Pediatric EM Morsels

FEBRUARY 2, 2024

In one ED study, ALL cases of missed travel-related illness did not have a documented travel history in their ED note , whereas 90% of the identified travel-related illnesses had a provider documented travel history (Greenky 2022) Those who are visiting friends and relatives (VFR) are typically at highest risk.

E-9-1-1 161

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

The Skeptics' Guide to EM

DECEMBER 8, 2017

A Prospective Randomized, Double-Dummy Trial Comparing Intravenous Push Dose of Low Dose Ketamine to Short Infusion of Low Dose Ketamine for Treatment of Moderate to Severe Pain in the Emergency Department. Guest Skeptic: Dr. Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas.

Emergency Department 130

Emergency Department ALS OR EMS 130

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

The Skeptics' Guide to EM

SEPTEMBER 10, 2022

Single-dose dexamethasone is not inferior to 2 doses in mild to moderate pediatric asthma exacerbations in the emergency department. Pediatr Emerg Care. 2022 Guest Skeptic: Dr. Harrison Hayward is a Pediatric Emergency Medicine fellow at Children’s National Hospital. Pediatr Emerg Care. Pediatr Emerg Care.

Emergency Department 130

Emergency Department ALS ED OR 130

EMDocs

JUNE 16, 2023

Podcast: Play in new window | Download (Duration: 13:57 — 19.2MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Management of the child with mental health problems who is boarding in the ED In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

ED 52

ED Mental Health Services Emergency Department Emergency Medical Services 52

Don't Forget the Bubbles

SEPTEMBER 30, 2024

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. examined 977,907 first-time ED presentations by children aged 0-15 across thirteen acute hospital trusts (between April 2014 and March 2017), trying to figure out how many were non-urgent.

Emergency Department 89

Emergency Department ALS ED OR 89

The Skeptics' Guide to EM

MAY 20, 2023

She is part of the Don’t Forget the Bubbles team and faculty at Queen Mary University in London where she teaches part of the Paediatric Emergency Medicine MSc. Upon arrival at the ED, your team promptly begins high quality CPR and manages to obtain return of spontaneous circulation. N Engl J Med. Reference: Harhay MO, et al.

CPR 130

CPR ALS Emergency Department EMS 130

ALiEM

APRIL 12, 2023

20 – Local Anesthetics, Ed(s): Hugh C. emDOCs.net – Emergency Medicine Education. Author information Ivan Ivanov, DO Resident Physician Emergency Department South Brooklyn Health | The post Trick of the Trade: Gel-free ultrasound-guided peripheral IV technique appeared first on ALiEM. Accessed April 5, 2023.

Emergency Department 258

Emergency Department ALS ED 258

EMDocs

SEPTEMBER 25, 2023

However, RSI has never been shown to reduce the risk of aspiration in the ED (13) or during emergent OR cases (14). While RSI should remain the gold standard in the vast majority of patients in the ED, FI presents an additional technique to mitigate anatomic or physiologic risk. We don’t want to go backwards!

ED 65

ED Emergency Department ALS Paramedic 65

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 74

ICU Emergency Department ED OR 74

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. of all ED visits resulting in 2.6

Emergency Department 130

Emergency Department ALS ED OR 130

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 81

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

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

The Skeptics' Guide to EM

MARCH 12, 2022

She is an emergency physician at Mount Sinai Hospital and a Clinician Scientist and the Deputy Director of the Schwartz-Reisman Emergency Medicine Institute. Dr. Varner’s research interests are in concussion and pregnancy care in the ED. This classic paper was published in Lancet 2001 and reviewed on SGEM#106.

Emergency Department 100

Emergency Department ED ALS OR 100

EMDocs

JULY 9, 2024

What can we do about this in the pediatric ED? Social Emergency Medicine: Capitalizing on the Pediatric Emergency Department Visit to Screen and Connect Patients and Families to Community Resources. Community Resource Needs Assessment Among Families Presenting to a Pediatric Emergency Department. Pediatrics.

Emergency Department 71

Emergency Department Emergency Medical Services ED EMS 71

The Skeptics' Guide to EM

DECEMBER 17, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. years ( 2 ).

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

The Skeptics' Guide to EM

NOVEMBER 20, 2021

You wonder if any emergency department (ED)-based interventions would help her and people like her be safe. Background: We looked at geriatric falls on an SGEM Xtra in 2015. Close to three million adults aged 65 and over visit American EDs annually after a fall [1]. There are three other GEAR 1.0

ALS 130

ALS ED Emergency Department OR 130

ACEP Now

NOVEMBER 7, 2024

Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. Many sought help from EDs, which were not and are not set up to provide involved care for such problems.

