Don't Forget the Bubbles

MAY 10, 2023

In May 2022, Holly and Joe, two students on the joint QMUL and DFTB PEM MSc , created video presentations on human factors. You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. Promoting hot debriefing in an emergency department. Scand J Trauma Resusc Emerg Med.

Emergency Department 91

Emergency Department ED CPR OR 91

REBEL EM

MAY 11, 2023

Background: The emergency department is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines. Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal.

Emergency Department 98

Emergency Department ED EMR OR 98

ACEP Now

MAY 5, 2023

What is your role as the emergency physician? Introduction Law enforcement officers frequently accompany emergency department (ED) trauma patients or patients who are under arrest or require assistance. Law enforcement gathering in the emergency department: Legal and ethical background and practical approaches.

Emergency Department 52

Emergency Department ED Public Safety OR 52

EMDocs

OCTOBER 30, 2023

” – Musings of an American ED resident in July 2022 when US healthcare was affected simultaneously by supply chain issues from GE Healthcare (contrast media) and Abbott Laboratories (Similac baby formula). A baby formula milk shortage for adults.” 11 Table 1.

E-9-1-1 73

E-9-1-1 Emergency Department ALS ED 73

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. 2022 Feb 8; PMID: 35156050 Higgins TL et al. 2022 Feb 24;7(1):29603. J Crit Care.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

ALiEM

NOVEMBER 17, 2023

A 4-year-old female with no significant past medical history is brought to the Emergency Department by her grandmother for concern for two days of progressive vaginal bleeding. It often presents to the emergency department with complaints of vaginal bleeding, difficulty urinating, or dysuria. Accessed January 5, 2022.

Emergency Department 250

Emergency Department OR 250

ALiEM

APRIL 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to related to procedures in the Emergency Department. More specifically, we identified 2 AIR and 4 Honorable Mentions.

EMS 246

EMS Emergency Department ED OR 246

REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

Core EM

JANUARY 25, 2024

source: “Thrombotic Thrombocytopenic Purpura (TTP)”, 2022 , National Heart, Lung, and Blood Institute. link] ) Laboratory Evaluation: Clinical presentation and laboratory findings can help suggest TTP in the emergency department. 2022 Feb 19;11(4):1103. if the patient is being transferred to another hospital).

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

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. Accessed March 9, 2022. Read More

E-9-1-1 246

E-9-1-1 Emergency Department OR 246

Broome Docs

OCTOBER 31, 2022

Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. 2022 Jan;48(1):78-91. 2022 Sep;21(9):781-791. 2022 Sep 15;387(11):989-1000. Emerg Med Australas. 2022 Sep 18. 2022 Aug;41(4):101096. Epub 2022 Apr 28. 2022 Aug 3;11:100284. Emerg Med J.

E-9-1-1 52

E-9-1-1 Defibrillator ICU Critical Care 52

Pediatric EM Morsels

JUNE 2, 2023

Today we are talking about a rare disease called FPIES (food protein induced enterocolitis syndrome) and how you might encounter these patients in the Pediatric Emergency Department. Allergy Asthma Clin Immunol 18, 54 (2022). You may not make the diagnosis, but detecting the clues is important for the family!

Emergency Department 189

Emergency Department ALS EMS OR 189

The Skeptics' Guide to EM

OCTOBER 1, 2022

Date: September 28th, 2022 Reference: Hartford et al. Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference. AEM September 2022. Date: September 28th, 2022 Reference: Hartford et al. AEM September 2022. AEM September 2022.

Emergency Department 130

Emergency Department ALS ED OR 130

Broome Docs

AUGUST 2, 2022

2022 Jun 23;386(25):2387-2398. 2022 Jan;175(1):20-28. 2022 Jan;175(1):29-35. As we gather more data on the topic, the best approach for emergency physicians is to ensure that you are only testing for PE in high risk patients. 2022 May 1;176(5):486-492. 2022 Mar;135(3):369-379.e1. Am J Emerg Med.

ED 52

ED Emergency Department ALS Critical Care 52

The Skeptics' Guide to EM

SEPTEMBER 10, 2022

Date: August 25th, 2022 Reference: Martin et al. Single-dose dexamethasone is not inferior to 2 doses in mild to moderate pediatric asthma exacerbations in the emergency department. Pediatr Emerg Care. 2022 Guest Skeptic: Dr. Harrison Hayward is a Pediatric Emergency Medicine fellow at Children’s National Hospital.

Emergency Department 130

Emergency Department ALS ED OR 130

ALiEM

MARCH 11, 2024

In July 2022, a 32-year-old male with a past medical history of HIV (on antiretroviral therapy, CD4 390, viral load undetectable) presented to the emergency department with constitutional symptoms and a rash for 4-5 days. Epub 2022 Jul 27. The 2022 outbreak and the pathobiology of the monkeypox virus. Eye (Lond).

Emergency Department 141

Emergency Department ALS OR 141

The Skeptics' Guide to EM

APRIL 2, 2022

Date: March 31st, 2022 Reference: Butt et al. Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. Date: March 31st, 2022 Reference: Butt et al. Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department.

Emergency Department 130

Emergency Department ALS ED OR 130

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. 2022 Dec 27;14(12):e33009.

E-9-1-1 152

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

The Skeptics' Guide to EM

JANUARY 29, 2022

Date: January 25th, 2022 Reference: Beyde et al. Efficacy of empiric antibiotic management of septic olecranon bursitis without bursal aspiration in emergency department patients. AEM January 2022 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Beyde et al.

