ALiEM

APRIL 12, 2024

Case A 48 year-old male with a history of hypertension and polysubstance abuse presented to the emergency department (ED) for shortness of breath and was found to have a left sided parapneumonic pleural effusion (Figure 1). doi: [link] Broder JS, Al-Jarani B, Lanan B, Brooks K. doi: [link] Vetrugno L, Guadagnin GM, Barbariol F, et al.

E-9-1-1 183

E-9-1-1 ALS Critical Care Emergency Department 183

Pediatric EM Morsels

SEPTEMBER 22, 2023

Tenenbein M, Macias CG, Sharieff GQ, et al, eds. McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. McGraw Hill Education; 2019:125-138 Ziu E, Mesfin FB. They may even need atropine and/or pacing for persistent bradycardia. 5 th Edition. 5 th Edition.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

EMDocs

AUGUST 22, 2024

6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. 6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. One cohort study in a public ED found that 84.5%

Emergency Department 81

Emergency Department ALS E-9-1-1 ED 81

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. x exp[0.02 and Seaver, M.

E-9-1-1 269

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

EMDocs

JUNE 16, 2023

Podcast: Play in new window | Download (Duration: 13:57 — 19.2MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Management of the child with mental health problems who is boarding in the ED In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

ED 52

ED Mental Health Services Emergency Department Emergency Medical Services 52

The Skeptics' Guide to EM

JULY 27, 2019

Date: July 22nd, 2019 Reference: Yadav et al. AEM July 2019 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and clinical lecturer in Calgary. Date: July 22nd, 2019 Reference: Yadav et al. Reference: Yadav et al.

Emergency Department 130

Emergency Department ED ALS 130

The Skeptics' Guide to EM

AUGUST 17, 2019

Date: August 9th, 2019 Reference: Daoust et al. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Date: August 9th, 2019 Reference: Daoust et al. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Volkow et al.

Emergency Department 130

Emergency Department ALS ED OR 130

EMDocs

SEPTEMBER 25, 2023

However, RSI has never been shown to reduce the risk of aspiration in the ED (13) or during emergent OR cases (14). While RSI should remain the gold standard in the vast majority of patients in the ED, FI presents an additional technique to mitigate anatomic or physiologic risk. To date, ketamine has been the agent of choice (12).

ED 65

ED Emergency Department ALS Paramedic 65

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Date: September 8th, 2021 Reference: Desch et al. He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP).

EMR 130

EMR Coronary Defibrillator Life Support 130

The Skeptics' Guide to EM

FEBRUARY 26, 2022

Date: February 21st 2022 Reference: Kim et al. Date: February 21st 2022 Reference: Kim et al. Case: You are in discussion with your emergency department (ED) manager about the number of patients boarding for hours to days and you are both aware that many of these patients are attending with mental health crises.

ED 130

ED ALS Emergency Department OR 130

EMDocs

NOVEMBER 13, 2024

Major takeaway: Consider SBP in any patient who comes into the ED with ascites. Biggins SW, Angeli P, Garcia-Tsao G, et al. Mattos AA, Wiltgen D, Jotz RF, et al. Aithal GP, Palaniyappan N, China L, et al. 2019 Jan 14;11:13-22. Angeli P, Bernardi M, Villanueva C, et al. Arvaniti V, D’Amico G, Fede G, et al.

E-9-1-1 71

E-9-1-1 ALS OR ED 71

Core EM

MARCH 1, 2024

Mumenthaler M , Mattle H , Taub E , ed. Epub 2019 Apr 17. 2019 Jul;42(4):673-685. Epub 2019 Jan 28. McGraw-Hill Education; 2019. 2019 Oct;15(4):299-303. 2019 Oct;15(4):299-303. Epub 2019 Aug 6. References Neurology. 4th Edition. Stuttgart: Thieme; 2003. Neuroanatomy, Motor Neuron. 2020:952–9.

Emergency Department 162

Emergency Department ED OR ALS 162

ALiEM

JUNE 15, 2023

Goldfrank’s Toxicologic Emergencies, 11e New York, NY: McGraw-Hill; 2019 Morimoto M, Tatsumi K, Yuui K, et al. PMID 29855084 De Silva HA, Fonseka MM, Pathmeswaran A et al. Retrieved Jun 5, 2023. Nelson LS, Goldfrank LR. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. J Clin Lab Anal.

ALS 246

ALS ED OR 246

Broome Docs

OCTOBER 6, 2024

Turgeon AF, Fergusson DA, Clayton L,et al. PMID: 38238065 Oral vs IV ABs… another negative trial Nielsen AB, Holm M, Lindhard MS, et al. 2019 Nov 5;322(17):1722. So follow along with the papers below and read to make up your own mind about the evidence presented. Too much ‘aint enough blood? N Engl J Med.

