Pediatric EM Morsels

APRIL 5, 2024

Climate change and changes in land usage have contributed to an expanded range of ticks (Beard 2016). Traveling Ticks are more than just ticking off a checklist before you get ready to travel! There are species of ticks found on every continent and carrying a variety of vectors capable of infecting humans.

E-9-1-1 161

E-9-1-1 ALS OR EMS 161

Pediatric EM Morsels

AUGUST 18, 2023

Jackson 2016) Ciprofloxacin was the first fluoroquinolone approved by the FDA in the 1980’s as a broad-spectrum antibiotic. Jackson 2016) It can also be used in UTIs , but is typically reserved for special cases where the infectious bacteria is found to be multidrug resistant or in complicated UTIs. Arthropathy was seen in 13.7%

E-9-1-1 130

E-9-1-1 OR ACS ALS 130

Pediatric EM Morsels

APRIL 7, 2023

References: Al Kasab S, Lynn MJ, Turan TN, Derdeyn CP, Fiorella D, Lane BF, Janis LS, Chimowitz MI; SAMMPRIS Investigators. Epub 2016 Oct 17. Observation, interaction with patient, as well as parent information is key to bring the whole picture together! Increase the Adult Percent! J Stroke Cerebrovasc Dis. 2017 Jan;26(1):108-115.

ALS 130

ALS OR Critical Care EMS 130

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

Date: August 30, 2023 Reference: Griffey et al. Date: August 30, 2023 Reference: Griffey et al. However, over the past 20 years, there is burgeoning evidence that fast-acting subcutaneous insulin analogs could be a potential treatment option for mild to moderate severity DKA including a 2016 Cochrane SRMA [4].

ICU 209

ICU ED Critical Care ALS 209

Pediatric EM Morsels

OCTOBER 27, 2023

Bowen 2016] Moral of the Morsel: Weight Matters! Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. 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

Core EM

JANUARY 25, 2024

Renal injury: isolated proteinuria or hematuria, moderate acute kidney injury with serum creatinine levels <2 mg/dL Skin: petechiae and purpura Despite severe thrombocytopenia, clinically significant bleeding is rare Figure 1.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

The Skeptics' Guide to EM

MAY 14, 2022

Date: May 13th, 2022 Reference: Abril et al. Date: May 13th, 2022 Reference: Abril et al. These include: acetaminophen ( Williams et al Lancet 2014), steroids ( Balakrishnamoorthy et al Emerg Med J 2014) and benzodiazepines ( Friedman et al Ann Emerg Med 2017). An Analysis of Data From Randomized Studies.

ALS 130

ALS Emergency Department ED OR 130

This Podcast Will Kill You

JULY 23, 2024

Caio, Giacomo, et al. Cenit, María Carmen, et al. Al-Dulaimi, D., Gasbarrini, Giovanni, et al. Gasbarrini, Giovanni Battista, et al. Kerner, Gaspard, et al. Newberry, Carolyn, et al. Suddenly, grocery stores were filled with gluten-free crackers, cookies, buns, you name it. 2019): 100. Rubin, J.E.

E-9-1-1 98

E-9-1-1 ALS OR 98

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

REBEL EM

APRIL 29, 2024

A study by Lee et al ( 7) compared femoral CVC placement to IO and demonstrated a first-pass success pass rate with IO of 90.3% Over the years emergency and critical care physicians have tried many ways to establish IV access in emergencies including the “crash” or “dirty” central line. compared to only 37.5% in the CVC group.

ALS 104

ALS Epinephrine Critical Care Emergency Department 104

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

This Podcast Will Kill You

MAY 7, 2024

Djaoudene, Ouarda, et al. Herasimenka, Aliaksandr, et al. Does it seem like the supplement section of your grocery store gets bigger every time you go in? You’re not imagining things. “Problems and prospects: public health regulation of dietary supplements.” ” Annual review of public health 39 (2018): 403-420.

