Core EM

JANUARY 25, 2024

A study by Duniec et al. Here are a handful of these studies and their conclusions: Nomura et al., of scans conducted and in <5 minutes in 100% of scans Ferre et al., times more attempts when adjusted for BMI Gottlieb et al., of scans conducted and in <5 minutes in 100% of scans Ferre et al., 3, 2018, pp.

ALS 246

ALS Critical Care OR 246

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. Disposition to ICU. Circulation.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

Core EM

JANUARY 25, 2024

Hosts: Joe Offenbacher, MD Audrey Bree Tse, MD [link] Download Leave a Comment Tags: Anticoagulation , Critical Care , Resuscitation Show Notes Coagulation Cascade: Algorithm for Anticoagulated Bleeding Patient in the ED: Indications for Anticoagulation Reversal: References: Baugh CW, Levine M, Cornutt D, et al. Ann Emerg Med.

Frozen Plasma 246

Frozen Plasma FFP Plasma Critical Care 246

Core EM

MAY 29, 2024

A review by Steinemann et al. Similarly, Miller et al. Multiple studies have demonstrated the effectiveness of in-situ simulation training in trauma care. showed that ISS training led to improvements in team communication, leadership, and resource management [1]. In situ simulation-based trauma team training: A pilot study. Miller, R.

ALS 203

ALS 203

The Skeptics' Guide to EM

OCTOBER 28, 2023

Date: October 26, 2023 Reference: Jones et al. Date: October 26, 2023 Reference: Jones et al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial placebo-controlled trial. Many pharmacologic treatments have been tried with limited efficacy.

ALS 221

ALS Emergency Department ED OR 221

The Skeptics' Guide to EM

NOVEMBER 2, 2024

Date: October 29, 2024 Reference: Galili et al. Reference: Galili et al. Low dose ketamine as an adjunct to morphine: a randomized controlled trial among patients with and without current opioid use. AEM Oct 2024. Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. AEM Oct 2024.

Emergency Department 244

Emergency Department ED ALS EMS 244

The Skeptics' Guide to EM

OCTOBER 5, 2024

Date: October 2, 2024 Reference: Paxton et al. Reference: Paxton et al. Headpulse measurement can reliably identify large-vessel occlusion stroke in prehospital suspected stroke patients: Results from the EPISODE-PS-COVID study.

Emergency Medical Services 262

Emergency Medical Services ALS EMS Paramedic 262

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Reference: Snelling et al. Reference: Snelling et al. Reference: Snelling et al. Ultrasonography or radiography for suspected pediatric distal forearm fractures. He is also a fully-fledged ultrasonographer. Ultrasonography or radiography for suspected pediatric distal forearm fractures.

Critical Care 310

Critical Care ALS ED Emergency Department 310

ALiEM

JUNE 24, 2024

Miyawaki IA, Gomes C, Caporal S Moreira V, et al. PMID 37162718 Kotruchin P, Chaiyakhan I, Kamonsri P, et al. The Single-Syringe Versus the Double-Syringe Techniques of Adenosine Administration for Supraventricular Tachycardia: A Systematic Review and Meta-Analysis. Am J Cardiovasc Drugs. 2023;23(4):341-353.

ALS 286

ALS 286

The Skeptics' Guide to EM

NOVEMBER 16, 2024

Date: October 28, 2024 Reference: Verma et al. Reference: Verma et al. Clinical evaluation of a machine learning–based early warning system for patient deterioration. CMAJ September 2024 Guest Skeptic: Michael Page is currently the Director of Artificial Intelligence (AI) Commercialization at Unity Health Toronto.

ICU 142

ICU Emergency Department ALS EMS 142

The Skeptics' Guide to EM

OCTOBER 12, 2024

Reference: Ma K et al. Reference: Ma K et al. 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.

Emergency Department 229

Emergency Department ED ALS OR 229

The Skeptics' Guide to EM

NOVEMBER 11, 2023

Date: November 2, 2023 Reference: Coventry et al. Date: November 2, 2023 Reference: Coventry et al. One of the best systematic reviews and meta-analyses on the topic discussing the diagnostic accuracy of the history, physical examination and imaging is by Carpenter et al from AEM 2014 [1]. Reference: Coventry et al.

ALS 244

ALS Emergency Department ED OR 244

The Skeptics' Guide to EM

DECEMBER 16, 2023

Reference: Punches et al. Reference: Punches et al. Reference: Punches el al. Patient Perceptions of Microaggressions and Discrimination Towards Patients During Emergency Department Care. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. AEM Dec 2023.

