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-9-1-1 258

E-9-1-1 ED EMS OR 258

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

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

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

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

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

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 89

Emergency Medical Services ED EMS 89

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

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

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

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

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

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 265

Plasma OR ED Critical Care 265

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

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

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

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-9-1-1 268

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

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

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

The Skeptics' Guide to EM

FEBRUARY 8, 2020

Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. 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.

Emergency Department 130

Emergency Department Critical Care ALS EMS 130

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

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

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). The Cochrane database of systematic reviews, 2019(10), CD002312. Br J Radiol. 2000;73(871):786-790.

E-9-1-1 183

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

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

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

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

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. Date: April 21st, 2020 Reference: Juergens et al. Date: April 21st, 2020 Reference: Juergens et al.

Emergency Department 100

Emergency Department ALS ED EMS 100

The Skeptics' Guide to EM

JUNE 6, 2020

Respir Crit Care Med 2019. 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. Date: June 2nd, 2020 Reference: Permpikul et al.

EMR 130

EMR ALS ICU Emergency Department 130

EMS 12-Lead

AUGUST 14, 2022

The ST changes went overlooked by both the ED physician and the on-call cardiologist, and the patient was subsequently admitted to telemetry. It was present only minimally in this case, and I can’t say with certainty if said unimpressive manifestation had any decision making influence during ED admission.

STEMI 130

STEMI MICU CAD Coronary 130

The Skeptics' Guide to EM

MARCH 22, 2019

Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia. Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia. Research by Hill et al (1) demonstrated that an ED shift can have 4,000 clicks.

EMR 130

EMR Emergency Department Ambulance ED 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. You arrive to find the patient awake and alert, with a facial droop, slurred speech and left-sided arm drift (FAST-ED score = 3). He has a history of hypertension.

Ambulance 130

Ambulance Paramedic EMS ALS 130

EMDocs

FEBRUARY 12, 2024

As the only respiratory therapist in the ED has been paged and is starting BiPAP for this patient, an overhead call for two incoming trauma alerts from a multivehicle collision sounds. Because the RT responsible for drawing arterial blood gases is busy caring for these patients, ABGs will be delayed.

Emergency Department 94

Emergency Department E-9-1-1 ED ICU 94

The Skeptics' Guide to EM

MARCH 20, 2021

Another study showed less than 10% of PE patients are discharged home from the ED for out-patient therapy ( Vinson et al 2017 ). A couple of international guidelines support the outpatient treatment of ED patients with low-risk PE.

ALS 130

ALS ED 130

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