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. He is also one of the world’s leading researchers on pain management in the emergency department, specifically the use of ketamine.

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Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

OCTOBER 14, 2023

Case: A 5-year-old boy presents to the emergency department (ED) with his parents for fever and fatigue. Time to change the reference ranges of children’s physiological observations in emergency care? He has had three days of high fevers at home. A prospective study. J Paediatr Child Health.

Life Support 217

Life Support Advanced Life Support Emergency Department ALS 217

Pediatric EM Morsels

OCTOBER 27, 2023

DeBoer 2020] Now seen as industry standard in pediatric emergency care. Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. K 2020] In Mexican children, the Broselow differed from actual weight by <10% in 46-64% of patients. Int J Emerg Med.

E-9-1-1 269

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

The Skeptics' Guide to EM

JULY 8, 2023

Case: A 57-year-old woman with hypertension, hyperlipidemia and type-2 diabetes mellitus presents to the emergency department (ED) with fever, cough, myalgias, headache and congestion. There was a large unblinded RCT of over 3,000 patients published in the Lancet in 2020.

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ALS Emergency Department EMS ED 233

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. AEM […] The post SGEM#295: Teacher Teacher – Tell Me How to Do It (Diagnose a PE) first appeared on The Skeptics Guide to Emergency Medicine. AEM June 2020. Reference: Westafer et al.

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Emergency Department ED ALS OR 130

The Skeptics' Guide to EM

OCTOBER 1, 2022

Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference. Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. AEM September 2022. AEM September 2022.

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Emergency Department ALS ED OR 130

ALiEM

MARCH 7, 2024

Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Chen et al.,

E-9-1-1 177

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

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.

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ALS ED Emergency Department OR 130

ACEP Now

JUNE 7, 2023

The role of emergency physicians has been made dramatically more important due to the pandemic. 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. Patient volume losses in 2020 reversed in 2021.

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Emergency Department ED EMS Ambulance 52

REBEL EM

JUNE 5, 2023

One study from a county in Massachusetts found that of all nonfatal opioid doses seen in the emergency department from 2011-2015, 1 in 20 patients subsequently died within one year of initial visit with 66% of these deaths being directly related to an opioid overdose (4). PMID 33392580.

Naloxone 98

Naloxone ED Overdose Emergency Department 98

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.

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Emergency Department ED EMS ALS 52

The Skeptics' Guide to EM

JANUARY 18, 2020

Date: January 16th, 2020 Reference: Troponin Testing and Coronary Syndrome in Geriatric Patients With Nonspecific Complaints: Are We Overtesting? AEM January 2020 Guest Skeptics: Dr. James VandenBerg: James has a master’s degree in clinical investigation from Washington University in St. Reference: Wang et al.

ACS 130

ACS Coronary Emergency Department OR 130

The Skeptics' Guide to EM

JULY 29, 2023

Another core element of emergency department (ED) and pre-hospital care is the assessment for potential spinal injuries [1,2]. Clinical Question: How has the rate of pre-hospital spinal immobilization/spinal motion restriction changed from 2009 to 2020? Reference: McDonald et al.

Emergency Medical Services 188

Emergency Medical Services ALS EMS Emergency Department 188

Core EM

JANUARY 25, 2024

Written by: Sadakat Chowdhury MD Edited by: Mak Sarich MD, Jay Lin MD, Jonathan Kobles MD Background: Ultrasound (US) guided nerve blocks offer an applicable option for achieving analgesia in the emergency department. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians.

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Epinephrine ED OR Emergency Department 246

EMDocs

SEPTEMBER 30, 2024

Today’s video evaluates inhaled corticosteroids (ICS) for asthma in the ED setting. EBM Updates: Inhaled Corticosteroids for Asthma in the ED Background : Asthma is a common ED issue, with patient presentations ranging from needing a medication refill to severe exacerbation in respiratory failure.

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ED Emergency Department OR 83

The Skeptics' Guide to EM

APRIL 17, 2021

Anthony Crocco is the Deputy Chief – McMaster Department of Pediatrics, Acting Head of Pediatric Cardiology, and creator of Sketchy EBM. JAMA Nov 2020 Case: A four-year-old girl with a known history of asthma presents to your emergency department (ED) after a one-day history of runny nose and cough.

Emergency Department 130

Emergency Department ALS ED 130

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

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Emergency Department ED OR ALS 135

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.

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Emergency Medical Services EMS STEMI Emergency Department 109

The Skeptics' Guide to EM

FEBRUARY 13, 2021

Dennis Ren is a paediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Pediatrics 2020 Case: A 4-year-old immunized girl presents to the emergency department (ED) with a fever and rhinorrhea for the […] The post SGEM#319: Is it Aseptic Meningitis or More Than This?

OR 130

OR Emergency Department ALS ED 130

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. Future articles will highlight solutions and success stories. Patients with sepsis get antibiotics.

Emergency Department 52

Emergency Department ED Naloxone ALS 52

The Skeptics' Guide to EM

APRIL 25, 2020

Date: April 21st, 2020 Reference: Juergens et al. Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. Date: April 21st, 2020 Reference: Juergens et al. Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke.

