Core EM

JANUARY 25, 2024

Background: An update to our 2015 post on HIET for beta-adrenergic receptor and calcium channel antagonists overdose. References: Yuan TH, Kerns WP, Tomaszewski CA, et al. von Lewinski D, Bruns S, Walther S, et al. Cole JB, Corcoran JN, Engebretsen KM, et al. Holger JS, Engebretsen KM, Fritzlar SJ, et al.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

REBEL EM

AUGUST 30, 2023

Most common organism is Staph Aureus (36-67% of cases) ( Boody 2015 ). Graphics Image 1: [link] Image 2: [link] References Berbari EF, Kanj SS, et al. Executive Summary: 2015 Infectious Disease Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults.

E-9-1-1 104

E-9-1-1 ALS ED OR 104

Pediatric EM Morsels

JULY 21, 2023

Holmes, James F et al. Systematic review showed 85% of studies with substantial reliability with kappa statistic >0.6 Performance of the Pediatric Glasgow Coma Scale Score in the Evaluation of Children With Blunt Head Trauma. Acad Emerg Med. 2016 Aug;23(8):878-84. doi: 10.1111/acem.13014. Epub 2016 Aug 1. PMID: 27197686. 2005): 814–819.

Critical Care 246

Critical Care ALS OR Life Support 246

Pediatric EM Morsels

NOVEMBER 15, 2024

2015) Childhood epilepsy centrotemporal spikes (benign Rolandic Epilepsy) , Epilepsy Foundation. Tsai ML, Wang CC, Wang AY, et al. 2024.03.015 Steinruecke M, Gillespie C, Ahmed N, et al. References : Hernandez, A., Holmes, G.L. and Fisher, R. Edited by E. Available at: [link] (Accessed: 14 November 2024). Pediatr Neurol.

ALS 152

ALS OR EMS 152

REBEL EM

SEPTEMBER 23, 2024

Opponents of ketamine often point to the risks of spiking intracranial pressure but this concern has been widely debunked ( Cohen 2015 ). PMID: 21373823 Cohen L et al. Ann Emerg Med 2015; 65(1): 43-51. PMID: 25064742 Kotani Y et al. J Crit Care 2023;77: PMID: 37127020 Koroki T, Kotani Y, Yaguchi T, et al.

ALS 75

ALS EMS ED OR 75

This Podcast Will Kill You

OCTOBER 1, 2024

Cabezas-Cruz, Alejandro, et al. Cabezas-Cruz, Alejandro, et al. Cabezas-Cruz, Alejandro, et al. de la Fuente, José, et al. “Anti‐G al: an abundant human natural antibody of multiple pathogeneses and clinical benefits.” Nunen, S.A.V., O’Connor, K.S., Clarke, L.R., Boyle, R.X. and Fernando, S.L.,

E-9-1-1 52

E-9-1-1 ALS OR 52

REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. Richards JE et al. NEJM 1994. [2]

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

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% link] Lubitz DS, Seidel JS, Chameides L, Luten RC, Zaritsky AL, Campbell FW. 2012.05.028 Silvagni D, Baggio L, Mazzi C, et al. in non-malnourished children.

E-9-1-1 269

E-9-1-1 Emergency Medical Services Life Support ALS 269

REBEL EM

APRIL 29, 2024

In these situations, the American Heart Association (AHA) and the European Resuscitation Council (ERC) of 2015 recommend the intraosseous (IO) route after the peripheral route and before the central venous route ( 1). A study by Lee et al ( 7) compared femoral CVC placement to IO and demonstrated a first-pass success pass rate with IO of 90.3%

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

ALiEM

APRIL 12, 2023

Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. References Cleaning and Disinfecting FUJIFILM SonoSite Products User Guide [PDF]. Accessed April 5, 2023. Disinfectants and Cleaning Solutions for Ultrasound Systems and Transducers [PDF].

Emergency Department 258

Emergency Department ALS ED 258

ALiEM

SEPTEMBER 27, 2023

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

ALS 169

ALS OR ED 169

The Skeptics' Guide to EM

APRIL 6, 2019

Date: April 5th, 2019 Reference: Connolly et al. Date: April 5th, 2019 Reference: Connolly et al. This changed in 2015 when the Food and Drug Administration (FDA) approved idarucizumab for the reversal of dabigatran. Full Study Report of Andexanet Alfa for Bleeding Associated with Factor Xa Inhibitors.

