The Skeptics' Guide to EM

DECEMBER 21, 2019

Date: December 17th, 2019 Reference: Reeves and Reynolds. AEM Dec 2019. Date: December 17th, 2019 Reference: Reeves and Reynolds. AEM Dec 2019. It was published last year in the 2018 BMJ holiday edition ( Yeh et al BMJ Dec 2018 ). Laupacis A et al NEJM 1988 ). It would be a cross over trial.

OR 100

OR ALS ED 100

ALiEM

APRIL 12, 2024

If the catheter appears correctly positioned on AP chest x-ray but is malfunctioning, consider obtaining additional imaging to confirm placement [11]: Lateral view chest-xray, or Chest CT (can also help characterize the pleural effusion) References Gammie JS, Banks MC, Fuhrman CR, et al. doi: [link] Broder JS, Al-Jarani B, Lanan B, Brooks K.

E-9-1-1 183

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

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. Lily of the valley ( Convallaria majalis ) is a woodland perennial with a sweet scented, white bell-shaped flower. ouabain, poison rope) Asclepias spp.

ALS 246

ALS ED OR 246

ALiEM

AUGUST 9, 2023

Ultrasound Technique Background The lungs were traditionally considered poorly accessible to ultrasound, as ultrasound waves cannot penetrate air-filled structures; however, lung POCUS relies on the interpretation of patterns of artifacts to evaluate the normal, air-filled lungs. Warm gel helps with the child’s comfort.

E-9-1-1 246

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

Pediatric EM Morsels

JUNE 14, 2024

(Tavasoli 2018, Wolf 2012) More common in adults; children comprise 20% of total cases (Pidcock 2007, Wang 2019) Bimodal age distribution (Absoud 2016) Children < 5 years Children > 10 years Symptoms evolve over 2-4 days and peak at 5-6 days (Absoud 2016) ATM may occur alone OR as part of another disorders (e.g.

Plasma 141

Plasma ALS OR EMS 141

The Skeptics' Guide to EM

JUNE 20, 2020

Reference: Kuppermann et al. Reference: Kuppermann et al. Several criteria have been developed previously, including the Rochester ( Jaskiewicz et al 1994 ), Boston ( Baskin et al 1992 ) and Philadelphia ( Baker et al 1993 ) criteria to help clinicians stratify the risk of serious bacterial infections (SBI).

OR 100

OR Emergency Department ALS ED 100

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

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.) The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Lay the patient supine when possible.

E-9-1-1 177

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

ALiEM

JANUARY 5, 2024

2019 Dec 9;21(1):96-101. What does the Electronic Residency Application Service (ERAS) preliminary data show just far for the 2024 residency application season? Has the program signaling option been working? Have there been any surprises or changes during interview season? What should students think about in the post-interview stage?

EMS 177

EMS ALS OR 177

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

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. Date: September 18th, 2019 Reference: Scheuermeyer et al.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Date: September 11th, 2019 Reference: Putzu et al. Date: September 11th, 2019 Reference: Putzu et al. Reference: Putzu et al. The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. Critical Care Medicine.

ICU 130

ICU Critical Care ALS Emergency Department 130

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

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. Date: December 13th, 2019 Reference: Belisle et al. Reference: Belisle et al.

ALS 130

ALS Emergency Department OR 130

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

OCTOBER 11, 2024

American Society of Hematology 2019 guidelines for immune thrombocytopenia. 2019 Dec 10;3(23):3829-3866. Provan D, Arnold DM, Bussel JB, et al. She reported no recent trauma or history of similar lesions in the past. Physical Exam Vitals : 98.3°F; Plt 6, WBC 10.3 INR : 1.05 Treatment for mild/moderate bleeding is more nuanced.

OR 152

OR ALS 152

The Skeptics' Guide to EM

JUNE 29, 2019

Date: June 28th, 2019 Reference: Cardona et al. AEM June 2019. Date: June 28th, 2019 Reference: Cardona et al. AEM June 2019. Reference: Cardona et al. AEM June 2019. Guest Skeptic:Dr. Unfortunately, available tools are only modestly accurate and have not been rigorously validated.1,2

Emergency Department 130

Emergency Department ALS OR 130

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. Date: February 17, 2023 Reference: Gettel et al. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019.

Emergency Department 130

Emergency Department ALS ED EMS 130

The Skeptics' Guide to EM

APRIL 6, 2019

Date: April 5th, 2019 Reference: Connolly et al. NEJM 2019 Guest Skeptic: Dr. Ryan Radecki is an Emergency Physician at Kaiser Permanente NW, co-host of the Annals of Emergency Medicine podcast and Journal Club section editor. Date: April 5th, 2019 Reference: Connolly et al.

Frozen Plasma 130

Frozen Plasma Plasma ALS EMS 130

The Skeptics' Guide to EM

DECEMBER 7, 2019

Date: October 2nd, 2019 Reference: Ramgopal et al. Pediatrics 2019 Guest Skeptic: Dr. Katie Noorbakhsh is a pediatric emergency physician at the Children’s Hospital of Pittsburgh. Date: October 2nd, 2019 Reference: Ramgopal et al. The diagnosis could have caused a great deal of anxiety in parents/caregivers.

CPR 130

CPR ALS OR 130

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. 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.

Emergency Department 130

Emergency Department ALS EMS OR 130

The Skeptics' Guide to EM

MAY 25, 2019

Date: May 23rd, 2019 Reference: Joseph et al. JAMA Surgery March 2019. Date: May 23rd, 2019 Reference: Joseph et al. JAMA Surgery March 2019. Reference: Joseph et al. JAMA Surgery March 2019. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma.

