ACEP Now

OCTOBER 9, 2023

emergencies, patient’s request). 3 A new 2022 proposed change to Section 1557 hopes to expand its scope to other HHS activities (including Medicare Part B) and telehealth services, require staff training on availability of services, and further define the roles of qualified versus nonqualified interpreters. Census Bureau, 60.6

Emergency Department 64

Emergency Department E-9-1-1 ALS OR 64

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 OR CPR 91

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.

Emergency Department 250

Emergency Department OR 250

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. Conclusion Emergency physicians may encounter requests for law enforcement information gathering in the ED.

Emergency Department 52

Emergency Department ED Public Safety OR 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. An example of petechiae and purpura frequently seen with thrombocytopenic disorders.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

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

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

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

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

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

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

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-9-1-1 285

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

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

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 183

Emergency Medical Services ALS Emergency Department ED 183

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

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

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 243

Emergency Department OR ED EMS 243

The Skeptics' Guide to EM

JANUARY 7, 2023

Acute management of atrial fibrillation in congestive heart failure with reduced ejection fraction in the emergency department. Acute management of atrial fibrillation in congestive heart failure with reduced ejection fraction in the emergency department. Date: January 4th, 2023 Reference: Hasbrouck et al.

Emergency Department 100

Emergency Department OR ALS Ambulance 100

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

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-9-1-1 268

E-9-1-1 Emergency Medical Services Life Support ALS 268

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

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Case: It is a steady Saturday afternoon in your rural emergency department (ED). Reference: Snelling et al.

Critical Care 316

Critical Care ALS ED Emergency Department 316

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

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. She endorsed mild, intermittent headaches associated with diplopia when looking to the left. Korean J Neurotrauma.

Emergency Department 169

Emergency Department OR 169

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

NOVEMBER 12, 2022

Date: November 10th, 2022 Reference: de-Madaria E et al. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. Date: November 10th, 2022 Reference: de-Madaria E et al.

ALS 130

ALS Emergency Department OR EMS 130

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

The Skeptics' Guide to EM

FEBRUARY 5, 2022

Date: February 7th, 2022 Reference: Williams et al. JAMA Pediatrics 2022 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Date: February 7th, 2022 Reference: Williams et al. Reference: Williams et al.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

JANUARY 14, 2023

AJEM 2022 Guest Skeptic: Dr. Kevan Sternberg is a urologist/endourologist. first appeared on The Skeptics Guide to Emergency Medicine. AJEM 2022 Guest Skeptic: Dr. Kevan Sternberg is a urologist/endourologist. Date: January 13, 2023 Reference: Razi et al. Date: January 13, 2023 Reference: Razi et al.

ALS 130

ALS Emergency Department ED OR 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. Sept 5, 2022. He points to his sternum when you ask him where the pain is. How common is sternal osteomyelitis?

Emergency Department 101

Emergency Department OR 101

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 OR Emergency Department 246

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Chris Bond is an emergency medicine physician and Assistant Professor at the University of Calgary. Case: You are an administrator responsible for staffing emergency departments (EDs) in a health care system comprising both urban and rural locales.

Emergency Department 130

Emergency Department ALS ED EMS 130

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. 2022, August 16). The patient is a contact lens wearer. No foreign body on lid eversion. Cont Lens Anterior Eye. 2021 Apr;44(2):330-367.

Emergency Department 152

Emergency Department ED OR 152

The Skeptics' Guide to EM

JANUARY 21, 2023

Neurology 2022 Date: January 3, 2023 Guest Skeptic: Dr. Jennifer Harmon is an MD, Ph.D Neurology 2022 Date: January 3, 2023 Guest Skeptic: Dr. Jennifer Harmon is an MD, Ph.D Case: A 9-year-old girl shows up at your emergency department (ED) with unilateral facial paralysis. Reference: Babl et al.

Emergency Department 100

Emergency Department ALS OR ED 100

The Skeptics' Guide to EM

APRIL 8, 2023

There have been many “temporary” rural emergency department closures during the past last year. In Ontario alone there have been approximately 160 emergency departments (ED) temporarily closed since the beginning of 2022. It was a stepped-wedge reconfiguration of the entire Danish emergency healthcare system.

Emergency Department 139

Emergency Department ED Ambulance ALS 139

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. 2022 Jun;62(3):400-412. Initially beginning on the torso and low back, the rash spread to the palms, soles, and genitalia. South Med J.

Emergency Department 161

Emergency Department OR 161