ED 59

ED Emergency Department ALS OR 59

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-9-1-1 104

E-9-1-1 ALS ED OR 104

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% Int J Emerg Med. J Emerg Med.

E-9-1-1 269

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

Don't Forget the Bubbles

JULY 19, 2023

Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. When they examined her and found that she had enlarged optic discs, they sent Olivia to the ophthalmology ED. 2015 Aug 1;19(4):344–8. She went to the optician today to get a new pair of glasses. Clin Ophthalmol.

ALS 98

ALS Emergency Department ED OR 98

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Kaushal Khambhati is also a fourth-year resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. She arrives in the emergency department (ED) with decreased level of consciousness and shock. She has a history of hypertension and non-insulin dependent diabetes mellitus.

EMR 130

EMR Coronary Defibrillator Life Support 130

REBEL EM

SEPTEMBER 13, 2023

patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 2015; 372(5):418-25. J Emerg Med 2013; 44 (4): 764-772. Angioedema in the Emergency Department: An Evidence Based Review. N Engl J Med.

Frozen Plasma 105

Frozen Plasma Allergic Reaction FFP Plasma 105

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. 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.

E-9-1-1 246

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

EMDocs

JUNE 3, 2023

The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. This is less critical in ED management of the unstable pelvic fracture, as the optimal site for identification of rectal or vaginal tears is the operating room.

ED 54

ED Operating Room ALS Frozen Plasma 54

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. J Emerg Med 2018 [6] 327 Prospective cohort study of children 6mo-18yrs comparing clinical assessment to POCUS 90.3% (83.4-94.7%) Pediatr Emerg Care.

E-9-1-1 161

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

The Skeptics' Guide to EM

JUNE 5, 2021

JAMA 2021 Case: A 74-year-old woman presents to your emergency department with 1.5 The tipping point came with the publication of MR. CLEAN in 2015. hours of right-sided weakness, aphasia, and neglect. A non-contrast CT shows no evidence of intracranial hemorrhage.

ALS 130

ALS Emergency Department ED 130

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

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 81

Epinephrine Allergic Reaction Emergency Department Emergency Manager 81

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

Broome Docs

JANUARY 30, 2023

Association of Chest Pain Protocol-Discordant Discharge With Outcomes Among Emergency Department Patients With Modest Elevations of High-Sensitivity Troponin. 2015 Apr;72(4):668-73. Epub 2015 Jan 23. Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs.

E-9-1-1 52

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

EMDocs

JUNE 8, 2024

A 27-year-old male presents to the ED for left eye pain after being hit in the face with a spare car part while working under the hood of his car. What is the diagnosis, and how do we manage it from the ED? A 32-year-old man presents to the emergency department with eye pain. 95% occupational injuries occur in males [1].

EMS 80

EMS Allergic Reaction Emergency Department ED 80

REBEL EM

FEBRUARY 22, 2023

Bagheri 2015 ). difficult to see due to corneal edema) Emergency Department Management All patients should get emergency ophthalmologic consultation Start with eye drops (see table below) and add systemic medications if severe or refractory symptoms/IOP. et al, Emergency Medicine Clinical Essentials ed 2.

Emergency Department 52

Emergency Department ALS ED Coronary 52

REBEL EM

MARCH 8, 2023

Bagheri 2015 ). Emergency Department Management: Emergency ophthalmology consultation. Emergency surgical management indicated if concomitant retinal tear, vitreous hemorrhage, or retinal detachment. et al, Emergency Medicine Clinical Essentials ed 2. >10 floaters, (+) LR 8.1-36

Emergency Department 52

Emergency Department ALS ED OR 52

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). BMC medicine.

E-9-1-1 105

E-9-1-1 Critical Care CPR ICU 105

Don't Forget the Bubbles

JANUARY 8, 2024

For paediatric ED doctors who come from a paediatric training background, dealing with agitated adolescents can be stressful. In paediatric emergency care, addressing the challenge of adolescent agitation is a complex and evolving task. As we are not used to sedating children in this way, choosing drugs and doses can be difficult.

Emergency Department 105

Emergency Department OR ED 105

Broome Docs

MARCH 28, 2024

A non-inferiority randomized controlled trial comparing nebulized ketamine to intravenous morphine for older adults in the emergency department with acute musculoskeletal pain. Casey wrote a protocol for peripheral noradrenaline 9 years ago… in 2015! Nebulized ketamine: the solution to a non-existent problem? Age Ageing.

E-9-1-1 107

E-9-1-1 ICU Emergency Department ALS 107