The Skeptics' Guide to EM

MARCH 2, 2024

Reference: Gibbons et al. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. AEM February 2024. Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY.

Operating Room 301

Operating Room Emergency Department ALS ED 301

Don't Forget the Bubbles

MAY 8, 2024

Dell KM, et al. 2024 Apr 27. Eisen S et al. 2024 Apr 16:archdischild-2024-326876. Fielder AR, et al. 2024 Apr 11 Why all newborn hip screening programs have same results-a mini review. 2024 Apr 11 Why all newborn hip screening programs have same results-a mini review. Bm MV, et al.

E-9-1-1 69

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

The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. AEM April 2024 Date: April 19, 2024 Guest Skeptic: Dr. Suchismita Datta.

Emergency Department 207

Emergency Department Overdose ALS ED 207

The Skeptics' Guide to EM

FEBRUARY 11, 2024

Reference: McLatchie et al and DAShED investigators. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. Reference: McLatchie et al and DAShED investigators.

ED 303

ED Emergency Department ALS OR 303

The Skeptics' Guide to EM

SEPTEMBER 28, 2024

Date: September 23, 2024 Reference: Essat et al. Annals of Emergency Medicine, May 2024 Guest Skeptic: Dr. Casey Parker is a Rural Generalist from Australia who is also an ultrasounder. Reference: Essat et al. Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis.

Emergency Department 201

Emergency Department ACS Coronary ALS 201

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. TIMELESS Investigators.

Emergency Department 287

Emergency Department ALS OR EMS 287

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. Brewster RCL, et al. 2024 Jul 9:e2023064794. 2024 Jul 8.

E-9-1-1 52

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

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. Ann Emerg Med. 2024 Feb 6:S0196-0644(24)00004-0.

Emergency Department 103

Emergency Department ALS OR ED 103

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 129

Emergency Department ALS OR ED 129

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 210

Emergency Medical Services Emergency Department EMS ALS 210

ACEP Now

MAY 9, 2024

Complications of Gluteal AFT The pale, prone patient with multiple surgical drains and a constrictive faja has become a common site in the Jackson Memorial Hospital Emergency Department. Nearly half of all post-AFT patients presenting to our emergency departments required admission and six percent required ICU admission.

Emergency Department 52

Emergency Department Operating Room Critical Care ALS 52

The Skeptics' Guide to EM

JULY 20, 2024

Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). 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.

ALS 227

ALS Emergency Department ED OR 227

The Skeptics' Guide to EM

NOVEMBER 23, 2024

Date: November 13, 2024 Reference: Lee WH, et al. Academic Emergency Medicine. Dec 2024 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC. Case: A 10-year-old boy presents to the community emergency department (ED) with abdominal pain.

ED 145

ED Emergency Department ALS OR 145

Broome Docs

MARCH 28, 2024

Emerg Med J. 2024 Jan 22;41(2):96-102. Great evidence for button battery ingestions (if you are treating a dead pig) Chiew AL, Lin CS, Nguyen DT, Sinclair FAW, Chan BS, Solinas A. Ann Emerg Med. 2024 Jan 2;53(1):afad255. 2024 Jan 29:jme-2023-109651. doi: 10.1136/emermed-2023-213285. 2023.08.018. Age Ageing.

E-9-1-1 107

E-9-1-1 ICU Emergency Department ALS 107

The Skeptics' Guide to EM

JULY 6, 2024

Reference: Tjan et al. Conflict in emergency medicine: A systematic review. 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.

ED 203

ED ALS Emergency Department OR 203

The Skeptics' Guide to EM

SEPTEMBER 14, 2024

Date: September 12, 2024 Reference: Anderson et al. Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergency department. AEM August 2024. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. A pivotal study by Raja et al.

ICU 136

ICU Emergency Department ALS ED 136

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. Prehospital Emergency Care. February 2024. first appeared on The Skeptics Guide to Emergency Medicine. Prehospital Emergency Care. February 2024.

ICU 189

ICU Defibrillator CPR Paramedic 189

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

The Skeptics' Guide to EM

MAY 25, 2024

Reference: Borgundvaag et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. When we combine SGEMHOP with an SGEM Xtra I hope we get some…AMAZING knowledge translation for GRACE4.

ED 193

ED Emergency Department ICU ALS 193

Don't Forget the Bubbles

SEPTEMBER 30, 2024

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. Simpson et al. Simpson et al. Emergency department overcrowding is a complex issue with multiple contributing factors. A 2011-2012 Australian study by Blake et al.

Emergency Department 89

Emergency Department ALS ED OR 89

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 176

Emergency Medical Services ALS Emergency Department ED 176

The Skeptics' Guide to EM

NOVEMBER 9, 2024

Date: October 28, 2024 Reference: Woelfle T et al. J Clin Epi Sept 2024. Guest Skeptic: Dr. Laura Walker is an Associate Professor of Emergency Medicine and the vice chair for digital emergency medicine at the Mayo Clinic. Benchmarking Human–AI collaboration for common evidence appraisal tools.

