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

The Skeptics' Guide to EM

NOVEMBER 19, 2022

Date: November 19th, 2022 Reference: Khatib N, and Sampsel K. Intimate partner violence (IPV) in the Emergency Department (ED). 2022 Nov Guest Skeptics: Dr. Nour Khatib is an emergency physician in Toronto working in community sites Markham Stouffville Hospital and Lakeridge health. This is an SGEM Xtra episode.

Emergency Department 102

Emergency Department ED OR 102

EMDocs

MARCH 4, 2024

Darnall Army Medical Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, (@long_brit) Disclaimer: The views expressed in this post are those of the authors and do not reflect the official policy or position of the Department of the Army, DoD, or the US Government.

Emergency Department 105

Emergency Department E-9-1-1 ALS OR 105

The Skeptics' Guide to EM

AUGUST 27, 2022

Date: August 23rd, 2022 Reference: Schoenfeld et al. AEM August 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: August 23rd, 2022 Reference: Schoenfeld et al. Reference: Schoenfeld et al.

Emergency Department 100

Emergency Department Naloxone Overdose ED 100

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. 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.

E-9-1-1 290

E-9-1-1 Epinephrine Emergency Department OR 290

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

ICU 246

ICU Emergency Department Critical Care ALS 246

Don't Forget the Bubbles

JULY 3, 2023

This time we have our first group of colleagues from Birmingham Children’s Hospital Emergency Department. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Am J Hematol.

Emergency Department 105

Emergency Department ED OR ALS 105

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. Recommended by ATLS and PALS.

E-9-1-1 271

E-9-1-1 Emergency Medical Services Life Support ALS 271

REBEL EM

NOVEMBER 6, 2024

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)

E-9-1-1 114

E-9-1-1 ACS OR Emergency Department 114

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). Rare diseases are not confined to the pages of a textbook or computer screen.

Emergency Department 193

Emergency Department ALS EMS OR 193

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

Pediatric EM Morsels

AUGUST 23, 2024

Concussions are commonly encountered in the Emergency Department. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. We have previously discussed an approach to the question of when a patient “ can return to sport.” Br J Sports Med.

Emergency Department 281

Emergency Department OR ED EMS 281

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. But what exactly are neurodivergence and neurodiversity?

Emergency Department 52

Emergency Department ED OR ALS 52

The Skeptics' Guide to EM

AUGUST 10, 2024

He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 65-year-old man is brought into the emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table.

Emergency Medical Services 224

Emergency Medical Services ALS Emergency Department ED 224

FOAMfrat

DECEMBER 26, 2024

IF YOU OR A LOVED ONE NEEDS HELP, CALL 988 OR SEEK CARE AT A LOCAL EMERGENCY DEPARTMENT. TRIGGER WARNING: TOPICS OF SUICIDE MAY BE HARD FOR SOME PEOPLE TO READ ABOUT. THIS ARTICLE IS COVERING THE MEDICAL ASPECTS OF CHEMICAL SUICIDES. REMEMBER, IF YOU ARE TREATING A SUICIDE ATTEMPT SURVIVOR, DO NOT PASS JUDGMENT.

Epinephrine 116

Epinephrine First Responder OR Emergency Manager 116

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-9-1-1 101

E-9-1-1 Emergency Department ALS CCT 101

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. We’ve incorporated some of our favourite elements from their presentations in this blog post.

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 95

Emergency Department ED EMR OR 95

ALiEM

NOVEMBER 3, 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 trauma in the Emergency Department. More specifically, we identified 3 AIR and 5 Honorable Mentions.

Critical Care 211

Critical Care EMS Emergency Department ALS 211

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. link] Lupu, L., Shmueli, H.,

E-9-1-1 131

E-9-1-1 OR Coronary ACS 131

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

EMDocs

NOVEMBER 19, 2024

His roommate found an empty pill bottle on the floor next to him. Second-generation antipsychotics (see Table 1 below) improve both positive and negative symptoms of schizophrenia and are less likely to be associated with EPS. 1,2 Most second-generation antipsychotics act as D 2 antagonists and inhibit the 5-HT 2A receptor.

Overdose 111

Overdose EMS Emergency Medical Services OR 111

Pediatric EM Morsels

JULY 21, 2023

Jain 2022] Now used for critically ill trauma and medical patients in >75 countries. Jain 2022] Now used for critically ill trauma and medical patients in >75 countries. Jain 2022] Glasgow Coma Scale in Children – How do you perform it correctly? When is it useful and what does it tell us?

Critical Care 246

Critical Care ALS Life Support OR 246

Core EM

JANUARY 25, 2024

Written by: Sadakat Chowdhury MD Edited by: Mak Sarich MD, Jay Lin MD, Jonathan Kobles MD Background: Ultrasound (US) guided nerve blocks offer an applicable option for achieving analgesia in the emergency department. Calculate the maximum safe local anesthetic dosage for the patient. Published February 4, 2022.

Epinephrine 246

Epinephrine ED Emergency Department OR 246

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

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

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center. CREDIT: Dr. P.

Operating Room 98

Operating Room Epinephrine ALS ED 98

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-9-1-1 154

E-9-1-1 Plasma Emergency Department OR 154

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245

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

EMDocs

JANUARY 11, 2025

2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation.

E-9-1-1 98

E-9-1-1 EMS Emergency Department OR 98

Don't Forget the Bubbles

MARCH 21, 2025

A total of eleven intensive care units (ten PICUs and one non-maternity NICU) and four emergency departments (EDs) took part in the study. Given the emergency setting, the trial used a research without prior consent model, with delayed consent-to-continue obtained from the childs legal guardian as soon as practical.

ICU 108

ICU Critical Care ED OR 108

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-9-1-1 187

E-9-1-1 Operating Room Emergency Department ALS 187

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. His fever was 103°F this morning and he received ibuprofen. He has also had abdominal and back pain. Warm gel helps with the child’s comfort. Use a linear high frequency probe.

E-9-1-1 246

E-9-1-1 Emergency Department ALS OR 246

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

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