The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. Background: We have covered rib fractures once before on the Skeptics’ Guide to Emergency Medicine.

Emergency Department 204

Emergency Department Overdose ALS ED 204

The Skeptics' Guide to EM

AUGUST 24, 2024

Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. Reference: Partyka et al.

Emergency Department 127

Emergency Department ALS OR ED 127

Pediatric EM Morsels

JULY 19, 2024

If bleeding, the only lab that is needed in the Emergency Department is a type and cross. 2021 Aug;147:110807. Epub 2021 Jun 24. Your support staff…depending on the amount of bleeding, you are about to have your hands full and may need IV access, medications, airway management, etc. Set up suction x2 in the room!

E-9-1-1 285

E-9-1-1 Epinephrine Emergency Department OR 285

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. Is this scalp swelling normal?

E-9-1-1 152

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

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. The patient is reluctant to abduct the right arm secondary to pain.

Emergency Department 246

Emergency Department OR EMS ED 246

Core EM

JANUARY 25, 2024

Lipophilic with adipose deposition, withdrawal symptoms after prolonged infusion Hydromorphone 5 – 15 min 2 – 3 hr 0.5 – 3 mg/hr No active metabolites however parent drug can accumulate in renal failure Morphine 5 – 10 min 3 – 4 hr 2 – 30 mg/hr Active metabolites can accumulate in renal failure Remifentanil 1 – 3 min 3 – 10 min Loading dose: 1.5

Emergency Department 246

Emergency Department ICU Critical Care ALS 246

Pediatric EM Morsels

FEBRUARY 2, 2024

Abdel-Haq 2021). Travel dates can help to exclude certain infections by their incubation periods (Abdel-Haq 2021) Physical examination can sometimes reveal concerning features including hepatomegaly , jaundice or a rash that may guide differential. A study of swiss tourists found they compromised 53.4%

E-9-1-1 161

E-9-1-1 ED OR Emergency Department 161

Core EM

JANUARY 25, 2024

SUMMARY: Upon initial evaluation of patients in the emergency department with clinical signs of soft tissue infections, consider using POCUS as a valuable tool to gather more information in patients with a high suspicion for the diagnosis and/or are too unstable to undergo CT imaging. Updated 2021 Jul 27]. Wallace HA, Perera TB.

E-9-1-1 246

E-9-1-1 Emergency Department OR 246

Core EM

JANUARY 25, 2024

link] ) Laboratory Evaluation: Clinical presentation and laboratory findings can help suggest TTP in the emergency department. fluoroquinolones, quinine, clopidogrel, and ticlopidine) Congenital/Familial TTP: 2% of cases occur in childhood via autosomal recessive mutations in the ADAMTS-13 gene.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

ALiEM

NOVEMBER 10, 2023

A 33-year-old male presented to the emergency department with a diffuse pruritic rash that appeared several days after starting Trimethoprim/Sulfamethoxazole (TMP-SMX) for a dental infection. 2021 Sep 1;57(9):925. Epub 2021 Jul 1. Progression stopped after discontinuing TMP-SMX. References Anderson HJ, Lee JB.

Emergency Department 161

Emergency Department OR 161

The Skeptics' Guide to EM

AUGUST 28, 2021

Date: August 27th, 2021 Reference: Gagnon et al. Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. first appeared on The Skeptics Guide to Emergency Medicine. Date: August 27th, 2021 Reference: Gagnon et al.

ED 130

ED Emergency Department ALS OR 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. 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 ALS ACS ED 130

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? You may be more familiar with the term “limited English proficiency” (LEP), defined as: someone who does not speak English as their primary language and has a limited ability to read, speak, write, or understand English.

Emergency Department 82

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

Core EM

JANUARY 25, 2024

An estimated 7% to 15% of acutely hospitalized psychiatric patients and psychiatric emergency department patients exhibit catatonia [4]. Malignant Catatonia (AKA “lethal catatonia”): An acute onset life-threatening subtype of catatonia that is characterized by fever, autonomic instability, delirium, and rigidity [4].

MICU 246

MICU Emergency Department OR ED 246

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. He is a GP by training but works in Emergency Department, Anaesthesia, Internal Medicine and Paediatrics. Date: April 6th, 2021 Guest Skeptic: Dr. Casey Parker is a Rural Generalist from the NW of Australia.

Emergency Department 130

Emergency Department Coronary 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. Case: A 25-day-old, full-term boy presents to the emergency department with fever.

Emergency Department 130

Emergency Department ALS OR ED 130

Don't Forget the Bubbles

AUGUST 19, 2024

Sione, a young Pacific Islander boy, is brought to the emergency department with a 3-day history of acute onset, progressively worsening central chest pain. of child emergency department presentations. He points to his sternum when you ask him where the pain is. There is no overlying bruising, erythema, or skin changes.

