The Skeptics' Guide to EM

JUNE 22, 2019

Date: June 20th, 2019 Reference: Pluymaeker et al. NEJM 2019 Guest Skeptic: Dr. David Glaser, emergency physician from a community teaching hospital in Denver and faculty member for the annual Emergency Medicine and Acute Care course series. Date: June 20th, 2019 Reference: Pluymaeker et al.

OR 100

OR Emergency Department ALS 100

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

Pediatric EM Morsels

OCTOBER 27, 2023

Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. At this time it does not include medication volumes/amounts, which still poses challenge to nurses who have to calculate volume based on dose.

E-9-1-1 268

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

EMDocs

AUGUST 22, 2024

You may be more familiar with the term “limited English proficiency” (LEP), defined as: someone who does not speak English as their primary language and has a limited ability to read, speak, write, or understand English. For instance, displaying posters in multiple languages that explain the language services patients are entitled to.

Emergency Department 82

Emergency Department ALS E-9-1-1 ED 82

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. Refers to the Spinal Cord Function and Reflexes, not specifically hemodynamic issues. Basics are the Best!

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

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

This Podcast Will Kill You

JULY 23, 2024

2019): 100. Caio, Giacomo, et al. ” BMC medicine 17 (2019): 1-20. Cenit, María Carmen, et al. Al-Dulaimi, D., Gasbarrini, Giovanni, et al. Gasbarrini, Giovanni Battista, et al. Kerner, Gaspard, et al. Newberry, Carolyn, et al. “Samuel Gee: the modern era for coeliac disease.”

E-9-1-1 98

E-9-1-1 ALS OR 98

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

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

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

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

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

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

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

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

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

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

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. A study by Stiell et al showed that the vast majority of patients (97%) were discharged home from the ED with 93% in normal sinus rhythm using this protocol ( SGEM#88 ).

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

APRIL 14, 2019

Date: April 11th, 2019 Reference: Brucker et al. AEM April 2019 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com WARNING: This SGEM episode discusses suicide. Date: April 11th, 2019 Reference: Brucker et al.

ED 130

ED Emergency Department ALS OR 130

ALiEM

NOVEMBER 1, 2023

In: Nelson LS, Goldfrank LR et al (eds): Goldfrank’s Toxicologic Emergencies. In: Nelson LS, Goldfrank LR et al (eds): Goldfrank’s Toxicologic Emergencies. McGraw-Hill Education; 2019 Madiwale T, Liebelt E. For iron toxicity, what are the indications for deferoxamine? What other medications can cause orange/red/brown urine? [6-9]

E-9-1-1 161

E-9-1-1 ALS OR ED 161

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

Pediatric EM Morsels

APRIL 7, 2023

References: Al Kasab S, Lynn MJ, Turan TN, Derdeyn CP, Fiorella D, Lane BF, Janis LS, Chimowitz MI; SAMMPRIS Investigators. Observation, interaction with patient, as well as parent information is key to bring the whole picture together! Increase the Adult Percent!

ALS 130

ALS OR Critical Care EMS 130

Pediatric EM Morsels

MARCH 17, 2023

Since we all inhabit the same beautiful world , and sometimes we humans overtake previous habitats of animals, we inevitably will cross paths with an animal that bites us. Usually, animals bite from fear or defense of their offspring ( ex, Brown Recluse ). Sometimes it’s a beloved pet who gets surprised or has an “off” day ( Dog Bites and PTSD ).

Frozen Plasma 130

Frozen Plasma First Aid Plasma OR 130

EMDocs

JANUARY 29, 2024

The American Heart Association/American Stroke Association (AHA/ASA) recommends maintaining BP below 185/110 mmHg in eligible patients undergoing thrombolytic therapy or endovascular intervention [1]. Following thrombolysis or endovascular therapy, the recommended blood pressure goal is below 180/105 mmHg to prevent hemorrhagic complications [1].

ALS 73

ALS Critical Care OR EMS 73

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

EMDocs

MAY 11, 2024

A) Basilar artery stroke B) Cavernous sinus syndrome C) Lateral medullary infarction D) Multiple sclerosis Answer: C Vertigo , or the internal sensation of motion when no motion exists, is often classified as either peripheral or central depending on the origin of the pathology. loss of pain and temperature sensation).

EMS 89

EMS E-9-1-1 ALS OR 89

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

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 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

NAEMSP

FEBRUARY 1, 2023

2019): 364-376. Article Summary by James Li, MD Sinclair, Julie E., “Characteristics, prehospital management, and outcomes in patients assessed for hypoglycemia: repeat access to prehospital or emergency care.” ” Prehospital Emergency Care 23.3 Background: Diabetes is a common chronic medical condition. were admitted.

OR 52

OR Emergency Department Emergency Medical Services Paramedic 52

ALiEM

AUGUST 16, 2023

Nelson, et al., 2019, McGraw-Hill Education: New York. Nelson, et al., 2019, McGraw-Hill Education: New York. Background Methemoglobinemia is a disorder of hemoglobin in which the iron atom has been oxidized from the normal Fe 2+ to Fe 3+. A variety of xenobiotics can act as oxidizing agents, inducing methemoglobinemia.

E-9-1-1 130

E-9-1-1 ALS OR 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

ALiEM

OCTOBER 30, 2023

After spending her first year acclimating to the new department and achieving board certification, Dr. Garcia finds herself at a bit of a crossroad. She likes teaching, but are not sure residency or medical student education leadership is for her. And as study after study tells us, everyone is susceptible to burnout. In short, no.

E-9-1-1 161

E-9-1-1 ALS OR 161

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 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

DECEMBER 11, 2021

Back in 2019 we were talking about Vitamin C for sepsis ( SGEM#268 ). Fujii et al ( VITAMINS RCT) JAMA 2020: n=216 patients with septic shock. Moskowits et al ( ACTS RCT) JAMA 2020: n=205 patients with septic shock. Moskowits et al ( ACTS RCT) JAMA 2020: n=205 patients with septic shock.

ALS 100

ALS OR 100