Pediatric EM Morsels

SEPTEMBER 22, 2023

McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. McGraw Hill Education; 2019:125-138 Ziu E, Mesfin FB. Spinal shock is a phenomenon of transient, physiologic (rather than anatomic) complete loss of spinal cord function inferior to an injury. It may, however, be seen preceding or concurrently with neurogenic shock.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300

Pediatric EM Morsels

OCTOBER 27, 2023

2019 Jan;22(1):147-156. 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%. Krug 2007] What If the Child is Obese or Emaciated? of children; PAWPER predicted within 10% for 89.2% x exp[0.02

E-9-1-1 269

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

Core EM

JANUARY 25, 2024

link] Published October 28, 2019. EVALUATION: Scan the affected and contralateral body part for comparison with a sterile cover (or Tegaderm) overlying a high frequency linear probe. REFERENCES: Castleberg E, Jenson N, Dinh VA. Diagnosis of necrotizing faciitis with bedside ultrasound: The staff exam. Western Journal of Emergency Medicine.

E-9-1-1 246

E-9-1-1 Emergency Department OR 246

Dr. Smith's ECG Blog

OCTOBER 15, 2024

See this case, where a patient with BTWI morphology and dramatic EKG changes within minutes is diagnosed with myocarditis: [link] com/2019/07/what-does-this- ecg-with-significant-st.html EKG 3 also has a saddleback morphology in V2, which is only rarely due to OMI. Still, such dramatic changes cannot be overlooked.

OR 114

OR STEMI ED Coronary 114

ALiEM

OCTOBER 4, 2023

2019 Aug;9(4):337-342. 2019 Oct;123(4):457-463. Epub 2019 Jun 24. This kit has historically been issued to US service members for treating nerve agent toxicity from agents such as soman, sarin, tabun, and VX, all of which are organophosphates and cause a cholinergic toxidrome. What are nerve agents? [1-3] McGraw Hill.

Plasma 195

Plasma OR ED 195

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

Pediatric EM Morsels

JULY 26, 2024

Epub 2019 Dec 19. While it is important for us to maintain a safe work environment for our patients and our team, managing the agitated patient requires more of us than administering Droperidol or Ketamine. Make sure to consult your friendly neighborhood pediatric neurologist and/or rheumatologist! The prevalence ranges from 12.5%-61%

Plasma 269

Plasma OR ED Critical Care 269

ALiEM

OCTOBER 21, 2024

2019 Aug;276(8):2199-2203. Epub 2019 May 11. This is a case of perichondritis of the auricle, or a bacterial infection of the ear’s cartilage. It often occurs in the setting of trauma, which may be occult. Findings suggestive of perichondritis (versus cellulitis) include sparing of the ear’s lobule. Klug TE, Holm N, Greve T, Ovesen T.

ED 169

ED OR 169

Core EM

JANUARY 25, 2024

2007;33(11):2019-2024. McGraw-Hill Education, New York, 11th edition, 2019. Supplement additional dextrose prn, if hypoglycemia occurs do not stop the insulin, increase the rate of the dextrose drip. Potassium Shifted intracellularly by insulin, total body potassium is normal Replete to goal 3-3.5 Intensive Care Med.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

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

ALiEM

OCTOBER 11, 2024

American Society of Hematology 2019 guidelines for immune thrombocytopenia. 2019 Dec 10;3(23):3829-3866. On the day of presentation, she developed a painful, intermittently bleeding “blood blister” to the left lower cheek that had increased in size, as well as new red spots on her arms and legs. Physical Exam Vitals : 98.3°F;

OR 152

OR ALS 152

REBEL EM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Patients with torso hemorrhage present a clinical conundrum often requiring interventional radiology or surgery, both of which take time to mobilize. 2 Despite these recommendations there are no randomized clinical trials to help guide practice until now.

OR 91

OR Emergency Medical Technician CPR Emergency Medical Services 91

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

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. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM.

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. 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. Critical Care Medicine. Reference: Putzu et al.

ICU 130

ICU Critical Care ALS Emergency Department 130

Core EM

JANUARY 25, 2024

2019 (meta-analysis) Included 12 pediatric and adult studies (n=957 patients; 505 adults and 452 children) Primary outcome: LP success in obtaining CSF Ultrasound guided LP was successful in 90% of patients versus 81.4% Technique: Probe selection: The linear probe is more ideal for pediatric patients and adults with a leaner body habitus.

