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. doi:10.3390/cancers13092025 Pisano M, Zorcolo L, Merli C, et al. Published 2018 Aug 13. 2021.03.001 Bauman BD, Witt JE, Vakayil V, et al.

E-9-1-1 77

E-9-1-1 ED ALS Operating Room 77

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.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

The Skeptics' Guide to EM

MARCH 20, 2021

Reference: Westafer et al. Reference: Westafer et al. Jeff Kline, was senior author on a paper that looked at treating VTE with outpatient management using a DOAC ( Bean et al AEM 2015 ). Literature from the USA reports that 90% of patients diagnosed with PE are admitted ( Singer et al 2016 ).

ALS 130

ALS ED 130

The Skeptics' Guide to EM

JULY 30, 2022

Date: July 28th, 2022 Reference: Brower et al. Date: July 28th, 2022 Reference: Brower et al. Case: A 63-year-old woman presents to your emergency department (ED) with two-day history of nausea, vomiting and constipation. Reference: Brower et al. She is also the creator of all those wonderful Paper in a Pictures.

ALS 130

ALS ED Emergency Department EMS 130

The Skeptics' Guide to EM

MAY 14, 2022

Date: May 13th, 2022 Reference: Abril et al. Date: May 13th, 2022 Reference: Abril et al. 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). His twitter handle is @PainFreeED.

ALS 130

ALS Emergency Department ED OR 130

The Skeptics' Guide to EM

AUGUST 18, 2018

[display_podcast] Date: August 16th, 2018 Reference: Hohl C et al. AEM Aug 2018. display_podcast] Date: August 16th, 2018 Reference: Hohl C et al. AEM Aug 2018. Case: A 54-year-old female presents to the emergency department (ED) with abdominal pain and profuse non-bloody diarrhea for the past 24 hours.

Emergency Department 130

Emergency Department Overdose ED ALS 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

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

ALiEM

JUNE 5, 2023

ED providers are only exposed in these cases if they have direct contact with drainage from open wounds while not using PPE or there is concern for aerosolization of spores For inhalational anthrax exposure, AVA should be given in combination with antimicrobials (ciprofloxacin or doxycycline) for 60 days. Pathophysiology of anthrax.

ALS 256

ALS OR ED 256

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. One alternative or adjunct to limit the use of opioids in the ED is low dose ketamine (LDK). Reference: Karlow et al.

Emergency Department 130

Emergency Department ALS ED OR 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

The Skeptics' Guide to EM

OCTOBER 8, 2022

Date: September 15, 2022 Reference: Ramnarayan P et al. Date: September 15, 2022 Reference: Ramnarayan P et al. Case: A 10-month-old male infant presents to the emergency department (ED) with a low-grade fever, rhinorrhea and reduced feeding during the last two days. In 2018, Ramnarayan et al.

Critical Care 130

Critical Care ALS Emergency Department ED 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. Case: A 51-year-old man presents to the emergency department (ED) with five-hour history of acute onset left flank pain.

Emergency Department 130

Emergency Department ALS ED OR 130

ALiEM

NOVEMBER 1, 2023

In: Nelson LS, Goldfrank LR et al (eds): Goldfrank’s Toxicologic Emergencies. 22 Aug 2018. The post was peer reviewed on behalf of ACMT by Drs. Blake Froberg, Bryan Judge, and Louise Kao. Read More in the Series References Perrone J. McGraw-Hill Education; 2019 Madiwale T, Liebelt E. Iron: not a benign therapeutic drug.

E-9-1-1 161

E-9-1-1 ALS OR ED 161

The Skeptics' Guide to EM

JUNE 29, 2018

[display_podcast] Date: June 20th, 2018 Reference: Fox LM et al. Am J EM 2018 Guest Skeptics: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. display_podcast] Date: June 20th, 2018 Reference: Fox LM et al. The first time was with Dr. Al Sacchetti. Reference: Fox LM et al.

Emergency Department 100

Emergency Department ALS ED EMS 100

The Skeptics' Guide to EM

JANUARY 26, 2019

Date: January 22nd , 2019 Reference: Frey et al Effect of Intranasal Ketamine vs Fentanyl on Pain Reduction for Extremity Injuries in Children: The PRIME Randomized Clinical Trial. Case: A 10-year-old girl presents to your emergency department (ED) after falling off a zipline at the playground. He even did a RANThony on this issue.

ALS 130

ALS ED Emergency Department OR 130

Core EM

JULY 23, 2024

Philadelphia, PA: Elsevier; 2018:(Ch) 138. 2021, [link] Shen, J, et al. 2020, [link] Shen, J, et al. Emergency Medicine: Concepts and Clinical Practice. Ionizing Radiation Injuries and Illnesses: Ensuring Patient Safety and Self-Preservation.” EmDOCs.net – Emergency Medicine Education, 7 Apr. Radiation injuries.

ALS 130

ALS OR Emergency Department ED 130

ALiEM

JUNE 1, 2023

Are you using phenobarbital instead of benzodiazepines as the first-line monotherapy for patients in alcohol withdrawal in the Emergency Department (ED)? Is phenobarbital safe for the treatment of EtOH withdrawal in the ED? References Rosenson J, Clements C, Simon B, et al. If not, you probably should be. Well not exactly.

Emergency Department 246

Emergency Department ICU ED OR 246

The Skeptics' Guide to EM

AUGUST 14, 2021

Date: August 12th, 2021 Reference: Daya et al. Date: August 12th, 2021 Reference: Daya et al. This was a critical appraisal of an observational study published in Annals of EM ( Kawano et al 2018 ). Reference: Daya et al. first appeared on The Skeptics Guide to Emergency Medicine.

