The Skeptics' Guide to EM

AUGUST 28, 2021

Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. Case: A forty-year-old woman presents to the emergency department […] The post SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED?

ED 130

ED Emergency Department ALS OR 130

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

Case: You are working the afternoon shift in the paediatric emergency department. Your shift is almost over and the department finally seems to be under control. In 2016, the American Academy of Pediatrics (AAP) reaffirmed their clinical practice guidelines for the diagnosis and management of UTIs.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

OCTOBER 1, 2022

Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference. Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. AEM September 2022. AEM September 2022.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

OCTOBER 7, 2017

BMJ Nov 2016. He served with the Canadian Forces as a Medical […] The post SGEM#191: No Time for Physio – Roll With It first appeared on The Skeptics Guide to Emergency Medicine. BMJ Nov 2016. However, these studies deal with ankle sprains in a specific group as compared to a generalized emergency department population.

Emergency Department 100

Emergency Department ALS OR 100

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

Case: A 28-year-old male with a history of type-1 diabetes mellitus presents to the emergency department (ED) with increase in thirst and light headedness. We have some exciting news to cap off the end of this amazing year. Suchi will be joining the SGEM faculty as part of the Hot Off the Press team. He is otherwise healthy.

ICU 196

ICU ED Critical Care ALS 196

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. Reference: Schuh et al.

Emergency Department 130

Emergency Department ALS ED 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

FEBRUARY 22, 2020

Maia Dorsett is an Emergency and EMS Physician at the University of Rochester Medical Center. Bringing value, balance and humanity to the emergency department: The Right Care Top 10 for emergency medicine. Emerg Med J 2019 This is an SGEM Xtra based on a recent publication by Dr. Dorsett and her team.

Emergency Department 130

Emergency Department ALS EMS OR 130

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. His work of breathing increased during his emergency department visit, and he was started on high flow nasal cannula at 30 L/min with improvement in his respiratory status.

E-9-1-1 246

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

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. 2016 Feb;30(1):3-11.

E-9-1-1 183

E-9-1-1 Operating Room Emergency Department ALS 183

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. 2016 Dec 28;7(Suppl 44):S1150-S1153.

Emergency Department 152

Emergency Department ED OR 152

The Skeptics' Guide to EM

MAY 14, 2022

Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. His twitter handle is @PainFreeED.

ALS 130

ALS Emergency Department ED OR 130

The Skeptics' Guide to EM

NOVEMBER 24, 2018

Working in the emergency department we are on the edge of life and death and that can lead to burnout. 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).

EMR 130

EMR ALS Emergency Department OR 130

Pediatric EM Morsels

JULY 21, 2023

Borgialli DA, Mahajan P, Hoyle JD Jr, Powell EC, Nadel FM, Tunik MG, Foerster A, Dong L, Miskin M, Dayan PS, Holmes JF, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN). Acad Emerg Med. 2016 Aug;23(8):878-84. Epub 2016 Aug 1. Academic emergency medicine 12.9 Ann Emerg Med. J Surg Res.

Critical Care 246

Critical Care ALS OR Life Support 246

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

The Skeptics' Guide to EM

MAY 25, 2019

. * Population: All adult (over 18 years of age) patients in the ACS-TQIP database from 2015-2016. Exclusions: Patients who were dead on arrival, were transferred from other facilities, had missing physiological parameters, or who underwent resuscitative thoracotomy were excluded.

ACS 130

ACS Emergency Department ALS OR 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. 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

DECEMBER 16, 2017

NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present.

ALS 100

ALS ICU Emergency Department Paramedic 100

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). Point-of-care ultrasound for the detection of hydronephrosis in emergency department patients with suspected renal colic.

E-9-1-1 177

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

REBEL EM

NOVEMBER 6, 2024

2016 Jan 6;17:6-11. 2016 Jul;24(7):413-23. Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. Multiple Concomitant Injuries in One Upper Extremity: A Case Report. Am J Case Rep. doi: 10.12659/ajcr.894984. PMID: 26732673 Akhondi H, Varacallo M. Anterior Interosseous Syndrome. 2023 Aug 4.

