EMDocs

JULY 17, 2023

and is poorly tolerated by patients with obstruction, it should not be a routine part of the ED evaluation for LBO unless it is critical for another diagnosis on the differential. 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation. Bowel Perforation: ED Presentations, evaluation and management.

E-9-1-1 78

E-9-1-1 ED Operating Room ALS 78

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. To date, ketamine has been the agent of choice (12).

ED 66

ED Emergency Department ALS Paramedic 66

EMDocs

JUNE 3, 2023

For a broader overview of pelvic trauma, please review Dr. Lupez’s 2017 article here: [link]. The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. 12 An AP x-ray of the pelvis should be obtained in the ED for unstable patients.

ED 54

ED Operating Room ALS Frozen Plasma 54

The Skeptics' Guide to EM

MAY 14, 2022

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. EDs annually (1). He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine.

ALS 130

ALS Emergency Department ED OR 130

Core EM

JANUARY 25, 2024

Three children (2.1%) had true hyperkalemia: one had known chronic renal failure and was referred to the ED due to concern for electrolyte abnormalities; the other 2 patients had diabetic ketoacidosis (DKA). mEq/L alone With insulin, ~1.2 mEq/L, additive effect Bicarbonate Controversy.

Epinephrine 246

Epinephrine OR ED 246

Core EM

OCTOBER 16, 2024

In: Marx J, ed. In: Wolfson A, ed. 2017 Jul 1;9(1):4-8. Br J Haematol. 2009 Nov;147(4):431-43. link] Emery, M. Blood and blood components. Rosen’s emergency medicine. Philadelphia, PA: Elsevier; 2014:75-80. Transfusion Reactions and Complications. Harwood-Nuss’ Clinical Practice of Emergency Medicine. Hirayama F.

Allergic Reaction 145

Allergic Reaction Plasma ED Epinephrine 145

EMDocs

NOVEMBER 22, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. He attributes the pain to neck extension during the ride, but 2 days later he notes numbness and tingling in both arms and goes to the ED. Blogpost, January, 2017. Kachalia A et al. Health Affairs, Vol.

ED 81

ED Emergency Department OR ALS 81

Core EM

JANUARY 8, 2024

JAMA Network, 2023 Background Computed tomography of the abdomen and pelvis (CT AP) is the most common diagnostic imaging test to evaluate abdominal pain in the ED. Clinical Question What is the diagnostic accuracy of using CT abdomen pelvis (CT AP) without contrast compared to contrast-enhanced CT AP in ED patients with acute abdominal pain?

Emergency Department 100

Emergency Department EMS ED ALS 100

ALiEM

APRIL 12, 2023

20 – Local Anesthetics, Ed(s): Hugh C. Preparation and Evaluation of Polymer-Based Ultrasound Gel and Its Application in Ultrasonography. 2022 Jan 6;8(1):42. doi: 10.3390/gels8010042. PMID: 35049577 ; PMCID: PMC8774352 Suzuko S, Peter G, Philipp L. Hemmings, Talmage D. DOI: 10.1016/B978-0-323-48110-6.00020-X R.

Emergency Department 258

Emergency Department ALS ED 258

Core EM

OCTOBER 2, 2024

In: Marx J, ed. In: Wolfson A, ed. 2017 Jul 1;9(1):4-8. Br J Haematol. 2009 Nov;147(4):431-43. link] Emery, M. Blood and blood components. Rosen’s emergency medicine. Philadelphia, PA: Elsevier; 2014:75-80. Transfusion Reactions and Complications. Harwood-Nuss’ Clinical Practice of Emergency Medicine. Hirayama F.

Allergic Reaction 100

Allergic Reaction Plasma ED Epinephrine 100

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

ALiEM

FEBRUARY 20, 2024

2017 Jul;17(3):260-266. Successful treatment of flecainide-induced cardiac arrest with extracorporeal membrane oxygenation in the ED. Valentino MA, Panakos A, Ragupathi L, Williams J, Pavri BB. Flecainide Toxicity: A Case Report and Systematic Review of its Electrocardiographic Patterns and Management. Cardiovasc Toxicol.

Life Support 183

Life Support Overdose ED 183

The Skeptics' Guide to EM

OCTOBER 14, 2023

Case: A 5-year-old boy presents to the emergency department (ED) with his parents for fever and fatigue. She is also a member of the Don’t’ Forget the Bubbles team where she serves as the editor for the monthly research round up, Bubble WRAP. He has had three days of high fevers at home. A prospective study. J Paediatr Child Health.

