The Skeptics' Guide to EM

OCTOBER 28, 2023

Acetaminophen ( Williams et al Lancet 2014) * Muscle relaxants ( Friedman et al JAMA 2015) * NSAIDs ( Machado et al Ann Rheum Dis 2017) * Steroids ( Balakrishnamoorthy et al Emerg Med J 2014) * Benzodiazepines ( Friedman et al Ann Emerg Med 2017) Many non-pharmacologic therapies have also been tried with limited efficacy.

ALS 268

ALS Emergency Department ED OR 268

ALiEM

APRIL 12, 2023

Figure 1: Peripheral IV ultrasound using alcohol under transparent film dressing and topical saline flush – all without ultrasound gel Read other Tricks of the Trade articles. References Cleaning and Disinfecting FUJIFILM SonoSite Products User Guide [PDF]. Accessed April 5, 2023. Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al.

Emergency Department 258

Emergency Department ALS ED 258

ALiEM

MAY 24, 2023

In: Fleisher and Ludwig’s Textbook of Pediatric Emergency Medicine, 7th ed, Shaw K, Bachur RG (Eds), Lippincott Williams & Wilkins, Philadelphia 2015. Genitourinary trauma.

ED 233

ED OR 233

First 10 EM

SEPTEMBER 25, 2023

Weingart 2011, Weingart 2015) It is a brilliant concept, makes a ton of sense on paper, and anecdotally has seemed to help a number of my patients. Introduced to the world by our friend Scott Weingart, delayed sequence intubation (DSI) is often summarized as procedural sedation for the procedure of preoxygenation.

EMS 142

EMS 142

First 10 EM

MARCH 25, 2024

Carpenter 2015) […] The post Overdiagnosis: Would we better better off not looking? Between 2001 and 2010 the use of CT in emergency departments increased 3-fold (and the use of MRI increased 9-fold, but for some reason it is still almost impossible for me to get one done.) appeared first on First10EM.

Emergency Department 137

Emergency Department 137

The Skeptics' Guide to EM

APRIL 6, 2019

This changed in 2015 when the Food and Drug Administration (FDA) approved idarucizumab for the reversal of dabigatran. We covered the interim analysis of 90 patients included in a prospective cohort study by Pollack et al NEJM 2015 on SGEM#139. Dabigatran is a direct thrombin inhibitor.

Frozen Plasma 130

Frozen Plasma Plasma ALS EMS 130

ALiEM

FEBRUARY 26, 2024

2015 Mar-Apr;60(2):211. Clinical and therapeutic approach to childhood acne: an update. Pediatr Dermatol. 2009 Jul-Aug;26(4):373-80. doi: 10.1111/j.1525-1470.2009.00932.x. 1525-1470.2009.00932.x. PMID: 19689511. Neonatal pustular dermatosis: an overview. Indian J Dermatol. doi: 10.4103/0019-5154.152558. PMID: 25814724; PMCID: PMC4372928.

195

195

Pediatric EM Morsels

OCTOBER 27, 2023

Britnell 2015] Broselow tape performed better than APLS method in Chinese children. Khouli 2015] In South Sudan, the Broselow system overestimated weight by 26.6% [Gültekingil-Keser 2017] Broselow out-performed age-based formulas (Theron, APLS, and Shann) in New Zealand, estimating within 10% of actual weight 73% of the time.

E-9-1-1 271

E-9-1-1 Emergency Medical Services Life Support ALS 271

ALiEM

NOVEMBER 22, 2023

Published 2015 Oct 19. Lago J, Rodríguez LP, Blanco L, Vieites JM, Cabado AG. Tetrodotoxin, an Extremely Potent Marine Neurotoxin: Distribution, Toxicity, Origin and Therapeutical Uses. 2015;13(10):6384-6406. PMID: 26492253 Pratap Chand. Marine Envenomations. In: Clinical Neurotoxicology. Pages 454-462. ISBN 9780323052603.

ALS 284

ALS ED OR 284

Pediatric EM Morsels

AUGUST 18, 2023

Binz 2015) Remember, dogs grow 18 times as fast an infant in the first year of life. Binz 2015) More recent lamb studies have been performed, where the growth more closely approximates a human child. Binz 2015). Oral Fluoroquinolone Prescribing to Children in the United States From 2006 to 2015. This myth is: BUSTED-ish.

E-9-1-1 130

E-9-1-1 ACS OR ALS 130

ALiEM

MARCH 7, 2024

Emergency Physician Interpretation of Point-of-care Ultrasound for Identifying and Grading of Hydronephrosis in Renal Colic Compared With Consensus Interpretation by Emergency Radiologists, Acad Emerg Med , 2018 [10] Secondary analysis of images, obtained 2014-2015 from a large volume ED. 2015 Oct;33(10):1531-4. Epub 2015 Jun 23.

E-9-1-1 177

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

The Skeptics' Guide to EM

MAY 20, 2023

However, we have not covered the Therapeutic Hypothermia after Out-of-Hospital Cardiac Arrest (OHCA) in Children or THAPCA-OH published in the New England Journal of Medicine in 2015. We’re adding on a second paper looking at the Bayesian interpretation of the original study. Original trial: Moler FW, Silverstein FS, Holubkov R, et al.

