2021 and ED - Paramedicine Now

High sensitivity cardiac troponins for ED chest pain evaluation (2022 ACC pathway)

ALiEM

FEBRUARY 9, 2024

Encourage your ED to set up an algorithm that you can follow based on your laboratory’s assay. Low-risk patients do not routinely require stress testing in the ED. You (or someone in your department) needs to know which assay your ED has, and use the appropriate values for that assay. Otherwise, apply a simplified approach.

E-9-1-1

E-9-1-1 ED Coronary ALS

SAEM Clinical Images Series: Spontaneous Eye Luxation

ALiEM

JANUARY 13, 2025

Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. A 55-year-old female presented with the complaint of my right eye popped out. Available at: [link] (Accessed: 04 January 2024).

Emergency Department

Emergency Department ED ALS OR

Summer Penile Syndrome

Pediatric EM Morsels

SEPTEMBER 8, 2023

McGraw Hill; 2021. J Emerg Med. 2014 Jan;46(1):e21-2. doi: 10.1016/j.jemermed.2013.08.081. 2013.08.081. Epub 2013 Nov 5. PMID: 24199728. Shah A, Sobolewski B, Mittiga MR. Summer Penile Syndrome. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. Accessed September 06, 2023.

EMS

EMS ED OR

TXA (Tranexamic Acid) in Pediatrics

Pediatric EM Morsels

MARCH 7, 2025

TXA has been mentioned previously on PEM Morsels in the following contexts: Post Tonsillectomy Hemorrhage , Hemophilia in the ED , Von Willebrand Disease , Epistaxis in Children , Hereditary Angioedema , Hemoptysis in Children , Hyphema , and even in Neonatal Subgaleal Hemorrhage. of IV form TXA [O’Neill 2020] Inexpensive !

E-9-1-1

E-9-1-1 ALS OR EMS

BPAP vs AVAPS for Hypercapnic Respiratory Failure in the ED

REBEL EM

JULY 1, 2024

Balkan Med J 2021. The AVAPS mode is as effective and safe as BPAP S/T in treating patients with hypercapnic respiratory failure in the ED.” Clinical Take Home Point: I n patients presenting to the ED with hypercapnic respiratory failure, AVAPS did lead to a faster improvement in pH and PaCO2 levels compared to BPAP S/T.

ED

ED Emergency Department ALS OR

Superior Mesenteric Artery Syndrome (SMA Syndrome) in Children

Pediatric EM Morsels

AUGUST 4, 2023

Let’s take a take a minute to review Superior Mesenteric Artery Syndrome presenting in the ED so we will be prepared when you see it! England, 2021) The third portion of the duodenum courses between the SMA and the aorta, which can lead to external compression of the duodenum. England, 2021). Record, 2015).

E-9-1-1

E-9-1-1 ED OR EMS

Pseudoparalysis of Parrot

Pediatric EM Morsels

JANUARY 19, 2024

Now, let’s discuss another complication of “The Great Mimicker” which may throw us for a loop in the ED – Pseudoparalysis of Parrot : Pseudoparalysis of Parrot – Basics First described by Jules Marie Parrot in 1871. In 2021 there were almost 177,000 cases of syphilis. July 22, 2021. The Journal of Pediatrics.

Plasma

Plasma OR EMS ED

SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED?

The Skeptics' Guide to EM

AUGUST 28, 2021

Date: August 27th, 2021 Reference: Gagnon et al. AEM 2021 Guest Skeptic: Dagny Kane-Haas is a physiotherapist who also has a master’s degree in Clinical Science in Manipulative Therapy. Date: August 27th, 2021 Reference: Gagnon et al. first appeared on The Skeptics Guide to Emergency Medicine.

ED

ED Emergency Department ALS OR

EM Journal Update: Prehospital Narrow Pulse Pressure Predicts Need for Resuscitative Thoracotomy and Emergent Intervention After Trauma

Core EM

JANUARY 25, 2024

2021 Background Prehospital trauma team activation criteria allow for prompt mobilization of personnel and resources. 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. Prehospital hypotension is one of those criteria.

