REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. ED visits /1000 adults with diabetes [1]. He is otherwise healthy.

ICU 201

ICU ED Critical Care ALS 201

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

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

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

ALiEM

MARCH 7, 2024

Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Chen et al.,

E-9-1-1 177

E-9-1-1 Emergency Department ALS ED 177

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

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

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

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

REBEL EM

JANUARY 23, 2023

Key Secondary Endpoints: 5 (3.9%) patients in the IV cetirizine group returned to any ED or clinic within 24 hours compared to 15 (11.1%) in the IV diphenhydramine group; P=0.04 7 (5.5%) patients in the IV cetirizine group returned to any ED or clinic within 48 hours compared to 19 (14.1%) in the IV diphenhydramine group; P=0.02

Allergic Reaction 52

Allergic Reaction ED E-9-1-1 Emergency Department 52

Pediatric EM Morsels

JULY 5, 2024

Using this decision rule would have cut down on ED CT C-spine ordering by >50% in this derivation cohort. I am hopeful it will also improve the flow in the ED.” While plain films for C-spine injury had previously fallen out of routine ED practice, we now have more evidence to support their use in intermediate risk patients.

ALS 161

ALS OR ED Emergency Department 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

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 81

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

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-9-1-1 269

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

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

ACEP Now

OCTOBER 11, 2024

Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. 3 Once the patient arrives in your emergency department, a rapid review of the patient’s status and results of resuscitative efforts should be performed. Am J Emerg Med.

ALS 52

ALS Emergency Department Emergency Medical Services ED 52

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 154

ALS Emergency Department OR ED 154

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

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

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

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. This data was collected over a five-year period (2016-2020) had true papilloedema. Clin Ophthalmol.

ALS 98

ALS Emergency Department ED OR 98

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

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

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

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

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

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

Dr. Smith's ECG Blog

OCTOBER 12, 2024

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. Vital signs were within normal limits on arrival to the Emergency Department. EKG on arrival to the ED is shown below: What do you think? Am J Emerg Med. Epub 2016 Aug 27.

STEMI 103

STEMI Coronary Emergency Department OR 103

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

Don't Forget the Bubbles

JULY 22, 2024

Pre-school wheezers remain a poorly understood cohort of children despite seeing them every day in paediatric EDs. However, there was no difference in LOS (83 minutes for placebo vs 79 minutes for prednisolone) in participants who were discharged straight from the ED ( 32% ). Compare this with the Panickar et al. study from 200 9.

E-9-1-1 105

E-9-1-1 ALS ACS ED 105

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 67

Emergency Department ALS Life Support OR 67

REBEL EM

JUNE 8, 2023

This study chose a relevant topic to analyze that could influence acute management in the ED and has a fairly larger sample size of patients to do so. If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Am J Emerg Med.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

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

Don't Forget the Bubbles

JANUARY 31, 2024

We have teamed up with the team from Wexham Park ED which has been coordinated by Dr Mohomed Ashraf Vahedna ST6 A&E. Article 1: What predicts parental anxiety in the Paediatric Emergency Department? Predictors of parental anxiety in a paediatric emergency department. Emergency Medicine Journal.

Emergency Department 72

Emergency Department ED ALS OR 72