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. The SB tube was created in 1950 in order to help tamponade variceal bleeds [1]. Pearl 1: Check the units of pressure being used. The conversion rate is: 1 cmH2O = 0.74

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

ACEP Now

OCTOBER 9, 2023

emergencies, patient’s request). However, actual increases in available services in emergency departments based on prior state-level requirements have been mixed. Accessed August 11, 2023. Department of Health and Human Services website. Last reviewed February 3, 2023. Accessed August 11, 2023.

Emergency Department 64

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

ALiEM

OCTOBER 2, 2023

A 6-year-old male presented to the pediatric emergency department (PED) for scalp lesions. F) temporal; Resp 18; SpO2 99%, RA Skin : Large, 3 x 3cm indurated, erythematous lesion located over the patient’s right temporal scalp (Image 1). Minakova E, Doniger SJ. Pediatr Emerg Care. 2014 Jun;30(6):437-9.

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E-9-1-1 Emergency Department OR 189

ACEP Now

AUGUST 29, 2023

9—Kickoff Party with a speakeasy theme at the Old Reading Terminal Oct. Check Out This New Opioids Education Series from E-QUAL ACEP’s Emergency Quality Network (E-QUAL) is serving up some fresh educational content as part of its Opioid Initiative. 10—Dine Around Dinners featuring the best of the Philly food scene Oct.

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E-9-1-1 Naloxone Emergency Department EMS 52

ACEP Now

OCTOBER 11, 2024

Introduction Pediatric intubations in the emergency department (ED) occur at only a tenth the frequency of adult intubations. 1 Pediatric rapid sequence intubation (RSI) in the ED is associated with a higher frequency of failed first attempts and adverse effects than in adult patients. Her breathing is irregular. 3 mg/kg IV.

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E-9-1-1 Emergency Department Advanced Life Support ALS 52

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. A radiograph is shown (see figure 1). LEARN MORE The most common nerve blocks in this study are shown in Table 1. LEARN MORE The most common nerve blocks in this study are shown in Table 1. 2023 Sep 2;15(9):e44583.

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E-9-1-1 Emergency Department ED ALS 52

EMDocs

OCTOBER 5, 2024

A 62-year-old female patient with a history of recurrent urinary tract infections (UTIs) presents to the emergency department with fever, chills, and dysuria. 3 Epidemiology 4-8 ESBL-producing Enterobacteriaceae (ESBL-E) have been reported worldwide. The gastrointestinal tract is the main reservoir for ESBL-E.

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E-9-1-1 EMS ALS OR 74

Broome Docs

JANUARY 30, 2023

PMID: 33933300 Khan A, Saleem MS, Willner KD, Sullivan L, Yu E, Mahmoud O, Alsaid A, Matsumura ME. Association of Chest Pain Protocol-Discordant Discharge With Outcomes Among Emergency Department Patients With Modest Elevations of High-Sensitivity Troponin. 2022 Sep 1;5(9):e2235575. Am J Emerg Med. JAMA Netw Open.

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E-9-1-1 Emergency Department Defibrillator ALS 52

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. Stein et al.

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E-9-1-1 ACS Emergency Department ALS 133

EMDocs

FEBRUARY 15, 2024

1 These plants contain tropane alkaloids such as atropine (mixture of d-hyoscyamine and l-hyoscyamine) and scopolamine which are muscarinic receptor antagonists. 2 Jimson weed ( Datura stramonium, Figure 1) is one of several anticholinergic plants that if ingested can cause anticholinergic toxicity. 3 Figure 1. 3 Figure 1.

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E-9-1-1 Overdose ED OR 90

ACEP Now

JANUARY 9, 2024

A 3-year-old male was brought to the emergency department (ED) by his mother, who reported the sudden onset of a rash (hives) covering his entire body, with no rash on his palms and soles. The next day, the patient’s mother was called to come to the emergency department with the patient due to abnormal labs.

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E-9-1-1 ALS Emergency Department ED 52

Don't Forget the Bubbles

MAY 8, 2024

You will find the list is broken down into four sections: 1.Reviews 2024 Apr 9. 2024 Apr 25:archdischild-2023-326533. A silent scream in the pediatric emergency department: child abuse and neglect. 2024 Apr 18:fetalneonatal-2023-326679. 2024 Apr 16:archdischild-2023-326247. 2024 Apr 9.

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E-9-1-1 ALS Emergency Department Epinephrine 69

EMDocs

MAY 11, 2024

CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis? Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al. Updated 2023 Jun 24]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Updated November 9, 2023.

