REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Paper: Mason JM, et al. Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

ALiEM

OCTOBER 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to respiratory diseases in the Emergency Department. Reference Lin M, Phipps M, Chan TM, et al. Ann Emerg Med.

Critical Care 169

Critical Care EMS Emergency Department ALS 169

Don't Forget the Bubbles

OCTOBER 12, 2024

Hibberd O, Chylinska AA, Finn K , et al. doi: 10.1136/archdischild-2023-326773 Two-year-old Moyo is brought to the emergency department because her parents were concerned about noisy breathing. Most children can be discharged from the emergency department after a dose of corticosteroids and an appropriate safety net.

Emergency Department 85

Emergency Department ALS OR 85

The Skeptics' Guide to EM

DECEMBER 10, 2022

Date: November 30th, 2022 Reference: Johnson et al. Date: November 30th, 2022 Reference: Johnson et al. DISCLAIMER: THE VIEWS AND OPINIONS OF THIS BLOG AND PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US MILITARY. He’s got a big job coming up in a couple of months and can’t work with a cast.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

APRIL 16, 2022

Date: April 16th, 2022 Reference: Blom et al. Disclaimer: The views and opinions of this blog […] The post SGEM#365: Stop! Date: April 16th, 2022 Reference: Blom et al. Disclaimer: The views and opinions of this blog and podcast do not represent the United States Government or the US Military. Tricoci et al.

Emergency Department 100

Emergency Department ALS OR ED 100

REBEL EM

JULY 1, 2024

Paper: Goren NZ et al. Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. References: Goren NZ et al. PMID: 34462252 Abubacker AP et al. Balkan Med J 2021. which patients and which conditions).

ED 133

ED Emergency Department ALS OR 133

The Skeptics' Guide to EM

JUNE 9, 2018

[display_podcast] Date: June 8th, 2018 Reference: April MD, et al. Aromatherapy Versus Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients: A Randomized Controlled Trial. display_podcast] Date: June 8th, 2018 Reference: April MD, et al.

Emergency Department 130

Emergency Department ALS OR 130

REBEL EM

MARCH 11, 2024

A 42-year-old man presents to the emergency department after a motor vehicle collision. In: Tintinalli JE, Ma OJ, Yealy DM, et al., Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. He has no medical problems. He sustained a crush injury to his left leg and a prolonged extraction time. Pulses are intact.

Emergency Department 59

Emergency Department ED ALS EMS 59

REBEL EM

NOVEMBER 15, 2023

“The ED-AWARENESS study: A prospective, observational cohort study of awareness with paralysis in mechanically ventilated patients admitted from the emergency department.” ” Annals of emergency medicine 77.5 References Pappal, Ryan D., 2021): 532-544.

Emergency Department 105

Emergency Department ED EMS ALS 105

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. Stein et al. This is a paper worth reading : Marchik et al. Kosuge et al.

E-9-1-1 137

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

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Date: November 10th, 2022 Reference: de-Madaria E et al. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. Date: November 10th, 2022 Reference: de-Madaria E et al.

ALS 130

ALS Emergency Department OR EMS 130

The Skeptics' Guide to EM

OCTOBER 20, 2018

[display_podcast] Date: October 17th , 2018 Reference #1: Aycock, Westafer et al. Ann Emerg Med 2018 (CRD42017056195) Reference #2: Weisbord SD, Gallagher M, Jneid H, et al; PRESERVE Trial Group. first appeared on The Skeptics Guide to Emergency Medicine. Reference: Aycock, Westafer et al.

Coronary 174

Coronary Emergency Department ALS OR 174

The Skeptics' Guide to EM

FEBRUARY 19, 2022

Tim Graham is a Clinical Professor of emergency medicine at the University of Alberta, and Associate Chief Medical Information Officer, Edmonton Zone, of Alberta Health Services from Edmonton, Alberta. It is intended for clinicians providing care to emergency patients, so they get the best care, based on the best evidence.

