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

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

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 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 217

ALS Emergency Department ED OR 217

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

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

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

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

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

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 BLS 130

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 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

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

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 188

Allergic Reaction Plasma ED Epinephrine 188

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

APRIL 5, 2024

2017 May;69(5):540]. A study in the February issue of Annals conducted a meta-analysis of 18 studies and concluded that bougie use was associated with increased first-attempt intubation success. Some important limitations of this analysis should be recognized. There was no analysis of operator experience or expertise. 2023;42(6):445-9.

OR 73

OR ALS Emergency Department Critical Care 73

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

ALiEM

DECEMBER 16, 2024

2017 Apr;30(2):179-181. She had followed up with the patients pediatrician and ENT and was given oral cephalexin and fluticasone nasal spray which did not make any changes in his symptoms. The patient denied any fevers or headaches. Physical Exam Vitals : Temp 97.4F; BP 100/58; HR 90; RR 18; SpO2 98%. Pott puffy tumor. Masterson L, Leong P.

OR 130

OR EMS 130

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 217

Life Support Advanced Life Support Emergency Department ALS 217

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

[display_podcast] Date: September 19th, 2017 Reference: Cournoyer et al. September 2017. display_podcast] Date: September 19th, 2017 Reference: Cournoyer et al. September 2017. Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. Academic Emergency Medicine.

Life Support 130

Life Support CPR Advanced Life Support Defibrillator 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.

Emergency Department 130

Emergency Department ALS EMS ED 130

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

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

The Skeptics' Guide to EM

JUNE 11, 2017

[display_podcast] Date: June 5th, 2017 Reference: Baharoglu et al. display_podcast] Date: June 5th, 2017 Reference: Baharoglu et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016.

ALS 130

ALS OR EMS 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

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

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

SEPTEMBER 30, 2017

[display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ April 17. BMJ April 17. The decision to obtain an invasive sample is a clinical one.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

NOVEMBER 25, 2017

[display_podcast] Date: November 24th, 2017 Reference: Roldan et al. AEM November 2017 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. display_podcast] Date: November 24th, 2017 Reference: Roldan et al. AEM November 2017.

Emergency Department 100

Emergency Department ALS EMS OR 100

ALiEM

DECEMBER 13, 2024

She has experienced a sudden loss of vision in her right eye for more than six hours. She reports no eye pain or redness, nor has she experienced any flashing lights. Over the past one to two months, the patient has lost 30 pounds and has noted increasing weakness over the last several weeks. In CRAO, remember arteritic and non-arteritic causes.

Emergency Department 130

Emergency Department OR ED 130

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

NOVEMBER 11, 2017

[display_podcast] Date: November 9th, 2017 Reference: Cronin JJ et al. display_podcast] Date: November 9th, 2017 Reference: Cronin JJ et al. A Randomized Trial of Single-Dose Oral Dexamethasone Versus Multidose Prednisolone for Acute Exacerbations of Asthma in Children Who Attend the Emergency Department. mg/kg (max.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

OCTOBER 7, 2017

[display_podcast] Date: October 5th, 2017 Reference: Brison et al. Steve completed his Sport Medicine fellowship training with the Fowler Kennedy Sport Medicine Clinic in 2017. display_podcast] Date: October 5th, 2017 Reference: Brison et al. BMJ Nov 2016. Guest Skeptic: Dr. Steve Joseph. BMJ Nov 2016. Reference: Brison et al.

Emergency Department 100

Emergency Department ALS OR 100

The Skeptics' Guide to EM

MAY 28, 2017

[display_podcast] Date: May 24th, 2017 Reference: Georgiou et al. Pediatrics 2017. display_podcast] Date: May 24th, 2017 Reference: Georgiou et al. Pediatrics 2017. Pediatrics 2017. Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta-analysis. Reference: Georgiou et al.

ALS 100

ALS Emergency Department EMS OR 100

The Skeptics' Guide to EM

JANUARY 7, 2018

[display_podcast] Date: December 19th, 2017 Reference: Perry J et al. CMAJ Nov 2017 Guest Skeptic: Dr. Chris Carpenter is from Washington University, Deputy Editor of Academic Emergency Medicine and faculty member of Emergency Medicine and Critical Care course. display_podcast] Date: December 19th, 2017 Reference: Perry J et al.

Emergency Department 100

Emergency Department Critical Care ALS OR 100