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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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 (..)

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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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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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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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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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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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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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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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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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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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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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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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EMDocs

OCTOBER 30, 2023

1 The shortage in supply posed difficulties for hospitals that significantly depend on GE Healthcare as their supplier, which encompassed approximately 50% of hospitals in the United States (US). Production levels increased steadily back to baseline, achieving normal supply levels in February 2023. 11 Table 1.

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REBEL EM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

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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.

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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]

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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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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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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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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?

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Don't Forget the Bubbles

JUNE 30, 2023

He has already climbed Ben Nevis in Scotland, visited the Gobi desert (possibly from the comfort of his parents 4 x 4, but who’s judging) and has his bronze D of E nailed. She calls out her findings: A – OK B – 1 puncture mark to the anterior left chest wall, covered with a three-sided dressing. Actively oozing.

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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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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.

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REBEL EM

FEBRUARY 5, 2024

Sites: Investigators recruited patients at 31 French emergency departments at university and nonuniversity hospitals Duration : June 1, 2009 to March 31, 2015. Recurrence of pneumothorax within 1 year. Pneumothorax recurrence within 1 year: 20% for aspirations, 27% for chest tubes. Panacek, E. Strange, C.,

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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.

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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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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.

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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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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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Don't Forget the Bubbles

AUGUST 4, 2024

Several case-based variables (older age, mechanism of injury given, location of injury) were associated with diagnostic error, and these variables can be used to close specific skill gaps for clinicians in an emergency department setting to avoid further harm. You will find the list is broken down into four sections: 1.Reviews

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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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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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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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ACEP Now

SEPTEMBER 3, 2024

1 Immediately after the purchase, the real estate holdings of the hospitals were spun off into a separate company owned by Paladin and other PE investors. 1 Immediately after the purchase, the real estate holdings of the hospitals were spun off into a separate company owned by Paladin and other PE investors.

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EMDocs

FEBRUARY 26, 2024

1 While PJP gained significant recognition among HIV-positive adults during the early AIDS epidemic, the growing utilization of immunosuppressants has resulted in an increased incidence of the disease in individuals who are HIV-negative. 9 The signs and symptoms of PJP infection are non-specific. for detecting pulmonary opacities.

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NAEMSP

APRIL 19, 2023

This CI does include 1; and further and further analysis of the data showed that the likelihood that calcium has a beneficial effect (e.g. The overall conclusion was that as less than 1% of cardiac arrest etiologies fall into a group that would potentially benefit from calcium, that routine use should be avoided (Padrao, et.

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