Emergency Department 130

Emergency Department ALS OR 130

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting." Reference on Troponins: Xenogiannis I, Vemmou E, Nikolakopoulos I, et al. Lindahl et al. From Gue at al. Lindahl B, Baron T, Erlinge D, et al. References: 1.

Emergency Department 52

Emergency Department E-9-1-1 Coronary STEMI 52

The Skeptics' Guide to EM

JULY 18, 2020

Date: July 13th, 2020 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com. He has a great new blog post about increasing diversity in medicine using something called the BSAP approach and an interesting Broome Doc podcast with Dr. Casey Parker called EBM 2.0.

ALS 130

ALS Emergency Department OR 130

REBEL EM

APRIL 29, 2024

A study by Lee et al ( 7) compared femoral CVC placement to IO and demonstrated a first-pass success pass rate with IO of 90.3% Labs can be drawn from an IO to help with rapid diagnosis in emergencies. References: 1 Astasio-Picado Á et al. World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

The Skeptics' Guide to EM

SEPTEMBER 3, 2017

[display_podcast] Date: September 2nd, 2017 Reference: Caputo et al. EmergeNcy Department use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). display_podcast] Date: September 2nd, 2017 Reference: Caputo et al. Reference: Caputo et al.

Emergency Department 130

Emergency Department Operating Room Critical Care ALS 130

The Skeptics' Guide to EM

OCTOBER 31, 2020

Date: October 29th, 2020 Guest Skeptic: Martha Roberts is a critical and emergency care, triple-certified nurse practitioner currently living and working in Sacramento, California. She writes a blog […] The post SGEM#307: Buff up the lido for the local anesthetic first appeared on The Skeptics Guide to Emergency Medicine.

Epinephrine 130

Epinephrine Emergency Department EMS ALS 130

REBEL EM

FEBRUARY 12, 2024

There are greater than 2 million annual emergency department visits for suspected renal colic in the US, and Ct scanning is performed for more than 90% of patients who receive a diagnosis of kidney stone. Moore CL, Carpenter CR, Heilbrun ME, et al. Am J Emerg Med. Smith-Bindman R, Aubin C, Bailitz J, et al.

Emergency Department 85

Emergency Department ALS ACS EMS 85

REBEL EM

FEBRUARY 21, 2024

Read More REBEL EM: The Ketorolac Analgesic Ceiling References Irizarry E et al. Acad Emerg Med 2021; 28(11): 1228-35. PMID: 34133820 Arora S et al. Can J Emerg Med 2007; 9(1): 30-2. PMID: 17391598 Wright JM et al. Ann Emerg Med 1995;26:117-20. PMID: 7618770 Neighbor ML et al. 2019; 36: 401-6.

E-9-1-1 64

E-9-1-1 Emergency Department ALS ED 64

FOAMfrat

NOVEMBER 21, 2024

If all of that sounded like nonsense, you can read more about it in my ABG blog. 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. Jessica Dawkins Mills BSN, et al. respectively. Accessed 10 Oct.

ICU 111

ICU Emergency Department OR Ambulance 111

The Skeptics' Guide to EM

JANUARY 20, 2018

[display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al. BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al. Reference: Sadeghirad B, et al.

Emergency Department 130

Emergency Department ALS EMS ED 130

The Skeptics' Guide to EM

NOVEMBER 18, 2017

[display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia.

ICU 130

ICU ED Emergency Department Critical Care 130

REBEL EM

SEPTEMBER 13, 2023

patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 Read More EMCrit: Podcast 145 – Awake Intubation Lecture from SMACC ERCast: Angioedema References: Baş M et al. PMID 25629740 Hassen GW et al.

Frozen Plasma 105

Frozen Plasma Allergic Reaction FFP Plasma 105

The Skeptics' Guide to EM

JANUARY 16, 2021

Date: January 5th, 2021 Reference: Shipman et al. Glaucomflecken” on Twitter and […] The post SGEM#315: Comfortably Numb with Topical Tetracaine for Corneal Abrasions first appeared on The Skeptics Guide to Emergency Medicine. Date: January 5th, 2021 Reference: Shipman et al.

