The Skeptics' Guide to EM

MAY 2, 2020

Date: April 24th, 2020 Reference: Watanabe et al. July 2019 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. This is Bob’s eleventh visit […] The post SGEM#291: Who’s Gonna Drive you to…the ED – with Lights & Sirens? Date: April 24th, 2020 Reference: Watanabe et al.

ED 100

ED Ambulance Medical Transportation EMS 100

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

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-9-1-1 268

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

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

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 9, 2019

Date: February 7th, 2019 Reference: Bouida et al. AEM February 2019. Date: February 7th, 2019 Reference: Bouida et al. AEM February 2019. Case: You are working in your local freestanding emergency department (ED). This is an ED not physically attached to a hospital, for the non-American listeners.

Emergency Department 130

Emergency Department ALS ED OR 130

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

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

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

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

The Skeptics' Guide to EM

FEBRUARY 8, 2020

Date: January 29th, 2020 Reference: Perry et al. Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. Date: January 29th, 2020 Reference: Perry et al. Reference: Perry et al. He also has this amazing #FOAMed blog called EM Nerd.

Emergency Department 130

Emergency Department Critical Care ALS EMS 130

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

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

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

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

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

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

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

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. There is a 3-4 hour wait in your ED that day. Background: Pain is the most common reason for an ED visit in children.

ALS 130

ALS ED Emergency Department OR 130

EMDocs

MAY 11, 2024

A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al.

EMS 89

EMS E-9-1-1 ALS OR 89

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

ACEP Now

DECEMBER 11, 2023

The Emergency Department Benchmarking Alliance (EDBA) is a membership organization composed of high-performance emergency departments (EDs) that share a commitment to quality. Thus, the survey included data for about one-third of all patients seen in US ED’s in 2022. 1 Boarding time increases led to unprecedented ed walkaway rates.

Emergency Department 52

Emergency Department ED EMS ALS 52

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

JUNE 20, 2020

Reference: Kuppermann et al. Reference: Kuppermann et al. Case: A 5-week-old full term female presents to the Emergency Department (ED) for fever with rectal temp of 100.6F (38.1C). Reference: Kuppermann et al. Dennis Ren is a Pediatric Emergency Medicine fellow at Children’s National Hospital in Washington, DC.

OR 100

OR Emergency Department ALS 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

ACEP Now

JUNE 7, 2023

The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. EDs weathered attacks from a variety of sources in recent years. ED leaders worked to develop new physician documentation and coding guidelines that needed to be implemented at the beginning of 2023.

Emergency Department 52

Emergency Department ED EMS Ambulance 52

The Skeptics' Guide to EM

OCTOBER 19, 2019

Date: October 17th, 2019 Reference: Driver et al. Date: October 17th, 2019 Reference: Driver et al. Reference: Driver et al. Bougie use may be helpful in ED intubation.” A Randomized Clinical Trial. Clinical Question: Does using a bougie increase first pass intubation success?

Firefighter 130

Firefighter Emergency Department Paramedic ALS 130

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

ALiEM

AUGUST 9, 2023

Study N Sensitivity Specificity Comments Pereda et al., Balk et al., Tsou et al., Acad Emerg Med 2019 25 studies; 3353 patients 94% 92% Significant difference in accuracy between novice and advanced sonographers. ED Course The patient received antibiotics for pneumonia. 2019 Sep;26(9):1074-1088. Pediatrics.

E-9-1-1 246

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

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.

Naloxone 130

Naloxone Overdose Emergency Medical Services Emergency Department 130

The Skeptics' Guide to EM

MAY 19, 2019

Date: May 15th, 2019 Reference: Terp et al. AEM May 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Date: May 15th, 2019 Reference: Terp et al. AEM May 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Terp et al.

Emergency Department 100

Emergency Department ALS ED OR 100

EMDocs

DECEMBER 19, 2023

In: Marx JA, Hockenberger RS, Biros MH, et al., McGraw Hill; 2019. 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. Accessed August 25, 2022.

First Aid 92

First Aid ED OR ALS 92

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. References: Powers WJ, Rabinstein AA, Ackerson T, et al. Stroke 2019; 50:e344. Leonardi-Bee J, et al; IST Collaborative Group. Okumura K, et al. Vlcek M, et al.

ALS 73

ALS Critical Care OR EMS 73

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. 2019 Oct;106(11):1542-1548.

ACPE 88

ACPE ALS OR ED 88

EMDocs

JANUARY 3, 2024

He has been taking increased doses of torsemide without improvement in his symptoms and was directed to the ED for inpatient therapy. Now, a remote outpatient pulmonary arterial pressure monitor and other heart failure detection devices (Table 1) are available that you may begin to see in your ED. 2019 Apr;6(2):308-18.

Defibrillator 87

Defibrillator Allergic Reaction ED ALS 87