ALiEM

AUGUST 26, 2024

A 27-year-old male with no past medical history presents to the Emergency Department with right eye pain. Iridodialysis Traumatic iridodialysis is an uncommon ocular emergency with very distinct findings that we can encounter in the Emergency Department. In The Atlas of Emergency Medicine (p. Agarwal, D.,

Emergency Department 177

Emergency Department OR 177

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. In May 2022, Holly and Joe, two students on the joint QMUL and DFTB PEM MSc , created video presentations on human factors. We’ve incorporated some of our favourite elements from their presentations in this blog post. Take a break.

Emergency Department 91

Emergency Department ED CPR OR 91

Pediatric EM Morsels

JULY 21, 2023

We use the GCS score in both trauma and medical patients, but where did this score come from? When is it useful and what does it tell us? Is it actually validated in children, like the Ottawa Ankle Rules or are we using a tool for something other than that for which it was designed and validated, like using Kocher criteria for knee and ankle joints?

Critical Care 246

Critical Care ALS OR Life Support 246

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.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

JUNE 20, 2020

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? first appeared on The Skeptics Guide to Emergency Medicine. Febrile infants commonly present to the emergency department. JAMA Pediatr.

OR 100

OR Emergency Department ALS ED 100

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. His fever was 103°F this morning and he received ibuprofen. He has also had abdominal and back pain. Warm gel helps with the child’s comfort. Use a linear high frequency probe.

E-9-1-1 246

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

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

Emergency Department 130

Emergency Department ALS 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. AEM October 2019. The Effect of Financial Incentives on Patient Decisions to Undergo Low-value Head Computed Tomography Scans. He had no pain, nausea, or neurologic symptoms.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

FEBRUARY 18, 2023

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. Date: February 17, 2023 Reference: Gettel et al.

Emergency Department 130

Emergency Department ALS ED EMS 130

ALiEM

MARCH 7, 2024

The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Her mother denies any fevers, upper respiratory symptoms, sore throat, or diarrhea. She adds that her daughter has complained of 2-3 episodes of dysuria and gross hematuria over the last few days. Lay the patient supine when possible.

E-9-1-1 177

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

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245

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. The Bougie and First-Pass Success in the Emergency Department.

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. DISCLAIMER: THE VIEWS AND OPINIONS OF THIS PODCAST DO NOT […] The post SGEM#258: REBOA, Re-Re-Re-REBOA first appeared on The Skeptics Guide to Emergency Medicine.

ACS 130

ACS Emergency Department ALS OR 130

The Skeptics' Guide to EM

JANUARY 11, 2020

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. 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.

Emergency Department 130

Emergency Department ALS EMS OR 130

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. Critical Care Medicine. Critical Care Medicine.

ICU 130

ICU Critical Care ALS Emergency Department 130

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 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?

Emergency Department 130

Emergency Department EMS 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. 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. Significance of the Inverted V Sign : This MRI sign is pathognomonic for subacute combined degeneration, indicating it is a distinct marker for this condition. 2020:952–9.

Emergency Department 162

Emergency Department ED OR ALS 162

The Skeptics' Guide to EM

DECEMBER 30, 2018

It is time to reflect upon 2018 and look forward to 2019. Last year we named 2017 the year of FeminEM and celebrated 15 amazing women in emergency medicine. This year I am going to highlight five of […] The post SGEM Xtra: Auld Lang Five first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 130

Emergency Department EMS 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. Despite the work of ED and hospital leaders to reduce this time interval, Boarding Times had been stuck at around 120 minutes from 2013 to 2019.

Emergency Department 52

Emergency Department ED EMS ALS 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

The Skeptics' Guide to EM

NOVEMBER 9, 2019

Date: November 2nd, 2019 Reference: Lee and Yun. Diagnostic Performance of Emergency Physician-Performed Point-of-Care Ultrasonography for Acute Appendicitis: A Meta-Analysis. Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals.

