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

APRIL 13, 2024

Reference: Albers GW et al. NEJM Feb 2024 Date: April 12, 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. Reference: Albers GW et al. TIMELESS Investigators. Tenecteplase for Stroke at 4.5

Emergency Department 295

Emergency Department ALS OR EMS 295

Don't Forget the Bubbles

FEBRUARY 5, 2024

2024 Jan 8. 2024 Jan 1;43(1):e11-e13. Anagnostou A, et al. 2024 Jan 12:archdischild-2023-326225. Rodgers O, et al. 2024 Jan 23:archdischild-2023-325984. Schoeffl I, et al. 2024 Jan 9. Garfinkle J, et al. 2024 Jan 8:e2023063654. 2024 Jan 8:e2023063801. Peprah P, et al.

E-9-1-1 52

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

Don't Forget the Bubbles

JANUARY 1, 2024

Musolino AM, et al. Chidini G, et al. Pawlowski TW, et al. Weiss SL, et al. Hua LL, et al. Delany C, et al. Kuehn LM, et al. Woods CR, et al. Montini G, et al. Redline S, et al. Hazkani I, et al. Yildirim I, et al. Hennefield L, et al. Lock JD, et al.

ALS 98

ALS OR ED 98

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. Case: A 70-year-old man presents to the emergency department (ED) with an exacerbation of COPD. Reference: Gibbs et al.

ALS 234

ALS Emergency Department ED OR 234

The Skeptics' Guide to EM

SEPTEMBER 14, 2024

Date: September 12, 2024 Reference: Anderson et al. AEM August 2024. Case: It’s another day, another dollar in the emergency department (ED). You wonder if she could have an allergy challenge dose of ceftriaxone in the ED. A pivotal study by Raja et al.

ICU 113

ICU Emergency Department ALS ED 113

Broome Docs

FEBRUARY 22, 2024

Welcome to the first episode for 2024 – and we have a range of papers covering the big life threatening issues to the tiniest pinky finger injuries and a lot in between. Should anybody be doing REBOA in 2024? Carson JL, Brooks MM, Hébert PC, et al; MINT Investigators. 2024 Feb 6:S0196-0644(24)00004-0. N Engl J Med.

Emergency Department 103

Emergency Department ALS OR ED 103

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

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

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

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. Case: You are doing great things and helping many patients during your shift in the emergency department (ED) when you hear a trauma alert being called overheard.

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

JULY 27, 2024

Reference: Knack et al. They were randomized to ceftriaxone 2gm intravenous (IV) in the ambulance or usual cares (fluids and supplementary oxygen) until arrive to the ED. A similar review by Sanders et al 2015 concludes that clinica. A randomized control trial (RCT) done in the prehospital setting enrolled 2,698 patients.

ICU 192

ICU ALS Ambulance OR 192

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

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. Inside Higher Ed. Published March 22, 2024.

ALS 111

ALS Emergency Department OR ED 111

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 113

ALS ED 113

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

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). 2 A study of routine EEG in the ED in 2013 found that five percent of ED patients with altered mental status had nonconvulsive seizures (of whom 75 percent were in nonconvulsive status epilepticus). Neurocrit Care.

Emergency Department 52

Emergency Department Critical Care ALS ED 52

Core EM

MARCH 1, 2024

Mumenthaler M , Mattle H , Taub E , ed. 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. References Neurology. 4th Edition. Stuttgart: Thieme; 2003. Updated 2023 Feb 7].

Emergency Department 162

Emergency Department ED OR ALS 162

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

When the patient arrived in the ED, he was still hypotensive in 70s, slowly improving with EMS fluids. Here is the ED ECG (a photo of the paper printout) What do you think? QOH ( Q ueen O f H earts ) and Dr. Smith's former resident immediately diagnosed acute OMI — but providers in the ED thought the ECG findings "looked old".

EMS 108

EMS CPR ED Coronary 108

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

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. 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.

OR 73

OR ALS Emergency Department Critical Care 73

Don't Forget the Bubbles

JUNE 19, 2024

A 2024 Cochrane systematic review compared available clinical decision rules (CDRs) (NEXUS, Canadian C-Spine Rule, PECARN retrospective criteria, NICE guidelines CG56 and CG176, Leonard de novo model, and PEDSPINE) for the evaluation of potential cervical spine injury following blunt trauma in children. 2024 Jun 3:S2352-4642(24)00104-4.

CPR 121

CPR Operating Room OR Emergency Department 121

ACEP Now

FEBRUARY 11, 2024

A 25-year-old Venezuelan male presented to a Chicago area emergency department (ED) in early November 2023. He had traveled with his family through Panama, Costa Rica, Nicaragua, Honduras, Guatemala, Mexico, and Texas before arriving in Chicago approximately one month prior to his ED visit. Accessed January 15, 2024.

Emergency Department 52

Emergency Department ED ALS OR 52

EMDocs

JUNE 27, 2024

An 8-year old male with a history of sickle cell anemia presents to the ED for evaluation of fever for 2 days and “feeling like I can’t get a full breath”. 768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. Alkindi S, Al-Busaidi I, Al-Salami B, Raniga S, Pathare A, Ballas SK.

