The Skeptics' Guide to EM

APRIL 13, 2024

He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 70-year-old woman was brought into the emergency department by EMS after her family reported she was having trouble talking. CT perfusion showed a 10 mL core and 189 mL penumbra.

Emergency Department 295

Emergency Department ALS OR EMS 295

ACEP Now

APRIL 5, 2024

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. 2 A study published in JAMA in 2018 found that among patients with a difficult airway characteristic, bougie use resulted in higher first attempt intubation success (96 percent), compared to endotracheal tube with stylet (82 percent).

OR 73

OR ALS Emergency Department Critical Care 73

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. No peritoneal signs. Non-tender rectal exam.

Emergency Department 152

Emergency Department ED OR 152

Core EM

JANUARY 25, 2024

link] ) Laboratory Evaluation: Clinical presentation and laboratory findings can help suggest TTP in the emergency department. Patients should undergo comprehensive work-up to rule out alternative causes of thrombocytopenia, evaluate for end-organ damage, and identify underlying infectious or autoimmune etiologies.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

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. first appeared on The Skeptics Guide to Emergency Medicine. Pediatrics. Pediatrics.

OR 130

OR Emergency Department ALS 130

ALiEM

MARCH 18, 2024

Shortly after that, the finger turned purple, so she came to the Emergency Department for evaluation. 2018 Jun 27;40:1-2. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger. She denied pain in the hand and has had no problems moving the finger. No other complaints or issues.

Emergency Department 306

Emergency Department ED OR 306

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. μg/kg IV Maintenance dose: 0.5 – 15 μg/kg/hr Rapid onset. Short acting. mg/kg 0.01 – 0.1

Emergency Department 246

Emergency Department ICU Critical Care ALS 246

ALiEM

FEBRUARY 2, 2024

Because of the concern for malignancy, a biopsy was performed in the emergency department after the ultrasound and CT scan confirmed there was no extension into the thorax. 2018 Sep;40(9):631-641. It was not painful unless she touched it, and then only mildly tender. Her review of systems and past medical history were negative.

Emergency Department 169

Emergency Department OR 169

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Is this scalp swelling normal?

E-9-1-1 152

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

The Skeptics' Guide to EM

JUNE 9, 2018

[display_podcast] Date: June 8th, 2018 Reference: April MD, et al. Aromatherapy Versus Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients: A Randomized Controlled Trial. display_podcast] Date: June 8th, 2018 Reference: April MD, et al.

Emergency Department 130

Emergency Department ALS OR 130

ALiEM

DECEMBER 8, 2023

A 45-year-old male status-post right nephrectomy secondary to a renal mass presented to the emergency department with right-sided flank pain. Patients without evidence of emergent hernia complications can be managed with outpatient surgical follow-up. 2018 Apr;22(2):353-361. Epub 2018 Jan 27. PMID: 32310432.

Emergency Department 152

Emergency Department OR 152

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. Differentiate abscess from other soft tissue pathologies such as cysts and lymph nodes. There has been no drainage from the lesion. Abscess with color Doppler flow Video 3.

E-9-1-1 161

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

ALiEM

DECEMBER 4, 2023

A 49-year-old male presented to the emergency department of an academic hospital with the chief concern of penile pain. 2018 May 9;13:158-163. doi: 10.1515/med-2018-0025. He then noticed the pain start and grow in intensity without radiating anywhere else except the glans. There is no crepitus or swelling. Magnesium : 2.6

Emergency Department 152

Emergency Department OR 152

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)? The Journal of Emergency Medicine. Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives. Open Access Emerg Med. 2012.07.056.

Emergency Department 246

Emergency Department ICU ED OR 246

The Skeptics' Guide to EM

OCTOBER 13, 2018

[display_podcast] Date: October 10th , 2018 Reference: Karlow et al. A Systematic Review And Meta-Analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. AEM Oct 2018. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. AEM Oct 2018.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

OCTOBER 20, 2018

[display_podcast] Date: October 17th , 2018 Reference #1: Aycock, Westafer et al. Ann Emerg Med 2018 (CRD42017056195) Reference #2: Weisbord SD, Gallagher M, Jneid H, et al; PRESERVE Trial Group. NEJM 2018 (ClinicalTrials.gov NCT01467466.) [display_podcast] Date: October 17th , 2018 Reference #1: Aycock, Westafer et al.

Coronary 171

Coronary Emergency Department ALS OR 171

The Skeptics' Guide to EM

JUNE 15, 2018

[display_podcast] Date: June 12th, 2018 Reference: DeMeester S et al. Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. display_podcast] Date: June 12th, 2018 Reference: DeMeester S et al.

Emergency Department 130

Emergency Department ALS OR EMS 130

The Skeptics' Guide to EM

OCTOBER 6, 2018

[display_podcast] Date: October 5th , 2018 Reference: Stiell et al. A Multicenter Program to Implement the Canadian C-Spine Rule by Emergency Department Triage Nurses. display_podcast] Date: October 5th , 2018 Reference: Stiell et al. She is worried she may have a serious injury to her neck. Reference: Stiell et al.