EMS 89

EMS E-9-1-1 ALS OR 89

EMDocs

APRIL 13, 2024

1] In a survey of college wrestlers, the incidence of auricular hematoma was found to be 52% for those who do not wear headgear versus 26% who wore ear protection.[2] 1] In a survey of college wrestlers, the incidence of auricular hematoma was found to be 52% for those who do not wear headgear versus 26% who wore ear protection.[2]

EMS 82

EMS E-9-1-1 OR Emergency Department 82

EMDocs

JUNE 27, 2024

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? 2022 Jul 5;328(1):57-68. 2020 Feb 12;10(1):2470.

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E-9-1-1 ICU ACS EMS 76

EMDocs

MARCH 30, 2024

Comprehensive physical exam is unremarkable, but she does have pain at the T-12/L-1 region of her back. Her patellar reflexes are 1+ bilaterally, no ankle clonus is noted, and she denies any saddle anesthesia or bowel/bladder incontinence. CT of lower spine is ordered and shows the following: 1 What is the diagnosis?

EMS 90

EMS E-9-1-1 Emergency Department Ambulance 90

EMDocs

NOVEMBER 18, 2023

A point of care ultrasound of the liver reveals the following: Image 1: Ultrasound of the liver showing abnormal hepatic artery flow and resistance index 1 Question: What is the diagnosis? Rosh Review Website Link References 1) Karmazyn B, Sağlam D, Rao GS, Jennings SG, Mangus RS. In: Molmenti E, Santibañes M, Santibañes E.

EMS 69

EMS E-9-1-1 ALS Emergency Department 69

EMDocs

JULY 29, 2023

A 75-year-old male with past history of HTN, CVA, DM II presents to the emergency department with right facial swelling since last night. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Other bacterial causes include anaerobic oral flora, Strep viridans, E. RR 18, SpO2 97% on RA.

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E-9-1-1 EMS Emergency Department OR 71

EMDocs

NOVEMBER 4, 2023

Accessed April 26, 2023. aureus infections among patients in the emergency department. Skin and Soft Tissue Infections in the Emergency Department. Emerg Med Clin North Am. 2008;1(1):165. link] =2969&sectionid=250456991 Moran GJ, Krishnadasan A, Gorwitz RJ, et al. Methicillin-resistant S.

EMS 68

EMS E-9-1-1 Emergency Department ALS 68

EMDocs

AUGUST 22, 2024

1 However, we recognize that many patients prefer to speak a language other than English regardless of their English proficiency, and this does not indicate a deficiency. 9 Less likely to be satisfied with their care and have a lower understanding of their discharge instructions. Annals of Emergency Medicine. 45:446-458.

Emergency Department 82

Emergency Department ALS E-9-1-1 ED 82

Don't Forget the Bubbles

FEBRUARY 5, 2024

Paediatric advocacy still has a long road ahead… You will find the list is broken down into four sections: 1.Reviews 2024 Jan 1;43(1):e11-e13. 2024 Jan 12:archdischild-2023-326225. 2024 Jan 23:archdischild-2023-325984. 2024 Jan 9. 2024 Jan 1;153(1):e2022060119. 2024 Jan 1;153(1):e2023063039.

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E-9-1-1 ALS ED Emergency Department 52

Don't Forget the Bubbles

MAY 6, 2024

Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. Clinical Course of Children 1 to 24 Months Old With Positive Urine Cultures Without Pyuria. 2024;24(1):111-118. 2024 Feb 28:fetalneonatal-2023-326501. doi: 10.1136/archdischild-2023-326501. Giannoni, E., Acad Pediatr.

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E-9-1-1 Emergency Department OR ALS 75

EMDocs

SEPTEMBER 7, 2023

1 Clinical Questions: When should a clinician suspect diethylene glycol (DEG) toxicity? Toxicity typically evolves through three phases: 2,3,7,8,9 Phase 1: Gastrointestinal symptoms (e.g., 1 Of the 57 children, 96% had confirmed exposures to the acetaminophen-based teething medication.

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E-9-1-1 ALS Emergency Department Plasma 66

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. Around 80% of those reported pass spontaneously, with another 10-20% requiring endoscopic removal and only 1% requiring surgical intervention. BMC Pediatrics , 21 (1), Jackson, J., Pediatric Emergency Care, 31 (8), pp.605-607. 2012 Jan;3(1):6.

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E-9-1-1 ALS Emergency Department OR 111

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. Antibiotics 2023, 12, 1092. cited 2023 Jan 3]. cited 2023 Jan 3].