Operating Room

Operating Room EMS ED ICU

ECG of the Week – 28 April 2021

EMergucate

APRIL 26, 2021

A 68 year old female presents to ED complaining of chest pain radiating to both arms. Below is the patients … Continue reading →

ED

ECG of the Week 19th May 2021

EMergucate

MAY 16, 2021

A 58 year old male presents to ED complaining of a headache and weakness to his left side. The following … Continue reading →

ED

ECG of the Week 22nd September 2021

EMergucate

SEPTEMBER 22, 2021

A 50 year old male presents to ED after being found in a park. Below is the patients ECG: Describe … Continue reading →

ED

ECG of the Week – 12th May 2021

EMergucate

MAY 11, 2021

3 y/o boy admitted via ED for viral induced wheeze as he was requiring ongoing bronchodilator therapy and supplemental oxygen. … Continue reading →

ED

ECG of the Week 29 December 2021 – Answer

EMergucate

DECEMBER 29, 2021

A 78 year old male presents to ED complaining of chest pain. Below are 2 ECG’s of the patient while he is in ED. He has a PPM and ICD in situ.

ED

ED EMS

ECG of the Week – 20th January 2021

EMergucate

JANUARY 19, 2021

The ECG below has been taken from an 89 year old gentleman who has just transferred from the SJA stretcher to an ED bed. He has a history of prostate cancer and Aortic Stenosis and had an episode o…

ED

Classic EM:

Core EM

JANUARY 25, 2024

The SQuID Protocol (Subcutaneous Insulin in Diabetic Ketoacidosis): Impacts on ED Operational Metrics. Data was collected from August 1, 2021 – February 20, 2022. Potential Impact To Current Practice ED boarding continues to be a major nationwide issue, and ICU bed availability is often limited.

EMS

EMS ICU ED OR

SAEM Clinical Images Series: Back Yard Football Injury

ALiEM

AUGUST 7, 2023

A 10-year-old male with no past medical history presents to the Emergency Department (ED) by EMS for evaluation of an injury sustained while playing tackle football. The patient was forcibly hit by another child against a tree. View other cases from this Clinical Image Series on ALiEM.

Emergency Department

Emergency Department OR EMS ED

ECG of the Week – 6th January 2021 – Answer

EMergucate

JANUARY 6, 2021

An 10 year old male presents to ED post a syncope. Below is the boys ECG: Describe and interpret the … Continue reading →

ED

ECG of the Week – 27th January 2021 – Answer

EMergucate

JANUARY 26, 2021

A 56 year old male presents to ED after a syncope Describe and interpret the ECG Answer Rate – 54 … Continue reading →

ED

ED EMS

ECG of the Week – 10th February 2021 – Interpretation

EMergucate

FEBRUARY 19, 2021

A 50 year old male presents to ED at 06h45 with chest pain radiating to his left arm which woke … Continue reading →

ED

ECG of the Week – 7th April 2021 – Answer

EMergucate

APRIL 7, 2021

A 51 year old male is brought to ED by his family. He was difficult to arouse this morning. No … Continue reading →

ED

ECG of the Week – 28th April 2021 – Interpretation

EMergucate

APRIL 28, 2021

A 68 year old female presents to ED complaining of chest pain radiating to both arms. Below is the patients … Continue reading →

ED

ECG of the Week – 19th May 2021 Interpretation

EMergucate

MAY 18, 2021

A 58 year old male presents to ED complaining of a headache and weakness to his left side. The following … Continue reading →

ED

ECG of the Week 9th June 2021 Interpretation

EMergucate

JUNE 9, 2021

86 year old male with a background of CRF, PPM and AF presents to ED with SOB Answer Rate: Ventricular … Continue reading →

ED

ECG of the Week 13th October 2021 – Answer

EMergucate

OCTOBER 13, 2021

A 60 year old female presents to ED after a heroin OD. The patient has a background of COPD and … Continue reading →

ED

ECG of the Week – 12th May 2021 – Interpretation

EMergucate

MAY 15, 2021

3 y/o boy admitted via ED for viral induced wheeze as he was requiring ongoing bronchodilator therapy and supplemental oxygen. … Continue reading →

ED

ECG of the Week – 20th January 2021 – Interpretation

EMergucate

JANUARY 19, 2021

The ECG below has been taken from an 89 year old gentleman who has just transferred from the SJA stretcher to an ED bed. He has a history of prostate cancer, IHD and Aortic Stenosis and had an epis…

ED

How to Best Inspect, Protect, and Dress Wounds in the Emergency Dept.

