ACEP Now

MAY 9, 2024

When seven South Florida gluteal AFT patients died tragically in one year alone, the Florida Board of Medicine issued an emergency regulation restricting fat injection to the subcutaneous space rather than injecting into muscle. Al Jazeera. Mofid MM, Teitelbaum S, Suissa D, et al. units per patient. Accessed March 6, 2024.

Emergency Department 52

Emergency Department Operating Room Critical Care ICU 52

Don't Forget the Bubbles

MAY 10, 2023

You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. Promoting hot debriefing in an emergency department. Team talk and team activity in simulated medical emergencies: a discourse analytical approach. Scand J Trauma Resusc Emerg Med. Emerg Med J.

Emergency Department 91

Emergency Department ED CPR OR 91

REBEL EM

MAY 11, 2023

Background: The emergency department is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines. 5 Paper: Lebin J et al. 5 Paper: Lebin J et al. Am J Emerg Med 2013 , 31 (4), 734-742.

Emergency Department 98

Emergency Department ED EMR OR 98

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. REFERENCES: Acute Respiratory Distress Syndrome Network et al.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Date: February 17, 2023 Reference: Gettel et al. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. AEM Feb 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and Assistant Professor at the University of Calgary. Reference: Gettel et al.

Emergency Department 130

Emergency Department ALS ED EMS 130

ALiEM

MARCH 7, 2024

Transvere ultrasound views of the bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.) Sagittal view of bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.)

E-9-1-1 177

E-9-1-1 Emergency Department ALS ED 177

REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Paper: Mason JM, et al. Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

Pediatric EM Morsels

OCTOBER 27, 2023

2010) ‘140: Does physician estimates of pediatric patient weights lead to inaccurate medication dosages’, Annals of Emergency Medicine , 56(3), p. Academic Emergency Medicine, 14: 500-501. link] Lubitz DS, Seidel JS, Chameides L, Luten RC, Zaritsky AL, Campbell FW. Ann Emerg Med. Emerg Med Australas. J Emerg Med.

E-9-1-1 269

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

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. Simpson et al. Emergency department overcrowding is a complex issue with multiple contributing factors. A 2011-2012 Australian study by Blake et al.

Emergency Department 89

Emergency Department ALS ED OR 89

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Review toolkits and studies that provide strategies for advancing language justice in your ED: Betancourt JRRM, et al. Lion KC, et al. Regenstein M, et al. Taira B, et al. Taira B, et al. April 2019. Lim T, Campbell R, et al.

Emergency Department 81

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

Broome Docs

OCTOBER 6, 2024

Turgeon AF, Fergusson DA, Clayton L,et al. Emerg Med J. PMID: 38238065 Oral vs IV ABs… another negative trial Nielsen AB, Holm M, Lindhard MS, et al. Emergency Medicine Journal Published Online First: 12 September 2024. 2019 Nov 5;322(17):1722. Too much ‘aint enough blood? N Engl J Med. 2024 Jun 13.

Critical Care 112

Critical Care ALS Emergency Department EMS 112

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. The Journal of Emergency Medicine.

E-9-1-1 183

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

The Skeptics' Guide to EM

JUNE 15, 2024

Reference: Jansen et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. The SGEM bottom line in 2019 was that REBOA is currently an intervention of uncertain benefit. vs. 18.9%, p=0.01).

Life Support 225

Life Support Emergency Department ALS 225

The Skeptics' Guide to EM

NOVEMBER 23, 2019

Date: November 21st, 2019 Reference: Daley et al. Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs. AEM November 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Daley et al.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

JULY 27, 2019

Date: July 22nd, 2019 Reference: Yadav et al. A Multifaceted Intervention Improves Prescribing for Acute Respiratory Infection for Adults and Children in Emergency Department and Urgent Care Settings. AEM July 2019 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and clinical lecturer in Calgary.

Emergency Department 130

Emergency Department ED ALS 130

The Skeptics' Guide to EM

SEPTEMBER 21, 2019

Date: September 18th, 2019 Reference: Scheuermeyer et al. AEM Sept 2019 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and clinical lecturer in Calgary. Electrical First Cardioversion first appeared on The Skeptics Guide to Emergency Medicine. Reference: Scheuermeyer et al.

Emergency Department 130

Emergency Department ALS OR 130

Pediatric EM Morsels

JULY 21, 2023

cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! Acad Emerg Med. Holmes, James F et al. Academic emergency medicine 12.9 2019 Jul;20(7):660-666. 2019 Sep;241:112-118. Epub 2019 Apr 22. Fun fact for animal lovers!- 2016 Aug;23(8):878-84.

Critical Care 246

Critical Care ALS OR Life Support 246

The Skeptics' Guide to EM

OCTOBER 26, 2019

Date: October 22nd, 2019 Reference: Iyengar R et al. AEM October 2019. Date: October 22nd, 2019 Reference: Iyengar R et al. AEM October 2019. Reference: Iyengar R et al. AEM October 2019. The patient is now feeling great, or as they say in New Zealand “sweet as”. His exam is normal.

Emergency Department 130

Emergency Department ALS OR 130

ALiEM

APRIL 12, 2023

Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. Egan, Pharmacology and Physiology for Anesthesia (Second Edition), Elsevier, 2019, Pages 390-411, ISBN 9780323481106. emDOCs.net – Emergency Medicine Education. Accessed April 5, 2023. 2022 Jan 6;8(1):42. doi: 10.3390/gels8010042. Hemmings, Talmage D.

