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. 2016 Nov;23(11):1298-1306.

E-9-1-1 161

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

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

The Skeptics' Guide to EM

JULY 30, 2022

Date: July 28th, 2022 Reference: Brower et al. Date: July 28th, 2022 Reference: Brower et al. Case: A 63-year-old woman presents to your emergency department (ED) with two-day history of nausea, vomiting and constipation. Reference: Brower et al. She is also the creator of all those wonderful Paper in a Pictures.

ALS 130

ALS ED Emergency Department EMS 130

Don't Forget the Bubbles

JULY 3, 2024

Lastly, in this month’s issue of JAMA Pediatrics, Gemmill et al. Saranti A, et al. Barlabà A, et al. Nemetz ETA, et al. Kusumi K, et al. Crawford CM, et al. Fundora MP, et al. Roby PR, et al. Jenssen BP, et al. Auger N, et al. Brewster RCL, et al. Forster CS, et al.

ALS 105

ALS ED OR EMS 105

The Skeptics' Guide to EM

APRIL 17, 2021

Reference: Schuh et al. Reference: Schuh et al. JAMA Nov 2020 Case: A four-year-old girl with a known history of asthma presents to your emergency department (ED) after a one-day history of runny nose and cough. Background: Asthma is a common presenting complaint for children in the ED.

Emergency Department 130

Emergency Department ALS ED 130

EMDocs

AUGUST 22, 2024

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. One cohort study in a public ED found that 84.5%

Emergency Department 82

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

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Bowen 2016] Moral of the Morsel: Weight Matters! 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-9-1-1 268

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

The Skeptics' Guide to EM

AUGUST 14, 2021

Date: August 12th, 2021 Reference: Daya et al. Date: August 12th, 2021 Reference: Daya et al. This was the ALPS randomized control trial published in NEJM 2016. This was a critical appraisal of an observational study published in Annals of EM ( Kawano et al 2018 ). Reference: Daya et al.

CPR 130

CPR BLS ALS Paramedic 130

The Skeptics' Guide to EM

MAY 29, 2021

Date: May 20th, 2021 Guest Skeptic: Dr. Robert Edmonds is an emergency medicine physician in the Air Force in Dayton, Ohio, and a University of Missouri-Kansas City residency alumni from 2016. Reference: Jhunjhunwala et al. Reference: Jhunjhunwala et al. Journal of Trauma and Acute Care Surgery.

Emergency Medical Services 130

Emergency Medical Services ACS ALS Emergency Department 130

The Skeptics' Guide to EM

FEBRUARY 8, 2020

Date: January 29th, 2020 Reference: Perry et al. Date: January 29th, 2020 Reference: Perry et al. We were surprised that in their background/introduction material they did not include the excellent SRMA on this topic by Carpenter et al. Reference: Perry et al. He also has this amazing #FOAMed blog called EM Nerd.

Emergency Department 130

Emergency Department Critical Care ALS EMS 130

The Skeptics' Guide to EM

NOVEMBER 1, 2022

Date: October 27th, 2022 Reference: Hayashi et al. Date: October 27th, 2022 Reference: Hayashi et al. Although minor adverse events, such as brief apnea or hypoxia, are common, significant adverse events are very rare, and the benefits are clear (Bellolio 2016).

ALS 152

ALS Emergency Department OR ED 152

This Podcast Will Kill You

SEPTEMBER 12, 2023

Kawamura, Shoji, et al. ” Human color vision (2016): 317-354. The history of color blindness. Wayenborgh Publishing, 2018. Gegenfurtner, K.R. and Kiper, D.C., Color vision. Annual review of neuroscience , 26 (1), pp.181-206. An immense world: How animal senses reveal the hidden realms around us. Knopf Canada, 2022. Almutairi, N.,

ALS 52

ALS ED 52

EMS 12-Lead

JUNE 1, 2022

He advises, however, recurrent syncopal episodes for the past six months, some of which have resulted in ED admission, yet no identifying mechanism could be determined. Chou’s Electrocardiography in Clinical Practice (6th ed). Josephson’s Clinical Cardiac Electrophysiology: Techniques and Interpretations (6th ed). 2] Meyers, H.

