EMDocs

AUGUST 22, 2024

have limited English proficiency according to the 2015 U.S. 6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. 6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits.

Emergency Department 82

Emergency Department ALS E-9-1-1 ED 82

REBEL EM

JUNE 5, 2023

One study from a county in Massachusetts found that of all nonfatal opioid doses seen in the emergency department from 2011-2015, 1 in 20 patients subsequently died within one year of initial visit with 66% of these deaths being directly related to an opioid overdose (4). PMID 33392580.

Naloxone 98

Naloxone ED Overdose Emergency Department 98

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-9-1-1 103

E-9-1-1 ALS ED OR 103

ALiEM

APRIL 12, 2023

Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. 20 – Local Anesthetics, Ed(s): Hugh C. References Cleaning and Disinfecting FUJIFILM SonoSite Products User Guide [PDF]. Accessed April 5, 2023. Disinfectants and Cleaning Solutions for Ultrasound Systems and Transducers [PDF]. 2022 Jan 6;8(1):42. doi: 10.3390/gels8010042.

Emergency Department 258

Emergency Department ALS ED 258

The Skeptics' Guide to EM

MARCH 20, 2021

Reference: Westafer et al. Reference: Westafer et al. 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

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

OCTOBER 10, 2020

Reference: Friedman et al. Date: October 9th, 2020 Guest Skeptic: Dr. Reference: Friedman et al. Background: Pain is one of the most frequent reasons to attend an ED. of all ED visits resulting in 2.6 million visits each year in the USA ( Friedman et al Spine 2010 ). His twitter handle is @PainFreeED.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Date: September 8th, 2021 Reference: Desch et al. He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP).

EMR 130

EMR Coronary Defibrillator Life Support 130

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. 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% 2012.05.028 Silvagni D, Baggio L, Mazzi C, et al.

E-9-1-1 268

E-9-1-1 Emergency Medical Services Life Support ALS 268

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

When the patient arrived in the ED, he was still hypotensive in 70s, slowly improving with EMS fluids. Here is the ED ECG (a photo of the paper printout) What do you think? The American Journal of Emergency Medicine 2015; 33(6):786-790. No Chest Pain, but somnolent. Smith : There is 1mm of STE in V1 and almost 1.5mm in V2.

EMS 108

EMS CPR ED Coronary 108

The Skeptics' Guide to EM

MARCH 12, 2022

Date: March 3rd, 2022 Reference: Macnow et al. Date: March 3rd, 2022 Reference: Macnow et al. Dr. Varner’s research interests are in concussion and pregnancy care in the ED. Case: An 18-year-old female presents to the emergency department (ED) after falling off a moving snowmobile and hitting her head on the ground.

Emergency Department 100

Emergency Department ED ALS OR 100

ALiEM

NOVEMBER 22, 2023

Pagel, Mark (ed.). “Evolution of Dietary Specialization and Chemical Defense in Poison Frogs (Dendrobatidae): A Comparative Analysis” The American Naturalist. Published 2015 Oct 19. Tarvin RD, Borghese CM, Sachs W, et al. The poison Dart frog’s batrachotoxin modulates Nav1.8. 2004;577(1-2):245-248.

ALS 284

ALS ED OR 284

EMDocs

MAY 11, 2024

A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al.

EMS 89

EMS E-9-1-1 ALS OR 89

REBEL EM

JANUARY 24, 2024

Wallace 2011 ) If addressed early and appropriately, most patients have good self-reported long-term outcomes regardless of the treatment modality Links Orthobullets: Achilles Tendon Rupture Resources: Sheth U et al. PMID: 9519398 Kayser R et al. PMID: 16244194 Margetic P et al. PMID: 17598414 Garras DN et al.

ALS 103

ALS ED OR EMS 103

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

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

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., ED Course The patient received antibiotics for pneumonia. 2015 Apr;135(4):714-22.

E-9-1-1 246

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

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., ” ( Ed. 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.,

E-9-1-1 111

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

The Skeptics' Guide to EM

JUNE 5, 2021

References: * Suzuki et al. JAMA 2021 * Zi et al. The tipping point came with the publication of MR. CLEAN in 2015. At work Garreth imagines himself as a student of evidence-based medicine trying to provide the best care based on the best evidence. A non-contrast CT shows no evidence of intracranial hemorrhage.

ALS 130

ALS Emergency Department ED 130

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

EMDocs

FEBRUARY 22, 2024

A 43-year-old male, with no significant medical history, presents to the ED for right eye pain. In: Tintinalli JE, Ma OJ, Yealy DM, et al., In: Knoop KJ, Stack LB, Storrow AB, Thurman RJ, eds. Published June 11, 2015. In: Tintinalli JE, Ma OJ, Yealy DM, et al., Wakai A, Lawrenson JG, Lawrenson AL, et al.

ALS 77

ALS ED EMS OR 77

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

He was intubated on arrival at the ED for mental status and airway protection due to vomiting. Rituparna et al — as well as Chauhan and Brahma ( Int. There is also large T wave inversion and long QT. Clinical context: A man in his 50s was found down outside in the cold, unresponsive but with intact vital signs. Smith’s ECG Blog ).

ICU 135

ICU OR ALS ED 135

This Podcast Will Kill You

OCTOBER 24, 2023

eds (2015) Broughton, E., Eds Converey, I., In Conflicts around domestic water and sanitation in India: cases, issues and prosects eds: Joy, KJ., .” Environmental Health 4.1 2005): 1-6. and Varma, D.R., The Bhopal disaster of 1984. Bulletin of Science, Technology & Society , 25 (1), pp.37-45. Carpenter, C.

