Pediatric EM Morsels

SEPTEMBER 22, 2023

Tenenbein M, Macias CG, Sharieff GQ, et al, eds. 2018 Oct;14(2):47-54. Epub 2018 Oct 31. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Treat patients suspected of having neurogenic shock with warming and vasopressors. They may even need atropine and/or pacing for persistent bradycardia. 5 th Edition. Neurogenic Shock.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

The Skeptics' Guide to EM

OCTOBER 12, 2024

Reference: Ma K et al. Reference: Ma K et al. A national survey of children’s experiences and needs when attending Canadian pediatric emergency departments. June 2024 Date: Oct 1, 2024 Guest Skeptic: Dr. Andrew (Andy) Tagg is an Emergency Physician with a special interest in education and lifelong learning.

Emergency Department 225

Emergency Department ED ALS OR 225

ALiEM

MARCH 7, 2024

Transvere ultrasound views of the bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.) Sagittal view of bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.)

E-9-1-1 177

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

Core EM

JANUARY 25, 2024

2018 Nov 30;2018(1):530-538. Paydary, Koosha, et al. Sawler D, Parker A, Britto J, et al. 2020.05.045. Scully M, Hunt BJ, Benjamin S, et al. High versus standard dose methylprednisolone in the acute phase of idiopathic thrombotic thrombocytopenic purpura: a randomized study. Ann Hematol. 2010 Jun;89(6):591-6.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

Pediatric EM Morsels

JULY 21, 2023

cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! Holmes, James F et al. Conzelmann M, Hoidis A, Bruckner T , et al. Fun fact for animal lovers!- Performance of the Pediatric Glasgow Coma Scale Score in the Evaluation of Children With Blunt Head Trauma.

Critical Care 246

Critical Care ALS OR Life Support 246

ALiEM

JUNE 15, 2023

Goldfrank’s Toxicologic Emergencies, 11e New York, NY: McGraw-Hill; 2019 Morimoto M, Tatsumi K, Yuui K, et al. 2018 Oct;32(8):e22583. PMID 29855084 De Silva HA, Fonseka MM, Pathmeswaran A et al. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Vet Med Sci. 2021 Nov;7(6):2440-2444. J Clin Lab Anal.

ALS 246

ALS ED OR 246

The Skeptics' Guide to EM

DECEMBER 7, 2018

Date: December 6th , 2018 Reference: Perkins et al. Date: December 6th , 2018 Reference: Perkins et al. There have been a number of papers published since OPALS that support the findings of not using ACLS drugs like epinephrine for OHCA ( Olavseengen et al. JAMA 2009, Hagihara et al.

Epinephrine 130

Epinephrine Life Support Advanced Life Support Defibrillator 130

The Skeptics' Guide to EM

JUNE 9, 2018

[display_podcast] Date: June 8th, 2018 Reference: April MD, et al. Ann Emerg Med 2018 Guest Skeptic: Meghan Groth is a pharmacist who has been practicing in emergency medicine for the past six years. display_podcast] Date: June 8th, 2018 Reference: April MD, et al. Reference: April MD, et al.

Emergency Department 130

Emergency Department ALS OR 130

Core EM

JANUARY 25, 2024

Critical Care Medicine 2018 Sedation: After absence of pain is ensured, pharmacologic sedation may be indicated to help relieve discomfort, improve synchrony with mechanical ventilation and decrease oxygen requirements and overall work of breathing. Can cause hallucinations and other psychological disturbances. Crit Care Med. N Engl J Med.

Emergency Department 246

Emergency Department ICU Critical Care ALS 246

ALiEM

JUNE 5, 2023

Read More in the Series References Klein F, et al. Current Opinion in Infectious Diseases 31(3):p 257-262, June 2018. | 0000000000000446 Hendricks KA, Wright ME, Shadomy SV, et al. The American College of Medical Toxicology hosts this Toxicology Visual Pearls series. Pathophysiology of anthrax. J Infect Dis (1966): 123-138.

ALS 256

ALS OR ED 256

The Skeptics' Guide to EM

FEBRUARY 23, 2019

Date: February 22nd, 2019 Reference: Lane et al. JAMA 2018 Guest Skeptics: Jay Loosley is the Superintendent of Education at Middlesex-London Paramedic Service. Date: February 22nd, 2019 Reference: Lane et al. JAMA 2018 Guest Skeptics: Jay Loosley is the Superintendent of Education at Middlesex-London Paramedic Service.

