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 221

Life Support Advanced Life Support Emergency Department ALS 221

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

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. 2014 Dec;24(12):1670-751. The patient had no significant past medical history. She also endorsed three weeks of cough and congestion, and one day of muffled voice. doi: 10.1089/thy.2014.0028.

ACS 161

ACS Emergency Department ED OR 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

The Skeptics' Guide to EM

NOVEMBER 11, 2023

Case: A 24-year-old manual labourer presents to the emergency department (ED) after drinking a few too many beers, having a disagreement with another beer drinker and gets knocked down. DISCLAIMER: THE VIEWS AND OPINIONS OF THIS BLOG AND PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US MILITARY.

ALS 244

ALS Emergency Department ED OR 244

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

The Skeptics' Guide to EM

AUGUST 5, 2023

Annals of Emergency Medicine 2014. Date: July 10, 2023 Guest Skeptic: Dr. Joe Mullally is a paediatric trainee in the Welsh paediatric training program and interested in Paediatric Emergency Medicine. Annals of Emergency Medicine 2014. Annals of Emergency Medicine 2014. Reference: Easter JS et al.

ALS 100

ALS Emergency Department OR 100

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 Manager 81

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

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. 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.

Emergency Department 89

Emergency Department ALS ED OR 89

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. Dessie et al.,

E-9-1-1 177

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

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

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

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

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 14, 2024

This recommendation is a departure from the 2014 guideline iteration that only recommended against CCBs in patients with decompensated heart failure. grams of IV magnesium to placebo, doses considerably higher than the two grams of magnesium often administered in the emergency department (ED). J Emerg Med. Circulation.

ALS 105

ALS Emergency Department ED OR 105

Pediatric EM Morsels

JULY 21, 2023

Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. doi: 10.1136/archdischild-2014-306851. Epub 2014 Sep 8. 2014 Oct;29(10):1299-304. Epub 2014 Feb 13. J Surg Res. 2019 Sep;241:112-118. doi: 10.1016/j.jss.2019.03.038. 2019.03.038. Epub 2019 Apr 22.

Critical Care 246

Critical Care ALS OR Life Support 246

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.

EMR 100

EMR Emergency Department ICU ALS 100

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

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

The Skeptics' Guide to EM

DECEMBER 17, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home.

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

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

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 Epinephrine ALS 169

The Skeptics' Guide to EM

FEBRUARY 26, 2022

She is Chair of the Royal College of Emergency Medicine Women in Emergency Medicine group and involved with the RCEM Public Health and Informatics groups. ED visits in the US for mental health conditions has increased by 44% from 2006 to 2014. Kirsty is also the creator of the wonderful infographics called #PaperinaPic.

ED 130

ED ALS Emergency Department 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

The Skeptics' Guide to EM

NOVEMBER 20, 2021

You wonder if any emergency department (ED)-based interventions would help her and people like her be safe. In 2014 the SGEM looked at a systematic review by Dr. Background: We looked at geriatric falls on an SGEM Xtra in 2015.

ALS 130

ALS ED Emergency Department OR 130

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

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

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

JULY 17, 2021

Case: Six-year-old Morten comes into your emergency department (ED) with what looks like pneumonia. He is the co-founder of website lead of Don’t Forget the Bubbles ( DFTB ). When not drinking coffee and reading Batman comics he is playing with his children. This was a relatively small study (n=115) from Israel.

ALS 130

ALS Emergency Department ED 130

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

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 98

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

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 67

Emergency Department ALS Life Support OR 67