Life Support 216

Life Support Advanced Life Support Emergency Department ALS 216

The Skeptics' Guide to EM

JULY 8, 2023

Case: A 57-year-old woman with hypertension, hyperlipidemia and type-2 diabetes mellitus presents to the emergency department (ED) with fever, cough, myalgias, headache and congestion. Wallach et al JAMA Intern Med 2017 , previously reported that subgroup claims are often not corroborated by subsequent studies and rarely confirmed.

ALS 232

ALS Emergency Department EMS ED 232

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Shah 2017] In Turkey, it has a “reliable correlation.” Gültekingil-Keser 2017] Broselow out-performed age-based formulas (Theron, APLS, and Shann) in New Zealand, estimating within 10% of actual weight 73% of the time.

E-9-1-1 269

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

ALiEM

JUNE 15, 2023

Elsevier; 2017. Read More in the Series References Lily of the valley: Convallaria majalis (Liliales: Liliaceae). Invasive Plant Atlas of the United States. Retrieved Jun 5, 2023. Nelson LS, Goldfrank LR. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Vet Med Sci. 2021 Nov;7(6):2440-2444. PMID 34469053 Graeme KA.

ALS 246

ALS ED OR 246

The Skeptics' Guide to EM

DECEMBER 17, 2022

Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. Background: Major trauma in older patients is increasing in frequency (1), with the median age of major trauma patients in the UK from 2012-2017 being 63.6 years ( 2 ).

Frozen Plasma 130

Frozen Plasma FFP Emergency Medical Services Plasma 130

The Skeptics' Guide to EM

OCTOBER 28, 2017

[display_podcast] Date: October 24th, 2017 Reference: Harrison et al. Pediatrics 2017 Guest Skeptic: Dr. Anthony Crocco is a Pediatric Emergency Physician and is the Medical Director & Division Head of the Division of Pediatric Emergency at McMaster’s Children’s Hospital. Anthony is also the creator of SketchyEBM.

ALS 130

ALS Emergency Department OR ED 130

The Skeptics' Guide to EM

DECEMBER 8, 2017

[display_podcast] Date: November 28th, 2017 Reference: Motov S et al. display_podcast] Date: November 28th, 2017 Reference: Motov S et al. A systematic review was just published in the Emergency Medicine Journal looking at 43 management of acute low back pain in the ED. The conclusions…we need more evidence.

Emergency Department 130

Emergency Department ALS OR EMS 130

The Skeptics' Guide to EM

JANUARY 20, 2018

BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. million visits annually to PCPs and EDs for sore throat.

Emergency Department 130

Emergency Department ALS EMS ED 130

ALiEM

JANUARY 12, 2024

Laboratory Data Laboratory workup in the ED revealed resolution of proteinuria with serum creatinine returning to normal baseline value (0.89 Erythema multiforme, Stevens Johnson syndrome, and toxic epidermal necrolysis reported after vaccination, 1999-2017. 2020 Feb 11;38(7):1746-1752. doi: 10.1016/j.vaccine.2019.12.028. 2019.12.028.

Emergency Department 130

Emergency Department EMS ED 130

ALiEM

NOVEMBER 15, 2023

2017, July 10). In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Goldfrank’s Toxicologic Emergencies, 11e. McGraw Hill; 2019. Accessed August 20, 2023. Nitrites (Amyl and Sodium) and Sodium Thiosulfate. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. McGraw Hill; 2019. McGraw Hill; 2019.

OR 169

OR ED 169

The Overrun

NOVEMBER 2, 2018

Ed Bauter We’ve all been there. In 2017, a retrospective, observational study was performed to determine if first-pass success was improved by the use of a bougie in the ED. RSI vs DSI These techniques have been used in the ED for a long time, but may be relatively new to your shop. What’s the right airway to use?

ED 52

ED Paramedic OR Ambulance 52

Don't Forget the Bubbles

NOVEMBER 29, 2023

Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED). Journal of Neurosurgical Anesthesiology 29(2): p 161-167, April 2017. |

E-9-1-1 135

E-9-1-1 Emergency Department ED CPR 135

REBEL EM

FEBRUARY 21, 2024

Clinical Scenario: A 34-year-old woman presents to the ED with back pain. Schwartz and colleagues performed an ingenious trial ( Schwartz 2000 ) Enrolled 64 ED patients with acute pain. The ceiling pain relief dose for ketorolac is 15 mg IV ( Motov 2017 ). Ann Emerg Med 2017; 70(2): 177-84. Arch Surg 1998;133:432-7.

