The Skeptics' Guide to EM

JUNE 17, 2023

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Date: June 15, 2023 Reference: Rees CA et al. Date: June 15, 2023 Reference: Rees CA et al. He denies any fever or difficulty breathing.

Emergency Department 186

Emergency Department ALS ED OR 186

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. Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal.

Emergency Department 97

Emergency Department ED EMR OR 97

Pediatric EM Morsels

JULY 21, 2023

We use the GCS score in both trauma and medical patients, but where did this score come from? When is it useful and what does it tell us? Is it actually validated in children, like the Ottawa Ankle Rules or are we using a tool for something other than that for which it was designed and validated, like using Kocher criteria for knee and ankle joints?

Critical Care 246

Critical Care ALS Life Support OR 246

EMDocs

JANUARY 11, 2025

2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation.

E-9-1-1 98

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

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. A 12-year-old male is being transported by ambulance after a road traffic accident. His name is Ben.

E-9-1-1 135

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

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior.

E-9-1-1 130

E-9-1-1 OR Coronary ACS 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

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

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

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. Abdominal : Soft.

ACS 161

ACS Emergency Department ED OR 161

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

ALiEM

MARCH 7, 2024

The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Her mother denies any fevers, upper respiratory symptoms, sore throat, or diarrhea. She adds that her daughter has complained of 2-3 episodes of dysuria and gross hematuria over the last few days. Lay the patient supine when possible.

E-9-1-1 177

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

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

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

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

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

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. A distinction between burnout and moral injury was made during the presentation. Shanafelt et al.

ALS 130

ALS 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

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

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

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. There are three other GEAR 1.0 Background: We looked at geriatric falls on an SGEM Xtra in 2015. Reference: Hammouda et al.

ALS 130

ALS ED Emergency Department OR 130

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. years ( 2 ).

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

ACEP Now

AUGUST 14, 2024

1 Most of the AHA/ACC recommendations are either irrelevant to the general emergency physician or common sense. The Beta Blocker Versus Calcium Channel Blocker Debate The ideal control agent for patients with AF with rapid ventricular response (AFRVR) is widely debated in emergency medicine. The study compared four grams and 9.5

ALS 105

ALS Emergency Department ED OR 105

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. Differentiate abscess from other soft tissue pathologies such as cysts and lymph nodes. There has been no drainage from the lesion. Abscess with color Doppler flow Video 3.

E-9-1-1 161

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

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. mg/dl or 107 umol/L).

EMR 100

EMR Emergency Department ICU ALS 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. A naphylaxis – Emergency Medicine Updates 2. His vital signs are normal. The patient is given 0.5 Read More: 1.

Epinephrine 81

Epinephrine Allergic Reaction Emergency Department Emergency Management 81

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. She has a history of similar episodes. There are no other concerning aspects to her examination. Am J Hematol.

Emergency Department 97

Emergency Department ED ALS OR 97

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

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. Utility of CRP 1. Like other biomarkers, it does not stand alone.

Emergency Department 40

Emergency Department ACS Critical Care Coronary 40

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 16, 2017

Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. Case: Johnny is a 22-year-old male patient who presents to the emergency department via EMS with a seizure. Reference: Legriel et al.

ALS 100

ALS ICU Emergency Department Paramedic 100

Don't Forget the Bubbles

MAY 29, 2023

Surgical subspecialties were often cited as comparably higher than other subspecialties, such as emergency medicine or paediatrics, for example. link] Isn’t it just ‘part of the job?’ Unfortunately, incivility may be familiar in your workplace. If individuals fear repercussions for speaking up, then this can lead to patient harm.

Critical Care 98

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

The Skeptics' Guide to EM

SEPTEMBER 7, 2018

Ben Lawton is a paediatric emergency physician in Brisbane Australia. He divides his time between a tertiary children’s hospital and a community hospital that is busy enough to have its own paediatric emergency department. He is part of the Don’t Forget the Bubbles team. Hypertonic saline has been tried for acute bronchiolitis.

ALS 100

ALS Emergency Department OR 100

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 94

Emergency Department ALS Life Support OR 94

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. Do not obtain comprehensive viral panel testing for patients who have suspected respiratory viral illnesses. SpO2 is 88%. If both answers are the same, don’t take the test.”

Emergency Department 84

Emergency Department ALS ED OR 84

Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. Thorough history taking and detailed examination can aid in diagnosis. Document the size, consistency and location in the notes to compare if they represent.

ALS 124

ALS Emergency Department OR 124

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