Pediatric EM Morsels

JUNE 30, 2023

I’m sure you can recall at least several parents who bring their children into the ED for concern of recurrent pneumonias. Often the parents focus on a possible underlying immunodeficiency. Fortunately, most commonly these pneumonias are due to viral infections, and we can often offer reassurances to the parent. Dec 46 (6) 999–1002, [link].

E-9-1-1 281

E-9-1-1 ED EMS OR 281

EMergucate

JUNE 18, 2019

An 86 year old diabetic man presents to ED with a 1 month history of diarrhoea and fatigue and intermittent upper abdominal pain over the last week. His ECG is as below.

ED 130

ED 130

Core EM

JANUARY 25, 2024

Background: The immediate post intubation period in the ED is a critical time for continued patient stabilization. The reality of ever increasing ED volumes and longer boarding times to the ICU makes it imperative for emergency physicians to learn how to manage these critical patients.

ICU 246

ICU Emergency Department Critical Care ALS 246

EMergucate

MARCH 5, 2019

The following ECG is from a 55 year old male who presented to the ED after experiencing on-going left sided … Continue reading →

ED 130

ED EMS 130

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. The SGEM has done two previous podcasts on APPs in the ED. Date: February 17, 2023 Reference: Gettel et al.

Emergency Department 130

Emergency Department ALS ED EMS 130

The Skeptics' Guide to EM

MAY 2, 2020

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? July 2019 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia.

ED 100

ED Ambulance Medical Transportation EMS 100

EMergucate

MARCH 5, 2019

The following ECG is from a 55 year old male who presented to the ED after experiencing on-going left sided … Continue reading →

ED 130

ED STEMI EMS 130

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

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. Epub 2019 Aug 6. References Neurology. 4th Edition. Stuttgart: Thieme; 2003. doi:10.1055/b-005-148905 Zayia LC, Tadi P. Neuroanatomy, Motor Neuron.

Emergency Department 162

Emergency Department ED OR ALS 162

REBEL EM

JANUARY 23, 2023

Moreover, the FDA approved intravenous (IV) cetirizine to treat acute urticaria in 2019. 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 Article: Abella BS et al. in the IV cetirizine group and 2.1

Allergic Reaction 52

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

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 66

ED Emergency Department ALS Paramedic 66

Pulsara

FEBRUARY 1, 2024

January Recap With four trade shows — NAEMSP, Florida Fire Conference, Arrowhead EMS Conference, and the MHCA Statewide Symposium — under our belts, January 2024 was our busiest January since 2019! Pictured: Brandon Means, Kate Leatherby, and Tim Hakamaki set up the booth at NAEMSP. Download the case study here.

Emergency Medical Services 94

Emergency Medical Services ED EMS 94

ALiEM

FEBRUARY 20, 2024

2019 Oct;37(10):1989.e1-1989.e3. Epub 2019 Jul 21. Successful treatment of flecainide-induced cardiac arrest with extracorporeal membrane oxygenation in the ED. Cardiovasc Toxicol. 2017 Jul;17(3):260-266. PMID: 27435408. Wilgenhof A, Michiels V, Cosyns B. An irregular, extremely broad QRS complex rhythm. Am J Emerg Med.

Life Support 183

Life Support Overdose ED 183

ALiEM

OCTOBER 4, 2023

2019 Aug;9(4):337-342. 2019 Oct;123(4):457-463. Epub 2019 Jun 24. Read More in the Series References Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson JL. Chemical terrorism. Romano JA Jr, Newmark J. Harrison’s Principles of Internal Medicine, 21e. McGraw Hill. Therapy for acute nerve agent poisoning: An update.

Plasma 195

Plasma OR ED 195

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

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. 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

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. References Coleman-Satterfield, TT.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

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. JAMA 2011).

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

FEBRUARY 16, 2019

Date: February 15th, 2019 Reference: Gottileb, Holladay and Peksa. AEM January 2019. Date: February 15th, 2019 Reference: Gottileb, Holladay and Peksa. AEM January 2019. Case: A 54-year-old diabetic female presents to your emergency department (ED) complaining of floaters of flashing lights and blurry vision.