Emergency Department 295

Emergency Department ED ALS OR 295

The Skeptics' Guide to EM

NOVEMBER 25, 2023

Date: November 22, 2023 Reference: Stopyra et al. Date: November 22, 2023 Reference: Stopyra et al. Reference: Stopyra et al. Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI. AEM November 2023. first appeared on The Skeptics Guide to Emergency Medicine. AEM November 2023.

Heart Attack 278

Heart Attack STEMI Emergency Medical Services Coronary 278

Don't Forget the Bubbles

NOVEMBER 6, 2024

Catassi G, et al. Marciano L, et al. Rao CK, et al. Hale L, et al. Vaičiūnas T, et al. Oberbaum M, et al. Tahir OE, et al. Jones H, et al. Vanhelst J, et al. Shadbegian R, et al. LeBlanc TT, et al. Gibbs AAM, et al. Synnes A, et al. Edwards EM, et al.

ALS 59

ALS ED OR EMS 59

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Date: September 18, 2024 Reference: Dillon et al. Reference: Dillon et al. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Network Open. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque.

Naloxone 242

Naloxone NARCAN Overdose CPR 242

ALiEM

APRIL 12, 2024

If the catheter appears correctly positioned on AP chest x-ray but is malfunctioning, consider obtaining additional imaging to confirm placement [11]: Lateral view chest-xray, or Chest CT (can also help characterize the pleural effusion) References Gammie JS, Banks MC, Fuhrman CR, et al. doi: [link] Broder JS, Al-Jarani B, Lanan B, Brooks K.

E-9-1-1 183

E-9-1-1 ALS Critical Care Emergency Department 183

The Skeptics' Guide to EM

OCTOBER 21, 2023

Date: October 20, 2023 Reference: Cai et al. Date: October 20, 2023 Reference: Cai et al. Reference: Cai et al. Implementation of a Clinical Management Tool for Spinal Epidural Abscess Early Diagnosis. AEM October 2023. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals.

Emergency Department 264

Emergency Department ALS ED OR 264

The Skeptics' Guide to EM

JANUARY 6, 2024

Reference: Remick KE, et al. Reference: Remick KE, et al. Reference: Remick KE, et al. National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. JAMA Netw Open. Pediatric Readiness of Emergency Departments first appeared on The Skeptics Guide to Emergency Medicine. JAMA Netw Open.

Emergency Department 261

Emergency Department Emergency Medical Services ALS ED 261

ALiEM

FEBRUARY 9, 2024

References Writing Committee, Kontos MC, de Lemos JA, et al. 2022.08.750 Collet JP, Thiele H, Barbato E, et al. doi: 10.1177/2048872620935399 Badertscher P, Boeddinghaus J, Twerenbold R, et al. 118.034260 Chew DP, Lambrakis K, Blyth A, et al. 119.042891 Ashburn NP, Snavely AC, O’Neill JC, et al. Circulation.

E-9-1-1 276

E-9-1-1 ED Coronary ALS 276

EMDocs

NOVEMBER 13, 2024

Biggins SW, Angeli P, Garcia-Tsao G, et al. Mattos AA, Wiltgen D, Jotz RF, et al. Aithal GP, Palaniyappan N, China L, et al. Angeli P, Bernardi M, Villanueva C, et al. Arvaniti V, D’Amico G, Fede G, et al. Chinnock B, Hendey GW, Minnigan H, et al. De Gottardi A, Thevenot T, Spahr L, et al. Hepatology.

E-9-1-1 72

E-9-1-1 ALS OR ED 72

The Skeptics' Guide to EM

OCTOBER 19, 2024

Date: October 7, 2024 Reference: Nguyen et al. Reference: Nguyen et al. Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Annals of EM 2024. mg/kg nebulized or 0.3

OR 193

OR Emergency Department ED ALS 193

The Skeptics' Guide to EM

APRIL 13, 2024

Reference: Albers GW et al. Reference: Albers GW et al. TIMELESS Investigators. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. TIMELESS Investigators. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection.

ALS 287

ALS Emergency Department OR EMS 287

Core EM

JANUARY 25, 2024

Read More emDocs: Post-intubation analgesia/sedation regimens in ED: Pearls & Pitfalls PulmCrit: Internet Book of Critical Care: Sedation References Barr J, Gilles L, Puntillo K, et al: Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. Crit Care Med.

