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. All revolve around understanding zipper anatomy and obtaining adequate exposure to assess how the skin is entrapped. Apply lidocaine gel on the area of entrapment for 2-3 minutes.

ED 233

ED OR 233

Handtevy

MARCH 28, 2019

The AHA published data in 2015 that states that outcomes from out of hospital pediatric arrest haven’t changed since the 1980’s. The amazing part of this story is that it took more than 20 years for the scientific community to prove this theory to be correct and for other doctors to accept it as standard practice.

OR 52

OR Paramedic 52

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 228

ALS Emergency Department ED OR 228

NAEMSP

FEBRUARY 1, 2023

of all EMS activations per NEMSIS data in 2015. [2] Article Summary by James Li, MD Sinclair, Julie E., “Characteristics, prehospital management, and outcomes in patients assessed for hypoglycemia: repeat access to prehospital or emergency care.” ” Prehospital Emergency Care 23.3 2019): 364-376. of the US population).

OR 52

OR Emergency Department Emergency Medical Services Paramedic 52

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. Other therapeutic hypothermia trials included Target Temperature Management or TTM trial ( SGEM #82 ), HYPERION ( SGEM #275 ), TTM2 ( SGEM #336 ). N Engl J Med.

CPR 130

CPR ALS Emergency Department EMS 130

REBEL EM

AUGUST 30, 2023

Most common organism is Staph Aureus (36-67% of cases) ( Boody 2015 ). REBEL Core Cast 107.0 – Vertebral Osteomyelitis Click here for Direct Download of the Podcast Definition Inflammation of the vertebrae due to a pyogenic, fungal or mycobacterial organism. Often used interchangeably with osteomyelitis. Other pathogens include: E.

E-9-1-1 94

E-9-1-1 ALS ED OR 94

The Skeptics' Guide to EM

OCTOBER 21, 2023

In SGEM#181, we were unconvinced of the value of routine use of whole body CT in trauma patients, and right back in 2015 on SGEM#106 discussing the Canadian CT head rule and the New Orleans Criteria. However, we’ve not previously looked at the intersection of non-traumatic back pain and rational investigation. AEM October 2023.

Emergency Department 271

Emergency Department ALS ED OR 271

ALiEM

SEPTEMBER 27, 2023

Disulfiram-like reaction with ethanol consumption Coprinus atramentarius or Ink Cap mushroom is well known to cause a disulfiram-like reaction when it is consumed prior to ethanol. This results in significant nausea and vomiting and can lead to tachycardia and hypotension. Encyclopedia of Toxicology (Third Edition), Academic Press. Goldfrank L.

ALS 169

ALS OR ED 169

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 mEq/L alone With insulin, ~1.2

Epinephrine 246

Epinephrine OR ED 246

EMDocs

JUNE 15, 2024

Source Shifts in Diagnostic Testing for Headache in the Emergency Department, 2015 to 2021. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: JAMA Netw Open. 2024 Apr 1;7(4):e247373. doi: 10.1001/jamanetworkopen.2024.7373.

ICU 75

ICU Emergency Department ED OR 75

Don't Forget the Bubbles

AUGUST 19, 2024

2015 Apr;34(4):e92-e101. 2015 Sep;35(6):634-9. He points to his sternum when you ask him where the pain is. and tells you that it is made worse by deep breathing and movement. His sternum is warm to touch and exquisitely tender, inferior to the manubrium. There is no overlying bruising, erythema, or skin changes. Pediatr Infect Dis J.

Emergency Department 101

Emergency Department OR 101

ALiEM

DECEMBER 22, 2023

2015 Nov 18;10:55. The patient stated that upon getting out of bed, she took 4-5 steps, lost her balance, and fell backward onto the bedroom floor. She denied loss of consciousness. She denied syncope or vertigo before the fall. Additional Images Physical Exam Vitals : 37.8°C; of cases were diagnosed by MRI and 14.6% World J Emerg Surg.

OR 161

OR 161

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% Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Krug 2007] What If the Child is Obese or Emaciated? Validation study done in Italy.

