.

Emergency Department 52

Emergency Department ALS ED OR 52

EM Didactic

OCTOBER 7, 2018

It is commonly used in Emergency Departments, especially in febrile and possibly infectious patients. Take Home In the ED, CRP should not be used to make a diagnosis but to assist evaluation and support your clinical suspicion. In clinically unwell patients, a normal CRP level should never delay antibiotic coverage in ED.

Emergency Department 40

Emergency Department ACS Critical Care Coronary 40

The Skeptics' Guide to EM

JANUARY 14, 2018

Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. Of course we were skeptical and wanted to review the evidence.

Emergency Department 130

Emergency Department ALS ED OR 130

EMDocs

JULY 9, 2024

What can we do about this in the pediatric ED? Social Emergency Medicine: Capitalizing on the Pediatric Emergency Department Visit to Screen and Connect Patients and Families to Community Resources. Community Resource Needs Assessment Among Families Presenting to a Pediatric Emergency Department. Pediatrics.

Emergency Department 71

Emergency Department Emergency Medical Services ED EMS 71

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ & Liska, H.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

The Skeptics' Guide to EM

DECEMBER 28, 2019

There was a trial published in 2014 comparing radiology department ultrasound, POCUS and CT for suspected nephrolithiasis (Smith-Bindman et al. NEJM 2014 ). The bottom line from that episode was bedside emergency department ultrasound is safe and has several advantages over CT for the diagnosis of kidney stones.

Emergency Department 100

Emergency Department ALS EMS ED 100

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. Jamie is admitted to the Paediatric Ward, and the paediatric trainee calls the ED to ask if a viral respiratory panel was obtained. 2014 Sep;134(3):555-62. SpO2 is 88%.

Emergency Department 84

Emergency Department ALS ED OR 84

ALiEM

NOVEMBER 29, 2023

Xylazine Intoxication in Humans and Its Importance as an Emerging Adulterant in Abused Drugs: A Comprehensive Review of the Literature. Published 2014 Mar 26. Opioid overdoses involving xylazine in emergency department patients: a multicenter study. How do you treat xylazine toxicity? Forensic Sci Int. 2014;240:1-8.

Naloxone 169

Naloxone Overdose ALS Epinephrine 169

EMDocs

AUGUST 22, 2023

Capnography has several novel uses in other disease states commonly seen in the ED such as trauma, DKA, sepsis and obstructive lung disease. Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. J Emerg Med. Ann Emerg Med. West J Emerg Med. BMC Emerg Med.

Emergency Department 68

Emergency Department ALS Life Support OR 68

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. Point-of-Care Ultrasound on Management of Cellulitis Versus Local Angioedema in the Pediatric Emergency Department. Pediatr Emerg Care. West J Emerg Med.

E-9-1-1 161

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

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. Despite its frequency, the majority of cases of acute diverticulitis are uncomplicated, and can be effectively managed on an outpatient basis 2.

Emergency Department 52

Emergency Department ALS ED OR 52

Don't Forget the Bubbles

MAY 24, 2023

A 5-year-old boy with a past medical history of Crouzon syndrome presents in the Pediatric ED. Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. Intubation of the Critically Unwell Child in the Emergency Department. Anaesthesia. 14123 Currie V.

Emergency Department 98

Emergency Department ED ALS OR 98

Don't Forget the Bubbles

MARCH 19, 2024

This case underscores the struggles many children with complex disabilities encounter, often arriving at the paediatric ED in crisis when their families can no longer provide safe care at home. Becasue paediatric emergency departments are accessible out-of-hours they become the de facto place of safety with access to immediate support.

Mental Health Services 52

Mental Health Services ED OR Emergency Department 52

REBEL EM

AUGUST 30, 2023

Evaluation and Treatment of Acute Back Pain in the Emergency Department. Orthopedic Emergencies 2015 May; 33(2) 311-26. In: Sherman SC eds. Simon’s Emergency Orthopedics. New York, NY: McGraw-Hill; 2014 Winters ME, Kluetz P et al. Back Pain Emergencies. J Spinal Disord Tech. Semin Arthritis Rheum.

E-9-1-1 103

E-9-1-1 ALS ED OR 103

REBEL EM

FEBRUARY 22, 2023

difficult to see due to corneal edema) Emergency Department Management All patients should get emergency ophthalmologic consultation Start with eye drops (see table below) and add systemic medications if severe or refractory symptoms/IOP. et al, Emergency Medicine Clinical Essentials ed 2. Cup to disc ratio >0.6

Emergency Department 52

Emergency Department ALS ED Coronary 52

EMDocs

MARCH 25, 2024

2, 3 Biliary POCUS can help decrease patient length of stay in the Emergency Department. 2, 3 Biliary POCUS can help decrease patient length of stay in the Emergency Department. Decreasing length of stay with emergency ultrasound examination of the gallbladder. Acad Emerg Med. Am J Emerg Med.

ALS 87

ALS Coronary Emergency Department ED 87

EMDocs

SEPTEMBER 27, 2023

It includes a number of expensive medications that patients in the ED are commonly prescribed such as Xarelto, Eliquis, and insulin. As emergency medicine physicians, we are acutely aware of how being unable to afford chronic medications leads to severe life-threatening complications and preventable visits to our Emergency Departments.

Emergency Department 63

Emergency Department ALS OR ED 63

EMDocs

SEPTEMBER 7, 2023

2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department. “Diethylene Glycol” in Goldfrank’s Toxicologic Emergencies , 11e Eds. 6, 1 June 2014, pp. CDC’s Morbidity and Mortality Weekly Report.

E-9-1-1 66

E-9-1-1 ALS Emergency Department Plasma 66

EMDocs

JUNE 7, 2023

F, HR 48, RR 28, BP 104/62, SPO2 88% on non-rebreather mask The patient’s friend who brought her to the ED tells you the patient made suicidal statements earlier in the day and was found in her yard shed. These are send-out labs with turn-around times that make them unlikely to affect the ED course or guide treatment. BMC Res Notes.

E-9-1-1 83

E-9-1-1 ICU Emergency Department ED 83

ACEP Now

MAY 10, 2024

A 59-year-old man presents to your community emergency department (ED) with chest pain that is radiating to his back. Remember to be skeptical of anything you learn, even if you heard it on the Skeptics’ Guide to Emergency Medicine. Emerg Med Australas. References Rotella JA, Yeoh M. 2018;30:119–21.

ALS 52

ALS OR Emergency Department ED 52

EMDocs

JUNE 14, 2023

These are send-out labs with turn-around times that make them unlikely to affect the ED course. This prevents ongoing exposure to the patient and ED staff. Iran Red Crescent Med J 16: e5072, 2014. In: Mattu A and Swadron S, ed. Parenteral organophosphorus poisoning in a rural emergency department: a case report.

E-9-1-1 70

E-9-1-1 Emergency Department Plasma ED 70

EMDocs

JANUARY 3, 2024

He has been taking increased doses of torsemide without improvement in his symptoms and was directed to the ED for inpatient therapy. Now, a remote outpatient pulmonary arterial pressure monitor and other heart failure detection devices (Table 1) are available that you may begin to see in your ED. Published May 2014.

Defibrillator 87

Defibrillator Allergic Reaction ED ALS 87

EMDocs

DECEMBER 2, 2023

A 50-year-old female with no past medical history presents to the ED with a diffuse, constant headache onset a few weeks. 2014 May;7(2):103-4. We’ll keep it short, while you keep that EM brain sharp. The patient describes droopiness of the left eye and double vision associated with specific directional movements of the eye. Kelliny, M.,

EMS 67

EMS Emergency Department OR ED 67

ALiEM

MARCH 7, 2024

Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Chen et al.,

E-9-1-1 177

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

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. 2014 May;145(5):950-957.

ED 82

ED NARCAN ALS OR 82

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. We don’t want to go backwards!

ED 65

ED Emergency Department ALS OR 65

Don't Forget the Bubbles

NOVEMBER 29, 2023

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. Pediatric Endotracheal Intubations for Airway Management in the Emergency Department.

E-9-1-1 135

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

EMDocs

OCTOBER 21, 2023

Median time from ED arrival to diagnosis was 8 hours 24 min in one study, with only 19% being diagnosed within the 4.5-hour Post TW, ed. Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department. link] Published January 2014. Epub 2014 Dec 4. Neurohospitalist.

EMS 74

EMS ALS OR ACS 74

EMDocs

JUNE 27, 2024

An 8-year old male with a history of sickle cell anemia presents to the ED for evaluation of fever for 2 days and “feeling like I can’t get a full breath”. 768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. 2014 Feb;69(2):144-51. Acute chest syndrome in sickle cell disease.

E-9-1-1 75

E-9-1-1 ICU ACS EMS 75

The Overrun

NOVEMBER 28, 2022

Although the role of ketamine in acute psychiatric disorders is hotly debated, the literature is starting to show that it is safe for use in prehospital environments and emergency departments for the control of psychomotor agitation and violent behavior 7,8,9. Emerg Med Clin North Am, vol. 2, May 2000, pp. 7 Barbic, D.,

EMT 52

EMT EMT Emergency Department ALS 52