ICU 246

ICU Emergency Department Critical Care ALS 246

Pediatric EM Morsels

APRIL 19, 2024

Davidson JS, Brown DJ, Barnes SN, et al. West S, Andrews J, Bebbington A, et al. Symons S, Rowsell M, Bhowal B, et al. One Brace: One Visit: Treatment of Pediatric Distal Radius Buckle Fractures With a Removable Wrist Brace and No Follow-up Visit. J Pediatr Orthop. 2018;Volume 00(00):DOI:10.1097/BPO.0000000000001169. Pediatrics.

ALS 286

ALS ACS Emergency Department ED 286

The Skeptics' Guide to EM

JULY 8, 2023

Date: July 6, 2023 Reference: Hanula R et al. Date: July 6, 2023 Reference: Hanula R et al. Wallach et al JAMA Intern Med 2017 , previously reported that subgroup claims are often not corroborated by subsequent studies and rarely confirmed. JAMA Int Med 2023. Managing editor of EM:RAP and Associate Editor at REBEL EM.

ALS 237

ALS Emergency Department EMS ED 237

The Skeptics' Guide to EM

JULY 20, 2024

Reference: Gibbs et al. 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. NEJM June 2024.

ALS 227

ALS Emergency Department ED OR 227

The Skeptics' Guide to EM

SEPTEMBER 28, 2024

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

Emergency Department 201

Emergency Department ACS Coronary ALS 201

ALiEM

MARCH 7, 2024

Transvere ultrasound views of the bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.) Sagittal view of bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.)

E-9-1-1 177

E-9-1-1 Emergency Department ALS ED 177

Core EM

JULY 23, 2024

A review by Steinemann et al. Similarly, Miller et al. Multiple studies have demonstrated the effectiveness of in-situ simulation training in trauma care. showed that ISS training led to improvements in team communication, leadership, and resource management [1]. In situ simulation-based trauma team training: A pilot study. Miller, R.

ALS 100

ALS 100

The Skeptics' Guide to EM

SEPTEMBER 14, 2024

Date: September 12, 2024 Reference: Anderson et al. 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. AEM August 2024.

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

ICU 189

ICU Defibrillator CPR Paramedic 189

The Skeptics' Guide to EM

JUNE 3, 2023

Date: June3, 2023 Reference: Kotani et al. Date: June3, 2023 Reference: Kotani et al. Reference: Kotani et al. Etomidate as an induction agent for endotracheal intubation in critically ill patients: A meta-analysis of randomized trials. first appeared on The Skeptics Guide to Emergency Medicine.

Critical Care 247

Critical Care ALS Paramedic 247

ALiEM

OCTOBER 11, 2023

Hassoun AER, Ujević I, Jemaa S et al. Alhatali B, Al Lawatia S, Khamis F, Kantur S, Al-Abri S, Kapil V, Thomas J, Johnson R, Hamelin EI, Coleman RM, Kazzi Z. Al-Sulaimani S, Titelbaum NV, Ward RE, Zahran TE, Chalhoub S, Kazzi Z. Chowdhury FR, Nazmul Ahasan HA, Mamunur Rashid AK, Al Mamun A, Khaliduzzaman SM.

E-9-1-1 204

E-9-1-1 ALS OR 204

Don't Forget the Bubbles

JUNE 14, 2023

Lava SAG, et al. Hsiao W, et al. Mullaly R, et al. Puoti MG, et al. Stenson EK, et al. Bruinsma RA, et al. Rivetti G, et al. van Gameren-Oosterom HBM, et al. Lester TR, et al. Mansell H, et al. Fernandes AER, et al. Wolstencroft J, et al. Roodbol J, et al.

ALS 119

ALS ACS ED OR 119

The Skeptics' Guide to EM

MARCH 2, 2024

Reference: Gibbons et al. Reference: Gibbons et al. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. AEM February 2024. AEM February 2024. Date: February 28, 2024 Guest Skeptic: Dr.

Operating Room 301

Operating Room Emergency Department ALS ED 301

Pediatric EM Morsels

JULY 5, 2024

Baumann F, Ernstberger T, Neumann C, et al. Leonard JC, Harding M, Cook LJ, et al. Leonard JC, Kuppermann N, Olsen C, et al. 2014;133(5) Mathews JD, Forsythe AV, Brady Z, et al. Nigrovic LE, Rogers AJ, Adelgais KM, et al. Slaar A, Fockens MM, Wang J, et al. Pediatr Emerg Care. 2018;34(10):677-686.

ALS 161

ALS OR ED Emergency Department 161