Emergency Department 101

Emergency Department OR 101

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. No foreign body on lid eversion. 2021.02.010.

Emergency Department 152

Emergency Department ED OR 152

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

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

FEBRUARY 19, 2022

Tim Graham is a Clinical Professor of emergency medicine at the University of Alberta, and Associate Chief Medical Information Officer, Edmonton Zone, of Alberta Health Services from Edmonton, Alberta. The title of the article was “Physician, heal thyself” and was in the humanities section of the October 2021 issue.

Emergency Department 130

Emergency Department ALS OR 130

ALiEM

AUGUST 18, 2023

A middle-aged man with a past medical history of hypertension and tobacco use disorder presented to the Emergency Department after evaluation by an ophthalmologist. He complained of ten days of a right-sided headache and three days of diplopia. He denied eye pain, pain with eye movements, photophobia, and vision loss.

Emergency Department 130

Emergency Department OR 130

The Skeptics' Guide to EM

DECEMBER 25, 2021

Date: December 21st, 2021 Guest Skeptic: Dr. Spencer Greaves is an Emergency Medicine resident at Florida Atlantic University. He and his wife live in Boynton Beach, FL […] The post SGEM#353: At the COCA, COCA for OCHA first appeared on The Skeptics Guide to Emergency Medicine. ” Reference: Vallentin et al.

Epinephrine 130

Epinephrine CPR ALS Emergency Department 130

The Skeptics' Guide to EM

APRIL 2, 2022

Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. AEM March 2022 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Reference: Butt et al.

Emergency Department 130

Emergency Department ALS ED OR 130

ACEP Now

MAY 10, 2024

Patients often seek care in the emergency department (ED) setting when flares of pain affect their ability to ambulate, climb stairs, or even stand up from sitting. Presentation of Knee Osteoarthritis in the Emergency Department: A Problem Worth Mentioning? 52, 196 (2021). J Emerg Med. Epub 2021 Jun 25.

Emergency Department 92

Emergency Department Ambulance ED OR 92

The Skeptics' Guide to EM

JANUARY 8, 2022

Date: December 28th, 2021 Reference: Kulvatunyou et al. November 2021. Guest Skeptic: Dr. Chris Root is a second-year resident physician in the Department of Emergency Medicine at the University […] The post SGEM#355: Bigger Isn’t Better When It Comes to Chest Tubes first appeared on The Skeptics Guide to Emergency Medicine.

ALS 130

ALS Emergency Department Paramedic OR 130

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Date: September 20th, 2021 Reference: Litell et al. Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. mg/dl or 107 umol/L).

Emergency Department 100

Emergency Department EMR ICU ALS 100

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. He is also the CME editor for Academic Emergency Medicine. Date: August 31st, 2021 Reference: McLean et al. He is also the CME editor for Academic Emergency Medicine.

Emergency Department 100

Emergency Department ALS OR ED 100

EMDocs

JUNE 15, 2024

Source Shifts in Diagnostic Testing for Headache in the Emergency Department, 2015 to 2021. The post Journal Feed Weekly Wrap-Up appeared first on emDOCs.net - Emergency Medicine Education. Originally published at JournalFeed , a site that provides daily or weekly literature updates. JAMA Netw Open.

ICU 75

ICU Emergency Department ED OR 75

The Skeptics' Guide to EM

APRIL 16, 2022

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. Case: A 55-year-old man comes into the emergency department (ED) for increasing knee pain and decrease in function. Reference: Blom et al.

Emergency Department 100

Emergency Department ALS OR ED 100

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. first appeared on The Skeptics Guide to Emergency Medicine. Reference: Varner et al. She was ambulatory on scene.

Emergency Department 130

Emergency Department ED ALS OR 130

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. Ann Emerg Med. 2021 Dec;78(6):752-758. Ann Emerg Med. Ann Emerg Med. 2021 Dec;78(6):752-758. PMID: 34353648.

Emergency Department 52

Emergency Department ALS ED OR 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. first appeared on The Skeptics Guide to Emergency Medicine. Date: September 8th, 2021 Reference: Desch et al.

EMR 130

EMR Coronary Defibrillator Life Support 130

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

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. She is an emergency physician at Mount Sinai […] The post SGEM#362: Screen Time – Can’t Take My Eyes Off of You – But Should I Post-Concussion?

Emergency Department 100

Emergency Department ED ALS OR 100

The Skeptics' Guide to EM

DECEMBER 18, 2021

Date: December 13th, 2021 Reference: Lee et al. Addressing gender inequities: Creation of a multi-institutional consortium of women physicians in academic emergency medicine. Date: December 13th, 2021 Reference: Lee et al. The literature describes many factors that contribute to gender inequity.

Emergency Department 100

Emergency Department ALS ED OR 100

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.

Emergency Department 135

Emergency Department ED OR ALS 135