ALS 98

ALS OR 98

The Skeptics' Guide to EM

JUNE 11, 2017

[display_podcast] Date: June 5th, 2017 Reference: Baharoglu et al. Lancet 2016. display_podcast] Date: June 5th, 2017 Reference: Baharoglu et al. Lancet 2016. Background: In the US, daily or every other day aspirin use has been reported to be as high as 61% in adults aged 65 or older ( Ajani et al Am J Prev Med 2006 ).

ALS 130

ALS OR EMS 130

NAEMSP

FEBRUARY 1, 2023

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. Background: Diabetes is a common chronic medical condition. of the US population).

OR 52

OR Emergency Department Emergency Medical Services Paramedic 52

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

Pediatric EM Morsels

JUNE 21, 2024

Available from: [link] Liu H, Li D, Yuan H, et al. The management of pediatric thermal burns always seems to be a hot topic , whether we are caring for a little future chef who splashed a scalding microwaved noodle cup on himself, or a toddling youngster who pulled a pot of boiling water on herself. Updated 2023 May 29]. doi: 10.1097/PEC.0000000000003098.

ALS 169

ALS OR EMS 169

EMDocs

SEPTEMBER 8, 2024

Paper: Brown CS, Oliveira J E Silva L, Mattson AE, et al. Anderson CS, Heeley E, Huang Y, et al; INTERACT2 Investigators. Qureshi AI, Palesch YY, Barsan WG, et al; ATACH-2 Trial Investigators and the Neurological Emergency Treatment Trials Network. 2016 Sep 15;375(11):1033-43. Neurocrit Care. 2022;37(2):435-446.

ALS 81

ALS OR 81

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

AUGUST 28, 2021

Date: August 27th, 2021 Reference: Gagnon et al. Date: August 27th, 2021 Reference: Gagnon et al. Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. first appeared on The Skeptics Guide to Emergency Medicine.

ED 130

ED Emergency Department ALS OR 130

EMDocs

AUGUST 22, 2024

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. For instance, displaying posters in multiple languages that explain the language services patients are entitled to.

Emergency Department 82

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

The Skeptics' Guide to EM

DECEMBER 7, 2019

Date: October 2nd, 2019 Reference: Ramgopal et al. Date: October 2nd, 2019 Reference: Ramgopal et al. The change in name took place in 2016. The subcommittee on ALTEs in the AAP published a practice guideline renaming ALTEs to brief resolved unexplained events ( BRUEs ) in 2016.

CPR 130

CPR ALS OR 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

The Skeptics' Guide to EM

APRIL 3, 2021

Reference: Toyoda et al. Background: We have talked about stroke management a number of times recently including SGEM#297 on the reanalysis of ECASS-3 by Alper et al 2020. hours after the onset of stroke symptoms ( Extend NEJM 2019 and ECASS-4: Extend 2016 ). A SRMA was published by Mistry et al Stroke 2017.

ALS 130

ALS Emergency Department OR 130

The Skeptics' Guide to EM

MAY 5, 2018

[display_podcast] Date: March 6th, 2018 Reference: White et al. Child Development December 2016. display_podcast] Date: March 6th, 2018 Reference: White et al. Child Development December 2016. Reference: White et al. Child Development December 2016.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

NOVEMBER 24, 2018

The highest prevalence of burnout (70%) was reported by emergency physicians (Shanafelt et al 2015). One of the most common reasons cited for burnout is the electronic medical record (EMR) (Shanafelt et al 2016). West et al 2016 published a SRMA in the Lancet on interventions to prevent and reduce physician burnout.

EMR 130

EMR ALS Emergency Department OR 130

The Skeptics' Guide to EM

OCTOBER 3, 2020

Reference: Claiborne Johnston S et al. Reference: Claiborne Johnston S et al. SGEM#24 reviewed a randomized controlled trial (RCT) of aspirin vs. aspirin + clopidogrel in patients with recent symptomatic lacunar infarcts identified by MRI ( Benavente et al NEJM 2012 ).

