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 95

Naloxone ED Overdose Emergency Department 95

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. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Tasian GE, Belfer RA. Genitourinary trauma.

ED 233

ED OR 233

The Skeptics' Guide to EM

OCTOBER 28, 2023

Case: A 37-year-old man without a significant past medical history presents to the emergency department (ED) with a chief complaint of lower back pain that started three days prior to the ED visit after unloading a truck with furniture. His twitter handle is @PainFreeED.

ALS 228

ALS Emergency Department ED OR 228

The Skeptics' Guide to EM

MAY 20, 2023

Case: You are working at the community emergency department (ED) when you receive a call from the local Emergency Medicine Service (EMS) team that they are bringing a 2-year-old boy who had a cardiac arrest at home. Upon arrival at the ED, your team promptly begins high quality CPR and manages to obtain return of spontaneous circulation.

CPR 130

CPR ALS Emergency Department EMS 130

EMDocs

JUNE 15, 2024

. #1: PREOXI RCT – Preoxygenation with Noninvasive Ventilation vs. Non-rebreather Mask Spoon Feed Noninvasive ventilation (NIV) was superior to a standard non-rebreather (NRB) oxygen mask for preoxygenation of critically ill ED or ICU patients requiring intubation, with a NNT of 11 to prevent 1 episode of hypoxemia <85%. Ann Emerg Med.

ICU 75

ICU Emergency Department ED OR 75

Pediatric EM Morsels

JUNE 30, 2023

I’m sure you can recall at least several parents who bring their children into the ED for concern of recurrent pneumonias. Often the parents focus on a possible underlying immunodeficiency. Fortunately, most commonly these pneumonias are due to viral infections, and we can often offer reassurances to the parent.

E-9-1-1 258

E-9-1-1 ED EMS OR 258

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. In: Sherman SC eds.

E-9-1-1 94

E-9-1-1 ALS ED OR 94

ALiEM

APRIL 12, 2023

20 – Local Anesthetics, Ed(s): Hugh C. 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.

Emergency Department 258

Emergency Department ALS ED 258

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. 2015 Aug 21;64(32):865-70. The patient is a contact lens wearer. MMWR Morb Mortal Wkly Rep. doi: 10.15585/mmwr.mm6432a2.

Emergency Department 152

Emergency Department ED OR 152

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 107

EMS CPR ED Coronary 107

ALiEM

FEBRUARY 20, 2024

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

Life Support 183

Life Support Overdose ED 183

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

Core EM

JANUARY 25, 2024

We revisit the topic of Hyperkelamia to update our prior episode from 2015 (pre-Lokelma) Hosts: Brian Gilberti, MD Jonathan Kobles, MD [link] Download Leave a Comment Tags: Renal Colic Show Notes Introduction Background Physiology : Normal range and the significance of deviations (>5.5

Epinephrine 246

Epinephrine OR ED 246

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

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. The poison Dart frog’s batrachotoxin modulates Nav1.8. 2004;577(1-2):245-248. PMID: 15527793 Darst, Catherine R.; Coloma, Luis A.;

ALS 284

ALS ED OR 284

EMDocs

JULY 9, 2024

What can we do about this in the pediatric ED? 2015 Feb;135(2):e296-304. Epub 2015 Jan 5. Epub 2015 Jul 14. If we don’t, it’s possible no one will. Garg A, Toy S, Tripodis Y, Silverstein M, Freeman E. Addressing social determinants of health at well child care visits: a cluster RCT. Pediatrics. doi: 10.1542/peds.2014-2888.

Emergency Department 71

Emergency Department Emergency Medical Services ED EMS 71

The Skeptics' Guide to EM

MARCH 20, 2021

Jeff Kline, was senior author on a paper that looked at treating VTE with outpatient management using a DOAC ( Bean et al AEM 2015 ). Another study showed less than 10% of PE patients are discharged home from the ED for out-patient therapy ( Vinson et al 2017 ).

ALS 130

ALS ED 130

The Skeptics' Guide to EM

OCTOBER 10, 2020

Case: A 41-year-old man without a significant past medical history presents to the emergency department (ED) with a chief complaint of lower back pain that started 48 hours prior to the ED visits after attempting to move a couch in his house. Background: Pain is one of the most frequent reasons to attend an ED.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

MARCH 12, 2022

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. It was a witnessed fall; she was wearing a helmet at the time and there was no loss of consciousness.

