The Skeptics' Guide to EM

NOVEMBER 20, 2021

Date: November 16th, 2021 Reference: Hammouda et al. AEM November 2021 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: November 16th, 2021 Reference: Hammouda et al.

ALS 130

ALS ED Emergency Department OR 130

EMDocs

JULY 17, 2023

and is poorly tolerated by patients with obstruction, it should not be a routine part of the ED evaluation for LBO unless it is critical for another diagnosis on the differential. Published 2021 Apr 22. doi:10.3390/cancers13092025 Pisano M, Zorcolo L, Merli C, et al. 2021.03.001 Bauman BD, Witt JE, Vakayil V, et al.

E-9-1-1 76

E-9-1-1 ED Operating Room ALS 76

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

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Date: September 8th, 2021 Reference: Desch et al. He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP).

EMR 130

EMR Coronary Defibrillator Life Support 130

The Skeptics' Guide to EM

FEBRUARY 27, 2021

Date: February 18th, 2021 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Reference: Brichko et al. Date: February 18th, 2021 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. AEM Feb 2021.

Emergency Department 130

Emergency Department ACS ALS ED 130

The Skeptics' Guide to EM

OCTOBER 3, 2021

Date: September 28th, 2021 Reference: Zampieri et al. Date: September 28th, 2021 Reference: Zampieri et al. Some bench work, observational studies, and now two large, unblinded, cluster-randomized single-center trials ( SMART and SALT-ED ) suggested a benefit to using balanced crystalloids (i.e.

OR 130

OR Critical Care ICU Plasma 130

The Skeptics' Guide to EM

AUGUST 24, 2024

Date: August 19, 2024 Reference: Partyka et al. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. The evidence was not robust enough back in 2021 to confidently use this potential tool. Reference: Partyka et al. We have covered rib fractures twice on the SGEM.

Emergency Department 129

Emergency Department ALS OR ED 129

The Skeptics' Guide to EM

JANUARY 23, 2021

Date: January 20th, 2021 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Reference: Pines et al. AEM January 2021 Case: A 50-year-old male presents to the Emergency Department (ED) with left lower quadrant abdominal pain.

ED 130

ED ALS Emergency Department OR 130

The Skeptics' Guide to EM

JULY 17, 2021

Date: July 14th, 2021 Reference: Pernica et al. Date: July 14th, 2021 Reference: Pernica et al. Case: Six-year-old Morten comes into your emergency department (ED) with what looks like pneumonia. This is because most pneumonias in this age-group are caused by viral pathogens ( Bradley et al 2011 ).

ALS 130

ALS Emergency Department ED 130

ALiEM

MARCH 7, 2024

Transvere ultrasound views of the bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.) Sagittal view of bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.)

E-9-1-1 177

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

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%

Emergency Department 81

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

The Skeptics' Guide to EM

JANUARY 8, 2022

Date: December 28th, 2021 Reference: Kulvatunyou et al. November 2021. Date: December 28th, 2021 Reference: Kulvatunyou et al. November 2021. Case: A 43-year-old male presents to your emergency department (ED) the day after being involved in an all-terrain vehicle (ATV) accident. November 2021.

ALS 130

ALS Emergency Department Paramedic OR 130

Core EM

JULY 23, 2024

2021, [link]. 2021, [link] Shen, J, et al. 2020, [link] Shen, J, et al. Sci Rep 11, 6162 (2021). MIT News | Massachusetts Institute of Technology, [link] Centers for Disease Control and Prevention, Centers for Disease Control and Prevention. Radiation Emergencies. Hryhorczuk D, Theobald JL. Radiation injuries.

ALS 130

ALS OR Emergency Department ED 130

The Skeptics' Guide to EM

APRIL 2, 2022

Date: March 31st, 2022 Reference: Butt et al. Date: March 31st, 2022 Reference: Butt et al. Lauren won the 2021 SAEM FOAMed Excellence in Education Award. Case: A 15-year-old male presents to the pediatric emergency department (ED) with right ankle pain sustained while twisting his ankle during dance practice.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

AUGUST 21, 2021

Date: August 19th, 2021 Reference: Pantell et al. Pediatrics 2021 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Date: August 19th, 2021 Reference: Pantell et al. Evaluation and management of well-appearing febrile infants 8 to 60 days old.

