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 fever was 103°F this morning and he received ibuprofen. He has also had abdominal and back pain. Warm gel helps with the child’s comfort. Use a linear high frequency probe.

E-9-1-1 246

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

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

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

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. Differentiate abscess from other soft tissue pathologies such as cysts and lymph nodes. There has been no drainage from the lesion. Abscess with color Doppler flow Video 3.

E-9-1-1 161

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

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

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

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

Pediatric EM Morsels

JULY 21, 2023

We use the GCS score in both trauma and medical patients, but where did this score come from? When is it useful and what does it tell us? Is it actually validated in children, like the Ottawa Ankle Rules or are we using a tool for something other than that for which it was designed and validated, like using Kocher criteria for knee and ankle joints?

Critical Care 246

Critical Care ALS OR Life Support 246

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

ALiEM

MARCH 7, 2024

The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Her mother denies any fevers, upper respiratory symptoms, sore throat, or diarrhea. She adds that her daughter has complained of 2-3 episodes of dysuria and gross hematuria over the last few days. Lay the patient supine when possible.

E-9-1-1 177

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

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

REBEL EM

NOVEMBER 6, 2024

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)

E-9-1-1 118

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

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

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

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

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

Pediatric EM Morsels

JULY 5, 2024

It seems like just yesterday ( or maybe ~ a month ago ) when we served up a tasty morsel on the PECARN decision rule for intra-abdominal traumatic injuries in children. Our friends at the PECARN injury group have remained busy this spring with generating more externally validated clinical decision rules. High Risk (12.8% High Risk (12.8%

ALS 161

ALS OR ED Emergency Department 161

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

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

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

Robert Edmonds is an emergency physician in the US Air Force in Virginia. Population: All adult (over 18 years of age) patients in the ACS-TQIP database from 2015-2016. This is Bob’s tenth visit to the SGEM. DISCLAIMER: THE VIEWS AND OPINIONS OF THIS PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US AIR FORCE.

ACS 130

ACS Emergency Department ALS OR 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. first appeared on The Skeptics Guide to Emergency Medicine. This was the ALPS randomized control trial published in NEJM 2016.

CPR 130

CPR BLS ALS Paramedic 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

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 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. She is the creator of the HEART Score and an enthusiastic researcher. Reference: Claiborne Johnston S et al. Reference: Claiborne Johnston S et al.

Emergency Department 100

Emergency Department ALS OR 100

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 […] The post SGEM#381: Put Your Hand on My Shoulder and Reduce It first appeared on The Skeptics Guide to Emergency Medicine.

ALS 118

ALS Emergency Department OR ED 118

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. Paper: Mason JM, et al.

Emergency Department 52

Emergency Department ALS Critical Care ED 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

EMDocs

DECEMBER 18, 2024

A 36-year-old male presents to the emergency department after being found down at home by his spouse. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. Per the mans wife, the patient is a heavy drinker often consuming two to three pints of vodka daily.

E-9-1-1 61

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

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

Core EM

MARCH 1, 2024

2016 Apr-Jun;19(2):183-7. Goldfrank’s Toxicologic Emergencies, 11e. The Clinical Presentations of Nitrous Oxide Users in an Emergency Department. Significance of the Inverted V Sign : This MRI sign is pathognomonic for subacute combined degeneration, indicating it is a distinct marker for this condition. 2020:952–9.

Emergency Department 162

Emergency Department ED OR ALS 162

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

APRIL 29, 2024

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. The IO can actually be your “GO-TO” emergency line or your second choice after failed PIV access.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

The Skeptics' Guide to EM

MAY 28, 2017

for Paediatric Appendicitis first appeared on The Skeptics Guide to Emergency Medicine. 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 ). Ross Fisher is a Paediatric Surgeon in Sheffield, England.

ALS 100

ALS Emergency Department EMS OR 100

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. Am J Emerg Med. 2016 Nov;34(11):2182-2185. Epub 2016 Aug 27. or basilar ischemia.

STEMI 106

STEMI Coronary Emergency Department OR 106

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

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. 2016, April 13). He was intubated for altered mental status. Chest trauma was suspected on initial exam. Here is his initial ECG around 1330: What do you think?

ALS 114

ALS Emergency Department OR EMS 114