ACEP Now

NOVEMBER 7, 2024

About three percent of emergency department (ED) visits are due to skin and soft tissue infections, but data are lacking on the contribution of chronic wounds to this number. Wound management in the ED is only a starting point, and appropriate referral and follow-up are key to an improved outcome. Back to the patient.

ED

ED OR Emergency Department Ambulance

Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

REBEL EM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

ED

ED E-9-1-1 Emergency Department ALS

SGEM#437: Don’t Be Fooled by the Meds I Got, I Still Need an ESP Block – For My Rib Fractures

The Skeptics' Guide to EM

APRIL 20, 2024

Case: You are doing great things and helping many patients during your shift in the emergency department (ED) when you hear a trauma alert being called overheard. The evidence was not robust enough back in 2021 to confidently use this potential tool. It risks stratified older patients with blunt trauma.

Emergency Department

Emergency Department Overdose ALS ED

Post-Intubation Sedation and Analgesia

Core EM

JANUARY 25, 2024

Background: The immediate post intubation period in the ED is a critical time for continued patient stabilization. The reality of ever increasing ED volumes and longer boarding times to the ICU makes it imperative for emergency physicians to learn how to manage these critical patients.

ICU

ICU Emergency Department Critical Care ALS

Infection and DKA, then sudden dyspnea while in the ED

Dr. Smith's ECG Blog

NOVEMBER 22, 2023

While in the ED, patient developed acute dyspnea while at rest, initially not associated with chest pain. The patient had no chest symptoms until he had been in the ED for many hours and had been undergoing management of his DKA. The patient was under the care of another ED physician. Another ECG was recorded: What do you think?

ED

ED Coronary CAD STEMI

Gen Z in the ED: Medical Student Perspectives on Emergency Medicine

Core EM

OCTOBER 16, 2024

Annie: I developed an interest in EM while working as a scribe in the ED during college. In addition to what Charlotte and Nick said, I can envision myself staying calm in the stressful situations that come up in the ED. Nick: Triaging your time and priorities as an ED doc on shift is so challenging.

ED

ED EMS Critical Care OR

Gen Z in the ED: Medical Student Perspectives on Emergency Medicine

Core EM

SEPTEMBER 24, 2024

Annie: I developed an interest in EM while working as a scribe in the ED during college. In addition to what Charlotte and Nick said, I can envision myself staying calm in the stressful situations that come up in the ED. Nick: Triaging your time and priorities as an ED doc on shift is so challenging.

ED

ED EMS Critical Care OR

ECG of the Week – 29th December 2021

EMergucate

DECEMBER 27, 2021

A 78 year old male presents to ED complaining of chest pain. Below are 2 ECG’s of the patient while he is in ED. He has a PPM and ICD in situ. Describe and Interpret the ECG’s

ED

SGEM#351: How to Stop Geriatrics from Free Fallin’

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

ALS ED Emergency Department OR

emDOCs Podcast – Episode 110: Primary Spontaneous Bacterial Peritonitis

EMDocs

NOVEMBER 13, 2024

Major takeaway: Consider SBP in any patient who comes into the ED with ascites. 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. 2021 Aug;74(2):1014-1048. 2021 May;19(5):976-986.e5.

E-9-1-1

E-9-1-1 ALS OR ED

Trick of the Trade: Gel-free ultrasound-guided peripheral IV technique

ALiEM

APRIL 12, 2023

20 – Local Anesthetics, Ed(s): Hugh C. Disinfectants and Cleaning Solutions for Ultrasound Systems and Transducers [PDF]. Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. 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

Emergency Department ALS ED