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. Published 2018 Aug 13. Bowel Perforation: ED Presentations, evaluation and management. He reports distension and the sensation of fullness.

E-9-1-1 77

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

ACEP Now

OCTOBER 31, 2023

Emergency physicians have a unique opportunity to recognize these cases and to intervene, as medically neglected children may be brought to the ED once illness becomes severe. Following appropriate medical treatment in the ED, the patient is hospitalized. Published May 1, 2018. Accessed October 11, 2023. Prince v Massachusetts.

ED 52

ED OR EMS 52

The Skeptics' Guide to EM

APRIL 13, 2024

When she arrives in your ED, her family tells you she was last seen normal about 12 hours ago. They noticed this earlier in the day and let her rest, but when she had trouble moving her right arm, they called 911. Initial evaluation by medics revealed right hemiplegia, a right facial droop, left gaze deviation, and aphasia.

Emergency Department 295

Emergency Department ALS OR EMS 295

ALiEM

MARCH 18, 2024

A 30-year-old female with a past medical history of Crohn’s Disease presented to the ED for evaluation of an acutely bruised right 4th finger. 2018 Jun 27;40:1-2. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger. EJVES Short Rep. doi: 10.1016/j.ejvssr.2018.05.008.

Emergency Department 306

Emergency Department ED OR 306

Pediatric EM Morsels

OCTOBER 6, 2023

Recently, a pediatric patient presented to the ED who just returned from abroad with a gastroenteritis presentation. The first case of extensively-drug resistant (XDR) typhoid fever was seen in Pakistan in 2018. Britto 2017, Chiodini 2018) Abdominal pain is the second most common symptom in pediatric patients, followed by diarrhea.

OR 161

OR EMS ED 161

ALiEM

FEBRUARY 28, 2024

This blog post provides an update to our 2018 blog articles to reflect these changes. References Iverson C, ed. We also must recognize the important contributions of media such as clinical photographs, radiology images, and ECGs. The American Medical Association (AMA) Manual of Style released its 11th edition in 2020. Video Title.

OR 130

OR ED 130

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

JULY 30, 2022

Case: A 63-year-old woman presents to your emergency department (ED) with two-day history of nausea, vomiting and constipation. CT is generally the first choice of imaging, the “abdominal series” of plain X-rays have been demonstrated to have poor predictive value, but a 2018 meta-analysis found 92.4% sensitivity and 96.6%

ALS 130

ALS ED Emergency Department EMS 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. Intervention: IV lidocaine given in the ED.

Emergency Department 130

Emergency Department ED ALS OR 130

The Skeptics' Guide to EM

MARCH 20, 2021

Another study showed less than 10% of PE patients are discharged home from the ED for out-patient therapy ( Vinson et al 2017 ). A couple of international guidelines support the outpatient treatment of ED patients with low-risk PE. The ACEP policy give outpatient management of PE patients a Level C recommendation:

ALS 130

ALS ED 130

Core EM

JANUARY 25, 2024

Background: The immediate post intubation period in the ED is a critical time for continued patient stabilization. The reality of ever increasing ED volumes and longer boarding times to the ICU makes it imperative for emergency physicians to learn how to manage these critical patients.

Emergency Department 246

Emergency Department ICU Critical Care ALS 246

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 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. Opiates became a very common treatment for acute pain in the ED setting after JACHO and the introduction of new and powerful opioids like oxycodone.

Emergency Department 130

Emergency Department ALS ED OR 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? Therapeutic Drug Monitoring of Antiepileptic Drugs in Epilepsy: A 2018 Update. Well not exactly.

Emergency Department 246

Emergency Department ICU ED OR 246

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

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

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. Battlefield acupuncture to treat low back pain in the emergency department.

Emergency Department 100

Emergency Department ALS ED EMS 100

The Skeptics' Guide to EM

DECEMBER 23, 2023

Without strong primary care patients will eventually end up in the ED. million in 2018. million in 2018. Some listeners may be wondering why we are discussing this on an emergency medicine podcast. Well, it is because we are all on Team Patient. Family Medicine is the foundation of healthcare.

ED 143

ED OR 143

EMDocs

JULY 9, 2024

What can we do about this in the pediatric ED? Epub 2018 Nov 22. 2018 Jul;84(1):10-21. Epub 2018 May 23. If we don’t, it’s possible no one will. Community Resource Needs Assessment Among Families Presenting to a Pediatric Emergency Department. Acad Pediatr. 2019 May-Jun;19(4):378-385. doi: 10.1016/j.acap.2018.11.009.

