Don't Forget the Bubbles

OCTOBER 4, 2023

2023 Sep 13. 2023 Sep 8. 2023 Sep 27. 2023 Sep 23;28(6):377-393. 2023 Sep 23;28(6):362-376. 2023 Sep 26;330(12):1175-1186. 2023 Sep 2;402(10404):809-824. 2023 Sep 14;389(11):987-997. 2023 Sep 15:113740. Arch Dis Child Fetal Neonatal Ed. 2023 Sep 14:fetalneonatal-2023-325600.

E-9-1-1 111

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

EMDocs

DECEMBER 31, 2023

Without further ado, here is our list of top posts from 2023 based on viewership from you, the readers: Neurogenic Shock: Definition, Identification, and Management in the ED We start off the list with a clinical post from Kira Brayan and Jenny Beck-Esmay on diagnosing and managing neurogenic shock! This post from Mary E.

ED 74

ED EMS OR 74

Pediatric EM Morsels

AUGUST 23, 2024

Concussion – Presentation [ Silverberg, 2023 ] There is no definitive test to diagnose concussion in the ED. Progression through Return to Learn and Return to Sport:[ Patricios, 2023 ] Is individualized and based on the person’s symptoms Typically takes a minimum of 1 week. Now highlights the scholastic component!

Emergency Department 243

Emergency Department OR ED EMS 243

The Skeptics' Guide to EM

MARCH 25, 2023

Date: March 22, 2023 Reference: Hilsden et al. Casey […] The post SGEM#398: Another Ab Gets BUSED – POCUS in the ED for Biliary Disease first appeared on The Skeptics Guide to Emergency Medicine. Date: March 22, 2023 Reference: Hilsden et al. He is also now a fully-fledged “sonologist”.

ED 130

ED Critical Care Emergency Department ALS 130

Don't Forget the Bubbles

OCTOBER 10, 2024

This time the team from Bristol Royal Children’s Hospital ED tell us what is new in the world of paediatric literature… Led by Dr John Coveney a Paediatric Emergency Medicine Trainee in Bristol who has revived The Journal Club at Bristol Royal Children’s Hospital ED on a monthly basis. 2023 Mar 30;110(4):432-438.

ED 75

ED Emergency Department OR ALS 75

ESO

MARCH 7, 2024

The 2023 ESO Trauma Index offers a detailed analysis of current trends and benchmarks in trauma care, setting a new standard for improvement. Antibiotics and Open Long Bone Fractures: The 2023 Index points out that 67.3% of patients with open long bone fractures receive antibiotics within the critical first 60 minutes of ED arrival.

Operating Room 105

Operating Room ICU OR ED 105

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 315

Critical Care ALS ED Emergency Department 315

EMDocs

NOVEMBER 6, 2023

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline for managing cardiac arrest or life-threatening toxicity due to poisoning was recently released. This post will focus on the key parts of the guideline that affect ED evaluation and management. COR Harm, LOE B-R.

Naloxone 94

Naloxone OR Overdose BLS 94

ALiEM

FEBRUARY 28, 2024

September 18, 2023. References Iverson C, ed. Example: Mason J. Trismus from Ludwig angina. Accessed February 20, 2024. Clinical photograph for: Ludwig Angina. CorePendium. In the example below, there is no specified date of publication for the image. Trick of the trade: getting the last bit of ultrasound gel from the bottle.

OR 130

OR ED 130

ALiEM

JULY 17, 2023

sought to identify program factors associated with unfilled post-graduate year 1 (PGY-1) emergency medicine (EM) positions in the 2023 Match [1]. as well as an analysis of the 2023 Match by Pupazan and Cook in Emergency Medicine News [3,4]. A staggering 131 (47%) EM residency programs had unfilled PGY-1 positions among in 2023 [7].

EMS 130

EMS ALS Emergency Department ED 130

The Skeptics' Guide to EM

DECEMBER 30, 2023

Overnight stay in the emergency department and mortality in older patients, JAMA Intern Med 2023 Date: December 18, 2023 Guest Skeptic: Dr. Chris Carpenter, Vice Chair of Emergency Medicine at Mayo Clinic. McG) presents to your emergency department (ED) after being found by family on the ground at her independent living facility.

Emergency Department 273

Emergency Department ED ALS OR 273

EMDocs

JANUARY 8, 2024

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association 2023 Guideline Updates for 2023 were just published. This post will focus on the key parts of the guideline that affect ED evaluation and management. COR 2a, LOE B-R. COR 2a, LOE C-LD. COR 2b, LOE B-R. COR 2b, LOE B-R.