E-9-1-1 75

E-9-1-1 ICU ACS EMS 75

FOAMfrat

JULY 3, 2024

If they are not already there, get ALS-level care to the patient as soon as possible. I personally know of 2 ALS providers who were exposed to chlorine gas in a pool incident on the job and both ended up retiring from their service and still have lifelong breathing problems as a result. Dept of Transportation, 2024) is 100M (330ft).

Life Support 105

Life Support ALS Emergency Response OR 105

EMDocs

MARCH 25, 2024

Ross M, Brown M, McLaughlin K, et al. Dumbrava BD, Bass GA, Jumean A, et al. Al-Khouja F, Mazumder P, Moeller J, Lahham S. Treasure Island (FL): StatPearls PublishingCopyright © 2024, StatPearls Publishing LLC.; Treasure Island (FL): StatPearls PublishingCopyright © 2024, StatPearls Publishing LLC.; Ultrasound.

ALS 87

ALS Coronary Emergency Department ED 87

ACEP Now

APRIL 2, 2024

An 18-year-old woman presented to the emergency department (ED) with symptoms of nausea, vomiting, diarrhea, and abdominal pain. Before arriving at our ED, the patient sought care at an urgent care clinic, where she was prescribed ondansetron without improvement. References Katibi OS, Olaosebikan R, et al. Updated 03/05/2024.

Plasma 40

Plasma ALS Emergency Department ED 40

EMDocs

SEPTEMBER 27, 2023

Proposed cuts to Medicare 2024 Continuing with a long-running annual trend, the Center for Medicare and Medicaid Services (CMS) is proposing cuts to the 2024 Medicare physician fee schedule which is the method through which physicians are reimbursed for their work. “Inside the proposed 2024 Medicare physician pay schedule.”

Emergency Department 63

Emergency Department ALS OR ED 63

ACEP Now

FEBRUARY 11, 2024

A 95-year-old female with a history of stage III chronic kidney disease (CKD), heart failure with reduced ejection fraction (HFrEF), and dementia with baseline orientation only to person and place, presented to the emergency department (ED) for upper extremity myoclonic jerking for one day. Lam N, Weir M, Yao Z, et al. Am J Kidney Dis.

Emergency Department 52

Emergency Department ALS ED OR 52

Don't Forget the Bubbles

MAY 6, 2024

Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. Reviewed by: Sarah Gentle and Owen Hibberd Article 2: Second attempt success in neonatal intubation Johnson MD, Tingay DG, Perkins EJ et al. Arch Dis Child Fetal Neonatal Ed. 2024 Feb 28:fetalneonatal-2023-326501. Acad Pediatr. Stocker, M.,

E-9-1-1 75

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

EMDocs

MARCH 11, 2024

Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy. How is this condition diagnosed and treated in the ED? Accessed March 5, 2024. Rehydration Therapy.

ED 90

ED OR ALS Plasma 90

ACEP Now

APRIL 2, 2024

It was developed by Ed Currie (founder of Puckerbutt Pepper Co.), References Barboza GE, García CC, et al. In: Liedtke WB, Heller S, eds. Accessed March 26, 2024. Sharma SK, Vij AS, et al. Gummin DD, Mowry JB, et al. Arens A, Ben-Youssef L, et al. Accessed March 26, 2024. 2020;167:13-29.

ALS 40

ALS OR ED 40

ACEP Now

MARCH 15, 2024

A 20-year-old man presents to the emergency department (ED) directly from the scene of a fall from a bicycle, where he lost balance and landed on his outstretched hand. 6 A missed DRUJ injury may lead to chronic wrist supination deficit and pain, which can be prevented with surgery in some cases, so early diagnosis in the ED is important.

ALS 52

ALS ED OR EMS 52

Don't Forget the Bubbles

AUGUST 4, 2024

Brewster RCL, et al. 2024 Jul 9:e2023064794. 2024 Jul 8. 2024 Jul 21. 2024 Jul 22;29(4):255-269. 2024 Jul 29. Strunk T, et al. 2024 Jul 20;404(10449):277-293. 2024 Jul 20;404(10449):277-293. 2024 Jul 11. Pinon A, et al. 2024 Jul 11. Vassilopoulou E, et al.

E-9-1-1 52

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

Don't Forget the Bubbles

JANUARY 17, 2024

After Meshram et al, 2020 When Orbeez are exposed to water, the water molecules diffuse into the polymer network through osmosis. Image adapted from Mullens et al., ” ( Ed. After Darracq et al., A recent literature review by Caré et al. Zamora et al., From Mullens et al., Krisch et al.

E-9-1-1 111

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

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. On ED presentation, he was experiencing 10 out of 10 pain level. In the January issue of Annals of Emergency Medicine , Merz-Herrara, et al., 2024 Jan;83(1):14-21. A radiograph is shown (see figure 1). Ann Emerg Med.

E-9-1-1 52

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