CPR 130

CPR ALS Emergency Department EMS 130

The Skeptics' Guide to EM

SEPTEMBER 16, 2017

A 2015 phase 2 study published in the NEJM (Bas et al) touted the role for icatibant in the treatment of these patients. We covered ACE-I induced angioedema and reviewed the 2015 icatibant study on SGEM#110. Icatibant is a selective bradykinin B2 receptor antagonist so it acts by blocking the production of bradykinin.

Epinephrine 130

Epinephrine ALS Emergency Department EMS 130

First 10 EM

JANUARY 29, 2024

Norii 2015, […] The post The UK-REBOA trial appeared first on First10EM. There have been some observational studies that suggested REBOA was associated with worse outcomes, but the outcomes were largely assumed to be the result of confounders.

EMS 102

EMS 102

ALiEM

FEBRUARY 20, 2024

2015 Oct;33(10):1542.e1-2. PMID: 26159649 ; PMCID: PMC4781799. Reynolds JC, Judge BS. Successful treatment of flecainide-induced cardiac arrest with extracorporeal membrane oxygenation in the ED. Am J Emerg Med. PMID: 26299692.

Life Support 183

Life Support Overdose ED 183

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

Guest Skeptic: Dr. Natalie May trained as an emergency physician with subspecialty paediatric emergency medicine in the UK and worked in Manchester and Oxford before moving to Australia in 2015 to work for Sydney […] The post SGEM#190: Wee are the Champions of Pediatric Urine Samples first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 130

Emergency Department ALS OR 130

This Podcast Will Kill You

FEBRUARY 11, 2025

2015): 602-604. Cymothoa indica (Crustacea, Isopoda, Cymothoidae) parasitizes the cultured larvae of the Asian seabass Lates calcarifer under laboratory conditions. Diseases of Aquatic Organisms, 66(1), pp.87-90. Jrgensen, Dolly. “Conservation implications of parasite co-reintroduction.” ” Conservation Biology 29.2

E-9-1-1 97

E-9-1-1 ALS OR 97

REBEL EM

AUGUST 30, 2023

Most common organism is Staph Aureus (36-67% of cases) ( Boody 2015 ). Executive Summary: 2015 Infectious Disease Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis 2015 Sept 15;61(6):859-63. Other pathogens include: E.

E-9-1-1 96

E-9-1-1 ALS ED OR 96

ALiEM

SEPTEMBER 27, 2023

Encyclopedia of Toxicology (Third Edition), Academic Press. doi: 10.1016/B978-0-12-386454-3.00754-5. Goldfrank L. In: Goldfrank’ s Toxicologic Emergencies. Hoffman et al. New York, NY. McGraw-Hill. Koppaka V, Thompson DC, Chen Y, et al.

ALS 169

ALS OR ED 169

ALiEM

MAY 19, 2023

Published July 13, 2015. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Sengstaken-Blakemore, Minnesotta and Linton-Nachlas tubes. Deranged Physiology. Accessed April 6, 2023. García-Pagán JC, Reverter E, Abraldes JG, Bosch J. Acute variceal bleeding. Semin Respir Crit Care Med. 2012 Feb;33(1):46-54.

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245

ALiEM

AUGUST 9, 2023

Pediatrics 2015 8 studies; 765 patients 96% 93% Evidence supports lung POCUS as an alternative for diagnosis of pneumonia in children. 2015 Apr;135(4):714-22. Table 1 summarizes these studies, showing an overall high accuracy for lung POCUS diagnosis of pneumonia in children. Study N Sensitivity Specificity Comments Pereda et al.,

E-9-1-1 246

E-9-1-1 Emergency Department ALS OR 246

ALiEM

SEPTEMBER 11, 2023

2015 Aug 21;64(32):865-70. References Cope JR, Collier SA, Rao MM, Chalmers R, Mitchell GL, Richdale K, Wagner H, Kinoshita BT, Lam DY, Sorbara L, Zimmerman A, Yoder JS, Beach MJ. Contact Lens Wearer Demographics and Risk Behaviors for Contact Lens-Related Eye Infections–United States, 2014. MMWR Morb Mortal Wkly Rep.

Emergency Department 152

Emergency Department ED OR 152

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

Sci 5[4] 268-270, 2015 ) both highlight a likely association between acute development of ischemic J waves — and high risk of developing malignant ventricular arrhythmias ( My Comment in the September 23, 2020 post ). Rituparna et al — as well as Chauhan and Brahma ( Int. Smith’s ECG Blog ).

ICU 137

ICU OR ALS ED 137

ALiEM

OCTOBER 30, 2024

2015 Apr 28;313(16):1636-44. PMID 28194688 D’Onofrio G, O’Connor PG, Pantalon MV, et al. Emergency department–initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. PMID 25919527 Sue KL, Cohen S, Tilley J, Yocheved A.