Coronary 130

Coronary ALS Firefighter ED 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., Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. ” ( Ed.

E-9-1-1 111

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

The Skeptics' Guide to EM

JANUARY 19, 2019

Date: January 17th , 2019 Reference: Clemency et al. Date: January 17th , 2019 Reference: Clemency et al. 1] Two-thirds of the all the drug overdoses in the US in 2016 (63,632) involved an opioid (42,249). [2] This teaching has been challenged by a systematic review by Willman et al 2017. Reference: Clemency et al.

Naloxone 130

Naloxone Overdose Emergency Medical Services Emergency Department 130

Don't Forget the Bubbles

AUGUST 23, 2023

Very rarely are the ED team allowed to stand, in silence, with a purpose. 2016) “Implementation of a Post-Code Pause: Extending Post-Event Debriefing to Include Silence”. Kapoor et al. It gives us permission to stop, breathe, recognise the enormity of what has happened, and provide a platform for acknowledgement. & Liska, H.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

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 27, 2023

Brown, Amanda MV, et al. 2016): 34955. . 2016): 34955. Ferri, Emanuele, et al. Gerth, Michael, et al. Kaur, Rupinder, et al. Quek, Shannon, et al. History Biology Hoerauf, Achim, and Ramakrishna U. Wolbachia: a bug’s life in another bug. Karger Medical and Scientific Publishers, 2007.

E-9-1-1 52

E-9-1-1 ALS ED 52

EMDocs

JUNE 22, 2024

A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. 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. Electronic address, p. link] j.ajog.2016.03.012

EMS 96

EMS Ambulance FFP ICU 96

ALiEM

AUGUST 9, 2023

Study N Sensitivity Specificity Comments Pereda et al., Balk et al., Tsou et al., ED Course The patient received antibiotics for pneumonia. PMID: 14722643 Pereda MA, Chavez MA, Hooper-Miele CC, et al. PMID: 25780071 Balk DS, Lee C, Schafer J, et al. PMID: 29696826 Tsou PY, Chen KP, Wang YH, et al.

E-9-1-1 246

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

Don't Forget the Bubbles

AUGUST 7, 2023

The controversy around what is ‘normal’ in infants’ and children’s vitals was demonstrated in a 2011 systematic review by Fleming et al. and two cohort studies, one performed in Australia by O’Leary et al. and one in the US by Bonafide et al. Brennan et al. Our study supports previous work by Nijman et al.

Life Support 98

Life Support Advanced Life Support ALS Emergency Department 98

EMDocs

DECEMBER 19, 2023

In: Marx JA, Hockenberger RS, Biros MH, et al., link] Published April 7, 2016. In: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9e. McGraw Hill; 2020. Accessed August 25, 2022. link] Edward OJ. Venomous Marine Animals.

First Aid 92

First Aid ED OR ALS 92

ACEP Now

FEBRUARY 11, 2024

A 95-year-old female with a history of stage III chronic kidney disease (CKD), heart failure with reduced ejection fraction (HFrEF), and dementia with baseline orientation only to person and place, presented to the emergency department (ED) for upper extremity myoclonic jerking for one day. Lam N, Weir M, Yao Z, et al. Am J Kidney Dis.

Emergency Department 52

Emergency Department ALS ED OR 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

The Skeptics' Guide to EM

MAY 11, 2019

Date: May 6th, 2019 Reference: Sceats et al. Date: May 6th, 2019 Reference: Sceats et al. Case: An 18-year-old woman presents with a Grade 1 appendicitis (Tominaga et al J Trauma Acute Care Surg 2016). Omar et al (2008) showed just how safe laparoscopic appendectomies have become. Reference: Sceats et al.

Critical Care 130

Critical Care ALS OR ED 130

EMS 12-Lead

APRIL 8, 2022

1] Here is the admitting ED ECG after cancellation of Code STEMI. The patient continued to verbalize cessation of symptoms while in the ED. However, in this context (i.e. cessation of symptoms), and in this unique territory (V2-V4), the T-wave characteristics are consistent with posterior reperfusion! [1] 1] Driver, B. 3] Niu, T.,

STEMI 130

STEMI ALS Coronary CAD 130

EMDocs

OCTOBER 21, 2023

Median time from ED arrival to diagnosis was 8 hours 24 min in one study, with only 19% being diagnosed within the 4.5-hour References: Gaillard F, Glick Y, Tatco V, et al. doi: 10.1136/neurintsurg-2016-012515. Epub 2016 Jul 15. Post TW, ed. 61.4.496 Navi BB, Kamel H, Shah MP, et al. J Neurointerv Surg.