Frozen Plasma 130

Frozen Plasma Plasma ALS EMS 130

This Podcast Will Kill You

SEPTEMBER 24, 2024

Datz, Christian, et al. Hodgskiss, Malcolm SW, et al. 2015): 39-58. Moalem, Sharon, et al. Olejarz, Jason, et al. Wade, Jon, et al. Gastroenterology , 139 (2), pp.393-408. ” Clinical chemistry 44.12 (1998): 2429-2432. Adams, P.C., NIH, June 15,2023. link] Distante, S., Hurrell, R. and Egli, I.,

ALS 52

ALS ACS 52

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 OR ACS ALS 130

EMDocs

AUGUST 22, 2024

have limited English proficiency according to the 2015 U.S. Review toolkits and studies that provide strategies for advancing language justice in your ED: Betancourt JRRM, et al. Lion KC, et al. Regenstein M, et al. Taira B, et al. Taira B, et al. Lim T, Campbell R, et al. Ngai K, Grudzen C, et al.

Emergency Department 81

Emergency Department ALS E-9-1-1 ED 81

This Podcast Will Kill You

JANUARY 16, 2024

Hoelzer, Karin, et al. ” Annual Review of Virology 2 (2015): 425-450. History Biology Allison, Andrew B., “Role of multiple hosts in the cross-species transmission and emergence of a pandemic parvovirus.” ” Journal of virology 86.2 2012): 865-872. Heegaard, E.D. and Brown, K.E., Human parvovirus B19. Young, N.S.

E-9-1-1 95

E-9-1-1 ALS 95

This Podcast Will Kill You

JULY 23, 2024

Caio, Giacomo, et al. Cenit, María Carmen, et al. 2015): 6900-6923. Al-Dulaimi, D., Gasbarrini, Giovanni, et al. Gasbarrini, Giovanni Battista, et al. Kerner, Gaspard, et al. Newberry, Carolyn, et al. Rostami, Kamran, et al. .” The Lancet Gastroenterology & Hepatology 4.2

E-9-1-1 98

E-9-1-1 ALS OR 98

REBEL EM

JANUARY 9, 2024

Additionally, multiple studies demonstrate increased harm with IV antibiotics such as increased rate of diarrhea ( Haran 2014 ), complications from IV placement ( Li 2015 ), and increased length of stay or cost ( Lorgelly 2010 ). PMID: 9114201 Siegel RE et al. PMID: 17090560 Castro-Guardiola A et al. PMID: 17567657 Rae N et al.

ALS 100

ALS ICU ED OR 100

ALiEM

AUGUST 9, 2023

Study N Sensitivity Specificity Comments Pereda et al., Pediatrics 2015 8 studies; 765 patients 96% 93% Evidence supports lung POCUS as an alternative for diagnosis of pneumonia in children. Balk et al., Tsou et al., PMID: 14722643 Pereda MA, Chavez MA, Hooper-Miele CC, et al. 2015 Apr;135(4):714-22.

E-9-1-1 246

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

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Date: September 8th, 2021 Reference: Desch et al. Defibrillation is the treatment of choice in these cases but does not often result in sustained ROSC ( Kudenchuk et al 2006). The TOMAHAWK Investigators. first appeared on The Skeptics Guide to Emergency Medicine.

EMR 130

EMR Coronary Defibrillator Life Support 130

Don't Forget the Bubbles

JANUARY 17, 2024

After Meshram et al, 2020 When Orbeez are exposed to water, the water molecules diffuse into the polymer network through osmosis. Image adapted from Mullens et al., After Darracq et al., 2015 But we all know that what happens in the lab does not always mirror what happens in real life. Zamora et al., Krisch et al.

E-9-1-1 111

E-9-1-1 ALS Emergency Department OR 111

ALiEM

MAY 13, 2024

Study N Methods POCUS Sensitivity (95% CI) POCUS Specificity (95% CI) Conclusions Gottleib et al., Lam et al., of cases* Subramaniam et al., Lam et al., of cases* Subramaniam et al., Adams et al., Adams et al., Sivitz et al., Yen ZS, Wang HP, Ma HM, et al. Epub 2015 Nov 10.

E-9-1-1 161

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

EMDocs

MAY 11, 2024

Rosh Review Website Link Further Reading: FOAMed: [link] [link] [link] [link] [link] [link] [link] References : Turi B, Smith D, Kusel K, et al. Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al. link] Sharma R, Gaillard F, Bell D, et al. 2015 Sep;66(3):322-333.e31.

EMS 88

EMS E-9-1-1 ALS OR 88

The Skeptics' Guide to EM

DECEMBER 17, 2022

Date: December 16th, 2022 Reference: Hohle et al. Date: December 16th, 2022 Reference: Hohle et al. Massive Blood Transfusion Following Older Adult Trauma: the Effect of Blood Ratios on Mortality. AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals.

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

REBEL EM

SEPTEMBER 13, 2023

Read More EMCrit: Podcast 145 – Awake Intubation Lecture from SMACC ERCast: Angioedema References: Baş M et al. 2015; 372(5):418-25. PMID 25629740 Hassen GW et al. PMID 23062323 Kostis JB et al. PMID 16043683 McCormick M et al. PMID 20954277 Sinnert R et al. Zuraw et al. N Engl J Med.

