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 209

ICU ED Critical Care ALS 209

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

Pediatric EM Morsels

OCTOBER 27, 2023

Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. Bowen 2016] Moral of the Morsel: Weight Matters! Reduces dosing errors during resus, up to 33.88%.

E-9-1-1 268

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

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

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

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245

FOAMcast

JANUARY 25, 2023

Am J Emerg Med. 2016 May 1;202(1):182-7. Ionised calcium levels in major trauma patients who received blood in the Emergency Department. Emerg Med J. 2016 Aug;33(8):569-72. Epub 2016 Feb 4. The diamond of death: Hypocalcemia in trauma and resuscitation. 2021 Mar;41:104-109. doi: 10.1016/j.ajem.2020.12.065.

Emergency Department 52

Emergency Department OR 52

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

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? 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.

Emergency Department 82

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

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

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

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

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. Karageorgos, S.; Hibberd, O.; Mullally, P.J.W.; Segura-Retana, R.;

Emergency Department 142

Emergency Department E-9-1-1 ALS OR 142

The Skeptics' Guide to EM

MAY 5, 2018

Child Development December 2016. He has particular interests in Emergency Care, Aboriginal Health, Paediatrics, Trauma and Women’s Anaesthesia. . […] The post SGEM#217: The Batman Effect on Improving Perseverance first appeared on The Skeptics Guide to Emergency Medicine. Child Development December 2016.

Emergency Department 130

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

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

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

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

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

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 152

ALS Emergency Department OR ED 152

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

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 104

ALS Epinephrine Critical Care Emergency Department 104

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. 1–4 Emergency physicians commonly prescribe opioid pain medications, and there is significant variability among prescribing patterns. In the January issue of Annals of Emergency Medicine , Merz-Herrara, et al., J Patient Saf.

E-9-1-1 52

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

EMDocs

JUNE 8, 2024

A 32-year-old man presents to the emergency department with eye pain. However, it would be expected to emerge with reduced visual acuity or other visual disturbances such as diplopia. Overview of Eye Injuries in the Emergency Department.” 95% occupational injuries occur in males [1]. UpToDate , 30 Oct.

EMS 81

EMS Allergic Reaction Emergency Department ED 81

The Skeptics' Guide to EM

APRIL 3, 2021

Stroke 2021 Case: A 74-year-old man presents to the emergency department after waking up with left sided weakness. hours after the onset of stroke symptoms ( Extend NEJM 2019 and ECASS-4: Extend 2016 ). MRI-guided thrombolysis (0.6 mg/kg) was beneficial for unknown onset stroke above a certain core size. THAWS RCT Substudy.

ALS 130

ALS Emergency Department OR 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

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

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

EMDocs

AUGUST 22, 2023

Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. J Emerg Med. Capnography for the nonintubated patient in the emergency setting. Ann Emerg Med. Predictive value of capnography for suspected diabetic ketoacidosis in the emergency department. West J Emerg Med.

Emergency Department 68

Emergency Department ALS Life Support OR 68

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. One study demonstrated that 65.9

Emergency Department 52

Emergency Department ALS ED OR 52

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

REBEL EM

MARCH 8, 2023

Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. Emergency Department Management: Emergency ophthalmology consultation. Emergency surgical management indicated if concomitant retinal tear, vitreous hemorrhage, or retinal detachment. >10 floaters, (+) LR 8.1-36

Emergency Department 52

Emergency Department ALS ED OR 52

REBEL EM

MARCH 23, 2023

The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores. Treatment options for alcohol withdrawal include benzodiazepines such as lorazepam, diazepam, or chlordiazepoxide, gabapentin, and phenobarbital (Buell et al.).

ICU 52

ICU Emergency Department ALS OR 52

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. 2 However, many emergency physicians are unaware of this interpretation, instead letting concern for violating HIPAA override patient-care needs. HHS website.

ED 52

ED Emergency Department 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

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

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Background: Acute alcohol intoxication is often identified early in a patient’s visit by behavioral changes accompanied by slurred speech, ataxia, nystagmus, or the smell of alcohol.

Emergency Department 52

Emergency Department OR EMS 52