Emergency Department 130

Emergency Department ALS OR ED 130

The Skeptics' Guide to EM

APRIL 17, 2021

Date: April 16th, 2021 Guest Skeptic: Dr. Anthony Crocco is the Deputy Chief – McMaster Department of Pediatrics, Acting Head of Pediatric Cardiology, and creator of Sketchy EBM. Reference: Schuh et al. Reference: Schuh et al. Background: Asthma is a common presenting complaint for children in the ED.

Emergency Department 130

Emergency Department ALS ED 130

Broome Docs

DECEMBER 9, 2023

Is it a good idea to keep geriatric patients in the ED overnight? Are you being irradiated by the portable Xray machines in your ED? Roussel M, Teissandier D, Yordanov Y, et al. 2021 Jun 15;72(12):2095-2100. PMID: 36755492 Freeman JJ, Asfaw SH, Vatsaas CJ, et al. How good is my intuition about PE diagnosis?

Emergency Department 120

Emergency Department ALS ED 120

EMDocs

NOVEMBER 13, 2024

Major takeaway: Consider SBP in any patient who comes into the ED with ascites. Biggins SW, Angeli P, Garcia-Tsao G, et al. Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology.

E-9-1-1 71

E-9-1-1 ALS OR ED 71

The Skeptics' Guide to EM

JUNE 26, 2021

Date: June 25th, 2021 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Reference: Chinnock et al. Date: June 25th, 2021 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary.

Emergency Department 100

Emergency Department ED ALS OR 100

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Date: November 10th, 2021 Reference: Andersen, et al: Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest. JAMA Sept 2021. JAMA Sept 2021. He had been admitted the night before for a new diagnosis of rapid atrial fibrillation.

Epinephrine 100

Epinephrine Critical Care Emergency Department Life Support 100

ALiEM

JUNE 15, 2023

Goldfrank’s Toxicologic Emergencies, 11e New York, NY: McGraw-Hill; 2019 Morimoto M, Tatsumi K, Yuui K, et al. 2021 Nov;7(6):2440-2444. PMID 29855084 De Silva HA, Fonseka MM, Pathmeswaran A et al. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Vet Med Sci. PMID 34469053 Graeme KA. J Clin Lab Anal.

ALS 246

ALS ED OR 246

The Skeptics' Guide to EM

MARCH 6, 2021

Date: March 4th, 2021 Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at St. Reference: Reuben A et al. Date: March 4th, 2021 Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at St. Reference: Reuben A et al.

ALS 130

ALS Emergency Department EMS ED 130

The Skeptics' Guide to EM

JUNE 5, 2021

Date: May 25th, 2021 Guest Skeptic: Dr. Garreth Debiegun is an emergency physician at Maine Medical Center in Portland, ME and clinical assistant professor with Tufts University School of Medicine. References: * Suzuki et al. JAMA 2021 * Zi et al. He also works at an urgent care and a rural critical access hospital.

ALS 130

ALS Emergency Department ED 130

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

FOAMcast

SEPTEMBER 6, 2023

Apple Podcasts , Spotify , Listen Here Alcohol-related emergency department (ED) visits are common – estimated to be comprise nearly 4% of all ED visits and up to 6% of hospitalizations. Historically, EDs have had little engagement in harm reduction around alcohol use disorder (AUD) and provision of medication for AUD.

Emergency Department 52

Emergency Department ALS ED OR 52

REBEL EM

NOVEMBER 15, 2023

However, data is limited in ED patients. The ED AWARENESS study found a 2.6% “The ED-AWARENESS study: A prospective, observational cohort study of awareness with paralysis in mechanically ventilated patients admitted from the emergency department.” 2021): 532-544. References Pappal, Ryan D.,

Emergency Department 105

Emergency Department ED EMS ALS 105

ALiEM

APRIL 12, 2023

Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. 20 – Local Anesthetics, Ed(s): Hugh C. Disinfectants and Cleaning Solutions for Ultrasound Systems and Transducers [PDF]. Preparation and Evaluation of Polymer-Based Ultrasound Gel and Its Application in Ultrasonography. 2022 Jan 6;8(1):42. doi: 10.3390/gels8010042.

