The Skeptics' Guide to EM

JULY 20, 2024

Reference: Gibbs et al. NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. Reference: Gibbs et al. NEJM June 2024. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial).

ALS 234

ALS Emergency Department ED OR 234

The Skeptics' Guide to EM

MARCH 2, 2024

Reference: Gibbons et al. AEM February 2024. Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Reference: Gibbons et al. AEM February 2024.

Operating Room 306

Operating Room Emergency Department ALS ED 306

The Skeptics' Guide to EM

APRIL 27, 2024

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. February 2024. Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation.

ICU 195

ICU Defibrillator CPR Paramedic 195

The Skeptics' Guide to EM

JULY 6, 2024

Reference: Tjan et al. AEM June 2024 Date: July 5, 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Reference: Tjan et al. Conflict in emergency medicine: A systematic review.

ED 210

ED ALS Emergency Department OR 210

The Skeptics' Guide to EM

APRIL 20, 2024

AEM April 2024 Date: April 19, 2024 Guest Skeptic: Dr. Suchismita Datta. AEM April 2024 Date: April 19, 2024 Guest Skeptic: Dr. Suchismita Datta. A clinical decision tool called the STUMBL score was derived and validated by Battle et al in 2014 [3]. These risks are particularly higher in the elderly [2].

Emergency Department 204

Emergency Department Overdose ALS ED 204

The Skeptics' Guide to EM

AUGUST 24, 2024

Date: August 19, 2024 Reference: Partyka et al. JAMA Surg 2024 Guest Skeptic: Dr. Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Reference: Partyka et al.

Emergency Department 127

Emergency Department ALS OR ED 127

The Skeptics' Guide to EM

SEPTEMBER 14, 2024

Date: September 12, 2024 Reference: Anderson et al. AEM August 2024. A pivotal study by Raja et al. Koo et al showed that offering amoxicillin oral challenges to ICU patients with low-risk penicillin allergies. Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergency department.

ICU 109

ICU Emergency Department ALS ED 109

The Skeptics' Guide to EM

JUNE 1, 2024

Reference: Tavender E, et al. 2024 Date: May 29, 2024 Guest Skeptic: Dr. Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washington School of Medicine and Health Sciences in Washington, DC.

Emergency Medical Services 207

Emergency Medical Services Emergency Department EMS ALS 207

Pediatric EM Morsels

JUNE 21, 2024

Liu 2024] A silver-based dressing has been shown to have longer healing times as compared to antibiotic ointment when compared head-to-head. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: [link] Liu H, Li D, Yuan H, et al. 2024; 40 (5): 390-394. Updated 2023 May 29]. In: StatPearls [Internet].

ALS 169

ALS OR EMS 169

The Skeptics' Guide to EM

AUGUST 10, 2024

Date: July 29, 2024 Reference: Connolly SJ et al (ANNEXA-I investigators) Andexanet for Factor Xa Inhibitor–Associated Acute Intracerebral Hemorrhage. NEJM May 2024 Guest Skeptic: Dr. Vasisht Srinivasan is an Emergency Medicine physician and neurointensivist at the University of Washington and Harborview Medical Center in Seattle, WA.

Emergency Medical Services 183

Emergency Medical Services ALS Emergency Department ED 183

ALiEM

JANUARY 5, 2024

What does the Electronic Residency Application Service (ERAS) preliminary data show just far for the 2024 residency application season? Aaron Kraut (University of Wisconsin PD) in this insightful, rapid-fire, practical episode through the lens of experienced residency program directors. Has the program signaling option been working?

EMS 177

EMS ALS OR 177

The Skeptics' Guide to EM

JUNE 8, 2024

Reference: Kruse et al. WJEM December 2023 Date: May 30, 2024 Guest Skeptic: Dr. Kay Dingwell is a rural emergency physician working in Prince County, PEI with a special interest in gender-affirming care and improving the care of trans and gender-diverse patients. Reference: Kruse et al.

Emergency Department 312

Emergency Department ED ALS Paramedic 312

The Skeptics' Guide to EM

JULY 27, 2024

Reference: Knack et al. A similar review by Sanders et al 2015 concludes that clinica. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. In those that did compare to clinical judgement, physician judgement was superior in 29% and equivalent or mixed in 46%.

ICU 192

ICU ALS Ambulance OR 192

The Skeptics' Guide to EM

JANUARY 13, 2024

Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Date: January 11, 2024 Guest Skeptic: Dr. Chris Root is an EMS fellow in the Department of Emergency Medicine at the University of New Mexico Health Sciences Center in Albuquerque, NM. Resuscitation 2023.

CPR 230

CPR Defibrillator First Responder Epinephrine 230

The Skeptics' Guide to EM

FEBRUARY 11, 2024

Reference: McLatchie et al and DAShED investigators. Date: February 11, 2024 Guest Skeptic: Nirdosh Ashok Kumar, Emergency Medicine Specialist – Aga Khan University Hospital, Karachi, Pakistan. […] The post SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Syndrome in the ED. EMJ Nov 2023. EMJ Nov 2023.