Emergency Department 100

Emergency Department ED ALS OR 100

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

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

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). She arrives in the emergency department (ED) with decreased level of consciousness and shock.

EMR 130

EMR Coronary Defibrillator Life Support 130

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. 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 ). Smith’s ECG Blog ).

ICU 134

ICU OR ALS ED 134

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., Drug and chemical toxicology , 42 (3), pp.321-327. Methyl Isocyanate the Bhopal gas” from Handbook of Toxicology of Chemical Warfare Agents (2nd Edition) Chapter 22 Elsevier.

E-9-1-1 52

E-9-1-1 ED ALS 52

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% in malnourished children and by 16.6%

E-9-1-1 268

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

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

JUNE 5, 2021

On rapid bedside assessment you calculate the National Institute of Health Stroke Score/Scale (NIHSS) of 11 and a Field Assessment for Stroke Triage for Emergency Destination (FAST-ED) score of 7; you suspect a large vessel occlusion (LVO) based on the high NIHSS and FAST-ED score >3.

ALS 130

ALS Emergency Department ED 130

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

REBEL EM

JANUARY 24, 2024

2015; 3(4): PMID: 26665055 Post Peer Reviewed By: Salim R. You will notice the squeeze will cause no motion if there is a full rupture/tear, and diminished motion if there is a partial tear Performance Characteristics ( Garras 2012 ) Sensitivity Specificity (+) LR (-) LR 96-100% 93-100% 13.7 J Bone Joint Surg Br 2011; 93(10):1362-6.

ALS 95

ALS ED OR EMS 95

ALiEM

APRIL 17, 2023

A 29 year-old-male with a past medical history of left eye enucleation secondary to a gunshot wound several years prior presents to the Emergency Department (ED) for blurry vision, redness, and concern for a deformity to his right eye. Published 2015 Dec 11. Corneeal Hydrops: A Complication of Keratoconus.

Emergency Department 130

Emergency Department OR ED 130

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. 2015 Sep;66(3):322-333.e31. Nov 10 th , 2015. We’ll keep it short, while you keep that EM brain sharp.

EMS 89

EMS E-9-1-1 ALS OR 89

Broome Docs

JANUARY 30, 2023

2015 Apr;72(4):668-73. Epub 2015 Jan 23. 2015 Dec;21(6):1244-6. Epub 2015 Dec 29. PMID: 36442064 Kappel S, Kleinerman R, King TH, Sivamani R, Taylor S, Nguyen U, Eisen DB. Does wound eversion improve cosmetic outcome?: Results of a randomized, split-scar, comparative trial. J Am Acad Dermatol. doi: 10.1016/j.jaad.2014.11.032.

E-9-1-1 52

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

The Overrun Podcast

AUGUST 5, 2019

Peter Antevy joins Ed to discuss a few pearls about pediatric care and resuscitation in the field. Dr. Antevy wears many hats in EMS and has served as the medical director for Davie fire rescue, Coral Springs-Parkland Fire Rescue, Palm Beach County Fire Rescue. Are kids just small adults? How do we handle a pediatric cardiac arrest scene?

EMS 52

EMS ED 52

EMDocs

JUNE 28, 2023

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. EMS is called, and he is brought to the ED for a reported “slip and fall” with associated facial abrasions. None of this is otherwise communicated to the ED provider – only noted in reports.

EMS 68

EMS ED OR 68

EMDocs

FEBRUARY 22, 2024

A 43-year-old male, with no significant medical history, presents to the ED for right eye pain. In: Knoop KJ, Stack LB, Storrow AB, Thurman RJ, eds. Published June 11, 2015. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. Prim Care Clin Off Pract. Eye Emergencies.

ALS 77

ALS ED EMS OR 77

Don't Forget the Bubbles

MARCH 19, 2024

This case underscores the struggles many children with complex disabilities encounter, often arriving at the paediatric ED in crisis when their families can no longer provide safe care at home. Canadian Journal of General Internal Medicine (2015) 10(4). Journal of Health and Social Behavior, 30(2), 220. link] Andrew, P. and, Powell, M.

Mental Health Services 52

Mental Health Services ED OR Emergency Department 52

This Podcast Will Kill You

NOVEMBER 7, 2023

Manne, eds. 2015): 83-92. 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. and Nizran, P., Skin cancer. Armstrong, Bruce K., Fisher, D.E.,

E-9-1-1 52

E-9-1-1 ALS ED OR 52

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