The Skeptics' Guide to EM

JANUARY 30, 2021

Steve completed his Sport Medicine fellowship training with the Fowler Kennedy Sport Medicine Clinic in 2017. Steve completed his Sport Medicine fellowship training with the Fowler Kennedy Sport Medicine Clinic in 2017. He served with the Canadian Forces as a Medical Officer and Flight Surgeon. J Bone Joint Surg Am.

OR 130

OR ALS 130

Pediatric EM Morsels

NOVEMBER 15, 2024

Have you ever had that feeling of falling that rapidly wakes you from sleep? While it’s unlikely that you were having Benign Epilepsy with CentroTemporal Spikes (BECTS) seizures or a benign Rolandic seizure, that tenuous state between sleeping and waking is a time when some odd neurologic things can happen, including BECTS.

ALS 152

ALS OR EMS 152

Pediatric EM Morsels

OCTOBER 6, 2023

Let us take a moment to review Typhoid Fever in children : Typhoid Fever: Basics Salmonella enterica serotype Typhi is the causative bacteria and represents 75% of cases of enteric fever (GBD 2017) Salmonella enterica serotypes Paratyphi A, B and C cause Paratyphoid fever which has clinically indistinguishable features.

OR 161

OR EMS ED 161

Pediatric EM Morsels

JUNE 2, 2023

2017 Jun 27;10:197-207. Rare diseases are not confined to the pages of a textbook or computer screen. Our patients have varied past medical histories that require us to be well-versed in even the most uncommon disorders (or know where to look things up in a pinch)! Michelet M, Schluckebier D, Petit LM, Caubet JC. J Asthma Allergy.

Emergency Department 189

Emergency Department ALS EMS OR 189

NAEMSP

APRIL 15, 2024

Background NAEMSP has had a position statement on patient restraint in 2002 and updated in 2017. Clinical care and restraint of agitated or combative patients by emergency medical services practitioners. Prehosp Emerg Care 2021 Sep-Oct;25(5):721-3. doi: 10.1080/10903127.2021.1917736. Epub 2021 Jun 7. PMID: 33877949.

OR 52

OR Emergency Medical Technician Emergency Medical Services EMS 52

The Skeptics' Guide to EM

OCTOBER 28, 2023

Acetaminophen ( Williams et al Lancet 2014) * Muscle relaxants ( Friedman et al JAMA 2015) * NSAIDs ( Machado et al Ann Rheum Dis 2017) * Steroids ( Balakrishnamoorthy et al Emerg Med J 2014) * Benzodiazepines ( Friedman et al Ann Emerg Med 2017) Many non-pharmacologic therapies have also been tried with limited efficacy.

ALS 221

ALS Emergency Department ED OR 221

ACEP Now

JULY 7, 2023

Heart disease and stroke statistics-2017 update: A report from the American Heart Association. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. amiodarone or lidocaine). N Engl J Med. 1999;341(12):871-878.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

Core EM

JANUARY 25, 2024

mEq/L Effect starts 10-20 mins after administration and can last 4-6 hours Albuterol 10-20 mg over 10 mins (NB: higher dose than for asthma) Peak effect at 90 mins Decreases by 0.5 – 1.0 mEq/L alone With insulin, ~1.2 mEq/L, additive effect Bicarbonate Controversy. mEq/L alone With insulin, ~1.2

Epinephrine 246

Epinephrine OR ED 246

The Good, The Bad & The Ugly Paramedic

JULY 1, 2020

As paramedics, whilst we often take great offence at being called ambulance drivers, the question is, when it’s our turn to drive, what exactly is it that we are providing? Do we fully engage in shared patient care with our attending partner, or do we switch off so that we can simply drive the ambulance and take it easy?

Ambulance Driver 52

Ambulance Driver Paramedic Ambulance OR 52

The Skeptics' Guide to EM

JUNE 4, 2017

[display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. Lancet August 2016.

OR 130

OR ALS CPR ICU 130

Core EM

JANUARY 25, 2024

Joaquín Valle Alonso, Ganapathiram Lakshmanan, Yasser Saleem, Use of POCUS Ultrasound in sepsis, bedside diagnosis of necrotizing fasciitis, QJM: An International Journal of Medicine , Volume 110, Issue 10, October 2017, Pages 687–688. REFERENCES: Castleberg E, Jenson N, Dinh VA. Western Journal of Emergency Medicine. 2014;15(1):111-113.