Emergency Department 130

Emergency Department EMS ALS ED 130

The Skeptics' Guide to EM

JUNE 24, 2018

[display_podcast] Date: June 15th, 2018 Reference: Silva et al. Safety and Efficacy of Intravenous Lidocaine for Pain Management in the Emergency Department: A Systematic Review. Ann Emerg Med. first appeared on The Skeptics Guide to Emergency Medicine. display_podcast] Date: June 15th, 2018 Reference: Silva et al.

Emergency Department 130

Emergency Department ED ALS OR 130

The Skeptics' Guide to EM

AUGUST 18, 2018

[display_podcast] Date: August 16th, 2018 Reference: Hohl C et al. Prospective Validation of Clinical Criteria to Identify Emergency Department Patients at High Risk for Adverse Drug Events. AEM Aug 2018. Guest Skeptic: Dr. Chris Bond is an emergency physician and clinical lecturer at the University of Calgary.

Emergency Department 130

Emergency Department Overdose ED ALS 130

The Skeptics' Guide to EM

MAY 19, 2018

[display_podcast] Date: May 16, 2018 Reference: Freund et al. Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events
 Among Low-Risk Emergency Department Patients: The PROPER Randomized Clinical Trial. JAMA February 2018. display_podcast] Date: May 16, 2018 Reference: Freund et al.

Emergency Department 130

Emergency Department ALS Coronary OR 130

NAEMSP

FEBRUARY 1, 2023

“Characteristics, prehospital management, and outcomes in patients assessed for hypoglycemia: repeat access to prehospital or emergency care.” ” Prehospital Emergency Care 23.3 43 patients (5.4%) had repeat access to prehospital or emergency department care. 2019): 364-376. of the US population).

OR 52

OR Emergency Department Emergency Medical Services Paramedic 52

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. His fever was 103°F this morning and he received ibuprofen. He has also had abdominal and back pain. Warm gel helps with the child’s comfort. Use a linear high frequency probe.

E-9-1-1 246

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

The Skeptics' Guide to EM

DECEMBER 30, 2018

Date: December 30th, 2018 Happy New Years to all the SGEMers out there in the #FOAMed world. It is time to reflect upon 2018 and look forward to 2019. Last year we named 2017 the year of FeminEM and celebrated 15 amazing women in emergency medicine. It is time to reflect upon 2018 and look forward to 2019.

Emergency Department 130

Emergency Department EMS OR 130

The Skeptics' Guide to EM

AUGUST 28, 2021

Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. Case: A forty-year-old woman presents to the emergency department […] The post SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED?

ED 130

ED 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. J Pain Res. J Pain Res. Kaymar M et al.

Emergency Department 130

Emergency Department ALS OR 130

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ & Liska, H.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

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. He is also the CME editor for Academic Emergency Medicine (AEM). 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

OCTOBER 19, 2019

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation. Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation.

Firefighter 130

Firefighter Emergency Department Paramedic ALS 130

The Skeptics' Guide to EM

JANUARY 27, 2018

[display_podcast] Date: January 25th, 2018 Reference: Hawkins et al. Peripheral Intravenous Cannula Insertion and Use in the Emergency Department: An Intervention Study. AEM Jan 2018 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency.

Emergency Department 100

Emergency Department ALS OR EMS 100

The Skeptics' Guide to EM

JUNE 29, 2018

[display_podcast] Date: June 20th, 2018 Reference: Fox LM et al. Battlefield acupuncture to treat low back pain in the emergency department. 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.

Emergency Department 100

Emergency Department ALS ED EMS 100

The Skeptics' Guide to EM

MAY 14, 2022

Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. His twitter handle is @PainFreeED.

ALS 130

ALS Emergency Department ED OR 130

EMDocs

DECEMBER 11, 2023

Traditionally, emergency providers looked for signs of ST-segment elevation myocardial infarction (STEMI) to indicate the need for intervention. In October 2022, the American College of Cardiology released an updated expert consensus decision regarding the evaluation of chest pain in the emergency department.

STEMI 110

STEMI Coronary Emergency Department OR 110

The Skeptics' Guide to EM

SEPTEMBER 22, 2018

[display_podcast] Date: September 17th, 2018 Reference: Meltzer, A. JAMA Internal Med, 2018. Guest Skeptics: Dr. Tony Seupaul, Professor and Chair, University of Arkansas for Medical Sciences Department of Emergency Medicine. display_podcast] Date: September 17th, 2018 Reference: Meltzer, A.

Emergency Department 130

Emergency Department ALS ED OR 130

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. Karageorgos, S.; Hibberd, O.; Mullally, P.J.W.; Segura-Retana, R.;

Emergency Department 142

Emergency Department E-9-1-1 ALS OR 142

The Skeptics' Guide to EM

JANUARY 14, 2018

[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. Dr. Rachel Littlefield is a PGY2 in Emergency Medicine at the University of […] The post SGEM#202: Lidocaine for Renal Colic?

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

APRIL 1, 2018

[display_podcast] Date: March 30th, 2018 Reference: Bronzetti et al. February 2018. Guest Skeptic: Dr. Robert Edmonds is an Emergency physician in the US Air Force. first appeared on The Skeptics Guide to Emergency Medicine. display_podcast] Date: March 30th, 2018 Reference: Bronzetti et al. February 2018.

Emergency Department 130

Emergency Department ALS OR 130