Paramedic 130

Paramedic ALS Ambulance EMS 130

The Skeptics' Guide to EM

APRIL 1, 2018

[display_podcast] Date: March 30th, 2018 Reference: Bronzetti et al. February 2018. display_podcast] Date: March 30th, 2018 Reference: Bronzetti et al. February 2018. Reference: Bronzetti et al. February 2018. International Journal of Cardiology. This is his 6th visit to the SGEM.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

MAY 26, 2018

[display_podcast] Date: May 16th, 2018 Reference: Beltaief K et al. 2018 Guest Skeptic: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine, University of Arkansas. display_podcast] Date: May 16th, 2018 Reference: Beltaief K et al. Kaymar M et al. Lee YH et al. J Pain Res.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

DECEMBER 15, 2018

Date: December 13th , 2018 Reference: Murata et al. 2018 Guest Skeptic: Dr. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Associate Professor for the University of Leicester’s SAPPHIRE group. Date: December 13th , 2018 Reference: Murata et al. Pediatrics. Pediatrics.

OR 130

OR Emergency Department ALS 130

Pediatric EM Morsels

JUNE 16, 2023

Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

Overdose 152

Overdose OR Critical Care ALS 152

The Skeptics' Guide to EM

APRIL 21, 2018

[display_podcast] Date: April 12th, 2018 Reference: Ohle R et al. AEM April 2018 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. display_podcast] Date: April 12th, 2018 Reference: Ohle R et al. Reference: Ohle R et al.

Emergency Department 130

Emergency Department ALS OR EMS 130

The Skeptics' Guide to EM

MAY 19, 2018

[display_podcast] Date: May 16, 2018 Reference: Freund et al. JAMA February 2018. display_podcast] Date: May 16, 2018 Reference: Freund et al. JAMA February 2018. Reference: Freund et al. JAMA February 2018. Clinical Question: Does PERC Rule work in France?

Emergency Department 130

Emergency Department ALS Coronary OR 130

The Skeptics' Guide to EM

JUNE 24, 2018

[display_podcast] Date: June 15th, 2018 Reference: Silva et al. 2018 Guest Skeptics: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. display_podcast] Date: June 15th, 2018 Reference: Silva et al. Reference: Silva et al.

Emergency Department 130

Emergency Department ED ALS OR 130

The Skeptics' Guide to EM

JULY 17, 2018

[display_podcast] Date: July 16th, 2018 Reference: Gupta M et al. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. display_podcast] Date: July 16th, 2018 Reference: Gupta M et al. Reference: Gupta M et al.

Emergency Department 130

Emergency Department ALS EMS 130

The Skeptics' Guide to EM

OCTOBER 13, 2018

[display_podcast] Date: October 10th , 2018 Reference: Karlow et al. AEM Oct 2018. display_podcast] Date: October 10th , 2018 Reference: Karlow et al. AEM Oct 2018. Reference: Karlow et al. AEM Oct 2018. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

OCTOBER 31, 2018

[display_podcast] Date: October 30th , 2018 Reference: Raskob GE et al. NEJM 2018 Guest Skeptic: Dr. Anand Swaminathan is an assistant professor of Emergency Medicine at the St. display_podcast] Date: October 30th , 2018 Reference: Raskob GE et al. Reference: Raskob GE et al.

ALS 130

ALS EMS OR 130

The Skeptics' Guide to EM

NOVEMBER 24, 2018

[display_podcast] Date: November 24th, 2018 As you may know, I was invited to give a keynote address on burnout at the Australasia College of Emergency Medicine 2018 Annual Scientific Meeting (#ACEM18) in Perth, Australia. The highest prevalence of burnout (70%) was reported by emergency physicians (Shanafelt et al 2015).

EMR 130

EMR ALS Emergency Department OR 130

The Skeptics' Guide to EM

SEPTEMBER 22, 2018

[display_podcast] Date: September 17th, 2018 Reference: Meltzer, A. JAMA Internal Med, 2018. display_podcast] Date: September 17th, 2018 Reference: Meltzer, A. JAMA Internal Med, 2018. Effect of Tamsulosin on Passage of Symptomatic Ureteral Stones: A Randomized Clinical Trial. Reference: Meltzer, A.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

[display_podcast] Date: September 21st, 2018 Reference: Kawano et al. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. display_podcast] Date: September 21st, 2018 Reference: Kawano et al.

BLS 130

BLS Defibrillator Critical Care CPR 130

The Skeptics' Guide to EM

OCTOBER 6, 2018

[display_podcast] Date: October 5th , 2018 Reference: Stiell et al. Annals of EM Oct 2018 Guest Skeptic: Alison Armstrong is an Emergency Department Nurse, TNCC Course Director, Trauma Program Coordinator and Canadian C-Spine Rule Nurse Champion. display_podcast] Date: October 5th , 2018 Reference: Stiell et al.

