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. He describes the pain as a gradually worsening pressure-like discomfort distributed across his entire abdomen. He reports distension and the sensation of fullness.

E-9-1-1 77

E-9-1-1 ED ALS Operating Room 77

ACEP Now

OCTOBER 31, 2023

Discussion In 2021, 588,229 children were the victims of child abuse and neglect. Emergency physicians have a unique opportunity to recognize these cases and to intervene, as medically neglected children may be brought to the ED once illness becomes severe. medical neglect accounts for approximately 2 percent of child-abuse cases.

ED 52

ED OR EMS 52

ALiEM

MARCH 1, 2024

A 24-year-old female with no pertinent PMHx presents to the ED with a chief complaint of eye pain. Her mom convinced her to go to the ED and she first went to an outside hospital, but was referred to come to our institution. McGraw Hill; 2021. She had been managing her pain with ice and had not taken any OTC medications.

ED 152

ED OR 152

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). Early Congenital Syphilis Present before 2 years of age [ Hussain, 2023 ; Foles, 2024; Fang, 2022; Morrisroe, 2021 ] Only ~33% of newborns present with symptoms at birth and can be subtle. Is this scalp swelling normal?

E-9-1-1 152

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

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. Short acting. mg/kg IV followed by 0.05 – 0.4

Emergency Department 246

Emergency Department ICU Critical Care ALS 246

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. 2021 Oct 9;22(20):10911. Wu CY, Wu JD, Chen CC.

Plasma 265

Plasma OR ED Critical Care 265

Pediatric EM Morsels

OCTOBER 6, 2023

Recently, a pediatric patient presented to the ED who just returned from abroad with a gastroenteritis presentation. The most common countries of acquisition were Bangladesh, India, Nepal, and Pakistan (Forster 2021) For travelers, the peak incidence occurs at age 10 and those who are visiting to their country of birth.

OR 161

OR EMS ED 161

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

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 204

Emergency Department Overdose ALS ED 204

EMDocs

DECEMBER 19, 2023

Possible early antibiotic treatment Minor Marine Trauma Mechanism: Bites, Stings, Nematocysts Envenomation Presentation: All can cause localized pain, erythema, and warmth Dermatologic: Urticaria, burning, pruritus, localized paresthesia. Marine Trauma and Envenomation. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9e.

First Aid 92

First Aid ED OR ALS 92

ALiEM

SEPTEMBER 11, 2023

A 29-year-old female with a past medical history of migraine headaches presented to the emergency department (ED) for several hours of bilateral eye pain, redness, and decreased visual acuity. 2021 Apr;44(2):330-367. Epub 2021 Mar 25. The patient is a contact lens wearer. CLEAR – Contact lens complications. 2021.02.010.

Emergency Department 152

Emergency Department ED OR 152

The Skeptics' Guide to EM

AUGUST 24, 2024

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. Interests include information systems and digital health, research and education. We have covered rib fractures twice on the SGEM.

Emergency Department 127

Emergency Department ALS OR ED 127

ALiEM

AUGUST 21, 2023

McGraw Hill; 2021. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2021 SAEM Annual Meeting | Copyrighted by SAEM 2021 – all rights reserved. Radiographs may be performed to evaluate for occult traumatic injury or foreign body. References Ritter K, Fitch R.

OR 130

OR ED 130

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. 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

Core EM

JANUARY 25, 2024

One week prior to ED arrival, the patient was becoming progressively despondent, less interactive with peers, exhibiting slow speech and movements, and was not eating. Patient Case: History: A 60-year-old male with history of schizophrenia and depression on multiple unknown antipsychotic medications presents with unresponsiveness x 1 day.

MICU 246

MICU Emergency Department OR ED 246

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. 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. Reference: Brichko et al.

Emergency Department 130

Emergency Department ALS ACS ED 130

EMDocs

JUNE 15, 2024

1: PREOXI RCT – Preoxygenation with Noninvasive Ventilation vs. Non-rebreather Mask Spoon Feed Noninvasive ventilation (NIV) was superior to a standard non-rebreather (NRB) oxygen mask for preoxygenation of critically ill ED or ICU patients requiring intubation, with a NNT of 11 to prevent 1 episode of hypoxemia <85%. Ann Emerg Med.