E-9-1-1 268

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

The Good, The Bad & The Ugly Paramedic

NOVEMBER 15, 2020

By the time we add reduced empathy levels, increased judgmental responses and less overall joy in life to the mix, it becomes clear to see that a negative spiral can occur, either gradually or suddenly, with every aspect further impacting on each other. So why would we want to do this to ourselves?

OR 52

OR EMS Paramedic Emergency Medical Services 52

ALiEM

SEPTEMBER 11, 2023

2015 Aug 21;64(32):865-70. She removed the contacts five hours later at 23:00, at which time she noted her eyes to feel drier than normal but did not note significant pain with removal, significant trauma, or a partial contact removal. For the eye dryness and mild irritation, she rinsed her eyes with her contact solution.

Emergency Department 152

Emergency Department ED OR 152

Pediatric EM Morsels

MAY 12, 2023

2015 Nov;100(11):1032-7. Epub 2015 Aug 21. PECARN is highly sensitive for identifying those with clinically important TBI. of these had a CT performed 1 (0.2%) had a clinically important TBI (ciTBI) 10 (5.1%) had any TBI on CT 9 (4.6%) had skull fractures Remember to always watch out for NAT ! Arch Dis Child.

OR 130

OR EMS 130

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 ). They’ve also been called the “camel-hump” sign. Rituparna et al — as well as Chauhan and Brahma ( Int. Smith’s ECG Blog ).

ICU 134

ICU OR ALS ED 134

ALiEM

AUGUST 9, 2023

Ultrasound Technique Background The lungs were traditionally considered poorly accessible to ultrasound, as ultrasound waves cannot penetrate air-filled structures; however, lung POCUS relies on the interpretation of patterns of artifacts to evaluate the normal, air-filled lungs. Warm gel helps with the child’s comfort.

E-9-1-1 246

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

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

FEBRUARY 13, 2024

“That time of the month”, “Aunt Flo”, “the red wave”, “period”, the list goes on. But what about euphemisms for menopause? We’ve got “the change” or “change of life”, “climacteric”, and… that’s it? There may be more out there, but the comparison is revealing. The slow moon climbs: The science, history, and meaning of menopause. Davis, S.R.,

ALS 98

ALS OR 98

ALiEM

MAY 13, 2024

Scan the entirety of the affected area in 2 planes. Be aware of the patient’s comfort throughout the examination. A water bath may be helpful to visualize lesions in extremities such as the hands or feet. The probe sits just below the water’s surface and does not need to contact the skin. It may also aid in identifying nearby vasculature.

E-9-1-1 161

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

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). One meta-analysis in trauma patients demonstrated that the first-attempt success rate was higher in IO compared to PIVs ( 2).

ALS 102

ALS Epinephrine Critical Care Emergency Department 102

EMDocs

AUGUST 22, 2024

have limited English proficiency according to the 2015 U.S. You may be more familiar with the term “limited English proficiency” (LEP), defined as: someone who does not speak English as their primary language and has a limited ability to read, speak, write, or understand English. Over 25 million individuals in the U.S.

Emergency Department 82

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

This Podcast Will Kill You

SEPTEMBER 3, 2024

“Is it gonna be poop or is it gonna be barf?” It’s the question we all fear during a bout of food poisoning when time is of the essence and a decision has to be made before it’s made for us. Often, the germ forcing this question upon us is none other than the dreaded norovirus. History Biology Adler, Jonathan L., and Raymond Zickl. 1969): 668-673.

ALS 52

ALS OR 52

FOAMcast

JANUARY 25, 2023

Epub 2015 Dec 30. doi: 10.1136/emermed-2015-205096. Apple Podcasts , Spotify , or Listen Here References: Wray JP, Bridwell RE, Schauer SG, Shackelford SA, Bebarta VS, Wright FL, Bynum J, Long B. The diamond of death: Hypocalcemia in trauma and resuscitation. Am J Emerg Med. 2021 Mar;41:104-109. doi: 10.1016/j.ajem.2020.12.065.