ACS 130

ACS Emergency Department ALS 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. Defibrillation is the treatment of choice in these cases but does not often result in sustained ROSC ( Kudenchuk et al 2006). The TOMAHAWK Investigators. first appeared on The Skeptics Guide to Emergency Medicine.

EMR 130

EMR Coronary Defibrillator Life Support 130

Pediatric EM Morsels

JUNE 21, 2024

Chaganti 2019] Other studies have not shown a difference in infection rates between silver-containing creams and antimicrobial ointments. Or maybe you have the adventurous adolescent who was a little too aggressive with the lighter fluid before igniting the campfire.

ALS 169

ALS OR EMS 169

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

Date: September 10th, 2019 Reference: Fournier et al. Emergency Medicine Journal 2019. Date: September 10th, 2019 Reference: Fournier et al. Emergency Medicine Journal 2019. Adapting the Canadian CT head rule age criteria for mild traumatic brain injury.

Emergency Department 130

Emergency Department ALS EMS OR 130

The Skeptics' Guide to EM

JULY 18, 2020

Reference: Ebell et al. A prior meta-analysis demonstrated that the combination of normal vital signs and normal lung exam effectively rules out pneumonia ( Marchellow eat al JABFM 2019 ), and that a physician’s overall clinical impression is moderately accurate ( Dale et al BrJGP 2019 ). Reference: Ebell et al.

ALS 130

ALS Emergency Department OR 130

The Skeptics' Guide to EM

FEBRUARY 26, 2019

Date: February 4th, 2019 Guest Skeptic: Dr. Jerome Hoffman is a Professor Emeritus of Medicine and Emergency Medicine, University of California, Los Angeles. Date: February 4th, 2019 Guest Skeptic: Dr. Jerome Hoffman is a Professor Emeritus of Medicine and Emergency Medicine, University of California, Los Angeles.

ALS 130

ALS EMS OR 130

Don't Forget the Bubbles

NOVEMBER 11, 2024

Kochanek et al. explored the evidence in a 2019 systematic review, which forms part of the Brain Trauma Foundation Guidelines, as did Utsumi et al. The guidelines by Kochanek et al. Should we aim to prevent fever, or should we cool patients? At the scene, his lowest GCS was 5 (E1V2M2). Three secondary analyses.

ALS 116

ALS Life Support Critical Care OR 116

The Skeptics' Guide to EM

MARCH 2, 2019

Date: February 26th, 2019 Reference: Benger et al. Date: February 26th, 2019 Reference: Benger et al. Reference: Benger et al, Effect of a Strategy of a Supraglottic Airway Device
vs. Effect of a Strategy of a Supraglottic Airway Device
vs. The AIRWAYS-2 Randomized Clinical Trial. Chest compression fraction.

CPR 130

CPR Firefighter Paramedic Defibrillator 130

International Journal of Paramedicine

OCTOBER 8, 2024

Data were obtained from the National Emergency Services Information System (NEMSIS) database for 2019. EMS responses (n = 4,375,568) were analyzed comparing patient acuity and CMS Service level, Advanced Life Support (ALS) vs Basic Life Support (BLS), to assess for associations in acuity and CMS Service level using logistic regression.

BLS 52

BLS Advanced Life Support ALS Community Paramedicine 52

Pediatric EM Morsels

APRIL 5, 2024

Silva-Ramos 2021) Majority of cases arise from travel to South Africa. (Frean 2019) The classic triad described is fever, eschar and rash. Ricardi 2019) Tick-Borne Encephalitis has a biphasic pattern of symptoms. Ricardi 2019) Initial symptoms are nonspecific and include fever, malaise, headache, nausea, vomting and myalgias.

E-9-1-1 161

E-9-1-1 ALS OR EMS 161

Core EM

MARCH 1, 2024

Epub 2019 Apr 17. 2019 Jul;42(4):673-685. Epub 2019 Jan 28. McGraw-Hill Education; 2019. Significance of the Inverted V Sign : This MRI sign is pathognomonic for subacute combined degeneration, indicating it is a distinct marker for this condition. PMID: 27293327; PMCID: PMC4888679. Transverse Myelitis. 2020:952–9.

Emergency Department 162

Emergency Department ED OR ALS 162

The Skeptics' Guide to EM

FEBRUARY 23, 2019

Date: February 22nd, 2019 Reference: Lane et al. Date: February 22nd, 2019 Reference: Lane et al. The study by Alam et al took adult patients with a diagnosis of suspected infection and randomized them to ceftriaxone 2g IV started pre-hospital or usual care with a primary outcome of all-cause mortality at 28 days.

Paramedic 130

Paramedic ALS Ambulance EMS 130

The Skeptics' Guide to EM

OCTOBER 14, 2019

Date: October 14th, 2019 Reference: CRASH-3 Trial Collaborators. The Lancet October 2019 Guest Skeptic: Dr. Salim Rezaie currently works as a community emergency physician at Greater San Antonio Emergency Physicians […] The post SGEM#270: CRASH-3 TXA for Traumatic Head Bleeds? first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 130

Emergency Department EMS ALS OR 130

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. 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

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. first appeared on The Skeptics Guide to Emergency Medicine. His 12-lead ECG shows a normal sinus rhythm without ST abnormality or ectopy.

Ambulance 130

Ambulance Paramedic EMS ALS 130

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Date: January 28th, 2019 Reference: Chu DK et al. Date: January 28th, 2019 Reference: Chu DK et al. Reference: Chu DK et al. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. The Lancet 2018. The Lancet 2018.

Life Support 130

Life Support ALS STEMI Emergency Department 130