Frozen Plasma 105

Frozen Plasma Allergic Reaction FFP Plasma 105

REBEL EM

JULY 20, 2022

White 2003 ) The most common locations of SVT of the lower extremity are: ( Cosmi 2015 ) Long saphenous vein – 50-60% Short saphenous vein – 11-15% Tributaries of the long/short saphenous – 30-40% Pathophysiology, causes and risk factors: Vascular clots are caused by a combination of venous stasis, endothelial injury and hypercoagulability.

ALS 52

ALS OR ED EMS 52

This Podcast Will Kill You

SEPTEMBER 3, 2024

Dolin, Raphael, et al. Al-Hello, H., Dolin, Raphael, et al. Hellysaz, Arash, et al. Lucero, Yalda, et al. History Biology Adler, Jonathan L., and Raymond Zickl. “Winter vomiting disease.” ” The Journal of infectious diseases 119.6 1969): 668-673. Robilotti, E., Deresinski, S. and Pinsky, B.A.,

ALS 52

ALS OR 52

This Podcast Will Kill You

OCTOBER 22, 2024

2015): 855-857. Schieppati, Arrigo, et al. 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.” Caffrey, D., and Arsan, C.,

ALS 52

ALS OR 52

The Skeptics' Guide to EM

SEPTEMBER 10, 2022

Date: August 25th, 2022 Reference: Martin et al. Date: August 25th, 2022 Reference: Martin et al. Reference: Martin et al. Single-dose dexamethasone is not inferior to 2 doses in mild to moderate pediatric asthma exacerbations in the emergency department. Pediatr Emerg Care. Pediatr Emerg Care. Pediatr Emerg Care.

Emergency Department 130

Emergency Department ALS ED OR 130

This Podcast Will Kill You

FEBRUARY 13, 2024

Ellis, Samuel, et al. The slow moon climbs: The science, history, and meaning of menopause. Princeton University Press, 2019. Davis, S.R., Lambrinoudaki, I., Lumsden, M., Mishra, G.D., Santoro, N. and Simoncini, T., Menopause (Primer). Nature Reviews: Disease Primers , 1 (1). Gunter, Jennifer. Hachette UK, 2021. Harlow, S.D., Rebar, R.W.,

ALS 98

ALS OR 98

The Skeptics' Guide to EM

OCTOBER 10, 2020

Reference: Friedman et al. Reference: Friedman et al. million visits each year in the USA ( Friedman et al Spine 2010 ). These include: acetaminophen ( Williams et al Lancet 2014), muscle relaxants ( Friedman et al JAMA 2015), NSAIDs ( Machado et al

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

NOVEMBER 20, 2021

Date: November 16th, 2021 Reference: Hammouda et al. Date: November 16th, 2021 Reference: Hammouda et al. Background: We looked at geriatric falls on an SGEM Xtra in 2015. Reference: Hammouda et al. You wonder if any emergency department (ED)-based interventions would help her and people like her be safe.

ALS 130

ALS ED Emergency Department OR 130

ALiEM

NOVEMBER 22, 2023

Published 2015 Oct 19. Tarvin RD, Borghese CM, Sachs W, et al. 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.

ALS 284

ALS ED OR 284

Don't Forget the Bubbles

JULY 19, 2023

Two smaller retrospective reviews ( Elhusseiny et al., 2023 and Kovarik et al., 2015 ) found an incidence of true papilloedema of 25% and 6%, respectively, in children referred to tertiary ophthalmology departments with suspected optic disc swelling. Two smaller retrospective studies (Maheswaran et al. Can J Ophthalmol.

ALS 98

ALS Emergency Department ED OR 98

ALiEM

JULY 17, 2023

The Study In an Annals of Emergency Medicine paper , Preiksaitis et al. Many of these findings were similar to a study of the 2022 EM Match results by Murano et al., 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).

EMS 130

EMS ALS Emergency Department ED 130

The Skeptics' Guide to EM

SEPTEMBER 16, 2017

[display_podcast] Date: September 12th, 2017 Reference: Sinert et al. display_podcast] Date: September 12th, 2017 Reference: Sinert et al. A 2015 phase 2 study published in the NEJM (Bas et al) touted the role for icatibant in the treatment of these patients. Reference: Sinert et al.

Epinephrine 130

Epinephrine ALS Emergency Department EMS 130

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

The 2015 ACC/AHA/HRS Guidelines on SVT ( Page et al — Circulation 133(14):e506-e574, 2016 ) list the usual upper rate limit for ectopic ATach and AVNRT at ~250/minute — though other sources suggest occasional rates for these rhythms ( and for AVRT in patients with an accessory pathway ) that may attain up to 280/minute ( StatPearls, 2023 ).

E-9-1-1 64

E-9-1-1 ALS OR ED 64