Emergency Department 130

Emergency Department ALS ED 130

ALiEM

OCTOBER 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to respiratory diseases in the Emergency Department. More specifically, we identified 3 AIR and 3 Honorable Mentions.

Critical Care 169

Critical Care EMS Emergency Department ALS 169

ALiEM

JULY 20, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to related to infectious diseases in the Emergency Department. More specifically, we identified 1 AIR and 5 Honorable Mentions.

Emergency Department 188

Emergency Department EMS OR 188

ALiEM

FEBRUARY 5, 2024

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to toxicology in the Emergency Department. More specifically, we identified 3 AIR and 5 Honorable Mentions.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

Core EM

JANUARY 25, 2024

Given the lack of outcome difference, the longer time to onset of peak effect, frequently inadequate level of sedation, and the risk of hypotension and bradycardia, propofol may be a more practical choice of sedative in the emergency department when clinically appropriate. mg/kg over several minutes 0.02 – 0.1 mg/kg 0.01 – 0.1

ICU 246

ICU Emergency Department Critical Care ALS 246

The Skeptics' Guide to EM

MAY 28, 2022

Date: May 24th, 2022 Reference: Broder et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE) 2: Low-Risk, Recurrent Abdominal Pain in the Emergency Department. Date: May 24th, 2022 Reference: Broder et al. Reference: Broder et al.

Emergency Department 100

Emergency Department ACS ALS Coronary 100

ALiEM

SEPTEMBER 30, 2024

A 23-year-old healthy male presented to the emergency department with left eye pain, soreness, and blurry vision after being hit in the left eye with a Nerf gun bullet two days prior. 2022 Dec 26. He had no prior ophthalmologic history and does not wear corrective lenses. Physical Exam Left eye : Visual acuity 20/30. 2001.28284.

Emergency Department 161

Emergency Department 161

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care.

ED 130

ED Critical Care Emergency Department ALS 130

Pediatric EM Morsels

OCTOBER 27, 2023

Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. PAWPER [Wells 2013, Silvagni 2022] Takes into account body habitus. Published 2022 Sep 15.

E-9-1-1 269

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

The Skeptics' Guide to EM

NOVEMBER 26, 2022

Date: November 26th, 2022 Reference: James et al. Emergency Department Condition Acuity, Length of Stay, and Revisits Among Deaf and Hard-of-Hearing Patients: A Retrospective Chart Review. AEM November 2022 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: James et al.

ED 100

ED Emergency Department ALS 100

The Skeptics' Guide to EM

DECEMBER 10, 2022

Date: November 30th, 2022 Reference: Johnson et al. Date: November 30th, 2022 Reference: Johnson et al. Bone Joint J 2022 Guest Skeptic: Dr.Matt Schmitz is an Orthopaedic Surgeon specializing in Adolescent Sports Medicine and Young Adult Hip Preservation. He asks if surgery would be a better option?

Emergency Department 130

Emergency Department ALS ED OR 130

Broome Docs

DECEMBER 9, 2023

Overnight Stay in the Emergency Department and Mortality in Older Patients. Risk of Radiation Exposure to Emergency Department Personnel From Portable Radiographs. J Emerg Med. 2022 Nov;63(5):645-650. Epub 2022 Oct 12. Droperidol versus ondansetron for nausea treatment within the emergency department.

Emergency Department 120

Emergency Department ED ALS 120

ALiEM

MARCH 22, 2024

A 53-year-old woman with no significant past medical history presented to the emergency department with a 3-day history of double vision on leftward gaze. 2022 Oct 24;18(2):329-334. 2022 Nov 7;18(1):152-158. Unilateral INO is more frequently related to ischemic/vascular causes whereas bilateral INO is associated with MS.

Emergency Department 169

Emergency Department OR 169

ACEP Now

NOVEMBER 8, 2024

First, research suggests a higher number of emergency department visits among individuals with ASD. About 30 percent of children with ASD need treatment in an emergency department, and this number increases to nearly 70 percent for those aged 15–18. Seeing the unseen: neurodiversity in the emergency department.

Emergency Department 52

Emergency Department ED OR ALS 52

Pediatric EM Morsels

JULY 19, 2024

If bleeding, the only lab that is needed in the Emergency Department is a type and cross. 2022 Sep-Oct;43(5):103582. Epub 2022 Aug 6. Am J Emerg Med. 2022 Mar 4;14(3):e22857. CBC, coagulation panels, von Willebrand factor etc are less useful. Am J Otolaryngol. doi: 10.1016/j.amjoto.2022.103582. 2022.103582.

E-9-1-1 286

E-9-1-1 Epinephrine Emergency Department OR 286

The Skeptics' Guide to EM

MAY 14, 2022

Date: May 13th, 2022 Reference: Abril et al. J Emerg Med 2022 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. Date: May 13th, 2022 Reference: Abril et al. An Analysis of Data From Randomized Studies.

ALS 130

ALS Emergency Department ED OR 130

ACEP Now

OCTOBER 9, 2024

Emergency physicians have long taken pride in delivering care every day of the week, every hour of the day. ACEP’s Emergency Department Accreditation program adds a layer to that, says Marianne Gausche-Hill, MD, FACEP, FAAP, FAEM, Chair of the program’s Board of Governors.

Emergency Department 52

Emergency Department Emergency Medical Services ED OR 52

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. 2022 May 11;10:864766. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med.

E-9-1-1 183

E-9-1-1 Operating Room Emergency Department ALS 183

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. 2023 May 17:archdischild-2022-325280. doi: 10.1136/archdischild-2022-325280. Arch Dis Child. Why was the DIMPLES study needed?

Emergency Department 135

Emergency Department ED OR ALS 135