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.

Emergency Department 52

Emergency Department Emergency Response ED ALS 52

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 82

The Skeptics' Guide to EM

AUGUST 28, 2021

Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. 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?

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ED Emergency Department ALS OR 130

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 ICU 52

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.

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ED Mental Health Services Emergency Department Emergency Medical Services 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.

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Naloxone ED Overdose Emergency Department 98

The Skeptics' Guide to EM

NOVEMBER 21, 2020

Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. The impact of advanced practice provider staffing on emergency department care: productivity, flow, safety, and experience. AEM November 2020.

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Emergency Department ALS ED OR 130

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. Shortly after that, the finger turned purple, so she came to the Emergency Department for evaluation. 2020 Apr;87(4):194. She denied trauma to the hand or finger.

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Emergency Department ED OR 306

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

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.

Emergency Department 85

Emergency Department ED 85

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

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. We don’t want to go backwards!

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ED Emergency Department ALS Paramedic 65

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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Emergency Department ALS ED OR 98

REBEL EM

SEPTEMBER 9, 2024

A newborn boy presents to the emergency department shortly after a home delivery. Post TW, ed. Accessed August 15, 2020. In: Shaw KN, Bachur RG, eds. Fleisher & Ludwig’s Textbook of Pediatric Emergency Medicine. The mother had routine prenatal care and reports that he was due in 2 days. UpToDate Inc.

Emergency Department 59

Emergency Department ED EMS 59

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.

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Life Support Advanced Life Support Emergency Department ALS 221

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

ACEP Now

NOVEMBER 8, 2024

First, research suggests a higher number of emergency department visits among individuals with ASD. About 30 percent of children with ASD need treatment in an emergency department, and this number increases to nearly 70 percent for those aged 15–18. Published August 5, 2020. Accessed October 17, 2024.

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Emergency Department ED OR ALS 52

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.,

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

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 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

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

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

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

REBEL EM

MARCH 11, 2024

A 42-year-old man presents to the emergency department after a motor vehicle collision. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. McGraw-Hill; 2020:(Ch) 89. Rezaie, MD (Twitter/X: @srrezaie ) The post Rosh Review MyEMCert Question appeared first on REBEL EM - Emergency Medicine Blog.

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Emergency Department ED ALS EMS 59

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.

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

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.

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

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.

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Emergency Medical Services ALS EMS Emergency Department 193

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. On arrival in the emergency department, invasive blood pressure was 35/15mmHg and the patient was in profound cardiogenic shock with severe confusion secondary to brain hypoperfusion.

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Coronary ACS Emergency Department Defibrillator 127

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 237

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.

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Emergency Department ALS ED 130

REBEL EM

DECEMBER 5, 2023

The risk of a biphasic reaction is what keeps patients in the ED while being observed for a set period of time. While the evidence is not strong, those who have been undertreated, experienced delays in treatment, or required multiple injections of epinephrine are more prone to experience a recurrence of symptoms ( Ellis 2007 , Liu 2020 ).

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Epinephrine Allergic Reaction Emergency Department Emergency Manager 81

EMDocs

AUGUST 3, 2024

He Was Right Spoon Feed This systematic review found that approximately 4%-27% of patients presenting to the ED with presyncope experienced serious outcomes within a 30-day period. Source Serious outcomes among emergency department patients with presyncope: A systematic review. Acad Emerg Med. Ann Emerg Med.

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Emergency Department ED OR 74

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.

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Emergency Department ALS ED EMS 100

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

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.

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ACS Coronary Emergency Department OR 130

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%

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Emergency Department ALS E-9-1-1 ED 81

ACEP Now

NOVEMBER 7, 2024

Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. Many sought help from EDs, which were not and are not set up to provide involved care for such problems.

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ED Emergency Department ALS OR 59