Emergency Department 140

Emergency Department ED ALS OR 140

EMDocs

OCTOBER 25, 2024

2024 Aug;81(8):e94-e106. Epub 2024 May 28. Spoon Feed This was a multi-hospital retrospective study of patients who presented to the emergency department with severe hypertension without end organ damage. Source Emergency Department Blood Pressure Treatment and Outcomes in Adults Presenting with Severe Hypertension.

Defibrillator 68

Defibrillator Emergency Department ALS OR 68

Don't Forget the Bubbles

OCTOBER 12, 2024

Hibberd O, Chylinska AA, Finn K , et al. Published Online First: 15 April 2024. doi: 10.1136/archdischild-2023-326773 Two-year-old Moyo is brought to the emergency department because her parents were concerned about noisy breathing. References Hibberd O, Chylinska AA, Finn K , et al.

Emergency Department 85

Emergency Department ALS OR 85

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. For Pediatric Oropharyngeal Trauma first appeared on The Skeptics Guide to Emergency Medicine.

ALS 165

ALS Emergency Department OR ED 165

ACEP Now

NOVEMBER 8, 2024

First, research suggests a higher number of emergency department visits among individuals with ASD. About 30 percent of children with ASD need treatment in an emergency department, and this number increases to nearly 70 percent for those aged 15–18. Accessed October 17, 2024. Accessed October 17, 2024.

Emergency Department 52

Emergency Department OR ED ALS 52

ALiEM

NOVEMBER 18, 2024

A 48-year-old male with no significant past medical history presented to the Emergency Department with a left-sided facial rash and associated burning left eye pain that started four days prior. Accessed January 11, 2024. Munawar K, Nayak G, Fatterpekar GM, et al. Burbank, CA: CorePendium, LLC. Updated August 16, 2023.

Emergency Department 161

Emergency Department ALS OR ED 161

The Skeptics' Guide to EM

JUNE 15, 2024

Reference: Jansen et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial.

Life Support 225

Life Support Emergency Department ALS 225

Pediatric EM Morsels

JULY 5, 2024

Pediatr Emerg Care. Baumann F, Ernstberger T, Neumann C, et al. Leonard JC, Harding M, Cook LJ, et al. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. 2024; Published online June 4, 2024.

ALS 161

ALS OR ED Emergency Department 161

ACEP Now

JULY 11, 2024

2 Although the opiate epidemic is certainly worthy of attention, it accounts for only about half of the number of deaths annually and only around a quarter of the number of emergency department visits annually relative to alcohol use. He returned to the emergency department, and you had the great privilege of saving his life.

Emergency Department 98

Emergency Department ALS ED OR 98

Pediatric EM Morsels

APRIL 19, 2024

Trauma season is at hand and like all other pediatric emergency departments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. Davidson JS, Brown DJ, Barnes SN, et al. West S, Andrews J, Bebbington A, et al. Symons S, Rowsell M, Bhowal B, et al. J Pediatr Orthop.

ALS 286

ALS ACS Emergency Department ED 286

The Skeptics' Guide to EM

MAY 11, 2024

Reference: Jain A, et al. March 2023 Date: May 7, 2024 Guest Skeptic: Dr. Brian Lee is a pediatric emergency medicine attending at the Children’s Hospital of Philadelphia and Assistant Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Reference: Jain A, et al.

ALS 154

ALS Emergency Department OR ED 154

FOAMfrat

NOVEMBER 21, 2024

Hypothermia Hypothermia, defined as core temperature less than 35oC (95oF) has been identified in up to 2/3 of trauma patients upon arrival to the emergency department. Coagulopathy is identified through lab work in the emergency department and is correlated in current literature with significantly worse patient outcomes.

ICU 111

ICU Emergency Department OR Ambulance 111

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). References Brophy GM, Bell R, Claassen J, et al. Zehtabchi S, Abdel Baki SG, Omurtag A, et al. Am J Emerg Med. Towne AR, Waterhouse EJ, Boggs JG, et al. Ann Emerg Med. Am J Emerg Med.

Emergency Department 52

Emergency Department Critical Care ALS ICU 52

ACEP Now

AUGUST 13, 2024

Dr. Kendall is the chief of clinician engagement at US Acute Care Solutions and has 15 years of emergency department leadership experience. 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.

ALS 111

ALS Emergency Department OR ED 111

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. In fact, Kosuge et al. Accessed May 28, 2024. Stein et al. What do you think?

E-9-1-1 137

E-9-1-1 ACS Emergency Department Coronary 137

ACEP Now

AUGUST 14, 2024

grams of IV magnesium to placebo, doses considerably higher than the two grams of magnesium often administered in the emergency department (ED). References Joglar JA, Chung MK, Armbruster AL, et al. Fromm C, Suau SJ, Cohen V, et al. J Emerg Med. January CT, Wann LS, Alpert JS, et al. Circulation.

ALS 105

ALS Emergency Department ED OR 105