Epinephrine 83

Epinephrine Defibrillator Coronary CPR 83

The Skeptics' Guide to EM

OCTOBER 21, 2023

Date: October 20, 2023 Reference: Cai et al. AEM October 2023. Case: You are in your group meeting and have heard about a case at a nearby emergency department (ED) where the […] The post SGEM#418: I Ain’t Missing You – Spinal Epidural Abscess first appeared on The Skeptics Guide to Emergency Medicine. AEM October 2023.

Emergency Department 269

Emergency Department ALS ED OR 269

The Skeptics' Guide to EM

JANUARY 6, 2024

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. 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.

Emergency Department 266

Emergency Department Emergency Medical Services ALS ED 266

ACEP Now

APRIL 5, 2024

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. The study found a mean increase in time to intubation of 13 seconds in the ED setting. Vital signs on arrival are: Temperature: 38.8 He has an absent gag reflex. There was no analysis of operator experience or expertise.

OR 73

OR ALS Emergency Department Critical Care 73

The Skeptics' Guide to EM

DECEMBER 2, 2023

JAMA July 2023 Date: October 17, 2023 Guest Skeptic: Dr. Alasdair Munro is a clinical research fellow specializing in pediatric infectious disease at the University of Southampton. Case: A 4-year-old girl presents to your emergency department (ED) with fever and nasal drainage. Reference: Shaikh N, et al.

Emergency Department 303

Emergency Department ALS OR ED 303

Broome Docs

OCTOBER 28, 2023

2023 Jun 14. 2023 Sep 5;120(36):e2222103120. Epub 2023 Aug 29. 2023 May 1;136(5):913-919. Epub 2023 Apr 14. 2023 Aug 3;389(5):418-429. Epub 2023 Jun 16. 2023 Sep 14;389(11):1051-1052. 2023 Aug 1;183(8):818-823. 2023 Jun 12. 2023 May 25;388(21):1956-1965. Fitzpatrick, S.

ALS 67

ALS ED OR 67

ACEP Now

NOVEMBER 7, 2023

ACEP President Speaks at Summit In October, ACEP President Dr. Aisha Terry spoke at the Summit on Emergency Department Sickle Cell Care, and discussed point of care tools, standardization of care processes, improving ED care and more. The post November 2023 News from the College appeared first on ACEP Now.

Emergency Department 98

Emergency Department EMS ED OR 98

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. 2023, March 23). Extraocular movements intact. Ocular pressure deferred. Absent right lens.

Emergency Department 161

Emergency Department OR ED 161

ACEP Now

SEPTEMBER 28, 2023

It is important to monitor key issues, including annual emergency department (ED) visits, geographic distribution of physicians, and the equilibrium between new entrants and retirees in the workforce. This report provides information on the 2023 job search for the most recent residency graduates. NRMP 2023 match data: results and data.

Emergency Department 98

Emergency Department ALS ED OR 98

ALiEM

FEBRUARY 5, 2024

Take the AIR Toxicology Module at ALiEMU Interested in taking the AIR quiz for fun or asynchronous (Individualized Interactive Instruction) credit? Please go to the above link. You will need to create a free, 1-time login account. Alex Rogers MD, J.D. Reference Lin M, Phipps M, Chan TM, et al. Ann Emerg Med. 2023;82(1):55-65.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. No peritoneal signs. Non-tender rectal exam.

Emergency Department 152

Emergency Department ED OR 152

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

Date: August 30, 2023 Reference: Griffey et al. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta. Date: August 30, 2023 Reference: Griffey et al. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta.

ICU 206

ICU ED Critical Care ALS 206

EMDocs

SEPTEMBER 27, 2023

It includes a number of expensive medications that patients in the ED are commonly prescribed such as Xarelto, Eliquis, and insulin. In today’s post, we’ll highlight the most important aspects of each topic. What’s the issue? Multiple changes to Medicare are being enacted or proposed this fall. References American Medical Association.

Emergency Department 63

Emergency Department ALS OR ED 63

The Skeptics' Guide to EM

NOVEMBER 25, 2023

Date: November 22, 2023 Reference: Stopyra et al. AEM November 2023. Date: November 22, 2023 Reference: Stopyra et al. AEM November 2023. We looked at 101 STEMI patients from two rural EDs. AEM November 2023. first appeared on The Skeptics Guide to Emergency Medicine. Reference: Stopyra et al.

