EMDocs

JULY 3, 2023

Louis); Alex Koyfman, MD (@EMHighAK); Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic Foundation) Case A 62-year-old male with past medical history of hypertension (HTN), hyperlipidemia (HLD), and prior cerebrovascular accident (CVA) presents to the emergency department (ED) via ambulance. Glasgow coma scale (GCS) is 12.

ED 85

ED E-9-1-1 ALS OR 85

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.

Emergency Department 71

Emergency Department Emergency Medical Services ED EMS 71

The Skeptics' Guide to EM

MAY 14, 2022

He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. Case: A 45-year-old man without a significant past medical history presents to your emergency department (ED) with two days of severe lower back pain after shoveling some dirt.

ALS 130

ALS Emergency Department ED OR 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

The Skeptics' Guide to EM

APRIL 17, 2021

Anthony Crocco is the Deputy Chief – McMaster Department of Pediatrics, Acting Head of Pediatric Cardiology, and creator of Sketchy EBM. 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.

Emergency Department 130

Emergency Department ALS ED 130

The Skeptics' Guide to EM

FEBRUARY 8, 2020

Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. Reference: Perry et al.

Emergency Department 130

Emergency Department Critical Care ALS EMS 130

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

JULY 30, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 63-year-old woman presents to your emergency department (ED) with two-day history of nausea, vomiting and constipation. She is also the creator of all those wonderful Paper in a Pictures.

ALS 130

ALS ED Emergency Department EMS 130

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Emergency Medical Services for Children] “Red to Head.” One end of the tape is red with an arrow. [Khouli 2015] In South Sudan, the Broselow system overestimated weight by 26.6% Int J Emerg Med. J Emerg Med.

E-9-1-1 268

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

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ & Liska, H.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

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. Journal of Trauma and […] The post SGEM#332: Think Outside the Cardiac Box first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Medical Services 130

Emergency Medical Services ACS ALS Emergency Department 130

The Skeptics' Guide to EM

NOVEMBER 1, 2022

AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency department (ED) with his first time anterior should dislocation after trying to recreate one of his favourite scenes in the movie Lethal Weapon.

ALS 152

ALS Emergency Department OR ED 152

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. 2016 May;31(5):478-85. Opioid-Prescribing Patterns of Emergency Physicians and Risk of Long-Term Use. A radiograph is shown (see figure 1). Goodwin J.

E-9-1-1 52

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

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. August 3, 2016; Available from: [link] -acute-corneal-hydrops.htm Stack L, Sheedy C, Bales B.

Emergency Department 130

Emergency Department OR ED 130

The Skeptics' Guide to EM

AUGUST 14, 2021

Circulation 2020 Guest Skeptic: Missy Carter is a PA practicing in emergency medicine in the Seattle area and an adjunct faculty member with the Tacoma Community College paramedic program. This was the ALPS randomized control trial published in NEJM 2016. The issue of amiodarone vs lidocaine has also been covered on SGEM#162.

CPR 130

CPR BLS ALS Paramedic 130

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 81

EMS Allergic Reaction Emergency Department ED 81

ACEP Now

OCTOBER 26, 2023

The Case A two-year-old female, seen three days ago at different local emergency department (ED)—Children’s General—presents with fever, headache, and neck pain. They return to the ED because her symptoms have not resolved, and her headache seems worse. Published January 2016. HHS website. Accessed October 9, 2023.

ED 52

ED Emergency Department OR 52

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. Published April 12, 2021.

Emergency Department 52

Emergency Department ALS ED OR 52

REBEL EM

MARCH 8, 2023

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 8.1-36 209-225 Walker R, Adhikari S.:

Emergency Department 52

Emergency Department ALS ED OR 52

REBEL EM

AUGUST 18, 2022

Fletcher, MD, FACEP and Nicholas Slattery, MD Background: Diverticulitis is a common finding amongst Emergency Department patients, accounting for more than 360,000 visits in 2013 alone 1. Despite its frequency, the majority of cases of acute diverticulitis are uncomplicated, and can be effectively managed on an outpatient basis 2.

Emergency Department 52

Emergency Department ALS ED OR 52

The Skeptics' Guide to EM

JANUARY 19, 2019

He is alert and oriented times three with normal vital signs by the time he arrives in the emergency department. 1] Two-thirds of the all the drug overdoses in the US in 2016 (63,632) involved an opioid (42,249). [2] Sixty minutes after receiving naloxone he is GCS 15 and walking to the desk demanding to be discharged.