E-9-1-1 52

E-9-1-1 ED ALS 52

REBEL EM

FEBRUARY 22, 2023

Bagheri 2015 ). Giant Cell Arteritis (arteritic anterior ischemic neuropathy) ( Bagheri 2015 , Hayreh 2009 ) Pathophysiology Giant cell arteritis(GCA) affects that medium-sized and large arteries. et al, Emergency Medicine Clinical Essentials ed 2. Persistent vision loss defined as loss of vision >24 hours.

Emergency Department 52

Emergency Department ALS ED Coronary 52

The Skeptics' Guide to EM

OCTOBER 28, 2017

[display_podcast] Date: October 24th, 2017 Reference: Harrison et al. display_podcast] Date: October 24th, 2017 Reference: Harrison et al. 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. Reference: Harrison et al.

ALS 130

ALS Emergency Department OR ED 130

This Podcast Will Kill You

NOVEMBER 7, 2023

Manne, eds. 2015): 83-92. Lee, Carrie, et al. and Al-Niami, F., Tune in for an info-packed episode that will have you reaching for that sunscreen bottle. History Biology Heckman, Carolyn J., and Sharon L. Shedding light on indoor tanning. Springer Science & Business Media, 2011. Linares, M.A., Zakaria, A. Skin cancer.

E-9-1-1 52

E-9-1-1 ALS ED OR 52

The Skeptics' Guide to EM

DECEMBER 8, 2017

[display_podcast] Date: November 28th, 2017 Reference: Motov S et al. display_podcast] Date: November 28th, 2017 Reference: Motov S et al. A systematic review was just published in the Emergency Medicine Journal looking at 43 management of acute low back pain in the ED. The conclusions…we need more evidence.

Emergency Department 130

Emergency Department ALS OR EMS 130

EMDocs

JUNE 22, 2024

A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. 2015 May;28(7):793-8. We’ll keep it short, while you keep that EM brain sharp. She had a precipitous delivery while the ambulance was pulling in. The newborn is doing well, but the mother is complaining of shortness of breath and chest pain.

EMS 96

EMS Ambulance FFP ICU 96

Broome Docs

JANUARY 30, 2023

Vedantham S, Goldhaber SZ, Julian JA, et al; ATTRACT Trial Investigators. 2015 Apr;72(4):668-73. Epub 2015 Jan 23. 2015 Dec;21(6):1244-6. Epub 2015 Dec 29. N Engl J Med. 2022 Nov 6. doi: 10.1056/NEJMoa2207304. Epub ahead of print. PMID: 3634215 You can read the full critical appraisal here. N Engl J Med.

E-9-1-1 52

E-9-1-1 Emergency Department Defibrillator ALS 52

The Skeptics' Guide to EM

OCTOBER 22, 2017

[display_podcast] Date: October 19th, 2017 Reference: Hofmann et al. display_podcast] Date: October 19th, 2017 Reference: Hofmann et al. Studies have shown that oxygen can cause vasoconstriction, increase blood pressure and decrease coronary artery blood flow ( Kones et al AM J Med 2011). NEJM Sept 2017. NEJM Sept 2017.

Emergency Medical Services 130

Emergency Medical Services Coronary ALS STEMI 130

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days. Ultrasound.

ALS 71

ALS Emergency Department ED OR 71

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. ED crowding impairs this mission. The Emergency Medical Treatment and Labor Act (EMTALA) mandates examination, treatment, and stabilization of anyone who comes to the ED.

Emergency Department 52

Emergency Department ED ALS OR 52

REBEL EM

MARCH 22, 2023

Valsalva maneuvers Have patient bear down as if they are having a bowel movement Have patient blow as hard as they can into a straw Syringe technique Postural Modification Success rate: 43% vs. 17% (standard Valsalva) (Appleboam 2015) Details of technique found at the St. PMID: 2022022 Appleboam A et al. Lancet 2015. Am Heart J.

ALS 52

ALS EMS ED OR 52

Don't Forget the Bubbles

JUNE 30, 2023

She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. Mazur P, Kosinski S, Podsiadlo P, et al.: Meert et al. 20 (2015): 1898-1908 As the PICU reg finishes their teaching and prescribes some warm IV fluids, Elsa’s sats drop to 54%. . Meert et al.

CPR 145

CPR Life Support Critical Care ALS 145

REBEL EM

MARCH 8, 2023

Bagheri 2015 ). et al, Emergency Medicine Clinical Essentials ed 2. Eye Emergencies, in Tintinalli J et al (eds): Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, Seventh Edition New York City: McGraw-Hill 2016 (Ch) 241 Guluma K, Lee JE. Transient vision loss defined as vision loss <24 hours.

Emergency Department 52

Emergency Department ALS ED OR 52

EMS 12-Lead

MAY 20, 2022

Below is the initial ED ECG. Smith comment : It is highly likely that it was open with flow at the time of the angiogram, given how much she was improved by the end of her ED stay. Manual of Cardiovascular Medicine (5th ed.). There is Sinus Brady with improved conduction as noted by the tighter QRS duration. References Naidu, S.

Coronary 130

Coronary STEMI Firefighter ED 130

REBEL EM

DECEMBER 5, 2023

The risk of a biphasic reaction is what keeps patients in the ED while being observed for a set period of time. Thus, if the patient has complete resolution of symptoms after appropriate treatment of anaphylaxis, there is no set time period for monitoring in the ED. 2015 May-Jun;3(3):408-16 Ellis A, Day J.

Epinephrine 80

Epinephrine Allergic Reaction Emergency Department Emergency Manager 80