Emergency Department 52

Emergency Department OR 52

FOAMfrat

JUNE 21, 2024

EVD Transport Checklist When was the EVD placed, and why? Aneurysmal SAH Arteriovenous malformation (AVM) ICH with ventricular extension Low-pressure hydrocephalus Meningitis or other infectious process) What was the opening pressure? Predictor of clinical outcome Current EVD orders? Is it to be kept clamped and utilized for ICP measurement only?

Ambulance 105

Ambulance OR Critical Care 105

Pediatric EM Morsels

JUNE 30, 2023

Let’s take a moment to digest a morsel on this condition that may lead to recurrent pulmonary problems: Congenital Pulmonary Airway Malformation: Basics Developmental lesion of the lungs characterized by pseudocysts, lesions, and dilated airways (Dessole, 2019) Incidence is 1 in 11,000 to 1 in 35,000 (Dessole, 2019) Most often unilateral 85% (..)

E-9-1-1 258

E-9-1-1 ED EMS OR 258

K.S. Chew

AUGUST 8, 2015

Rashidi Ahmad from UMMC during the 2nd National Emergency and Critical Care Symposium 2015 in Ipoh (08 August 2015) New or Presumed New LBBB To Be Treated As a STEMI Equivalent? A Debate from Chew Keng Sheng The 6-page companion notes below can also be downloaded at: [link] OR at the

STEMI 40

STEMI OR Critical Care 40

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

NOVEMBER 22, 2023

Published 2015 Oct 19. Because the toxin can be absorbed cutaneously, the natives used waxy leaves as gloves during the preparation of extracting the secretions from glands on the skin [3]. The amount of toxin collected from one frog is potent enough to kill 10 humans and can be used to cover 30-50 darts for hunting [4]. Marine Envenomations.

ALS 284

ALS ED OR 284

EMDocs

MAY 11, 2024

A) Basilar artery stroke B) Cavernous sinus syndrome C) Lateral medullary infarction D) Multiple sclerosis Answer: C Vertigo , or the internal sensation of motion when no motion exists, is often classified as either peripheral or central depending on the origin of the pathology.

EMS 89

EMS E-9-1-1 ALS OR 89

ALiEM

APRIL 17, 2023

Published 2015 Dec 11. Over the past 3-4 days, he noticed an acute decline in his vision with what the patient describes as a “cloudy bump” appearing during that time. The patient normally does not wear contacts or corrective lenses but states his vision is very blurry and he is now having difficulty reading. Visual Diagnosis Ophthalmology.

Emergency Department 130

Emergency Department OR ED 130

This Podcast Will Kill You

MAY 7, 2024

2015): 478-485. Does it seem like the supplement section of your grocery store gets bigger every time you go in? You’re not imagining things. Nature Reviews Endocrinology , 12 (7), pp.407-420. Denham, Bryan E. “Dietary supplements in the USA: problematic trends.” ” Public Health Nutrition 24.9 2021): 2771-2775. Starr, R.R.,

ALS 98

ALS OR 98

The Skeptics' Guide to EM

FEBRUARY 19, 2022

Tim Graham is a Clinical Professor of emergency medicine at the University of Alberta, and Associate Chief Medical Information Officer, Edmonton Zone, of Alberta Health Services from Edmonton, Alberta. Reference: Graham T. Physician heal thyself. Reference: Graham T. Physician heal thyself. This is an SGEM Xtra episode.

Emergency Department 130

Emergency Department ALS OR 130

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. Many of these characteristics are immutable.

EMS 130

EMS ALS Emergency Department ED 130

Core EM

JANUARY 25, 2024

Background: An update to our 2015 post on HIET for beta-adrenergic receptor and calcium channel antagonists overdose. Beta-adrenergic receptor antagonists (Beta blockers, BB) and calcium channel antagonists (calcium channel blockers) are common drugs that can produce profound cardiac depression and shock when taken in overdose.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

ALiEM

MAY 19, 2023

Published July 13, 2015. Another minor difference is that the gastric balloon in the Minnesota tube holds 450-500 ccs of air, while the SB gastric balloon holds 250 ccs of air [2]. If bleeding persists, you can go to a maximum of 45 mmHg. What is this “manometer” typically used for the esophageal balloon? In: StatPearls [Internet].

E-9-1-1 245

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