Emergency Department 130

Emergency Department EMS ALS ED 130

ALiEM

AUGUST 9, 2023

Study N Sensitivity Specificity Comments Pereda et al., Balk et al., Pediatr Pulmonol 2018 12 studies; 1510 patients 96% 95% Lung POCUS had significantly better sensitivity than chest X-ray, which had a sensitivity of 87%. Tsou et al., PMID: 14722643 Pereda MA, Chavez MA, Hooper-Miele CC, et al. Pediatrics.

E-9-1-1 246

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

The Skeptics' Guide to EM

MARCH 2, 2019

Date: February 26th, 2019 Reference: Benger et al. JAMA 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the Seattle area and an adjunct faculty […] The post SGEM#247: Supraglottic Airways Gonna Save You for an OHCA?

CPR 130

CPR Firefighter Paramedic Defibrillator 130

Pediatric EM Morsels

JUNE 14, 2024

Tavasoli 2018, Wolf 2012) More common in adults; children comprise 20% of total cases (Pidcock 2007, Wang 2019) Bimodal age distribution (Absoud 2016) Children < 5 years Children > 10 years Symptoms evolve over 2-4 days and peak at 5-6 days (Absoud 2016) ATM may occur alone OR as part of another disorders (e.g. first sign of MS).

Plasma 141

Plasma ALS OR EMS 141

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Date: January 28th, 2019 Reference: Chu DK et al. The Lancet 2018. Date: January 28th, 2019 Reference: Chu DK et al. The Lancet 2018. Reference: Chu DK et al. The Lancet 2018. Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. This is Bob’s ninth visit to the SGEM.

Life Support 130

Life Support ALS STEMI Emergency Department 130

The Skeptics' Guide to EM

FEBRUARY 15, 2020

Date: February 11th, 2020 Reference: Yeh et al. Date: February 11th, 2020 Reference: Yeh et al. Reference: Yeh et al. Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial. Guest Skeptic: Marcus Prescott is a nurse in Norway. He is also now a third-year medical student.

ALS 130

ALS Emergency Department OR 130

The Skeptics' Guide to EM

APRIL 6, 2019

Date: April 5th, 2019 Reference: Connolly et al. Date: April 5th, 2019 Reference: Connolly et al. In contrast, protamine could be used for heparin and LMWH reversal and vitamin K, fresh frozen plasma and prothrombinase complex concentrate could be used to reverse coumadin ( Hunt and Levi BMJ 2018 ).

Frozen Plasma 130

Frozen Plasma Plasma ALS EMS 130

The Skeptics' Guide to EM

JANUARY 19, 2019

Date: January 17th , 2019 Reference: Clemency et al. Date: January 17th , 2019 Reference: Clemency et al. This teaching has been challenged by a systematic review by Willman et al 2017. We reviewed the Willman et al publication on SGEM#179 and generally agreed with the authors’ conclusions. Reference: Clemency et al.

Naloxone 130

Naloxone Overdose Emergency Medical Services Emergency Department 130

Pediatric EM Morsels

JUNE 21, 2024

Palmieri 2002, Choi 2018, Raymond 2018] A systematic review with moderate quality evidence found no difference in the rate of wound healing or epithelialization with silver sulfadiazine compared to silver impregnated foam dressing. Irie 2018] Moral of the Morsel Burns are Bad! Available from: [link] Liu H, Li D, Yuan H, et al.

ALS 169

ALS OR EMS 169

Pediatric EM Morsels

OCTOBER 27, 2023

link] Lubitz DS, Seidel JS, Chameides L, Luten RC, Zaritsky AL, Campbell FW. 2012.05.028 Silvagni D, Baggio L, Mazzi C, et al. doi:10.1111/1742-6723.12389 Zhu S, Zhu J, Zhou H, et al. Epub 2018 Oct 18. and Seaver, M. 2020) The Times & Tapes Are a-Changin’: The Latest Broselow-Luten Tape for EMS , EMS World.

E-9-1-1 269

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

ALiEM

MAY 13, 2024

Study N Methods POCUS Sensitivity (95% CI) POCUS Specificity (95% CI) Conclusions Gottleib et al., Lam et al., J Emerg Med 2018 [6] 327 Prospective cohort study of children 6mo-18yrs comparing clinical assessment to POCUS 90.3% (83.4-94.7%) of cases* Subramaniam et al., Lam et al., of cases* Subramaniam et al.,

E-9-1-1 161

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

The Skeptics' Guide to EM

JANUARY 14, 2018

[display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. A study from Bindman et al. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

JANUARY 20, 2018

[display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al. display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al. Reference: Sadeghirad B, et al. Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials.

Emergency Department 130

Emergency Department ALS EMS ED 130