The Skeptics' Guide to EM

OCTOBER 12, 2024

A national survey of children’s experiences and needs when attending Canadian pediatric emergency departments. June 2024 Date: Oct 1, 2024 Guest Skeptic: Dr. Andrew (Andy) Tagg is an Emergency Physician with a special interest in education and lifelong learning. Reference: Ma K et al.

Emergency Department 225

Emergency Department ED ALS OR 225

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

JUNE 1, 2024

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. Reference: Tavender E, et al.

Emergency Medical Services 210

Emergency Medical Services Emergency Department EMS ALS 210

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. Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis. Her pain seems to have settled.

Emergency Department 196

Emergency Department ACS Coronary ALS 196

Pediatric EM Morsels

JULY 19, 2024

If bleeding, the only lab that is needed in the Emergency Department is a type and cross. 2024 Feb;177:111859. Epub 2024 Jan 10. Your support staff…depending on the amount of bleeding, you are about to have your hands full and may need IV access, medications, airway management, etc. Set up suction x2 in the room!

E-9-1-1 286

E-9-1-1 Epinephrine Emergency Department OR 286

Broome Docs

OCTOBER 6, 2024

2024 Jun 13. Emerg Med J. 2024 May 28;41(6):342-349. 2024 Jul 15:S2352-4642(24)00133-0. PMID: 39025092 Is early CT actually 100% sensitivity for SAH (Of course not) Roberts et al, Subarachnoid haemorrhage in the emergency department (SHED): a prospective, observational, multicentre cohort study.

Critical Care 112

Critical Care ALS Emergency Department EMS 112

Broome Docs

SEPTEMBER 3, 2024

Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med. 2024 Mar 25:S0196-0644(24)00099-4. CJEM debate series: #StillTheOne-while more challenging than ever, emergency medicine is still the best career path available for medical students.

E-9-1-1 109

E-9-1-1 Emergency Department ICU ALS 109

The Skeptics' Guide to EM

NOVEMBER 16, 2024

Date: October 28, 2024 Reference: Verma et al. CMAJ September 2024 Guest Skeptic: Michael Page is currently the Director of Artificial Intelligence (AI) Commercialization at Unity Health Toronto. CMAJ September 2024 Population: Patients admitted to the General Internal Medicine (GIM) unit of an academic medical center

ICU 215

ICU Emergency Department ALS EMS 215

The Skeptics' Guide to EM

JULY 20, 2024

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. NEJM June 2024. Reference: Gibbs et al. Reference: Gibbs et al.

ALS 222

ALS Emergency Department ED OR 222

The Skeptics' Guide to EM

JULY 6, 2024

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. Conflict in emergency medicine: A systematic review.

ED 199

ED ALS Emergency Department OR 199

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? MRIs may be warranted in a small subset of patients, but those MRIs do not need to occur in an emergency department.

Emergency Department 103

Emergency Department ALS OR ED 103

Dr. Smith's ECG Blog

MAY 13, 2024

Written by Destiny Folk, MD, Adam Engberg, MD, and Vitaliy Belyshev MD A man in his early 60s with a past medical history of hypertension, type 2 diabetes, obesity, and hyperlipidemia presented to the emergency department for evaluation of chest pain. Chest Pain – Benign Early Repol or OMI?

OR 116

OR STEMI Heart Attack Coronary 116

The Skeptics' Guide to EM

APRIL 27, 2024

Prehospital Emergency Care. February 2024. Date: April 25, 2024 Guest Skeptic: Missy Carter is a PA working in an ICU in the Tacoma area and an adjunct faculty member with the Tacoma Community College paramedic program. Prehospital Emergency Care. February 2024. Prehospital Emergency Care. February 2024.

ICU 185

ICU Defibrillator CPR Paramedic 185

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Is this scalp swelling normal?

E-9-1-1 152

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

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

Broome Docs

MARCH 28, 2024

Emerg Med J. 2024 Jan 22;41(2):96-102. Until we see more science, it seems very reasonable to provide honey, jam, or sucralfate (which wasn’t studied here), every 10 minutes while arranging for that emergent scope. 2024 Jan 2;53(1):afad255. 2024 Jan 29:jme-2023-109651. doi: 10.1136/emermed-2023-213285. Age Ageing.

E-9-1-1 107

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

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. We see all different flavors of upper extremity injuries. The minority of parents would have wanted clinic follow up (6%) and reimaging (14%).

ALS 286

ALS ACS Emergency Department ED 286

The Skeptics' Guide to EM

FEBRUARY 24, 2024

Journal of Consumer Psychology 2023, Date: February 23, 2024 Guest Skeptic: Ethan Milne is a Marketing PhD student at the Ivey Business School (Western University). Journal of Consumer Psychology 2023, Date: February 23, 2024 Guest Skeptic: Ethan Milne is a Marketing PhD student at the Ivey Business School (Western University).