Emergency Department 71

Emergency Department Emergency Medical Services ED EMS 71

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. 153,5 (2018): 1201-1212.

Emergency Department 52

Emergency Department ALS EMS ED 52

ALiEM

MAY 13, 2024

J Emerg Med 2018 [6] 327 Prospective cohort study of children 6mo-18yrs comparing clinical assessment to POCUS 90.3% (83.4-94.7%) 2018 Jan;54(1):96-101. 2018 Nov;55(5):693-701. Epub 2018 Aug 28. Study N Methods POCUS Sensitivity (95% CI) POCUS Specificity (95% CI) Conclusions Gottleib et al., 97.4%) 85.4% (78.9-90.2%)

E-9-1-1 161

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

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

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. Published 2020 May 12.

ALS 256

ALS OR ED 256

EMDocs

AUGUST 28, 2023

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The ED physician orders an x-ray of the leg. The ED is notified that further imaging is recommended, but the family is not informed so it is never done. To opt in to the free subscriber list, click here.

ED 65

ED EMS OR 65

The Skeptics' Guide to EM

OCTOBER 8, 2022

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. On exam, you notice increased work of breathing, nasal flaring, grunting with subcostal and intercostal retractions.

Critical Care 130

Critical Care ALS Emergency Department ED 130

The Skeptics' Guide to EM

JANUARY 26, 2019

JAMA Pediatrics December 2018 Guest Skeptic: Dr. Samina Ali is a pediatric emergency physician, clinician-scientist, and Professor of Pediatrics & Emergency Medicine at the University of Alberta in Edmonton. Case: A 10-year-old girl presents to your emergency department (ED) after falling off a zipline at the playground.

ALS 130

ALS ED Emergency Department OR 130

Pediatric EM Morsels

AUGUST 9, 2024

Foles, 2024 ] In the US, from 2013-2018, cases increased from 362 to 1,306. Congenital Syphilis may still occur in patients presenting to your ED! Worldwide, congenital syphilis complicates about 1 million pregnancies / year. Hussain, 2023 ] Leads to >300,000 perinatal deaths / year globally.

E-9-1-1 152

E-9-1-1 Emergency Department Plasma OR 152

EMDocs

DECEMBER 19, 2023

In: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9e. McGraw Hill; 2020. Accessed August 25, 2022. link] Edward OJ. Venomous Marine Animals. In: Marx JA, Hockenberger RS, Biros MH, et al., Goldfrank’s Toxicologic Emergencies, 11e.

First Aid 92

First Aid ED OR ALS 92

Dr. Smith's ECG Blog

JULY 26, 2023

How would YOU interpret ECG #1 if this was the only tracing you saw — and — the only thing you knew about the patient, was that he/she was being seen in the ED? He presented to the ED for today's visit because of vertigo. To facilitate comparison in Figure-1 — I put this 2018 prior tracing ( = ECG #3 ) — together with ECG #1.

STEMI 52

STEMI ED OR 52

REBEL EM

DECEMBER 5, 2023

The risk of a biphasic reaction is what keeps patients in the ED while being observed for a set period of time. Thus, if the patient has complete resolution of symptoms after appropriate treatment of anaphylaxis, there is no set time period for monitoring in the ED. This is called a biphasic reaction. Read More: 1.

Epinephrine 78

Epinephrine Allergic Reaction Emergency Department Emergency Management 78

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. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 130

Emergency Department ALS ED OR 130

EMDocs

FEBRUARY 12, 2024

As the only respiratory therapist in the ED has been paged and is starting BiPAP for this patient, an overhead call for two incoming trauma alerts from a multivehicle collision sounds. Because the RT responsible for drawing arterial blood gases is busy caring for these patients, ABGs will be delayed.

Emergency Department 94

Emergency Department E-9-1-1 ED ICU 94

The Skeptics' Guide to EM

OCTOBER 19, 2019

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. Bougie use may be helpful in ED intubation.”

Firefighter 130

Firefighter Emergency Department Paramedic ALS 130

The Skeptics' Guide to EM

MAY 19, 2019

Civil Monetary Penalties Resulting from Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018. Civil Monetary Penalties Resulting from Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018.

Emergency Department 100

Emergency Department ALS ED OR 100

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. AEM Jan 2018 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Emergency Department 100

Emergency Department ALS OR EMS 100