ED 307

ED Emergency Department ALS OR 307

Don't Forget the Bubbles

SEPTEMBER 2, 2024

Neonatal Bubble Wrap from Brian Dunn Seidler AL, Aberoumand M, Hunter KE, Barba A, Libesman S, Williams JG, Shrestha N, Aagerup J, Sotiropoulos JX, Montgomery AA, Gyte GM. 2024 May 30;390(20):1885-94. 2024 Mar 26;331(12):1035-44. 2024 Aug 1;178(8):784-91. 2024 Aug 1;178(8):784-91. 2024 Jul 11;391(2):144-54.

ALS 105

ALS EMS OR 105

ACEP Now

AUGUST 13, 2024

Accessed July 15, 2024. Accessed July 15, 2024. Accessed July 15, 2024. McGregor B, Belton A, Henry TL, et al. Published March 25, 2024. Accessed July 15, 2024. Accessed July 15, 2024. Nguyen, A, Siman, N, Barry, M, Cleland, C, et al. Published March 22, 2024. Accessed July 15, 2024.

ALS 111

ALS Emergency Department OR ED 111

The Skeptics' Guide to EM

FEBRUARY 3, 2024

Reference: Curry SD, et al. March 2023 Date: January 30, 2024 Guest Skeptic: Dr. Alexandra (Ali) Espinel is an Associate professor of pediatrics and otolaryngology at Children’s National Hospital and George Washington University. Reference: Curry SD, et al. Reference: Curry SD, et al. Laryngoscope. Laryngoscope.

ALS 163

ALS Emergency Department OR ED 163

Pediatric EM Morsels

APRIL 5, 2024

CDC 2024) Generally, most ticks require >24 hours of attachment for there to be a risk of transfer of the infectious agent. Other Rickettsial Disease of concern from non-tick vectors (CDC Yellow Book 2024) Murine Typhus Causative Agent: Rickettsia typhi and the principal vector is the Asiatic rat flea. John H, Jian J, RIchards AL.

E-9-1-1 161

E-9-1-1 ALS OR EMS 161

EMOttawa

MAY 13, 2024

Methodology: 4/5 Usefulness: 3/5 von Hellmann R, et al. 2024 Feb;83(2):132-144. Ann Emerg Med. Question and Methods: Systematic review of 18 studies (12 RCT) of adult patients comparing bougie use vs standard of care in tracheal intubations to evaluate first-attempt success.

ALS 112

ALS ED 112

Core EM

JANUARY 25, 2024

References: Yuan TH, Kerns WP, Tomaszewski CA, et al. von Lewinski D, Bruns S, Walther S, et al. Cole JB, Corcoran JN, Engebretsen KM, et al. Holger JS, Engebretsen KM, Fritzlar SJ, et al. Kerns W, Schroeder D, Williams C, et al. Kline JA, Tomaszewski CA, Schroeder JD, et al. 2007;33(11):2019-2024.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

The Skeptics' Guide to EM

MAY 25, 2024

Reference: Borgundvaag et al. AEM May 2024 Date: May 22, 2024 Dr. Bjug Borgundvaag Guest Skeptic: Dr. Bjug Borgundvaag is the Founding Director of the Schwartz/Reisman Emergency Medicine Institute (SREMI), at Sinai Health System.

ED 199

ED Emergency Department ICU ALS 199

The Skeptics' Guide to EM

MARCH 23, 2024

Reference: Marx et al. Reference: Marx et al. 2023 Date: March 22, 2024 Guest Skeptic: Dr. Richard Malthaner holds the prestigious position of Chair/Head of the Division of Thoracic Surgery and serves as the Director of the Thoracic Robotic Program at Western University’s Schulich School of Medicine and Dentistry.

ALS 143

ALS OR 143

The Bottom Line

APRIL 26, 2024

Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock Møller JE et al. DOI: 10.1056/NEJMoa2312572 Clinical Question In adults presenting with STEMI and cardiogenic shock does the use of a microaxial flow pump (Impella CP) compared to standard care reduce death from any cause at day 180?

STEMI 79

STEMI ALS OR 79

The Skeptics' Guide to EM

APRIL 6, 2024

Reference: Drysdale SB et al. 2023 Date: March 29, 2024 Guest Skeptic: Dr. Michael Cosimini is a pediatrician in Portland Oregon. Reference: Drysdale SB et al. 2023 Date: March 29, 2024 Guest Skeptic: Dr. Michael Cosimini is a pediatrician in Portland Oregon. N Engl J Med. N Engl J Med.

ALS 127

ALS Emergency Department ED 127

The Skeptics' Guide to EM

JUNE 15, 2024

Reference: Jansen et al. 2023 Date: June 10, 2024 Guest Skeptic: Dr. Rob Leeper is an intensivist, trauma surgeon, and general surgeon at Western University where he also serves as the director of the Royal College Surgical Foundations program.