Heart Attack 283

Heart Attack STEMI Emergency Medical Services Coronary 283

ALiEM

OCTOBER 27, 2023

A 26-year-old male with no significant past medical history presented to the ED after slipping on wet pavement and hitting his head on the ground three hours prior. He endorsed a constant, achy 7/10 headache accompanied by nausea and photophobia. He denied vomiting, dizziness, diplopia, loss of consciousness, or seizures.

OR 278

OR ED 278

ALiEM

MARCH 1, 2024

A 24-year-old female with no pertinent PMHx presents to the ED with a chief complaint of eye pain. Her mom convinced her to go to the ED and she first went to an outside hospital, but was referred to come to our institution. Accessed January 2023. She had been managing her pain with ice and had not taken any OTC medications.

ED 152

ED OR 152

The Skeptics' Guide to EM

OCTOBER 28, 2023

Date: October 26, 2023 Reference: Jones et al. Lancet July 2023 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. Date: October 26, 2023 Reference: Jones et al. His twitter handle is @PainFreeED.

ALS 226

ALS Emergency Department ED OR 226

ALiEM

AUGUST 30, 2024

A 5-year-old female presented to the emergency department (ED) with a one-year history of gradually increasing anterior neck swelling. She was discharged from the ED on levothyroxine 25 mcg daily with endocrinology outpatient follow-up. The patient had no significant past medical history. Abdominal : Soft. No distention or tenderness.

ACS 161

ACS Emergency Department ED OR 161

The Skeptics' Guide to EM

JUNE 24, 2023

Date: June 16, 2023 Reference: Reed et al. AEM June 2023 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Date: June 16, 2023 Reference: Reed et al. cm left forearm abscess. Reference: Reed et al.

Overdose 187

Overdose Emergency Department ALS ED 187

ALiEM

MARCH 18, 2024

A 30-year-old female with a past medical history of Crohn’s Disease presented to the ED for evaluation of an acutely bruised right 4th finger. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved.

Emergency Department 306

Emergency Department ED OR 306

ACEP Now

OCTOBER 31, 2023

Emergency physicians have a unique opportunity to recognize these cases and to intervene, as medically neglected children may be brought to the ED once illness becomes severe. medical neglect accounts for approximately 2 percent of child-abuse cases. Caregivers may neglect the medical care of children for varied reasons.

ED 52

ED OR EMS 52

ACEP Now

NOVEMBER 15, 2023

It is important to monitor key issues, including annual emergency department (ED) visits, geographic distribution of physicians, and the equilibrium between new entrants and retirees in the workforce. This report provides information on the 2023 job search for the most recent residency graduates. Click to enlarge. Click to enlarge.

Emergency Department 52

Emergency Department ALS ED OR 52

Pediatric EM Morsels

JULY 26, 2024

It is commonly missed during the first few ED visits. Keep a high index of suspicion for anti-NMDAr encephalitis in children and adolescents who have had multiple ED visits for new and worsening psych/behavioral concerns, seizures, and/or movement disorders over several months. 2023 Jul 17. The prevalence ranges from 12.5%-61%

Plasma 265

Plasma OR ED Critical Care 265

Pediatric EM Morsels

AUGUST 9, 2024

Hussain, 2023 ] Leads to >300,000 perinatal deaths / year globally. Congenital syphilis differs from syphilis contracted by an “adult” in that: [ Hussain, 2023 ] T. Hussain, 2023 ] Excellent prognosis if treated early. Neonates presenting to the Emergency Department often cause a lot of uncertainty.

E-9-1-1 152

E-9-1-1 Plasma Emergency Department OR 152

REBEL EM

JUNE 5, 2023

These statistics make the ED a crucial treatment initiation point to prevent further morbidity and mortality from opioid overdoses. The benefit of accessibility, availability, and safety of buprenorphine compared to methadone makes it a viable option for opioid use disorder treatment initiation in the ED. PMID 33392580.

Naloxone 98

Naloxone ED Overdose Emergency Department 98

ALiEM

MAY 24, 2023

Updated 2023 Mar 11]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. In: Fleisher and Ludwig’s Textbook of Pediatric Emergency Medicine, 7th ed, Shaw K, Bachur RG (Eds), Lippincott Williams & Wilkins, Philadelphia 2015. Apply lidocaine gel on the area of entrapment for 2-3 minutes.

ED 233

ED OR 233