CPR 130

CPR BLS ALS Paramedic 130

The Skeptics' Guide to EM

OCTOBER 19, 2019

Date: October 17th, 2019 Reference: Driver et al. JAMA May 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the […] The post SGEM#271: Bougie Wonderland for First Pass Success first appeared on The Skeptics Guide to Emergency Medicine.

Firefighter 130

Firefighter Emergency Department Paramedic ALS 130

Don't Forget the Bubbles

AUGUST 23, 2023

Very rarely are the ED team allowed to stand, in silence, with a purpose. 2018) “Benefits of using the pause after death in emergency departments: a Delphi study”. Kapoor et al. 2018) “Sacred Pause Imitative in the ICU: A survey of ICU physicians and nurses”. The Pause allows us to take the foot off the pedal briefly.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

The Skeptics' Guide to EM

APRIL 16, 2022

Date: April 16th, 2022 Reference: Blom et al. Date: April 16th, 2022 Reference: Blom et al. Case: A 55-year-old man comes into the emergency department (ED) for increasing knee pain and decrease in function. Tricoci et al. An update was published by Fanaroff et al in JAMA 2019. Reference: Blom et al.

Emergency Department 100

Emergency Department ALS OR ED 100

Silk City Blog

JANUARY 27, 2023

Written by Jessica DiPeri, MD This post first appeared on REBEL EM Background: Pneumothorax management is a common clinical condition in the emergency department (ED) occurring in patients of varying ages and caused by multiple etiologies, including spontaneous, traumatic, and iatrogenic pneumothorax. Article: Chang, Su-Huan et al. “A

Emergency Department 52

Emergency Department ALS EMS ED 52

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., ED Course The patient received antibiotics for pneumonia. Pediatrics.

E-9-1-1 246

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

The Skeptics' Guide to EM

JANUARY 27, 2018

[display_podcast] Date: January 25th, 2018 Reference: Hawkins et al. AEM Jan 2018 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. display_podcast] Date: January 25th, 2018 Reference: Hawkins et al. Some studies report that up to half of these are never used ( Limm et al).

Emergency Department 100

Emergency Department ALS OR EMS 100

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

The Skeptics' Guide to EM

MAY 11, 2019

Date: May 6th, 2019 Reference: Sceats et al. JAMA Surgery 2018 Guest Skeptic: Dr. Robert Leeper is an assistant professor of surgery at Western University and the London Health Sciences Centre. Date: May 6th, 2019 Reference: Sceats et al. Omar et al (2008) showed just how safe laparoscopic appendectomies have become.

Critical Care 130

Critical Care ALS OR ED 130

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

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. While staff exposure to this violence varies, literature shows nurses are most frequently exposed, with up to 90 percent having experienced workplace violence in their ED careers.

Emergency Department 52

Emergency Department Emergency Response ED ALS 52

EMDocs

NOVEMBER 7, 2023

For more on the ED evaluation of diverticulitis, please see Part 1. The DIABLO trial: Daniels L, Ünlü Ç, de Korte N, et al; Dutch Diverticular Disease (3D) Collaborative Study Group. Randomized van Dijk ST, Daniels L, Ünlü Ç, et al; Dutch Diverticular Disease (3D) Collaborative Study Group. 2018 Jul;113(7):1045-1052.

ACPE 88

ACPE ALS OR ED 88

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. 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.

E-9-1-1 268

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

The Skeptics' Guide to EM

MAY 19, 2019

Date: May 15th, 2019 Reference: Terp et al. Civil Monetary Penalties Resulting from Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018. Date: May 15th, 2019 Reference: Terp et al. Reference: Terp et al.

Emergency Department 100

Emergency Department ALS ED OR 100

Core EM

MARCH 12, 2024

Philadelphia, PA: Elsevier; 2018:(Ch) 138. 2021, [link] Shen, J, et al. 2020, [link] Shen, J, et al. Emergency Medicine: Concepts and Clinical Practice. Ionizing Radiation Injuries and Illnesses: Ensuring Patient Safety and Self-Preservation.” EmDOCs.net – Emergency Medicine Education, 7 Apr. Radiation injuries.

ALS 130

ALS OR Emergency Department ED 130

ACEP Now

APRIL 5, 2024

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. The study found a mean increase in time to intubation of 13 seconds in the ED setting. References von Hellmann R, Fuhr N, et al. Koh LK, Kong CE, et al. Driver BE, Prekker ME, et al. Waldron O, Sena R, et al.

OR 73

OR ALS Emergency Department Critical Care 73

EMDocs

JANUARY 25, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. A CBC, Chem 7m and CT of the soft tissues of the neck are ordered by the departing ED doc whose clinical info for the radiologist is “facial swelling”. Baek BS et al. Vranckx P et al.

ED 72

ED ALS OR 72

The Skeptics' Guide to EM

MARCH 13, 2021

Reference: Post et al. Reference: Post et al. Lancet 2021 Case: You’re working a busy evening shift in your community emergency department (ED) when a 58 year old female presents with a rapid onset terrible intensity headache. Fast forward to 2018 and the validation of the Ottawa SAH Rule by Dr. Perry and his group.

ALS 100

ALS Emergency Department ED OR 100

Don't Forget the Bubbles

FEBRUARY 5, 2024

The study surveyed 2855 Canadian adolescents in 2018 and found that those who skipped breakfast were 2.55 Anagnostou A, et al. Rodgers O, et al. Schoeffl I, et al. Garfinkle J, et al. Peprah P, et al. Pehlivanturk Kizilkan M, et al. Pigdon L, et al. Yildirim I, et al. DaFonte TM, et al.

E-9-1-1 52

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