Emergency Department 258

Emergency Department ALS ED 258

The Skeptics' Guide to EM

JUNE 12, 2021

Date: June 11th, 2021 Guest Skeptic: Dr. Dennis Ren is a paediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Reference: McLaren SH, et al. Date: June 11th, 2021 Guest Skeptic: Dr. Dennis Ren is a paediatric emergency medicine fellow at Children’s National Hospital in Washington, DC.

Emergency Department 100

Emergency Department ALS ED OR 100

The Skeptics' Guide to EM

MARCH 12, 2022

Date: March 3rd, 2022 Reference: Macnow et al. JAMA Pediatrics 2021 Guest Skeptic: Dr. Catherine Varner is an Assistant Professor and Clinician Investigator in the Department of Family and Community Medicine at the University of Toronto. Date: March 3rd, 2022 Reference: Macnow et al.

Emergency Department 100

Emergency Department ED ALS OR 100

The Skeptics' Guide to EM

FEBRUARY 13, 2021

Date: February 12th, 2021 Guest Skeptic: Dr. Dennis Ren is a paediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Reference: Mintegi S et al. Date: February 12th, 2021 Guest Skeptic: Dr. Dennis Ren is a paediatric emergency medicine fellow at Children’s National Hospital in Washington, DC.

OR 130

OR Emergency Department ALS ED 130

EMDocs

DECEMBER 19, 2023

In: Marx JA, Hockenberger RS, Biros MH, et al., McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. In: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH. McGraw Hill; 2020.

First Aid 91

First Aid ED OR ALS 91

ALiEM

SEPTEMBER 27, 2023

Hoffman et al. Koppaka V, Thompson DC, Chen Y, et al. Updated 2021 Nov 1]. Encyclopedia of Toxicology (Third Edition), Academic Press. doi: 10.1016/B978-0-12-386454-3.00754-5. Goldfrank L. In: Goldfrank’ s Toxicologic Emergencies. New York, NY. McGraw-Hill. Pharmacol Rev. 2012 Jul;64(3):520-39. PMID: 22544865. Disulfiram.

ALS 169

ALS OR ED 169

The Skeptics' Guide to EM

APRIL 16, 2022

Date: April 16th, 2022 Reference: Blom et al. BMJ 2021 Guest Skeptic: Dr. Matt Schmitz, Pediatric Orthopedics, Adolescent Sports Medicine and Young Adult Hip Preservation Surgeon at San Antonio Military Medical Center in Texas. Date: April 16th, 2022 Reference: Blom et al. Tricoci et al. Reference: Blom et al.

Emergency Department 100

Emergency Department ALS OR ED 100

Core EM

MARCH 12, 2024

2021, [link]. 2021, [link] Shen, J, et al. 2020, [link] Shen, J, et al. Sci Rep 11, 6162 (2021). MIT News | Massachusetts Institute of Technology, [link] Centers for Disease Control and Prevention, Centers for Disease Control and Prevention. Radiation Emergencies. Hryhorczuk D, Theobald JL. Radiation injuries.

ALS 130

ALS OR Emergency Department ED 130

The Skeptics' Guide to EM

SEPTEMBER 4, 2021

Date: August 31st, 2021 Reference: McLean et al. AEM Sept 2021 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Date: August 31st, 2021 Reference: McLean et al. AEM Sept 2021 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: McLean et al.

Emergency Department 100

Emergency Department ALS OR ED 100

ALiEM

NOVEMBER 29, 2023

Published 2021 Sep 17. PMID: 34529640 Ayub S, Parnia S, Poddar K, et al. PMID: 24769343 Ehrman-Dupre R, Kaigh C, Salzman M et al. PMID: 36148197 Love JS, Levine M, Aldy K, et al. PMID: 37014353 Ball NS, Knable BM, Relich TA et al. How do you treat xylazine toxicity? MMWR Morb Mortal Wkly Rep. 2023;15(3):e36864.

Naloxone 169

Naloxone Overdose ALS Epinephrine 169

The Skeptics' Guide to EM

AUGUST 14, 2021

Date: August 12th, 2021 Reference: Daya et al. Date: August 12th, 2021 Reference: Daya et al. This was a critical appraisal of an observational study published in Annals of EM ( Kawano et al 2018 ). Reference: Daya et al. first appeared on The Skeptics Guide to Emergency Medicine.

CPR 130

CPR BLS ALS Paramedic 130