ED 130

ED Emergency Department OR 130

ALiEM

NOVEMBER 15, 2023

McGraw Hill; 2019. McGraw Hill; 2019. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Goldfrank’s Toxicologic Emergencies, 11e. Accessed August 20, 2023. Nitrites (Amyl and Sodium) and Sodium Thiosulfate. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Malashock H.

OR 169

OR ED 169

ALiEM

MARCH 7, 2024

Ann Emer Med , 2005 [7] Prospective, blinded, observational study performed in the pediatric ED, 3 month period N=44, < 2 years of age Created a bladder urinary index by multiplying the AP and transverse bladder diameters. Author, Title, Journal, Publication Year Study Type, Location, Time Frame N, Ages Summary Milling et al., Chen et al.,

E-9-1-1 177

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

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. Reference: Daley et al.

Emergency Department 130

Emergency Department ALS ED 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

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 82

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

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. 2019 Jan;22(1):147-156. Good correlation to bed scale weight in trauma patients (Pearson coefficient 0.86), but there was some error in the highest weight category. x exp[0.02 2016;23(1):21-28. doi:10.1111/acem.12854

E-9-1-1 269

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

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

FEBRUARY 26, 2022

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 visits in the US for mental health conditions has increased by 44% from 2006 to 2014. Reference: Kim et al.

ED 130

ED ALS Emergency Department OR 130

ALiEM

APRIL 12, 2023

20 – Local Anesthetics, Ed(s): Hugh C. Egan, Pharmacology and Physiology for Anesthesia (Second Edition), Elsevier, 2019, Pages 390-411, ISBN 9780323481106. 2022 Jan 6;8(1):42. doi: 10.3390/gels8010042. PMID: 35049577 ; PMCID: PMC8774352 Suzuko S, Peter G, Philipp L. Hemmings, Talmage D. DOI: 10.1016/B978-0-323-48110-6.00020-X R.

Emergency Department 258

Emergency Department ALS ED 258

Pediatric EM Morsels

JULY 26, 2024

It is commonly missed during the first few ED visits. Keep a high index of suspicion for anti-NMDAr encephalitis in children and adolescents who have had multiple ED visits for new and worsening psych/behavioral concerns, seizures, and/or movement disorders over several months. Epub 2019 Dec 19. Serum AND CSF antibody titers!

Plasma 269

Plasma OR ED Critical Care 269

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

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). She arrives in the emergency department (ED) with decreased level of consciousness and shock.

EMR 130

EMR Coronary Defibrillator Life Support 130

Core EM

OCTOBER 16, 2024

In: Marx J, ed. In: Wolfson A, ed. Br J Haematol. 2009 Nov;147(4):431-43. link] Emery, M. Blood and blood components. Rosen’s emergency medicine. Philadelphia, PA: Elsevier; 2014:75-80. Transfusion Reactions and Complications. Harwood-Nuss’ Clinical Practice of Emergency Medicine. Hirayama F. Blood , 113 (15), 3406–3417.

Allergic Reaction 145

Allergic Reaction Plasma ED Epinephrine 145

EMDocs

DECEMBER 19, 2023

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

First Aid 92

First Aid ED OR ALS 92

Dr. Smith's ECG Blog

MAY 3, 2024

But this time the Queen gets it wrong (thinks it is not OMI): There were runs of VT: Tha patient arrived in profound shock and had an ED ECG: Now there is some evolution to include the ST elevation (rather than ST depression) in V4-V6. Figure-1: I've labeled the initial EMS ECG and the 1st 12-lead tracing done on arrival in the ED.

ACS 117

ACS ED Coronary EMS 117

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

Pediatric EM Morsels

OCTOBER 6, 2023

Recently, a pediatric patient presented to the ED who just returned from abroad with a gastroenteritis presentation. Banerjee 2018, Rohilla 2019) Moral of the Morsel “ Ken-ya tell me if you recently travelled?” 2019 Apr;19(4):369-381. 2019 Jul;25(7):1082-1088. 2019 Apr-Jun; 11(2): 164–170.

OR 161

OR EMS ED 161

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

ALiEM

JUNE 15, 2023

Goldfrank’s Toxicologic Emergencies, 11e New York, NY: McGraw-Hill; 2019 Morimoto M, Tatsumi K, Yuui K, et al. Invasive Plant Atlas of the United States. Retrieved Jun 5, 2023. Nelson LS, Goldfrank LR. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS.

ALS 246

ALS ED OR 246