E-9-1-1 161

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

The Skeptics' Guide to EM

MARCH 20, 2021

PE guru, creator of the PERC Rule and Editor-in-Chief of Academic Emergency Medicine, Dr. Jeff Kline, was senior author on a paper that looked at treating VTE with outpatient management using a DOAC ( Bean et al AEM 2015 ). Literature from the USA reports that 90% of patients diagnosed with PE are admitted ( Singer et al 2016 ).

ALS 130

ALS ED 130

ALiEM

DECEMBER 22, 2023

2015 Nov 18;10:55. References Deleanu B, Prejbeanu R, Tsiridis E, Vermesan D, Crisan D, Haragus H, Predescu V, Birsasteanu F. Occult fractures of the proximal femur: imaging diagnosis and management of 82 cases in a regional trauma center. World J Emerg Surg. doi: 10.1186/s13017-015-0049-y. PMID: 26587053; PMCID: PMC4652353.

OR 161

OR 161

Pediatric EM Morsels

MAY 12, 2023

2015 Nov;100(11):1032-7. Epub 2015 Aug 21. Burrows P, Trefan L, Houston R, Hughes J, Pearson G, Edwards RJ, Hyde P, Maconochie I, Parslow RC, Kemp AM. Head injury from falls in children younger than 6 years of age. Arch Dis Child. doi: 10.1136/archdischild-2014-307119. PMID: 26297697; PMCID: PMC4680174.

OR 130

OR EMS 130

EMDocs

JUNE 15, 2024

Source Shifts in Diagnostic Testing for Headache in the Emergency Department, 2015 to 2021. JAMA Netw Open. 2024 Apr 1;7(4):e247373. doi: 10.1001/jamanetworkopen.2024.7373. PMID: 38639937; PMCID: PMC11031686. The post Journal Feed Weekly Wrap-Up appeared first on emDOCs.net - Emergency Medicine Education.

ICU 97

ICU Emergency Department ED OR 97

The Skeptics' Guide to EM

NOVEMBER 6, 2021

There were a few earlier studies on MT that failed to demonstrate superiority, but it was the study MR CLEAN published in NEJM 2015 that really changed practice. Mechanical thrombectomy is indicated only for patients with large vessel occlusions (LVOs) on imaging.

ALS 130

ALS OR 130

The Skeptics' Guide to EM

OCTOBER 28, 2017

That rant relied upon a Cochrane SRMA by Stevens B et al 2013 and a randomized clinical trail published in Pediatrics by Gray L et al 2015. There is a RANThony on pediatric pain control and one of the interesting treatments was sucrose.

ALS 130

ALS Emergency Department OR ED 130

The Skeptics' Guide to EM

FEBRUARY 19, 2022

The highest prevalence of burnout was reported by emergency physicians. COVID19 has been hard on the health care system.

Emergency Department 130

Emergency Department ALS OR 130

This Podcast Will Kill You

OCTOBER 22, 2024

2015): 855-857. Baizabal-Carvallo, J.F. and Jankovic, J., Stiff-person syndrome: insights into a complex autoimmune disorder. Journal of Neurology, Neurosurgery & Psychiatry , 86 (8), pp.840-848. Gavin, Pamela. “The importance of natural histories for rare diseases.” ” Expert Opinion on Orphan Drugs 3.8 Caffrey, D.,

ALS 98

ALS OR 98

ALiEM

JULY 17, 2023

In fact, the average number of applicants between 2015-2020 and 2022-2023 were relatively similar, with the latter demonstrating 122 more applicants (2,801 vs 2,923). However, between 2015 and 2023, the number of available EM positions grew, with an annual addition of 149 PGY1 positions.

EMS 130

EMS ALS Emergency Department ED 130

The Skeptics' Guide to EM

SEPTEMBER 10, 2017

Acetaminophen Williams et al (Lancet 2014) * Muscle relaxants Friedman et al (JAMA 2015) * NSAIDs Machado et al (Ann Rheum Dis 2017) * Benzodiazepines Friedman et al (Ann Emerg Med 2017) Opioids are very effective at reducing pain. Many different treatment modalities have been tried to treat low back pain with limited success.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

There are five steps in the Chain-of-Survival for OHCA: Most of us can agree with the first three steps. You need to recognize an arrest and activate your EMS system.

CPR 130

CPR Life Support Advanced Life Support Defibrillator 130

The Skeptics' Guide to EM

DECEMBER 8, 2017

SGEM#87 : Let Your Back-Bone Slide (Paracetamol for Low-Back Pain) * SGEM#173 : Diazepam Won’t Get Back Pain Down * Muscle Relaxant Friedman et al (JAMA 2015) * NSAIDs Machado et al (Ann Rheum Dis 2017) * Systematic Review Ashbrook et al (Emerg Med J 2017) Then there is the issue of opioids use for low back pain.

Emergency Department 130

Emergency Department ALS OR EMS 130

The Skeptics' Guide to EM

JUNE 9, 2018

There’s some data supporting the use of an inhalation of isopropyl alcohol in emergency department patients (Beadle, et al Ann Emerg Med 2015 ). They concluded that aromatherapy may have similar effectiveness to placebo based on low-quality evidence. We covered that paper on the SGEM in Episode #144.

Emergency Department 130

Emergency Department ALS OR 130