Emergency Department 143

Emergency Department E-9-1-1 ALS OR 143

REBEL EM

JULY 3, 2023

Impact of intravenous calcium with diltiazem for atrial fibrillation/flutter in the emergency department. Am J Emerg Med. What They Did: Researchers conducted a multicenter, retrospective cohort study in three community hospitals and two freestanding emergency departments. Article: Rossi N et al.

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E-9-1-1 EMR Emergency Department ED 98

Don't Forget the Bubbles

MAY 29, 2023

A study of teams over a 1-year period highlights that people witnessing incivility are also affected, which could lead to individuals feeling unsupported in their teams. 2021:36:1–2, NP448–NP473 Available at. Review of Cultivating Communities of Practice: A Guide to Managing Knowledge, by Wenger E, McDermott R, Snyder WM].

Critical Care 98

Critical Care E-9-1-1 Paramedicine Paramedicine 98

ALiEM

MARCH 7, 2024

Ultrasound probes from left to right: linear (nenoates), phased array (infants/younger children), and curvilinear (older children/adolescents) Pro tips for performing renal/bladder POCUS on a child [1] Addressing potential anxiety leads to a more efficient and comfortable examination. Estimated volume = 39.2

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E-9-1-1 Emergency Department ALS ED 177

Dr. Smith's ECG Blog

MARCH 9, 2023

Sent by anonymous, written by Pendell Meyers A man in his 50s with no prior known medical history presented to the Emergency Department with severe intermittent chest pain. Proven STEMI has an open artery in 19% to 36% of cases, depending on whether it is TIMI −1, −2, or −3 flow. Pol Arch Intern Med. 2017;127:401–411.

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E-9-1-1 STEMI Coronary ALS 52

Don't Forget the Bubbles

OCTOBER 19, 2023

Dani gave this talk at the Irish Association of Emergency Medicine Annual Scientific Conference in October 2023 Once upon a time, there were two beautiful people, Barbie and Ken. However, the primary outcome, a quality of life score at six months, the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7%

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E-9-1-1 ED OR Emergency Department 81

Don't Forget the Bubbles

JULY 17, 2023

’, ‘ Does the language of the patient influence A&E triage? ’, ‘ What is the association between breastfeeding duration and educational achievement? ’, and ‘ What are the findings of the SCOUT trial? ’. You will find the list is broken down into four sections: 1.Reviews 2023 Jun;38(6):1733-1751. 2023 May 16;28(3):172-183.

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E-9-1-1 ALS Emergency Department Emergency Medical Services 98

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Bibl K, Pracher L, Küng E, Wagner M, Roesner I, Berger A, Hermon M, Werther T. Acad Emerg Med. 1994 Jul;125(1):57-62. West J Emerg Med. 2023 Apr 28;24(3):579-587. 2019 Sep;74(9):1186-1190.

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

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. ECG 1 What do you think?

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E-9-1-1 OR Coronary ACS 111

Broome Docs

MARCH 28, 2024

Emerg Med J. doi: 10.1136/emermed-2023-213285. 2023 Sep 21:ciad571. Ann Emerg Med. 2023 Sep 19:S0196-0644(23)00671-6. Am J Emerg Med. PMID: 34890894 Myth 1: Kayexalate is safe and useful. 2024 Jan 2;53(1):afad255. 2023 Dec;193:109991. 2024 Jan 22;41(2):96-102. Is our PPE evidence-based?

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E-9-1-1 ICU Emergency Department ALS 100

Don't Forget the Bubbles

JULY 22, 2024

study from 200 9. A large proportion of the trials come from Finland (3) and The UK (2) and also from Australia (1) and the US (1), but only a small number took place in the ED. Castro-Rodriguez JA, Beckhaus AA, Forno E. Annals of Emergency Medicine. 2019 Aug;9(8):e028511. 2023 Dec;78(12):1175–80.

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E-9-1-1 ALS ACS ED 105

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). Here are ten things to think about: 1. Churruca K, Pavithra A, McMullan R, Urwin R, Tippett S, Cunningham N, Loh E, Westbrook J.

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E-9-1-1 Critical Care CPR ICU 105

Don't Forget the Bubbles

AUGUST 14, 2023

You will find the list is broken down into four sections: 1.Reviews 2023 Jul 31. 2023 Jul 25:e2022060531. 2023 Jul 22;28(5):324-330. 2023 Jul 20. 2023 Jul 19:archdischild-2023-325668. 2023 Jul 20;389(3):251-261. 2023 Jul 28:113648. 2023 Jul 28:113647. 2023 Jul 27.

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