Naloxone 130

Naloxone Overdose Emergency Medical Services Emergency Department 130

Core EM

MARCH 1, 2024

Mumenthaler M , Mattle H , Taub E , ed. 2016 Apr-Jun;19(2):183-7. Goldfrank’s Toxicologic Emergencies, 11e. The Clinical Presentations of Nitrous Oxide Users in an Emergency Department. References Neurology. 4th Edition. Stuttgart: Thieme; 2003. doi:10.1055/b-005-148905 Zayia LC, Tadi P. Updated 2023 Jul 24].

Emergency Department 162

Emergency Department ED OR ALS 162

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. ED Course The patient received antibiotics for pneumonia. 2016 Jul;150(1):131-8. His fever was 103°F this morning and he received ibuprofen. J Ultrasound Med.

E-9-1-1 246

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

EMDocs

AUGUST 22, 2023

Capnography has several novel uses in other disease states commonly seen in the ED such as trauma, DKA, sepsis and obstructive lung disease. Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. J Emerg Med. Ann Emerg Med. West J Emerg Med. BMC Emerg Med.

Emergency Department 68

Emergency Department ALS Life Support OR 68

The Skeptics' Guide to EM

OCTOBER 28, 2017

Stevens and colleagues updated their review in 2016 and concluded “sucrose is effective for reducing procedural pain” and “no serious side effects or harms have been documented with this intervention”. There are certain patient populations who are at risk for in adequate pain management.

ALS 130

ALS Emergency Department OR ED 130

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

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. The next day, the patient’s mother was called to come to the emergency department with the patient due to abnormal labs.

E-9-1-1 52

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

Don't Forget the Bubbles

MAY 24, 2023

A 5-year-old boy with a past medical history of Crouzon syndrome presents in the Pediatric ED. Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. Intubation of the Critically Unwell Child in the Emergency Department. Anaesthesia. 14123 Currie V.

Emergency Department 98

Emergency Department ED ALS OR 98

Don't Forget the Bubbles

AUGUST 7, 2023

Clinicians may under or over-estimate paediatric patients presenting to the ED as being at high-risk for sepsis if there do not have evidence-based heart and respiratory rate ranges, Brennan et al set out to add to our understanding of what is ‘normal ’ in paediatric vital signs. Acad Emerg Med. NICE; 2016 [cited 2023 Mar 28].

Life Support 98

Life Support Advanced Life Support ALS Emergency Department 98

Don't Forget the Bubbles

JULY 3, 2023

This time we have our first group of colleagues from Birmingham Children’s Hospital Emergency Department. BCH ED is a busy paediatric major trauma centre tertiary ED in the West Midlands and the workplace of Vicki Currie, BW lead and editor. Discharge home from ED was the primary. Am J Hematol.

Emergency Department 105

Emergency Department ED OR ALS 105

REBEL EM

FEBRUARY 22, 2023

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. Cup to disc ratio >0.6

Emergency Department 52

Emergency Department ALS ED Coronary 52

EMDocs

SEPTEMBER 9, 2023

He presents to the ED with profound difficulty extending his middle and ring finger. The Atlas of Emergency Medicine, 5e. 2021.0052 Emergency Department Management of Extensor Tendon Lacerations – Page 3 of 4. 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

EMDocs

NOVEMBER 4, 2023

He came to the ED because he now has a fever, chills, and nausea along with his testicular pain. The Atlas of Emergency Medicine, 5e. aureus infections among patients in the emergency department. Skin and Soft Tissue Infections in the Emergency Department. Emerg Med Clin North Am. December 27, 2016.

EMS 68

EMS E-9-1-1 Emergency Department ALS 68

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. Int J Cardiol 2016 3. Kontos et al.

STEMI 63

STEMI Coronary Paramedic ALS 63

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e. McGraw Hill; 2016. Emerg Med Pract.

Operating Room 52

Operating Room ACS Critical Care Coronary 52

EMDocs

JUNE 27, 2024

An 8-year old male with a history of sickle cell anemia presents to the ED for evaluation of fever for 2 days and “feeling like I can’t get a full breath”. 768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. 2016 Dec;91(12):1185-1190. Epub 2016 Oct 3. PMID: 29648482.

E-9-1-1 75

E-9-1-1 ICU ACS EMS 75

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. ” ( Ed. What are the risks of water beads? Roy was less than impressed when young Kendall tried to eat his Orbeez.

E-9-1-1 111

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