Emergency Department 100

Emergency Department ALS OR 100

Dr. Smith's ECG Blog

MAY 27, 2024

Nikus et al. Kontos et al. Bischof et al. Am J Emerg Med 2016 5. Meyers et al. Meyers et al. Herman et al. She is not bothered by lead orientation, and is equally comfortable identifying OMI by the reciprocal hyperacute T waves or in the reciprocal ST depression. Curr Cardiol Red 2021 3.

STEMI 123

STEMI Coronary ALS Emergency Department 123

EMDocs

JANUARY 29, 2024

The American Heart Association/American Stroke Association (AHA/ASA) recommends maintaining BP below 185/110 mmHg in eligible patients undergoing thrombolytic therapy or endovascular intervention [1]. Following thrombolysis or endovascular therapy, the recommended blood pressure goal is below 180/105 mmHg to prevent hemorrhagic complications [1].

ALS 73

ALS Critical Care OR EMS 73

The Skeptics' Guide to EM

OCTOBER 7, 2017

[display_podcast] Date: October 5th, 2017 Reference: Brison et al. BMJ Nov 2016. display_podcast] Date: October 5th, 2017 Reference: Brison et al. BMJ Nov 2016. Hupperets et al. BMJ 2009 * Janssen et al. Reference: Brison et al. BMJ Nov 2016. Guest Skeptic: Dr. Steve Joseph.

Emergency Department 100

Emergency Department ALS OR 100

Don't Forget the Bubbles

JULY 24, 2023

Kieu V, Palit S, Wilson G, Ditchfield M, Buttery J, Burgner D, et al. McNamara AL, Dickerson EC, Gomez-Hassan DM, Cinti SK, Srinivasan A. Modic MT, Feiglin DH, Piraino DW, Boumphrey F, Weinstein MA, Duchesneau PM, et al. 2016 Apr 9;17. A wide range of causative pathogens have been identified. Adapted from Alghamdi, A.,

ALS 98

ALS OR 98

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. After Darracq et al.,

E-9-1-1 111

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

Don't Forget the Bubbles

MARCH 18, 2024

Typical HUS has a diarrheal prodrome, usually caused by an infection with a Shiga-toxin-producing E. coli (STEC). Children can acquire STEC from contaminated food or water, through person-to-person contact or from contact with animals/ Only 6-14% of cases of STEC go on to develop HUS, so how does infection with STEC lead to HUS?

E-9-1-1 59

E-9-1-1 ALS OR 59

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

JUNE 24, 2017

[display_podcast] Date: June 20th, 2017 Reference: Bernard et al. Circulation 2016. display_podcast] Date: June 20th, 2017 Reference: Bernard et al. Circulation 2016. Then came the Targeted Temperature Management (TTM) Trial ( Nielsen et al NEJM 2013 ). Reference: Bernard et al. Circulation 2016.

CPR 100

CPR Epinephrine ALS Paramedic 100

The Skeptics' Guide to EM

MAY 2, 2020

Date: April 24th, 2020 Reference: Watanabe et al. Date: April 24th, 2020 Reference: Watanabe et al. Reference: Watanabe et al. Yes Results: The 2016 NEMSIS database contained 20.4 Is Use of Warning Lights and Sirens Associated With Increased Risk of Ambulance Crashes? Annals of Emergency Medicine.

ED 100

ED Ambulance Medical Transportation EMS 100

EMS 12-Lead

JUNE 1, 2022

Steve Smith [link] @SmithECGblog A 72 y/o Male experiences a syncopal episode while seated. This occurred in a public place, so bystanders rushed to his aid and provided immediate assistance to protect against any associated fall or head strike. It’s reported that he regained consciousness after 30 seconds, approximately.

Coronary 130

Coronary ALS Firefighter ED 130

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

[display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. In 2016, the American Academy of Pediatrics (AAP) reaffirmed their clinical practice guidelines for the diagnosis and management of UTIs. BMJ April 17. BMJ April 17.

Emergency Department 130

Emergency Department ALS OR 130