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

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

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. Paper: Owyang CG, et al. J Crit Care. of patients left the ED on TV settings of 450 mL and 36.1%

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

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

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 CCT 73

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

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-9-1-1 122

E-9-1-1 OR Coronary ACS 122

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. Paper: Mason JM, et al.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

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 Plasma Emergency Department 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

ICU 246

ICU Emergency Department 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

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 189

Emergency Department ALS EMS OR 189

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

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

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-9-1-1 286

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

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

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

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

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

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

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

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-9-1-1 269

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

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

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

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 176

Emergency Medical Services ALS Emergency Department ED 176

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

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 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 310

Critical Care ALS ED Emergency Department 310

NAEMSP

OCTOBER 9, 2024

In the emergency department, a lack of awareness about Addison’s disease led to delayed steroid administration. In the emergency department, the patient was evaluated and safely discharged. These cases highlight the impact of adrenal insufficiency on patients, especially during encounters with emergency care systems.

EMS 122

EMS Crisis Prevention Emergency Department BLS 122

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

Don't Forget the Bubbles

OCTOBER 2, 2024

A previously well 6-year-old boy is brought into the emergency department at a major trauma centre via HEMS following a road traffic accident, in which he was hit by a car while crossing the road. A full primary survey is carried out. Imaging is performed, including a CT Head. Pediatric Critical Care Medicine.

OR 49

OR Critical Care ALS Emergency Department 49

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 270

Emergency Department OR ED EMS 270

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

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. His vital signs are normal. Reference: Broder et al.

Emergency Department 100

Emergency Department ACS ALS Coronary 100