Emergency Department 100

Emergency Department ALS ED EMS 100

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. doi: 10.1136/bcr-2020-240532.

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

The Skeptics' Guide to EM

JUNE 6, 2020

Date: June 2nd, 2020 Reference: Permpikul et al. Guest Skeptic: Dr. Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory. Date: June 2nd, 2020 Reference: Permpikul et al. Case: It’s another day in your emergency department (ED).

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EMR ALS ICU Emergency Department 130

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? Date: January 5th, 2021 Reference: Grunau et al.

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EMS Emergency Medical Services CPR Critical Care 130

The Skeptics' Guide to EM

AUGUST 14, 2021

Circulation 2020 Guest Skeptic: Missy Carter is a PA practicing in emergency medicine in the Seattle area and an adjunct faculty member with the Tacoma Community College paramedic program. Date: August 12th, 2021 Reference: Daya et al. Missy is also now the director […] The post SGEM#340: Andale, Andale Get An IO, IO for Adult OHCA?

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The Skeptics' Guide to EM

NOVEMBER 20, 2021

You wonder if any emergency department (ED)-based interventions would help her and people like her be safe. Back then we found that at one academic site older adults attending ED with falls didn’t receive guideline-based assessment, risk stratification or management. There are three other GEAR 1.0

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ALS ED Emergency Department OR 130

ALiEM

JANUARY 12, 2024

A 42-year old Bengali man with a history of hyperlipidemia presented to the Emergency Department with facial swelling, diffuse rash, renal insufficiency and proteinuria after receiving his COVID-19 vaccine (Moderna) booster dose. He was advised to go to the Emergency Department. 2020 Feb 11;38(7):1746-1752.

Emergency Department 130

Emergency Department EMS ED 130

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. While staff exposure to this violence varies, literature shows nurses are most frequently exposed, with up to 90 percent having experienced workplace violence in their ED careers.

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Emergency Department Emergency Response ED ALS 52

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.

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The Skeptics' Guide to EM

JANUARY 23, 2021

Emergency Physician and Advanced Practice Provider Diagnostic Testing and Admission Decisions in Chest Pain and Abdominal Pain. AEM January 2021 Case: A 50-year-old male presents to the Emergency Department (ED) with left lower quadrant abdominal pain. The patient is seen by an advanced practice provider (APP).

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ED ALS Emergency Department OR 130

Core EM

MARCH 1, 2024

Mumenthaler M , Mattle H , Taub E , ed. 2020:952–9. Goldfrank’s Toxicologic Emergencies, 11e. The Clinical Presentations of Nitrous Oxide Users in an Emergency Department. 2020 May 15;412:116778. Epub 2020 Mar 19. References Neurology. 4th Edition. Stuttgart: Thieme; 2003. Updated 2023 Jul 24].

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Emergency Department ED OR ALS 162

ACEP Now

MAY 9, 2024

Complications of Gluteal AFT The pale, prone patient with multiple surgical drains and a constrictive faja has become a common site in the Jackson Memorial Hospital Emergency Department. Nearly half of all post-AFT patients presenting to our emergency departments required admission and six percent required ICU admission.

Emergency Department 52

Emergency Department Operating Room Critical Care ALS 52

The Skeptics' Guide to EM

JANUARY 16, 2021

Annals of EM 2020 Guest Skeptic: Dr. Will Flanary is an ophthalmologist, writer, and comedian who moonlights in his free time as “Dr. Glaucomflecken” on Twitter and […] The post SGEM#315: Comfortably Numb with Topical Tetracaine for Corneal Abrasions first appeared on The Skeptics Guide to Emergency Medicine.

ALS 130

ALS Emergency Department EMS ED 130

The Skeptics' Guide to EM

JULY 30, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 63-year-old woman presents to your emergency department (ED) with two-day history of nausea, vomiting and constipation. She is also the creator of all those wonderful Paper in a Pictures. sensitivity and 96.6%

ALS 130

ALS ED Emergency Department EMS 130

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Guest Skeptic: Dr. Neil Dasgupta is an emergency physician and ED intensivist from Long Island, NY, and currently an assistant clinical professor and Director of Emergency Critical Care […] The post SGEM#350: How Did I Get Epi Alone? JAMA Sept 2021.

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Epinephrine Critical Care Emergency Department Life Support 100

The Skeptics' Guide to EM

DECEMBER 5, 2020

Date: November 30th, 2020 Reference: Ohle R et al. Can Emergency Physicians Accurately Rule Out a Central Cause of Vertigo Using the HINTS Examination? AEM 2020 Guest Skeptic: Dr. Mary McLean is an Assistant Program Director at St. John’s Riverside Hospital Emergency Medicine Residency in Yonkers, New York.

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ALS Emergency Department ED OR 100

EM Literature of Note

SEPTEMBER 13, 2024

These are each awful, of course, in their own way from a patient- and parent-oriented standpoint, but they’re also quite awful at the population level, overburdening limited pediatric and emergency department resources. The two “COVID seasons” of 2020-21 and 2021-22 were excluded from their comparisons.

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Emergency Department ED 85