E-9-1-1 246

E-9-1-1 Emergency Department OR 246

Core EM

OCTOBER 16, 2024

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 145

Allergic Reaction Plasma ED Epinephrine 145

Pediatric EM Morsels

OCTOBER 27, 2023

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. 2017), Evaluation of the accuracy of common weight estimation formulae in a Zambian paediatric surgical population.

E-9-1-1 269

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

The Skeptics' Guide to EM

MAY 14, 2022

These include: acetaminophen ( Williams et al Lancet 2014), steroids ( Balakrishnamoorthy et al Emerg Med J 2014) and benzodiazepines ( Friedman et al Ann Emerg Med 2017). The pain is 10/10 in intensity, gets worse with bending, turning, and prolonged walking. A heating pad and acetaminophen has not helped with the pain.

ALS 130

ALS Emergency Department ED OR 130

ALiEM

DECEMBER 18, 2023

2017 Jun 9;18(6):1243. The patient specifically denied mucous membrane involvement (mouth, eyes, genitalia), vomiting, diarrhea, dysuria, hematuria, neck stiffness, cough, dyspnea, chest pain, or exposure to ticks or exotic animals. Additional Images Physical Exam Vitals : T 39.6°C; Additional Images Physical Exam Vitals : T 39.6°C;

Emergency Department 177

Emergency Department OR 177

Pediatric EM Morsels

APRIL 5, 2024

However, it is often overlooked that tickborne illnesses are among the most common travel-related illnesses globally (CDC Traveller’s Health 2017). We frequently ask children and their parents if they have had recent tick bites when they present for fever after a recent camping activity. Omsk Hemorrhagic Fever. Tickborne Disease Abroad.

E-9-1-1 161

E-9-1-1 ALS OR EMS 161

Core EM

OCTOBER 2, 2024

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 100

Allergic Reaction Plasma ED Epinephrine 100

ALiEM

FEBRUARY 16, 2024

Indian J Gastroenterol 36, 66–67 (2017). His daughter had reported to staff he had been feeling unwell for five days, intermittently having nausea and generalized abdominal pain, subjective fevers, chest pain, and shortness of breath. His daughter also reported a history of intermittent lower abdominal cramping which was chronic for him.

Coronary 161

Coronary OR 161

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. Guest Skeptic: Dr. Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas. She was lifting something heavy and felt a“pop” in her back.

Emergency Department 130

Emergency Department ALS OR EMS 130

Core EM

JANUARY 8, 2024

Design Design Multi-center, retrospective study of 201 consecutive ED patients spanning from April 1, 2017, to April 22, 2017. The most common reasons for withholding contrast from a patient include hypersensitivity reactions to contrast medium, kidney disease, or contrast shortages. This was the reference standard.

Emergency Department 100

Emergency Department EMS ED ALS 100

The Skeptics' Guide to EM

OCTOBER 14, 2023

March 2023 * Population: Children 0-16 years recruited consecutively from October 2017 to September 2020 from three emergency departments and one urgent care centre in England- serving populations with significant inequalities in health and life expectancty.

Life Support 221

Life Support Advanced Life Support Emergency Department ALS 221

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

ALiEM

SEPTEMBER 25, 2023

2017 Mar 13;1(2):104-107. Case Question: What complication should be considered if no arterial pulse is palpated on exam? Phlegmasia Cerulea Dolens has a high amputation rate secondary to venous gangrene or compartment syndrome. If no pulse is noted on exam, a high suspicion for compartment syndrome must be maintained. Ann Vasc Dis.

OR 152

OR 152

ALiEM

JUNE 15, 2023

Elsevier; 2017. Lily of the valley ( Convallaria majalis ) is a woodland perennial with a sweet scented, white bell-shaped flower. It blooms from April to June in North America and bears orange-red berries in July [1]. It resembles wild leek or garlic ( Allium tricoccum ) and misidentification has led to case reports of toxicity [2].