Critical Care 112

Critical Care ALS Emergency Department EMS 112

EMDocs

JUNE 3, 2023

The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. This is less critical in ED management of the unstable pelvic fracture, as the optimal site for identification of rectal or vaginal tears is the operating room.

ED 54

ED Operating Room ALS Frozen Plasma 54

The Skeptics' Guide to EM

NOVEMBER 23, 2019

Date: November 21st, 2019 Reference: Daley et al. AEM November 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Date: November 21st, 2019 Reference: Daley et al. AEM November 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Emergency Department 130

Emergency Department ALS ED OR 130

ALiEM

APRIL 12, 2023

Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. 20 – Local Anesthetics, Ed(s): Hugh C. Egan, Pharmacology and Physiology for Anesthesia (Second Edition), Elsevier, 2019, Pages 390-411, ISBN 9780323481106. Preparation and Evaluation of Polymer-Based Ultrasound Gel and Its Application in Ultrasonography.

Emergency Department 258

Emergency Department ALS ED 258

REBEL EM

JANUARY 23, 2023

Moreover, the FDA approved intravenous (IV) cetirizine to treat acute urticaria in 2019. Article: Abella BS et al. Key Secondary Endpoints: 5 (3.9%) patients in the IV cetirizine group returned to any ED or clinic within 24 hours compared to 15 (11.1%) in the IV diphenhydramine group; P=0.04 in the IV cetirizine group and 2.1

Allergic Reaction 52

Allergic Reaction ED E-9-1-1 Emergency Department 52

ALiEM

NOVEMBER 29, 2023

Notes from the Field: Xylazine Detection and Involvement in Drug Overdose Deaths – United States, 2019. PMID: 34529640 Ayub S, Parnia S, Poddar K, et al. PMID: 24769343 Ehrman-Dupre R, Kaigh C, Salzman M et al. PMID: 36148197 Love JS, Levine M, Aldy K, et al. PMID: 37014353 Ball NS, Knable BM, Relich TA et al.

Naloxone 169

Naloxone Overdose ALS Epinephrine 169

REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. Richards JE et al. NEJM 1994. [2]

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

The Skeptics' Guide to EM

JUNE 6, 2020

Date: June 2nd, 2020 Reference: Permpikul et al. Respir Crit Care Med 2019. Date: June 2nd, 2020 Reference: Permpikul et al. Respir Crit Care Med 2019. Case: It’s another day in your emergency department (ED). The triage nurse places a 61 year-old-man with fever, hypotension, cough into the smallest room in the ED.

EMR 130

EMR ALS ICU Emergency Department 130

Don't Forget the Bubbles

JULY 22, 2024

Pre-school wheezers remain a poorly understood cohort of children despite seeing them every day in paediatric EDs. However, there was no difference in LOS (83 minutes for placebo vs 79 minutes for prednisolone) in participants who were discharged straight from the ED ( 32% ). Compare this with the Panickar et al.

E-9-1-1 105

E-9-1-1 ALS ACS ED 105

ACEP Now

JULY 11, 2024

Deaths from drinking increased 25 percent from 2019 to 2020 and another 10 percent in 2021. 5,6 Only one in six ED physicians routinely screens for dangerous drinking, and only one in 36 are using a validated screening tool. Notably for ED physicians, one of the criteria is “using [alcohol] in situations that might be dangerous.”

Emergency Department 98

Emergency Department ALS ED OR 98

REBEL EM

JANUARY 9, 2024

Bottom Line Up Top: In patients with infectious processes that are stable for discharge home, there is no role for giving a first dose of antibiotics IV in the ED. PMID: 9114201 Siegel RE et al. BMJ (Clinical research ed.). PMID: 17090560 Castro-Guardiola A et al. PMID: 1664833 Addo-Yobo E, et al. Pneumonia 2017.

ALS 100

ALS ICU ED OR 100

Don't Forget the Bubbles

SEPTEMBER 30, 2024

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. Simpson et al. Patients who Did Not Wait are a feature of most EDs worldwide. A 2011-2012 Australian study by Blake et al. of those children later returned to the ED.

Emergency Department 89

Emergency Department ALS ED OR 89

REBEL EM

FEBRUARY 21, 2024

Clinical Scenario: A 34-year-old woman presents to the ED with back pain. Schwartz and colleagues performed an ingenious trial ( Schwartz 2000 ) Enrolled 64 ED patients with acute pain. Read More REBEL EM: The Ketorolac Analgesic Ceiling References Irizarry E et al. PMID: 34133820 Arora S et al. 2019; 36: 401-6.

