The Skeptics' Guide to EM

AUGUST 28, 2021

Case: A forty-year-old woman presents to the emergency department […] The post SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED? Case: A forty-year-old woman presents to the emergency department (ED) with a sore lower back after moving some boxes at home over the weekend.

ED 130

ED Emergency Department ALS OR 130

ALiEM

OCTOBER 25, 2024

A 64-year-old male with a history of bipolar 1 disorder, PTSD, anxiety, depression, obsessive-compulsive disorder, GERD, and HTN presented to the ED with the chief complaint of foreign body and self-injury. 2020 Jun 15;101(12):740-747. He reported years of sticking sewing needles into his right arm, most recently yesterday.

ED 177

ED OR 177

EMergucate

JULY 15, 2020

The below ECG is from a 69 year old male who presented to ED with general malaise and fatigue. The patient is has a background of metastatic colon cancer and depression.

ED 130

ED 130

EMergucate

AUGUST 5, 2020

A 50 year old female presents to ED complaining of chest pain. The patient is well known to the department, with frequent presentations with chest pain. Recent MPS shows mild reversible inferior ch…

ED 130

ED 130

EMergucate

AUGUST 4, 2020

A 50 year old female presents to ED complaining of chest pain. The patient is well known to the department, with frequent presentations with chest pain. Recent MPS shows mild reversible inferior ch…

ED 130

ED 130

EMergucate

JUNE 21, 2020

He presents to ED complaining of increasing shortness of breath and leg swelling. The following ECG is from a 52 year old male with a history of bipolar mood disorder and cardiomyopathy. The patie…

ED 130

ED 130

EMergucate

OCTOBER 12, 2020

A 70 year old male presents to ED complaining of shortness of breath. The patient has a history of pulmonary … Continue reading →

ED 130

ED 130

EMergucate

AUGUST 31, 2020

A 80 year old lady presents to ED complaining of chest pain and feeling light headed. Initial ECG taken on … Continue reading →

ED 130

ED 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

EMergucate

NOVEMBER 17, 2020

The ECG below is from a 46 year old lady who has presented to ED at 7pm after experiencing palpitations since 2am that day, but otherwise feels well.

ED 130

ED 130

EMergucate

SEPTEMBER 1, 2020

A 80 year old lady presents to ED complaining of chest pain and feeling light headed Rate: Ventricular rate 42 … Continue reading →

ED 130

ED 130

EMergucate

NOVEMBER 4, 2020

A 53 year old male presents to ED complaining of chest pain. An ECG is done and is presented to … Continue reading →

ED 130

ED EMS 130

EMergucate

JULY 13, 2020

The below ECG is from a 69 year old male who presented to ED with general malaise and fatigue. The patient is has a background of metastatic colon cancer and depression.

ED 100

ED EMS 100

EMergucate

NOVEMBER 17, 2020

The ECG below is from a 46 year old lady who has presented to ED at 7pm after experiencing palpitations since 2am that day, but otherwise feels well.

ED 100

ED 100

REBEL EM

JUNE 5, 2023

These statistics make the ED a crucial treatment initiation point to prevent further morbidity and mortality from opioid overdoses. The benefit of accessibility, availability, and safety of buprenorphine compared to methadone makes it a viable option for opioid use disorder treatment initiation in the ED. PMID 33392580.

Naloxone 98

Naloxone ED Overdose Emergency Department 98

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 65

ED Emergency Department ALS Paramedic 65

REBEL EM

NOVEMBER 21, 2024

A parent presents to the ED with their 6-week-old infant for evaluation of a fever. McGraw Hill; 2020:(Ch) 119. The infant was born full term and has no other symptoms. Physical exam is normal and vital signs are HR is 150 bpm, SpO2 is 99%, and a rectal T is 101.4°F link] Rodriguez DM, Nesiama JAO, Wang VJ.

ALS 59

ALS ED EMS 59

EMergucate

NOVEMBER 1, 2020

A 53 year old male presents to ED complaining of chest pain. An ECG is done and is presented to … Continue reading →

ED 100

ED EMS 100

ALiEM

FEBRUARY 28, 2024

The American Medical Association (AMA) Manual of Style released its 11th edition in 2020. References Iverson C, ed. Oxford University Press, 2020. We also must recognize the important contributions of media such as clinical photographs, radiology images, and ECGs. Video Publications Last Name First Initial. Video Title.

OR 130

OR ED 130

ALiEM

MARCH 15, 2024

A 28-year-old male presented to the ED for evaluation of an injury to his right eye. 2020, March 18). While working out with an exercise band, it snapped back, hitting the patient in the right eye. He experienced blurry vision and excess eye tearing immediately after the incident occurred. References Cline, D., Meckler, G. Thomas, S.

ED 161

ED OR 161

EMergucate

OCTOBER 14, 2020

A 70 year old male presents to ED complaining of shortness of breath. The patient has a history of pulmonary … Continue reading →

ED 100

ED 100

The Skeptics' Guide to EM

MAY 2, 2020

Date: April 24th, 2020 Reference: Watanabe et al. This is Bob’s eleventh visit […] The post SGEM#291: Who’s Gonna Drive you to…the ED – with Lights & Sirens? This is Bob’s eleventh visit […] The post SGEM#291: Who’s Gonna Drive you to…the ED – with Lights & Sirens? Date: April 24th, 2020 Reference: Watanabe et al.