ALS 130

ALS Emergency Department EMS ED 130

REBEL EM

AUGUST 17, 2023

A 24-year-old woman presents to the emergency department with persistent severe pain in her right thigh following a direct blow during a soccer match 2 weeks ago. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., Rosen’s Emergency Medicine: Concepts and Clinical Practice. Femur and hip injuries. Elsevier; 2023:(Ch) 47.

EMS 52

EMS Emergency Department ED ALS 52

FOAMfrat

MAY 19, 2024

This blog is an example of exactly that. While transporting to the emergency department, the patient’s mother informed me that PDCD affects less than 1 in 50,000 individuals and is more common in males than females. 6. Giribaldi G, Doria-Lamba L, Biancheri R, Severino M, Rossi A, Santorelli FM, et al. 2009 Jun 11.

E-9-1-1 97

E-9-1-1 ALS Emergency Department EMT 97

The Skeptics' Guide to EM

JULY 16, 2022

Date: July 16th, 2022 Reference: Lamontagne F et al. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. Date: July 16th, 2022 Reference: Lamontagne F et al.

ICU 100

ICU ALS Critical Care Emergency Department 100

REBEL EM

AUGUST 28, 2023

Read More REBEL EM: The Ketorolac Analgesic Ceiling References Irizarry E et al. Acad Emerg Med 2021; 28(11): 1228-35. PMID: 34133820 Arora S et al. Can J Emerg Med 2007; 9(1): 30-2. PMID: 17391598 Wright JM et al. Ann Emerg Med 1995;26:117-20. PMID: 7618770 Neighbor ML et al. 2019; 36: 401-6.

E-9-1-1 52

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

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

[display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. display_podcast] Date: September 26th, 2017 Reference: Kaufman, et al. Emlyn’s blog and podcast since 2012. Case: You are working the afternoon shift in the paediatric emergency department. BMJ April 17. BMJ April 17.

Emergency Department 130

Emergency Department ALS OR 130

REBEL EM

JUNE 5, 2023

One study from a county in Massachusetts found that of all nonfatal opioid doses seen in the emergency department from 2011-2015, 1 in 20 patients subsequently died within one year of initial visit with 66% of these deaths being directly related to an opioid overdose (4). PMID 33392580. Of note, there are ongoing RCTs on this topic.

Naloxone 98

Naloxone ED Overdose Emergency Department 98

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. Am J Emerg Med.

STEMI 118

STEMI Emergency Department Coronary OR 118

REBEL EM

JUNE 8, 2023

Paper: Singer S, et al. Am J Emerg Med. If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. 2022 Sep 5.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

The Skeptics' Guide to EM

FEBRUARY 6, 2021

Additionally, they host selected guests for special episodes, and publish blogs dedicated to more advanced medical questions or topics. Reference: Ruberto et al. Case: A 32-year-old male patient presents to your emergency department (ED) with severe nausea, vomiting and abdominal pain. Reference: Ruberto et al.

ALS 100

ALS Emergency Department Paramedic OR 100

REBEL EM

MARCH 23, 2023

Treatment options for alcohol withdrawal include benzodiazepines such as lorazepam, diazepam, or chlordiazepoxide, gabapentin, and phenobarbital (Buell et al.). Phenobarbital can be used as a monotherapy or in combination with benzodiazepines to treat alcohol withdrawal (Hawa et al.). Paper : Hawa F et al.

ICU 52

ICU Emergency Department ALS OR 52

EMS 12-Lead

APRIL 21, 2022

Dedicated followers of the Smith ECG Blog know that the STD of true subendocardial ischemia does not localize, yet some of the examples listed below demonstrate the opposite, and were subsequently labeled “diffuse ischemia” or “generic subendocardial changes” as a diagnosis of convenience. However, the maximal STD in this case is V3.

Coronary 130

Coronary ALS OR ACS 130

The Skeptics' Guide to EM

MAY 7, 2017

[display_podcast] