The Skeptics' Guide to EM

OCTOBER 14, 2023

Case: A 5-year-old boy presents to the emergency department (ED) with his parents for fever and fatigue. Background: We have looked at pediatric vital signs on the SGEM back in 2014 with PedEM superhero Dr. Anthony Crocco ( SGEM#98 ). He has had three days of high fevers at home. It seems awfully high. Does he have sepsis?”

Life Support 228

Life Support Advanced Life Support Emergency Department ALS 228

Pediatric EM Morsels

FEBRUARY 2, 2024

2014 Dec;31(6):678-87. Internationally Acquired Severe Systemic Infections in Febrile Pediatric Travelers Presenting to the Emergency Department. Pediatr Emerg Care. Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel. 2021 Dec 1;37(12):e1315-e1320.

E-9-1-1 161

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

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

ALiEM

APRIL 12, 2023

Hynynen, 10.08 – Ultrasound Therapy, Editor(s): Anders Brahme, Comprehensive Biomedical Physics, Elsevier, 2014, Pages 153-168, ISBN 9780444536334. emDOCs.net – Emergency Medicine Education. DOI 10.1016/B978-0-444-53632-7.01010-8 LeDonne S, Sengupta D. US Probe: Ultrasound Water Bath for Distal Extremity Evaluation.

Emergency Department 258

Emergency Department ALS ED 258

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 78

Epinephrine Allergic Reaction Emergency Department Emergency Management 78

EM Didactic

OCTOBER 7, 2018

It is commonly used in Emergency Departments, especially in febrile and possibly infectious patients. The value of C-reactive protein in emergency medicine. 2014 Jan 1;3(1):1-5. C-reactive protein (CRP) is an acute phase protein synthesized in the liver. References Su YJ. Journal of Acute Disease.

Emergency Department 40

Emergency Department ACS Critical Care Coronary 40

ALiEM

OCTOBER 2, 2023

A 6-year-old male presented to the pediatric emergency department (PED) for scalp lesions. Pediatr Emerg Care. 2014 Jun;30(6):437-9. He was seen by his pediatrician 2 weeks prior and prescribed antibiotics and a delousing shampoo for suspected cellulitis versus lice infestation. cm in the long axis diameter.”

E-9-1-1 189

E-9-1-1 Emergency Department OR 189

EMergucate

FEBRUARY 15, 2014

This week’s ECG is from a middle aged male who presented to the Emergency Department with abdominal pain. His ‘routine’ … Continue reading →

Emergency Department 100

Emergency Department EMS 100

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. 2014 Nov;107(11):724-7. Initially beginning on the torso and low back, the rash spread to the palms, soles, and genitalia. South Med J.

Emergency Department 161

Emergency Department OR 161

EMergucate

FEBRUARY 7, 2014

This week’s ECG is from a 39 yr old female who presented to the Emergency Department with vomiting, diarrhoea, and … Continue reading →

Emergency Department 100

Emergency Department EMS 100

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. His twitter handle is @PainFreeED.

Emergency Department 130

Emergency Department ALS ED OR 130

EMergucate

FEBRUARY 21, 2014

Clinical conclusion and interpretation on last week’s ECG case of a middle aged male who presented to the Emergency Department with … Continue reading →

Emergency Department 100

Emergency Department EMS 100

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

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. 2014 May 14;311(18):1889-900. Example emergency department algorithm below, also see UCSF protocol Anderson ES et al.

Emergency Department 52

Emergency Department ALS ED OR 52

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. Evidence-based management of sickle cell disease: Expert panel report, 2014. link] Published 2014.

Emergency Department 97

Emergency Department ED ALS OR 97

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. Date: September 20th, 2021 Reference: Litell et al.

Emergency Department 100

Emergency Department EMR ICU ALS 100

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

SEPTEMBER 14, 2019

She is interested in social determinants of health in the emergency department and health policy. Dr. Ian Holley is also a PGY-3 resident in Emergency Medicine at Washington University School of Medicine in St. He is interested in ultrasound and international emergency medicine.

Emergency Department 130

Emergency Department ALS EMS OR 130

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. 2014 May;133(5):e1121-1127. Karageorgos, S.; Hibberd, O.; Mullally, P.J.W.;

Emergency Department 142

Emergency Department E-9-1-1 ALS OR 142

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

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

The emergency department takes care of some of the highest risk patients with the worst access to health care and social services Over the past 20 years, many researchers have created and validated social needs screeners Some examples: iHELP, WE CARE, SEEK, USDA 2-item food insecurity questionnaire Does screening make a difference?

Emergency Department 71

Emergency Department Emergency Medical Services ED EMS 71

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. Forensic Sci Int. 2014;240:1-8. 2022;14(8):e28160. Published 2022 Aug 19.

Naloxone 169

Naloxone Overdose ALS Epinephrine 169

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. Respiratory viral panel testing did not reduce antibiotic use in the emergency department. 2014 Sep;134(3):555-62. SpO2 is 88%. Pediatrics. J Clin Virol. Pediatrics.

Emergency Department 84

Emergency Department ALS ED OR 84

The Skeptics' Guide to EM

JANUARY 12, 2019

He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. We haver reviewed papers on pain management in the emergency department for many years on the SGEM. However, these were not patients recruited from the emergency department.

Emergency Department 100

Emergency Department ALS OR 100

REBEL EM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Prerost 2014) In a patient with chronic alcohol use, hallucinations should prompt consideration of acute intoxication, alcoholic hallucinosis, or delirium tremens (DT). Annals of Emergency Medicine.

Emergency Department 52

Emergency Department OR EMS 52

The Skeptics' Guide to EM

SEPTEMBER 12, 2020

Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. It was an opportunity to share my journey and give an important message about kindness. Shanafelt et al. Mayo Clin Proc 2015 * Shanafelt et al.

Emergency Department 130

Emergency Department ALS OR 130

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

Don't Forget the Bubbles

MAY 29, 2023

BMJ Quality & Safety [Internet] 2014; 23:106-115. Acad Med [Internet] 2014; 89:5:817-827. Bad manners in the Emergency Department: Incivility among doctors. BMC Health Serv Res [Internet] 2014:14:61 (2014). PLoS ONE [Internet] 2014 9(8): e104720. Available at: [link] Fehr R, Gelfand MJ, Nag M.

Critical Care 97

Critical Care E-9-1-1 Paramedicine Paramedicine 97

EMDocs

AUGUST 22, 2023

Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. J Emerg Med. Capnography for the nonintubated patient in the emergency setting. Ann Emerg Med. Predictive value of capnography for suspected diabetic ketoacidosis in the emergency department. West J Emerg Med.

Emergency Department 68

Emergency Department ALS Life Support OR 68

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. of symptom-triggered phenobarbital versus symptom-triggered lorazepam in the emergency department (n=44). A randomized, blinded clinical trial (Hendey et al.)

ICU 52

ICU Emergency Department ALS OR 52

FOAMfrat

MAY 19, 2024

While transporting to the emergency department, the patient’s mother informed me that PDCD affects less than 1 in 50,000 individuals and is more common in males than females. Upon arrival in the pediatric emergency department, the patient was conscious and alert to her normal mental status, which included being nonverbal.

E-9-1-1 97

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

ACEP Now

OCTOBER 30, 2023

These initiatives aim to equip physicians with an evidence-based approach and effective management strategies for common emergency-department scenarios. ESEM hosted the second Global Network Collaborative Conference on Emergency Medicine in 2013 and organized its first large scientific conference in Dubai in December 2014.

Emergency Department 52

Emergency Department ALS CPR Critical Care 52

ACEP Now

JULY 7, 2023

CASE A 30-year-old woman presents to the emergency department with left arm pain from a chronic wound. Opioid overdoses involving xylazine in emergency department patients: a multicenter study. US Department of Justice, Drug Enforcement Administration. She reports fevers up to 103 degrees Fahrenheit. 2014;240:1-8.

Overdose 98

Overdose ALS Naloxone Emergency Department 98

The Skeptics' Guide to EM

MAY 4, 2019

Nikki Abela is a final year trainee in Emergency Medicine and Paediatric Emergency Medicine in Liverpool, UK from sunny Malta. Case: 6-year-old Caroline is brought to the emergency department by her parents. A study by Easter et al ( Ann Emerg Med 2014 ) concluded that PECARN seemed to be the best of the three tools.

ALS 130

ALS Emergency Department OR 130

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. 2014 AHA/ACC guideline for the management of patients with non-ST elevation acute coronary syndromes.

STEMI 121

STEMI Coronary ALS CAD 121

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. If clinical worsening or poor symptomatic control was detected at any time, the patient was referred to the Emergency Department.

Emergency Department 52

Emergency Department ALS ED OR 52