ED 100

ED Ambulance Medical Transportation EMS 100

Core EM

JANUARY 25, 2024

A narrow pulse pressure has been shown to predict the need for hemorrhage control in the ED setting but has not been assessed as a predictor in the prehospital setting. A narrow pulse pressure occurs due to compensatory increased systemic vascular resistance in the setting of decreased cardiac output.

Operating Room 246

Operating Room EMS ED ICU 246

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

ALiEM

MARCH 18, 2024

A 30-year-old female with a past medical history of Crohn’s Disease presented to the ED for evaluation of an acutely bruised right 4th finger. 2020 Apr;87(4):194. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger. EJVES Short Rep. 2018 Jun 27;40:1-2. doi: 10.1016/j.ejvssr.2018.05.008.

Emergency Department 306

Emergency Department ED OR 306

The Skeptics' Guide to EM

NOVEMBER 21, 2020

Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. AEM November 2020. Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. AEM November 2020. AEM November 2020. Reference: Pines et al. Reference: Pines et al.

Emergency Department 130

Emergency Department ALS ED OR 130

REBEL EM

MAY 20, 2024

A 67-year-old woman with a history of atrial fibrillation on apixaban presents to the ED for epistaxis that began 30 minutes ago. Post TW, ed. McGraw Hill; 2020(Ch) 244. McGraw Hill; 2020:(Ch) 239. Her vital signs are within normal limits. How should this patient’s apixaban be managed? UpToDate Inc. link] McGinnis HD.

ALS 59

ALS ED EMS 59

The Skeptics' Guide to EM

DECEMBER 12, 2020

Date: December 10th, 2020 Reference: Ladde et al. AEM December 2020 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). Date: December 10th, 2020 Reference: Ladde et al. Reference: Ladde et al.

ALS 130

ALS ED Emergency Department OR 130

REBEL EM

SEPTEMBER 9, 2024

Post TW, ed. Accessed August 15, 2020. In: Shaw KN, Bachur RG, eds. 100% 21% 30% 50% References Fernandes CJ. Neonatal resuscitation in the delivery room. UpToDate Inc. link] Myers SR, Schinasi DA, Nadel FM. Cardiopulmonary resuscitation. Fleisher & Ludwig’s Textbook of Pediatric Emergency Medicine.

Emergency Department 59

Emergency Department ED EMS 59

The Skeptics' Guide to EM

OCTOBER 10, 2020

Date: October 9th, 2020 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. Date: October 9th, 2020 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City.

Emergency Department 130

Emergency Department ALS ED OR 130

REBEL EM

JANUARY 23, 2023

Ann Emerg Med 2020. 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 Anecdotally, the persistence of urticaria often has little influence on the decision to discharge a patient from the ED.

Allergic Reaction 52

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

Pulsara

JANUARY 25, 2024

With a new protocol and Pulsara, Metropolitan Emergency Medical Services can now transport eligible pediatric behavioral health patients directly to behavioral health facilities—resulting in a 44% decrease of pediatric behavioral health patients transported to the ED. MEMS transports around 77,000 patients each year.

Emergency Medical Services 109

Emergency Medical Services EMS STEMI Emergency Department 109

Core EM

JANUARY 25, 2024

More than 1/3 of geriatric trauma patients presenting to the ED after a fall return to the ED or die within one year of initial evaluation. 4 Elderly patients, who comprise only 8-12% of total ED major trauma cases, represent a disproportionate 15-30% of trauma mortalities and costs. 2020 Sep 15;11:2151459320955087.

ALS 246

ALS ED ICU OR 246

ACEP Now

JULY 11, 2024

Deaths from drinking increased 25 percent from 2019 to 2020 and another 10 percent in 2021. The percentage of suicides while intoxicated with alcohol has increased, particularly among women, and traffic fatalities in 2020 were at their highest point in over a decade. problem drinking has reached a steady state.

Emergency Department 98

Emergency Department ALS ED OR 98

The Skeptics' Guide to EM

JUNE 13, 2020

Date: June 9th, 2020 Guest Skeptic: Dr. Chris Bond is an Emergency Medicine Physician and Assistant Professor at the University of Calgary. Date: June 9th, 2020 Guest Skeptic: Dr. Chris Bond is an Emergency Medicine Physician and Assistant Professor at the University of Calgary. AEM June 2020. Reference: Westafer et al.

Emergency Department 130

Emergency Department ED ALS OR 130

International Journal of Paramedicine

OCTOBER 8, 2024

Background: A comprehensive stroke center (CSC) servicing remote areas in South Florida became HEMS direct-from-field capable on October 15, 2020. Assessment tools utilized by HEMS included the Cincinnati stroke scale (4%) and the FAST-ED (37%); most cases (59%) did not document a stroke assessment tool.

Emergency Medical Services 52

Emergency Medical Services EMS ED 52

ALiEM

JANUARY 8, 2024

She then presented again to the ED with two weeks of worsening shortness of breath, intermittent fevers (Tmax 101°F), nausea/vomiting, fatigue, and arthralgias. 2020 Aug 1;59(8):2161-2163. She underwent a brief admission of six days for shortness of breath but did not have an oxygen requirement at that time. kg/m2; Wt 79.4

ED 152

ED OR 152