ALS 246

ALS Critical Care OR 246

ALiEM

JUNE 15, 2023

Goldfrank’s Toxicologic Emergencies, 11e New York, NY: McGraw-Hill; 2019 Morimoto M, Tatsumi K, Yuui K, et al. Lily of the valley ( Convallaria majalis ) is a woodland perennial with a sweet scented, white bell-shaped flower. It blooms from April to June in North America and bears orange-red berries in July [1]. Nelson LS, Goldfrank LR.

ALS 246

ALS ED OR 246

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. Changes in the Management of Children With Brief Resolved Unexplained Events (BRUEs).

CPR 130

CPR ALS OR 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

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. first appeared on The Skeptics Guide to Emergency Medicine. Reference: Belisle et al.

ALS 130

ALS Emergency Department OR 130

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. Reference: Daoust et al.

Emergency Department 130

Emergency Department ALS ED OR 130

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

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

ALiEM

AUGUST 26, 2024

His vision slowly improved though it never normalized. He continued to have pain, so he presented for evaluation. He also reported seeing floaters and denied pain with eye movement, increased light sensitivity, or eye discharge. Additional Images Physical Exam Eyes : Lids without injury. Visual acuity was 20/50 OD, 20/30 OS. References Knoop, K.

Emergency Department 177

Emergency Department OR 177

Pediatric EM Morsels

JULY 7, 2023

Horan, 2006 ] Anatomy of the PTF Joint [ Cunningham, 2019 ] The PTF joint is a synovial joint between the lateral condyle of the tibia and the head of the fibula. Cunningham, 2019 ] Treatment [ Horan, 2006 ] 1st option for Subluxation and Anterolateral Dislocation is Manual Reduction ( similar to reducing that Nursemaid’s Elbow ).

OR 141

OR EMS 141

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. AEM June 2019. Prospective Validation of a Checklist to Predict Short-term Death in Older Patients After Emergency Department Admission in Australia and Ireland. Guest Skeptic:Dr.

Emergency Department 130

Emergency Department ALS OR 130

The Skeptics' Guide to EM

NOVEMBER 9, 2019

Date: November 2nd, 2019 Reference: Lee and Yun. Date: November 2nd, 2019 Reference: Lee and Yun. Diagnostic Performance of Emergency Physician-Performed Point-of-Care Ultrasonography for Acute Appendicitis: A Meta-Analysis. He also hosts a great #FOAMed blog and podcast called TOTAL EM.

Emergency Department 130

Emergency Department EMS 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. The CCHR is the most researched CDR in mTBI [3] and ha.

Emergency Department 130

Emergency Department ALS EMS OR 130

ALiEM

APRIL 12, 2024

The Cochrane database of systematic reviews, 2019(10), CD002312. Obstruction may also occur from clotted blood [9] or pleural effusion loculations [12, 13] within the catheter lumen. The pigtail catheter for pleural drainage: a less invasive alternative to tube thoracostomy. Br J Radiol. 2000;73(871):786-790. doi: [link] Altmann, E.

E-9-1-1 183

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

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

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. 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

JUNE 9, 2023

Specific Therapies for Variceal Hemorrhage : [ Luoto, 2020 ; Castillo, 2019; Garcia-Tsao, 2007 ] Antibiotic prophylaxis (usually for 7 days) Ceftriaxone is reasonable 1st choice. Castillo, 2019 ] Somatostatin (or its analogues, like Octreotide) Guidelines do recommend this… There is great variability in its administration, though.

OR 152

OR EMS Critical Care 152

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

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

JANUARY 11, 2020

NEJM 2019 Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at St. 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. Ubrogepant for the Treatment of Migraine. Joseph’s Hospital in Paterson, NJ.

Emergency Department 130

Emergency Department ALS EMS OR 130

Pediatric EM Morsels

OCTOBER 6, 2023

Forster, 2021) Transmission is by Fecal-Oral route (Chiodini 2018) Incubation period 6-30 days after exposure (Chiodini 2018) Salmonella typhi produces an endotoxin although its clinical significance is not yet well understood (Gibani 2019) Two typhoid vaccines are available for those > 6 m/o and are 50-80% effective. Lancet Infect Dis.

OR 161

OR EMS ED 161