Emergency Department 130

Emergency Department EMS OR 130

The Skeptics' Guide to EM

JANUARY 19, 2019

Date: January 17th , 2019 Reference: Clemency et al. Date: January 17th , 2019 Reference: Clemency et al. He is alert and oriented times three with normal vital signs by the time he arrives in the emergency department. 1] Two-thirds of the all the drug overdoses in the US in 2016 (63,632) involved an opioid (42,249).

Naloxone 130

Naloxone Overdose Emergency Medical Services Emergency Department 130

The Skeptics' Guide to EM

MARCH 2, 2019

Date: February 26th, 2019 Reference: Benger et al. JAMA 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the Seattle area and an adjunct faculty […] The post SGEM#247: Supraglottic Airways Gonna Save You for an OHCA?

CPR 130

CPR Firefighter Paramedic Defibrillator 130

The Skeptics' Guide to EM

JANUARY 12, 2019

Date: January 10th , 2019 Reference: Busse JW et al. JAMA December 2018 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. Date: January 10th , 2019 Reference: Busse JW et al. His twitter handle is @PainFreeED.

Emergency Department 100

Emergency Department ALS OR 100

The Skeptics' Guide to EM

FEBRUARY 16, 2019

Date: February 15th, 2019 Reference: Gottileb, Holladay and Peksa. AEM January 2019. Guest Skeptic: Dr. Daniel Theodoro is an Assistant Professor of Emergency Medicine at Washington University School of Medicine in St. Louis and the Emergency Medicine Point of Care Ultrasound Section Chief. AEM January 2019.

ED 130

ED Emergency Department OR 130

The Skeptics' Guide to EM

JULY 18, 2020

Background: Depending on the time of year, fever and cough can be one of the most common presentations seen in the emergency department. However, being an evidence-based medicine enthusiast, you wonder what aspects of the patient’s presentation are going to be truly helpful in making a diagnosis.

ALS 130

ALS Emergency Department OR 130

The Skeptics' Guide to EM

FEBRUARY 22, 2020

Maia Dorsett is an Emergency and EMS Physician at the University of Rochester Medical Center. Bringing value, balance and humanity to the emergency department: The Right Care Top 10 for emergency medicine. Emerg Med J 2019 This is an SGEM Xtra based on a recent publication by Dr. Dorsett and her team.

Emergency Department 130

Emergency Department ALS EMS OR 130

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

She arrives in the emergency department (ED) with decreased level of consciousness and shock. Emergency coronary angiography is reasonable for select (eg, electrically or hemodynamically unstable) adult patients who are comatose after OHCA of suspected cardiac origin but without ST elevation on ECG (Class IIa, LOE B-NR).

EMR 130

EMR Coronary Defibrillator Life Support 130

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Is this scalp swelling normal?

E-9-1-1 152

E-9-1-1 Plasma Emergency Department OR 152

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

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. Click to enlarge.) are caused by a behavioral crisis.

Emergency Department 52

Emergency Department Emergency Response ED ALS 52

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Date: January 28th, 2019 Reference: Chu DK et al. Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. DISCLAIMER: THE […] The post SGEM#243: Enough is Enough (O2 Saturation of 94-96%) first appeared on The Skeptics Guide to Emergency Medicine. The Lancet 2018. The Lancet 2018.

Life Support 130

Life Support ALS STEMI Emergency Department 130

The Skeptics' Guide to EM

NOVEMBER 30, 2019

Date: November 13th, 2019 Reference: van der Pol et al. NEJM 2019 Guest Skeptic: Dr. Theresa Robertson-Chenier is currently an Emergency Physician practicing at the Peterborough Regional Health Centre. She is also an adjunct faculty member with Queen’s University, Department of Family Medicine.

Emergency Department 100

Emergency Department ALS OR 100

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. Or Helly Larson describing the first week after her Miami BBL as “absolute hell” to a Vox reporter.

Emergency Department 52

Emergency Department Operating Room Critical Care ALS 52