E-9-1-1 64

E-9-1-1 Emergency Department ALS ED 64

The Skeptics' Guide to EM

OCTOBER 22, 2017

[display_podcast] Date: October 19th, 2017 Reference: Hofmann et al. NEJM Sept 2017. display_podcast] Date: October 19th, 2017 Reference: Hofmann et al. NEJM Sept 2017. Oxygen Therapy in Suspected Acute Myocardial Infarction. Guest Skeptic: Marcus Prescott is a nurse in Norway. He is also now a first-year medical student.

Emergency Medical Services 130

Emergency Medical Services Coronary ALS STEMI 130

ACEP Now

JULY 11, 2024

The United States Preventive Services Task Force (USPSTF) recommends screening for problem drinking in the primary setting, but we know that patients who present to the ED are twice as likely to engage in dangerous drinking, so arguably the ED is an important venue for screening as well. Anton RF, O’Malley SS, Ciraulo DA, et al.

Emergency Department 98

Emergency Department ALS ED OR 98

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. 2017 Feb 16;376(7):663-673. 2017 Nov;17(8):1097-1104. Physical examination was notable for left lower extremity with foreshortening and external rotation.

E-9-1-1 52

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

Dr. Smith's ECG Blog

JUNE 2, 2023

Despite otherwise normal vital signs, she was appropriately triaged to the critical care area of the ED. They are rare and hard to find in normal practice in the ED. She denied chest pain and denied feeling any palpitations, even during her triage ECG: What do you think? The diagnosis is not easy (see below).

ED 82

ED OR ALS CAD 82

The Skeptics' Guide to EM

SEPTEMBER 1, 2018

February 2017 Guest Skeptic: Dr. Simon McCormick is an Emergency Medicine Consultant from Northern Ireland who works in Rotherham Hospital in Yorkshire, England. February 2017 Guest Skeptic: Dr. Simon McCormick is an Emergency Medicine Consultant from Northern Ireland who works in Rotherham Hospital in Yorkshire, England. Pediatrics.

ALS 130

ALS Emergency Department OR EMS 130

REBEL EM

JANUARY 9, 2024

Bottom Line Up Top: In patients with infectious processes that are stable for discharge home, there is no role for giving a first dose of antibiotics IV in the ED. BMJ (Clinical research ed.). Pneumonia 2017. Clinical Scenario: A 45-year-old woman with hypertension presents with a productive cough and fever. 2014; 32(10):1195-9.

ALS 100

ALS ICU ED OR 100

ACEP Now

OCTOBER 29, 2024

Our patient is a 33-year-old male with spastic quadriparesis due to cerebral palsy with chronic indwelling suprapubic catheter (SPC) who presented to the emergency department (ED) due to concern for Foley catheter obstruction. SPC was exchanged in the ED with clear yellow fluid observed draining into the bag. Click to enlarge.)

ED 52

ED Emergency Department OR 52

The Skeptics' Guide to EM

FEBRUARY 2, 2018

AEM Dec 2017. AEM Dec 2017. In her spare time, Melissa also enjoys being the fellowship director to an amazing group of PEM trainees. Case: Brian is a 14-year-old male who presents to the emergency department (ED) complaining of acute onset testicular pain. AEM Dec 2017. Reference: Frohlich LC, et al.

Operating Room 100

Operating Room Emergency Department ALS ED 100

This Podcast Will Kill You

SEPTEMBER 26, 2023

DiSalvo, eds. Mediators of inflammation , 2017. 2017): 10-1128. ” Nature Reviews Immunology 17.10 (2017): 635-646. History Biology Al-Doory, Yousef, and Arthur F. Blastomycosis. Springer Science & Business Media, 2012. Gauthier, G.M., Espinel-Ingroff, Ana. Springer Science & Business Media, 2003. Enbiale, W.,

ALS 52

ALS 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

JANUARY 19, 2019

Background: There have been close to 400,000 deaths from an overdose involving any opioid (prescription and illicit opioids) between 1999 and 2017. [1] This teaching has been challenged by a systematic review by Willman et al 2017. 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

ALiEM

MARCH 7, 2024

Ann Emer Med , 2005 [7] Prospective, blinded, observational study performed in the pediatric ED, 3 month period N=44, < 2 years of age Created a bladder urinary index by multiplying the AP and transverse bladder diameters. Author, Title, Journal, Publication Year Study Type, Location, Time Frame N, Ages Summary Milling et al., Chen et al.,

E-9-1-1 177

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