Emergency Department 258

Emergency Department ALS ED 258

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

Date: September 10th, 2019 Reference: Fournier et al. Emergency Medicine Journal 2019. Guest Skeptics: Dr. Sarah Berg is a PGY-3 resident in Emergency Medicine at Washington University School of Medicine in St. Date: September 10th, 2019 Reference: Fournier et al. Emergency Medicine Journal 2019.

Emergency Department 130

Emergency Department ALS EMS OR 130

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. Study N Sensitivity Specificity Comments Pereda et al., Balk et al., Tsou et al., PMID: 14722643 Pereda MA, Chavez MA, Hooper-Miele CC, et al.

E-9-1-1 246

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

The Skeptics' Guide to EM

JANUARY 11, 2020

Date: January 10th, 2020 Reference: Dodick DW et al. NEJM 2019 Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at St. first appeared on The Skeptics Guide to Emergency Medicine. Date: January 10th, 2020 Reference: Dodick DW et al. Reference: Dodick DW et al.

Emergency Department 130

Emergency Department ALS EMS OR 130

NAEMSP

OCTOBER 9, 2024

In the emergency department, a lack of awareness about Addison’s disease led to delayed steroid administration. In the emergency department, the patient was evaluated and safely discharged. These cases highlight the impact of adrenal insufficiency on patients, especially during encounters with emergency care systems.

EMS 122

EMS Crisis Prevention Emergency Department BLS 122

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. first appeared on The Skeptics Guide to Emergency Medicine. Date: September 8th, 2021 Reference: Desch et al.

EMR 130

EMR Coronary Defibrillator Life Support 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. Xylazine Intoxication in Humans and Its Importance as an Emerging Adulterant in Abused Drugs: A Comprehensive Review of the Literature. MMWR Morb Mortal Wkly Rep.

Naloxone 169

Naloxone Overdose ALS Epinephrine 169

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. West J Emerg Med.

E-9-1-1 183

E-9-1-1 Operating Room Emergency Department ALS 183

The Skeptics' Guide to EM

OCTOBER 19, 2019

Date: October 17th, 2019 Reference: Driver et al. Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation. Date: October 17th, 2019 Reference: Driver et al. Reference: Driver et al.

Firefighter 130

Firefighter Emergency Department Paramedic ALS 130

The Skeptics' Guide to EM

MAY 25, 2019

Date: May 23rd, 2019 Reference: Joseph et al. JAMA Surgery March 2019. Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. Date: May 23rd, 2019 Reference: Joseph et al. JAMA Surgery March 2019. Reference: Joseph et al. JAMA Surgery March 2019.

ACS 130

ACS Emergency Department ALS OR 130

ACEP Now

JULY 11, 2024

Deaths from drinking increased 25 percent from 2019 to 2020 and another 10 percent in 2021. 2 Although the opiate epidemic is certainly worthy of attention, it accounts for only about half of the number of deaths annually and only around a quarter of the number of emergency department visits annually relative to alcohol use.

Emergency Department 98

Emergency Department ALS ED OR 98

The Skeptics' Guide to EM

JUNE 20, 2020

Dennis Ren is a Pediatric Emergency Medicine fellow at Children’s National Hospital in Washington, DC. Reference: Kuppermann et al. Case: A 5-week-old full term female presents to the Emergency Department […] The post SGEM#296: She’s Got the Fever but Does She Need an LP, Antibiotics or an Admission? JAMA Pediatr.

OR 100

OR Emergency Department ALS ED 100

The Skeptics' Guide to EM

APRIL 25, 2020

Date: April 21st, 2020 Reference: Juergens et al. Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. Date: April 21st, 2020 Reference: Juergens et al. Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke.

Emergency Department 100

Emergency Department ALS ED EMS 100

The Skeptics' Guide to EM

DECEMBER 14, 2019

Date: December 13th, 2019 Reference: Belisle et al. AEM December 2019 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. first appeared on The Skeptics Guide to Emergency Medicine. Date: December 13th, 2019 Reference: Belisle et al.

ALS 130

ALS Emergency Department OR 130

Core EM

MARCH 1, 2024

Epub 2019 Apr 17. 2019 Jul;42(4):673-685. Epub 2019 Jan 28. Goldfrank’s Toxicologic Emergencies, 11e. McGraw-Hill Education; 2019. The Clinical Presentations of Nitrous Oxide Users in an Emergency Department. 2019 Oct;15(4):299-303. 2019 Oct;15(4):299-303. Epub 2019 Aug 6.

Emergency Department 162

Emergency Department ED OR ALS 162

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.’ Kapoor et al.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Date: September 11th, 2019 Reference: Putzu et al. Guest Skeptics: Dr. Erin Willard is a PGY-3 Emergency Medicine Resident, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Date: September 11th, 2019 Reference: Putzu et al. Reference: Putzu et al.

ICU 130

ICU Critical Care ALS Emergency Department 130

The Skeptics' Guide to EM

DECEMBER 28, 2019

Date: December 16th, 2019 Reference: Moore et al. Annals of EM, JU, and JACR 2019. Guest Skeptics: Dr. Christopher Moore is an Associate Professor of Emergency Medicine a Yale School of Medicine. Date: December 16th, 2019 Reference: Moore et al. Annals of EM , JU, and JACR 2019. NEJM 2014 ).

Emergency Department 100

Emergency Department ALS EMS ED 100

REBEL EM

FEBRUARY 21, 2024

Surgical Patients Quereshi 2019 Double-blind RCT IM diclofenac 75 mg vs PO diclofenac 100 mg Small difference favoring IM in terms of speed to pain relief Authors conclude PO superior due to time to prepare injection The data looks fairly clear in terms of analgesic efficacy but, don’t some patients simply prefer to receive a shot?

E-9-1-1 64

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