Life Support 232

Life Support Emergency Department ALS 232

EMOttawa

JUNE 10, 2024

5 Montini G, et al. 2024 Jan 1;153(1):e2023062598. Methodology: 3.5/5 5 Usefulness: 2.5/5 Pediatrics. Findings: The primary outcome of recurrence of UTI within 30 […] The post Short Oral Antibiotic Therapy for Pediatric Febrile Urinary Tract Infections: A Randomized Trial appeared first on EMOttawa Blog.

ALS 62

ALS 62

EMOttawa

JUNE 24, 2024

5 Usefulness: 2/5 Nasr Isfahani M, et al. 2024 Jan 25;24(1):15. Methodology: 3.5/5 BMC Emerg Med. Question and Methods: This triple blinded RCT of 158 patients with isolated closed limb fractures assessed pain scores at 1-hour following the administration of intravenous acetaminophen, acetaminophen plus ibuprofen, or morphine.

OR 52

OR ALS 52

Dr. Smith's ECG Blog

MAY 27, 2024

Int J Cardiol 2024 2. Nikus et al. Kontos et al. Kontos et al. Bischof et al. Meyers et al. Meyers et al. Herman et al. Eur Herat J Digital Health 2024 Systematic review and meta-analysis of diagnostic test accuracy of ST-segment elevation for acute coronary occlusion.

STEMI 122

STEMI Coronary ALS Emergency Department 122

ACEP Now

JULY 7, 2024

References Brophy GM, Bell R, Claassen J, et al. Zehtabchi S, Abdel Baki SG, Omurtag A, et al. Towne AR, Waterhouse EJ, Boggs JG, et al. Huff JS, Melnick ER, Tomaszewski CA, et al. Gunawardena S, Chikkannaiah M, Stolfi A, et al. Paliwal P, Wakerley BR, Yeo LLL, et al. Prud‘hon S, Amiel H, Zanin A, et al.

Emergency Department 52

Emergency Department Critical Care ALS ED 52

Dr. Smith's ECG Blog

JUNE 14, 2024

The native QRS may be more obvious in one lead or another. == MY Comment , by K EN G RAUER, MD ( 5/30 /2024 ): == I was not taught about artifact in medical school. KEY Point: As per Dr. Frick: i ) Artifact is "alive and well" in 2024. The May XXX, 2024 post ( = Today's case by Dr. Frick ) — re Telemetry artifact that simulates PMVT.

Defibrillator 78

Defibrillator ALS Coronary OR 78

Core EM

MARCH 1, 2024

Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Accessed February 27, 2024. Stuttgart: Thieme; 2003. doi:10.1055/b-005-148905 Zayia LC, Tadi P. Neuroanatomy, Motor Neuron. Updated 2023 Jul 24].

Emergency Department 162

Emergency Department ED OR ALS 162

Dr. Smith's ECG Blog

JUNE 17, 2024

In fact, Kosuge et al. Accessed May 28, 2024. Stein et al. This is a paper worth reading : Marchik et al. Kosuge et al. Witting et al. This does not contradict the conclusions of Kosuge et al. It is nearly pathognomonic for PE. studied ECG findings of PE in 6049 patients, 354 of whom had PE.

E-9-1-1 139

E-9-1-1 ACS Emergency Department ALS 139

EMDocs

SEPTEMBER 3, 2024

EBM Update: ANNEXA-1 and DOAC Reversal in ICH Article: Connolly SJ, Sharma M, Cohen AT, et al; ANNEXA-I Investigators. 2024 May 16;390(19):1745-1755. 2024 Jul 5;28(1):221. Guideline: Greenberg SM, Ziai WC, Cordonnier C, et al; American Heart Association/American Stroke Association. N Engl J Med. 2.77) and 1.71 (95% CI 1.01–2.89),

ALS 76

ALS OR 76

FOAMfrat

AUGUST 28, 2024

2024, www.ncbi.nlm.nih.gov/books/NBK536919/. Accessed 28 July 2024. Hopkins, Erin, et al. Accessed 28 July 2024. Accessed August 8, 2024. Accessed August 8, 2024. Accessed August 8, 2024. National Library of Medicine , StatPearls Publishing, 8 Jan. Physiology, Acid Base Balance.” Metabolic Acidosis.

Critical Care 98

Critical Care Overdose OR ALS 98

ACEP Now

APRIL 5, 2024

References von Hellmann R, Fuhr N, et al. Koh LK, Kong CE, et al. Driver BE, Prekker ME, et al. Waldron O, Sena R, et al. Brown CA 3rd, Bair AE, et al. Driver BE, Semler MW, et al. Accessed March 26, 2024. Accessed March 26, 2024. Hershey Medical Center and associate editor of ACEP Now.

OR 73

OR ALS Emergency Department Critical Care 73

Dr. Smith's ECG Blog

AUGUST 2, 2024

118.007305) from Heitner et al. , We've highlighted a considerable number of acute RV MI cases in Dr. Smith's ECG Blog ( See the October 7, 2019 and May 10, 2024 posts , to name just two ). In this patient's case, the answer was clear at time of angiography, but the "culprit game" is more important than just a fun parlor trick.

STEMI 112

STEMI ALS OR 112