Emergency Department 174

Emergency Department OR 174

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 172

Emergency Medical Services ALS Emergency Department ED 172

Pediatric EM Morsels

AUGUST 23, 2024

Concussions are commonly encountered in the Emergency Department. We have previously discussed an approach to the question of when a patient “ can return to sport.” It does NOT have structural brain damage visible on standard neuroimaging.

Emergency Department 270

Emergency Department OR ED EMS 270

Core EM

AUGUST 28, 2024

Perelman Center for Emergency Services in Manhattan, NYU Langone Hospital—Brooklyn , and NYU Langone Health—Cobble Hill Emergency Department at the Joseph S. and Diane H. Steinberg Ambulatory Care Center , as well as NYC Health + Hospitals/Bellevue.

Emergency Department 130

Emergency Department OR 130

Core EM

AUGUST 6, 2024

Perelman Center for Emergency Services in Manhattan, NYU Langone Hospital—Brooklyn , and NYU Langone Health—Cobble Hill Emergency Department at the Joseph S. and Diane H. Steinberg Ambulatory Care Center , as well as NYC Health + Hospitals/Bellevue.

Emergency Department 130

Emergency Department OR 130

Pediatric EM Morsels

JUNE 7, 2024

Lucky for us, in 2020 there were some updates made to the NIH Asthma Management Guidelines and we’re going to discuss which ones can help us in the Emergency Department! You’re probably asking yourself… is this really important for us in the Emergency Department to know? No more SABA ! Can we decrease corticosteroid use?

Emergency Department 206

Emergency Department OR EMS 206

The Skeptics' Guide to EM

FEBRUARY 3, 2024

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. Case: You’re working the morning shift in the emergency department (ED) when you encounter a 3-year-old boy and his family.

ALS 165

ALS Emergency Department OR ED 165

CanadiEM

MARCH 12, 2024

Welcome back to the 2024 CJEM year! In this issue, we collaborated with the CJEM team to present “Hypotension and respiratory events related to electrical cardioversion for atrial fibrillation or atrial flutter in the emergency department” in a visual abstract format​1​.

Emergency Department 52

Emergency Department OR ED 52

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

Don't Forget the Bubbles

MAY 8, 2024

2024 Apr 27. 2024 Apr 16:archdischild-2024-326876. 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. 2024 Apr 9. 2024 Apr;183(4):1543-1553. 2024 Apr;183(4):1485-1497.

E-9-1-1 69

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

ACEP Now

APRIL 5, 2024

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. Vital signs on arrival are: Temperature: 38.8 degrees Celsius Heart rate:128 Blood pressure: 74 over 48 Respiratory rate: 10 Oxygen saturation: 77 percent Physical examination was notable for lethargy and confusion.

OR 73

OR ALS Emergency Department Critical Care 73

The Skeptics' Guide to EM

DECEMBER 14, 2024

He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate of FOAMed. He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate of FOAMed. Dr. Damian Roland Case: A 3-year-old boy arrives at the emergency department (ED) with a high fever, rapid breathing, and lethargy.

ALS 139

ALS Emergency Department ED OR 139

ALiEM

OCTOBER 7, 2024

A 52-year-old female with a past medical history of hypertension and prediabetes presented to the emergency department with double vision that started one day prior to arrival. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. She stated that her double vision improved when she closed one eye. Abducens Nerve Palsy.

Emergency Department 161

Emergency Department OR 161

Pediatric EM Morsels

JULY 5, 2024

It seems like just yesterday ( or maybe ~ a month ago ) when we served up a tasty morsel on the PECARN decision rule for intra-abdominal traumatic injuries in children. Our friends at the PECARN injury group have remained busy this spring with generating more externally validated clinical decision rules. High Risk (12.8% High Risk (12.8%

ALS 161

ALS OR ED Emergency Department 161

ACEP Now

MAY 9, 2024

When seven South Florida gluteal AFT patients died tragically in one year alone, the Florida Board of Medicine issued an emergency regulation restricting fat injection to the subcutaneous space rather than injecting into muscle. Or Helly Larson describing the first week after her Miami BBL as “absolute hell” to a Vox reporter.

Emergency Department 52

Emergency Department Operating Room Critical Care ALS 52

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 (..)

E-9-1-1 118

E-9-1-1 ACS OR Emergency Department 118

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. He also endorsed left-sided facial weakness and diplopia for the last eight days. CorePendium.

Emergency Department 177

Emergency Department ALS OR ED 177

The Skeptics' Guide to EM

MAY 11, 2024

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. Reference: Jain A, et al.

ALS 154

ALS Emergency Department OR ED 154

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-. Significance of the Inverted V Sign : This MRI sign is pathognomonic for subacute combined degeneration, indicating it is a distinct marker for this condition.

Emergency Department 162

Emergency Department ED OR ALS 162

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. Accessed May 28, 2024. What do you think? Labs obtained and notable for an elevated troponin I to 0.10 Stein et al.

E-9-1-1 141

E-9-1-1 ACS Emergency Department Coronary 141