E-9-1-1 118

E-9-1-1 ACS OR Emergency Department 118

NAEMSP

OCTOBER 9, 2024

In the emergency department, a lack of awareness about Addison’s disease led to delayed steroid administration. In the emergency department, the patient was evaluated and safely discharged. These cases highlight the impact of adrenal insufficiency on patients, especially during encounters with emergency care systems.

EMS 122

EMS Crisis Prevention Emergency Department BLS 122

ALiEM

AUGUST 18, 2023

A middle-aged man with a past medical history of hypertension and tobacco use disorder presented to the Emergency Department after evaluation by an ophthalmologist. 2016 May-Aug;9(2):80-6. He complained of ten days of a right-sided headache and three days of diplopia. Physical Exam Vitals : Temp 98.4 °F Semin Neurol.

Emergency Department 130

Emergency Department OR 130

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

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. 2022 Sep 7.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

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

Pulsara

JUNE 7, 2024

CSFD has long been proactive in striving to improve communication between first responders and the Emergency Department. In 2016, they were early adopters of Pulsara , a streamlined, HIPAA-compliant app designed to help unite and inform inter-organizational care teams throughout major incidents and beyond.

Firefighter 91

Firefighter First Responder Emergency Response Emergency Department 91

The Skeptics' Guide to EM

OCTOBER 3, 2020

Date: October 2nd, 2020 Guest Skeptic: Dr.Barbra Backus is an emergency physician at the Emergency Department of the Erasmus University Medical Center in Rotterdam, the Netherlands. A trial of ticagrelor alone did not show a benefit over aspirin in preventing subsequent cardiovascular events ( Johnston et al NEJM 2016 ).

Emergency Department 100

Emergency Department ALS OR 100

Pediatric EM Morsels

JULY 5, 2024

Emerg Radiol. 2016; Published June 20, 2016. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. J Spinal Disord Tech. 2015;28(7). PMID: 26165728. Cui LW, Probst MA, Hoffman JR, Mower WR.

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

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

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 118

ALS Emergency Department OR ED 118

EMDocs

DECEMBER 18, 2024

A 36-year-old male presents to the emergency department after being found down at home by his spouse. 2016; 83(1): 67-79. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department.

E-9-1-1 61

E-9-1-1 Emergency Department ICU ED 61

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

MAY 28, 2017

Case: It is 7pm on a quiet evening in the emergency department and Bobby comes in. in adults when it reviewed a pilot study by Dr. David Talan ( Ann Emerg Med 2016 ). He’s 12 years old and complains of a belly ache, pointing to his right iliac fossa pain. In girls I would probably use a laparoscope.

ALS 100

ALS Emergency Department EMS OR 100

The Skeptics' Guide to EM

JULY 2, 2017

Case: A 22-year-old patient presents to the emergency department with sudden onset shortness of breath. The 2015 Chest Guidelines recommend systemically administered thrombolytic therapy in patients with acute PE associated with hypotension (systolic BP<90mmHg) who do not have a high risk of bleeding ( Kearon et al 2016). *

ALS 100

ALS Emergency Department OR 100

The Skeptics' Guide to EM

DECEMBER 2, 2017

He is currently deployed, practicing emergency medicine in an undisclosed location. Case: You are working a regular shift in the emergency department when you hear a code blue called. The American Heart Association ( AHA ) reports that were 209,000 IHCA arrests in 2016.

CPR 100

CPR Defibrillator ALS Emergency Response 100

REBEL EM

SEPTEMBER 9, 2024

A newborn boy presents to the emergency department shortly after a home delivery. Fleisher & Ludwig’s Textbook of Pediatric Emergency Medicine. Philadelphia, PA: Wolters Kluwer; 2016:27–54. The mother had routine prenatal care and reports that he was due in 2 days. His heart rate is 80 bpm.

Emergency Department 58

Emergency Department ED EMS 58