ICU 75

ICU Emergency Department ED OR 75

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

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 82

Emergency Department ALS E-9-1-1 ED 82

Core EM

MARCH 12, 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

The Skeptics' Guide to EM

APRIL 10, 2021

Date: April 6th, 2021 Guest Skeptic: Dr. Casey Parker is a Rural Generalist from the NW of Australia. Date: April 6th, 2021 Guest Skeptic: Dr. Casey Parker is a Rural Generalist from the NW of Australia. Most of the trials were done in marathon and ultra-marathon runners whom we do not see very often in the ED [5-7].

Emergency Department 130

Emergency Department Coronary ED OR 130

Core Ultrasound

MARCH 25, 2024

Old IVC Vid (2021) TEE VTI Here are Dr. Spiegel’s Notes: 1. For example a pt in the ED with sepsis, and a collapsible IVC, dry lungs and no peripheral edema is more likely to benefit from fluid than be harmed Take that same pt, with the same US and physical exam findings and make it 72-hrs later in the ICU after 6-10 L.

ICU 246

ICU ED OR 246

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. 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.

Emergency Department 100

Emergency Department ED ALS OR 100

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

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. Background: Parents often bring their infants to the ED with concerns about fever.

Emergency Department 130

Emergency Department ALS OR ED 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. Blocks with larger volumes of anesthetic carry higher risk of LAST.

Epinephrine 246

Epinephrine ED OR Emergency Department 246

Dr. Smith's ECG Blog

DECEMBER 5, 2023

An ECG was perfomed on arrival to our ED: NSR with ST elevation II,III, aVF with reciprocal depression in aVL Would you refer this pediatric patient for emergent PCI? Pediatric cardiology performed a bedside echo in ED with EF estimation of 60%, no pericardial effusion, and no regional wall motion abnormalities. Epub 2021 Jul 7.

Coronary 116

Coronary CAD ACS ALS 116

ALiEM

SEPTEMBER 27, 2023

Updated 2021 Nov 1]. 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

The Skeptics' Guide to EM

MAY 22, 2021

Date: May 21st, 2021 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. AEM May 2021 Case: A 32-year-old female presents with headache after a low-speed motor vehicle collision as a restrained driver. Reference: Varner et al.

Emergency Department 130

Emergency Department ED ALS OR 130

The Skeptics' Guide to EM

MARCH 13, 2021

Date: March 11th, 2021 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Ohio. Lancet 2021 Case: You’re […] The post SGEM#322: TXA for SAH – Won’t Stop Me Now first appeared on The Skeptics Guide to Emergency Medicine. Reference: Post et al. Reference: Post et al.

ALS 100

ALS Emergency Department ED OR 100

The Skeptics' Guide to EM

MARCH 12, 2022

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. Dr. Varner’s research interests are in concussion and pregnancy care in the ED. Date: March 3rd, 2022 Reference: Macnow et al.

Emergency Department 100

Emergency Department ED ALS OR 100

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. 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.

Emergency Department 100

Emergency Department ALS ED OR 100

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

The Skeptics' Guide to EM

APRIL 2, 2022

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. Clinical Question: Does a 5-minute virtual reality program reduce situational anxiety in the pediatric ED?

Emergency Department 130

Emergency Department ALS ED OR 130

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

APRIL 17, 2023

A 29 year-old-male with a past medical history of left eye enucleation secondary to a gunshot wound several years prior presents to the Emergency Department (ED) for blurry vision, redness, and concern for a deformity to his right eye. He also reports photophobia and mild eye pain. Head: No visible traumatic injuries. Published 2015 Dec 11.

Emergency Department 130

Emergency Department OR ED 130

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. 1 Boarding time increases led to unprecedented ed walkaway rates.

Emergency Department 52

Emergency Department ED EMS ALS 52