Core EM

JANUARY 25, 2024

A quick primer on hypocalcemia in the ED. UpToDate; Jul 17, 2020. Pfenning CL, Slovis CM: Electrolyte Disorders; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. Diagnosis and management of hypocalcaemia. BMJ 2008; 336:1298. Desai TK, Carlson RW, Geheb MA.

Critical Care 246

Critical Care ED ALS OR 246

Emergency Medicine Cases

FEBRUARY 11, 2020

The current outbreak of the novel respiratory pathogen Coronavirus is an opportunity to remind ourselves of how to properly and adequately prepare for an emergency outbreak in our EDs. The post Preparation for Emergency Infectious Outbreak in your ED – Coronavirus appeared first on Emergency Medicine Cases.

ED 130

ED EMS 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

The Skeptics' Guide to EM

FEBRUARY 13, 2021

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? Reference: Mintegi S et al. Clinical Prediction Rule for Distinguishing Bacterial from Aseptic Meningitis. Reference: Mintegi S et al.

OR 130

OR Emergency Department ALS ED 130

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

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Cardiology consult note written around that time documents that "Pain improved with NTG, morphine in ED but still present." Smith comment: But the tests (ECG and troponin) are extremely specific and so the post test probability is nearly 100%. Repeat cTnI drawn at around 8 AM was 3.910 ng/mL. This patient was not one of the lucky 6.4%

E-9-1-1 122

E-9-1-1 OR Coronary ACS 122

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. amiodarone or lidocaine).

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

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

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Both cases had an EMS ECG that was transmitted to the ED physician asking "should we activate the cath lab?" On arrival to the ED, while waiting for cath lab team, he obtained another ECG: You can now see the full voltage of the high-voltage QRS, likely with some degree of LVH. Both were awake and alert with normal vital signs.

OR 120

OR STEMI EMS ED 120

The Skeptics' Guide to EM

DECEMBER 21, 2019

Outside of his academic duties, he works clinically in the adult ED at Spectrum Health in Grand Rapids, Michigan, the tertiary care center for Western Michigan. It will be covered as an SGEM Xtra in 2020. Dr. Joshua Reynolds is […] The post SGEM Xtra: NNT – WET or DRI first appeared on The Skeptics Guide to Emergency Medicine.

OR 100

OR ALS ED 100

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.

ED 65

ED Emergency Department ALS Paramedic 65

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. She denied trauma to the hand or finger. EJVES Short Rep.

Emergency Department 306

Emergency Department ED OR 306

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. Pressure: OD (21), OS (16). Meckler, G.

ED 161

ED OR 161

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

Pediatric EM Morsels

JULY 26, 2024

It is commonly missed during the first few ED visits. Keep a high index of suspicion for anti-NMDAr encephalitis in children and adolescents who have had multiple ED visits for new and worsening psych/behavioral concerns, seizures, and/or movement disorders over several months. 2020 Feb;75:55-62. doi: 10.1016/j.seizure.2019.12.016.

Plasma 269

Plasma OR ED Critical Care 269

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

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.

ALS 130

ALS ED Emergency Department OR 130

The Skeptics' Guide to EM

JUNE 20, 2020

Date: June 14th, 2020 Guest Skeptic: Dr. Dennis Ren is a Pediatric Emergency Medicine fellow at Children’s National Hospital in Washington, DC. Date: June 14th, 2020 Guest Skeptic: Dr. Dennis Ren is a Pediatric Emergency Medicine fellow at Children’s National Hospital in Washington, DC. Reference: Kuppermann et al. JAMA Pediatr.

OR 100

OR Emergency Department ALS ED 100

EMDocs

JUNE 3, 2023

The nuances of fracture patterns and delineating mechanically unstable pelvic fractures from stable ones is less important to the ED. Her initial vital signs are blood pressure 76/54 mmHg, heart rate 128 bpm, temperature 37.0˚ C, respiratory rate 20 breaths per minute, and oxygen saturation 95% on room air. of pelvic fractures to be open.

ED 54

ED Operating Room ALS Frozen Plasma 54

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

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

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

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

Pediatric EM Morsels

AUGUST 9, 2024

2019, there were 1,875 and this trend has continued to increase (2,157 case in 2020; 2,855 cases in 2021). Neonates presenting to the Emergency Department often cause a lot of uncertainty. Is this scalp swelling normal? Is this bloody stool concerning? Are this odd movements part of normal development? Is that umbilical area ok or concerning?

E-9-1-1 152

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

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

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 Article: Abella BS et al. Patients were randomized in a 1:1 ratio. The mean time spent at a treatment center in hours was 1.7

Allergic Reaction 52

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

Core EM

JULY 23, 2024

Author: Mallika Singh, MD Editor: Jonathan Kobles, MD Background Unintentional or intentional exposure to radiological material represents a potential threat to human health on the individual to mass-casualty scale. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. 10-Hour Flight: 0.03

ALS 130

ALS OR Emergency Department ED 130

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. Came out in 1986. x exp[0.02

E-9-1-1 269

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

ALiEM

JUNE 5, 2023

ED providers are only exposed in these cases if they have direct contact with drainage from open wounds while not using PPE or there is concern for aerosolization of spores For inhalational anthrax exposure, AVA should be given in combination with antimicrobials (ciprofloxacin or doxycycline) for 60 days. Is cutaneous anthrax reportable? [6,

ALS 256

ALS OR ED 256

Core EM

MARCH 1, 2024

Mumenthaler M , Mattle H , Taub E , ed. 2020:952–9. Significance of the Inverted V Sign : This MRI sign is pathognomonic for subacute combined degeneration, indicating it is a distinct marker for this condition. Once symptoms start to improve, the frequency of injections can be reduced to once a week. References Neurology. 4th Edition.

Emergency Department 162

Emergency Department ED OR ALS 162

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

Core EM

JANUARY 25, 2024

1 2 3 4 This article will focus on three lower extremity (LE) nerve blocks commonly used for acute lower extremity pain in the ED. 1 2 3 4 This article will focus on three lower extremity (LE) nerve blocks commonly used for acute lower extremity pain in the ED. Published June 2020. J Emerg Trauma Shock. 2012;5(1):28-32.

Epinephrine 246

Epinephrine ED OR Emergency Department 246

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

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. first appeared on The Skeptics Guide to Emergency Medicine. Date: August 12th, 2021 Reference: Daya et al.

CPR 130

CPR BLS ALS Paramedic 130

REBEL EM

OCTOBER 2, 2023

One solution to decrease ICU admission is to treat these patients in the ED until their anion gap is closed and the patient can be transitioned from IV insulin infusion to SQ insulin. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. Paper: Griffey RT et al. Acad Emerg Med 2023.

ICU 105

ICU ED ALS OR 105

ALiEM

SEPTEMBER 27, 2023

2020 Feb 21;64(3): e02167-19. Disulfiram-like reaction with ethanol consumption Coprinus atramentarius or Ink Cap mushroom is well known to cause a disulfiram-like reaction when it is consumed prior to ethanol. This results in significant nausea and vomiting and can lead to tachycardia and hypotension. doi: 10.1016/B978-0-12-386454-3.00754-5.

ALS 169

ALS OR ED 169