ALS 246

ALS ED OR 246

The Skeptics' Guide to EM

SEPTEMBER 10, 2017

[display_podcast] Date: September 7th, 2017 Reference: Cohen et al. display_podcast] Date: September 7th, 2017 Reference: Cohen et al. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. million visits annually.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

MAY 21, 2017

[display_podcast] Date: May 19th, 2017 Reference: Willman et al. Clinical Toxicology 2017. display_podcast] Date: May 19th, 2017 Reference: Willman et al. Clinical Toxicology 2017. Clinical Toxicology 2017. Do heroin overdose patients require observation after receiving naloxone? Reference: Willman et al.

Naloxone 130

Naloxone Overdose First Responder Emergency Department 130

The Skeptics' Guide to EM

SEPTEMBER 3, 2017

[display_podcast] Date: September 2nd, 2017 Reference: Caputo et al. display_podcast] Date: September 2nd, 2017 Reference: Caputo et al. EmergeNcy Department use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial).

Emergency Department 130

Emergency Department Operating Room Critical Care ALS 130

This Podcast Will Kill You

JULY 23, 2024

” Current gastroenterology reports 19 (2017): 1-8. CW: discussion of disordered eating, eating disorders Did the word gluten manifest in everyone’s consciousness one day in 2010? Suddenly, grocery stores were filled with gluten-free crackers, cookies, buns, you name it. Cenit, María Carmen, et al. ” Nutrients 7.8 2015): 6900-6923.

E-9-1-1 98

E-9-1-1 ALS OR 98

Don't Forget the Bubbles

AUGUST 19, 2024

2017 Sep;49(3):223-226. Epub 2017 May 23. He points to his sternum when you ask him where the pain is. and tells you that it is made worse by deep breathing and movement. His sternum is warm to touch and exquisitely tender, inferior to the manubrium. There is no overlying bruising, erythema, or skin changes. MRI is superior to CXR.

Emergency Department 104

Emergency Department OR 104

The Skeptics' Guide to EM

SEPTEMBER 16, 2017

[display_podcast] Date: September 12th, 2017 Reference: Sinert et al. J Allergy Clin Immunol Pract 2017. display_podcast] Date: September 12th, 2017 Reference: Sinert et al. J Allergy Clin Immunol Pract 2017. J Allergy Clin Immunol Pract 2017. Reference: Sinert et al.

Epinephrine 130

Epinephrine ALS Emergency Department EMS 130

FirstNet Authority

FEBRUARY 26, 2024

Established in 2017, the award recognizes the spirit of service, commitment, and dedication that is a proud tradition among public safety. From 2012 to 2017, Chief McEwen served as the Chair of the FirstNet Authority PSAC. McEwen Public Safety Broadband Communications Award The prestigious Chief Harlin R.

Public Safety 52

Public Safety Emergency Manager Emergency Management First Responder 52

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

This Podcast Will Kill You

SEPTEMBER 3, 2024

” (2017). ” Current opinion in virology 22 (2017): 64-70. ” Nausea and vomiting: diagnosis and treatment (2017): 15-25. “Is it gonna be poop or is it gonna be barf?” It’s the question we all fear during a bout of food poisoning when time is of the essence and a decision has to be made before it’s made for us.

ALS 52

ALS OR 52

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.

Emergency Department 130

Emergency Department ALS EMS ED 130

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

Critical Care Scenarios

DECEMBER 27, 2020

Initial approach, supportive care, risk stratification, and management of the troublesome complications for ruptured subarachnoid aneurysm, with Thomas Lawson (@TomLawsonNP), nurse practitioner in the neurocritical care unit at OSU Wexner Medical Center. Aneurysmal SAH is much different from traumatic and other etiologies of SAH.

OR 100

OR 100

The Skeptics' Guide to EM

DECEMBER 2, 2017

[display_podcast] Date: November 24th, 2017 Reference: Andersen et al. JAMA 2017 Guest Skeptic: Dr. Bob Edmonds is an Emergency Physician in the US Air Force. display_podcast] Date: November 24th, 2017 Reference: Andersen et al. JAMA 2017 Guest Skeptic: Dr. Bob Edmonds is an Emergency Physician in the US Air Force.

CPR 100

CPR Defibrillator ALS Emergency Response 100