E-9-1-1 64

E-9-1-1 Emergency Department ALS ED 64

ALiEM

NOVEMBER 1, 2023

In: Nelson LS, Goldfrank LR et al (eds): Goldfrank’s Toxicologic Emergencies. McGraw-Hill Education; 2019 Madiwale T, Liebelt E. 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. Iron: not a benign therapeutic drug. Deferoxamine.

E-9-1-1 161

E-9-1-1 ALS OR ED 161

The Skeptics' Guide to EM

NOVEMBER 16, 2019

Date: November 6th, 2019 Reference: Lascarrou et al. NEJM Oct 2019 Guest Skeptic: Dr. Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Reference: Lascarrou et al.

ALS 100

ALS CPR ICU EMS 100

Core EM

JANUARY 24, 2024

2017.09.1085 Gómez-Outes A, Alcubilla P, Calvo-Rojas G, et al. Published 2019 Jun 6. doi:10.1186/s13054-019-2492-8 Baugh CW, Levine M, Cornutt D, et al. 2019.09.001 Gilbert BW, Morton L, Huffman JB, et al. 2019.10.013 Patel IJ, Rahim S, Davidson JC, et al. Background Around 6 million people in the U.S. J Emerg Med.

FFP 130

FFP Frozen Plasma Plasma ALS 130

The Skeptics' Guide to EM

APRIL 25, 2020

Date: April 21st, 2020 Reference: Juergens et al. Date: April 21st, 2020 Reference: Juergens et al. Proc Baylor Univ Med Center Oct 2019 Guest Skeptic: Dr. Chuck Sheppard is an attending Emergency Department Physician at Mercy Hospital in Springfield, Missouri and the medical director for Mercy Life Line air medical service.

Emergency Department 100

Emergency Department ALS ED EMS 100

Don't Forget the Bubbles

JULY 19, 2023

Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. When they examined her and found that she had enlarged optic discs, they sent Olivia to the ophthalmology ED. Two smaller retrospective reviews ( Elhusseiny et al., 2023 and Kovarik et al., 2020 and Hyde et al.

ALS 98

ALS Emergency Department ED OR 98

The Skeptics' Guide to EM

JULY 17, 2021

Date: July 14th, 2021 Reference: Pernica et al. Date: July 14th, 2021 Reference: Pernica et al. Case: Six-year-old Morten comes into your emergency department (ED) with what looks like pneumonia. This is because most pneumonias in this age-group are caused by viral pathogens ( Bradley et al 2011 ). Bradley et al 2011 ).

ALS 130

ALS Emergency Department ED 130

ACEP Now

DECEMBER 10, 2023

In the program, Medicare patients who visit a participating emergency department (ED) with specific diagnoses will have their 14-day total cost of care measured across all settings by the state regulatory agency, also known as the Health Services Cost Review Commission (HSCRC). 1 In total, the program includes 535 ED diagnoses.

Emergency Department 52

Emergency Department ED ALS OR 52

EMDocs

NOVEMBER 19, 2024

10 Table 1: Second-Generation Antipsychotics and Associated Adverse Effects Adapted from: UpToDate 8 with additional sources Micromedex 9 and Riboldi, et al 11 *SL=sublingual, IM=intramuscular, PO=oral, ODT=orally disintegrating tablets, ER=extended release, IR=immediate release. +to New York, NY: McGraw-Hill Education; 2019.

Overdose 74

Overdose EMS Emergency Medical Services OR 74

The Skeptics' Guide to EM

APRIL 12, 2019

Date: April 10th, 2019 Guest Skeptic: Dr. Scott Weingart. He is an ED intensivist from New York City and runs the popular EMCrit blog and podcast. Date: April 10th, 2019 Guest Skeptic: Dr. Scott Weingart. He is an ED intensivist from New York City and runs the popular EMCrit blog and podcast.

ALS 130

ALS ED EMS OR 130

The Skeptics' Guide to EM

DECEMBER 28, 2019

Date: December 16th, 2019 Reference: Moore et al. Annals of EM, JU, and JACR 2019. Date: December 16th, 2019 Reference: Moore et al. Annals of EM , JU, and JACR 2019. Imaging in Suspected Renal Colic: Systematic Review of the Literature and Multispecialty Consensus. NEJM 2014 ).

Emergency Department 100

Emergency Department ALS EMS ED 100

The Skeptics' Guide to EM

OCTOBER 5, 2019

Date: September 25th, 2019 Reference: Bath PM et al. The Lancet March 2019. Date: September 25th, 2019 Reference: Bath PM et al. The Lancet March 2019. You arrive to find the patient awake and alert, with a facial droop, slurred speech and left-sided arm drift (FAST-ED score = 3). mmol/L).

Ambulance 130

Ambulance Paramedic EMS ALS 130