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

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

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

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 80

Epinephrine Allergic Reaction Emergency Department Emergency Manager 80

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

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

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

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

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. PMID: 34353648.

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. 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

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

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).

Emergency Department 100

Emergency Department EMR ICU ALS 100

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

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

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

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

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. Karageorgos, S.; Hibberd, O.; Mullally, P.J.W.; Segura-Retana, R.;

Emergency Department 142

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

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).

Emergency Department 52

Emergency Department OR EMS 52

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

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.

Emergency Department 130

Emergency Department ALS OR 130

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 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

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 98

E-9-1-1 ALS Emergency Department EMT 98

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

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. Treatment options for alcohol withdrawal include benzodiazepines such as lorazepam, diazepam, or chlordiazepoxide, gabapentin, and phenobarbital (Buell et al.).

ICU 52

ICU Emergency Department ALS OR 52

Dr. Smith's ECG Blog

AUGUST 4, 2024

Context: a man in his 40s presented to the emergency department with 1 day of sudden onset chest pain. A DDENDUM ( 8/3/2024 ) : In the following 5 Figures — I post written summary from my ECG-2014-ePub on the ECG diagnosis of A cute P ericarditis. I sent this to our group without information and Dr. Smith responded: "Not OMI.

STEMI 99

STEMI OR Emergency Department 99

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

Don't Forget the Bubbles

MARCH 19, 2024

Becasue paediatric emergency departments are accessible out-of-hours they become the de facto place of safety with access to immediate support. In 2014, 71% (397) of emergency removals of children by police occurred out-of-hours or at weekends.

Mental Health Services 52

Mental Health Services ED OR Emergency Department 52

REBEL EM

AUGUST 30, 2023

REBEL Core Cast 107.0 – Vertebral Osteomyelitis Click here for Direct Download of the Podcast Definition Inflammation of the vertebrae due to a pyogenic, fungal or mycobacterial organism. Classified as either acute (days), subacute (weeks) or chronic (months) Spondylodiscitis: a term encompassing osteomyelitis, spondylitis and discitis.

E-9-1-1 103

E-9-1-1 ALS ED OR 103

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

EMDocs

SEPTEMBER 27, 2023

Below we discuss three that will likely have the greatest impact on emergency medicine physicians and our patients. 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. Upon review of the history, several of the patients had been exposed to a liquid acetaminophen-based teething medication. What are the public health implications of DEG toxicity?

E-9-1-1 66

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

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

MARCH 25, 2024

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. Ma and Mateer’s Emergency Ultrasound, 3e. New York, NY: The McGraw-Hill Companies; 2014. 1999;6:1020-1023.

ALS 87

ALS Coronary Emergency Department ED 87