EMS 74

EMS ALS OR ACS 74

Core EM

MARCH 1, 2024

Mumenthaler M , Mattle H , Taub E , ed. 2016 Apr-Jun;19(2):183-7. Available from: [link] Hemmer B, Glocker FX, Schumacher M , et al Subacute combined degeneration: clinical, electrophysiological, and magnetic resonance imaging findings Journal of Neurology, Neurosurgery & Psychiatry 1998;65:822-827. References Neurology.

Emergency Department 162

Emergency Department ED OR ALS 162

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. References: Powers WJ, Rabinstein AA, Ackerson T, et al. Leonardi-Bee J, et al; IST Collaborative Group. Okumura K, et al. Oliveira-Filho J, et al. Vlcek M, et al.

ALS 73

ALS Critical Care OR EMS 73

ACEP Now

NOVEMBER 7, 2023

1 In 2016, the 21st Century Cures Act (Cures Act) took additional steps to authorize the Secretary of Health and Human Services to identify and define information blocking and associated exceptions. The most frequently invoked exception in the ED is preventing harm. Published December 16, 2016. HealthIT.gov website.

ED 52

ED ALS OR Emergency Department 52

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. On ED presentation, he was experiencing 10 out of 10 pain level. In the January issue of Annals of Emergency Medicine , Merz-Herrara, et al., 2016 May;31(5):478-85. A radiograph is shown (see figure 1). J Patient Saf. Goodwin J.

E-9-1-1 52

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

ACEP Now

JANUARY 9, 2024

A 3-year-old male was brought to the emergency department (ED) by his mother, who reported the sudden onset of a rash (hives) covering his entire body, with no rash on his palms and soles. Nakhaee S, Amirabadizadeh A, Brent J, et al. Ruckart PZ, Jones RL, Courtney JG, et al. Zardast M, Khorashadi-Zadeh SS, Nakhaee S, et al.

E-9-1-1 52

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

Dr. Smith's ECG Blog

JUNE 8, 2023

According to the STEMI paradigm, the patient doesn’t have an acute coronary occlusion and doesn't need emergent reperfusion, so the paramedics can bring them to the ED for assessment, without involving cardiologists. paramedic transportation to the ED as “chest pain, STEMI negative” 2. Kontos et al. Welsh et al.

STEMI 63

STEMI Coronary Paramedic ALS 63

FOAMfrat

JULY 3, 2024

If they are not already there, get ALS-level care to the patient as soon as possible. I personally know of 2 ALS providers who were exposed to chlorine gas in a pool incident on the job and both ended up retiring from their service and still have lifelong breathing problems as a result. Thomas, Eds.) Bronstein, A. Fernandez, M.

Life Support 105

Life Support ALS Emergency Response OR 105

REBEL EM

MARCH 8, 2023

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. Philadelphia: Elsevier, 2013 (Ch) 26: p. 209-225 Walker R, Adhikari S.:

Emergency Department 52

Emergency Department ALS ED OR 52

EMDocs

SEPTEMBER 9, 2023

He presents to the ED with profound difficulty extending his middle and ring finger. e1 Rosh AJ, Kwon NS, Wilburn JM, et al. A 35-year-old right handed male with no significant past medical history presents with a deep hand laceration. The patient states they suffered a cut with a box cutter at a construction site. Tendon Lacerations.

EMS 78

EMS ED ALS Emergency Department 78

Dr. Smith's ECG Blog

DECEMBER 5, 2023

An ECG was perfomed on arrival to our ED: NSR with ST elevation II,III, aVF with reciprocal depression in aVL Would you refer this pediatric patient for emergent PCI? Pediatric cardiology performed a bedside echo in ED with EF estimation of 60%, no pericardial effusion, and no regional wall motion abnormalities. Circulation.

Coronary 116

Coronary CAD ACS ALS 116