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SGEM #425: Are You Ready for This? Pediatric Readiness of Emergency Departments

The Skeptics' Guide to EM

National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC. Are general emergency departments ready to care for children?

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High sensitivity cardiac troponins for ED chest pain evaluation (2022 ACC pathway)

ALiEM

The 2022 American College of Cardiology (ACC) pathway provides timely guidance [1]. Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. Time to know your hs-cTn better.

E-9-1-1 276
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SAEM Clinical Images Series: Pediatric Genitourinary Bleeding

ALiEM

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.

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ALiEM AIR Series | Procedures Module

ALiEM

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.

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Thrombotic Thrombocytopenic Purpura (TTP)

Core EM

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.

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Ultrasound Diagnosis of Necrotizing Soft Tissue Infections

Core EM

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
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Post-Intubation Sedation and Analgesia

Core EM

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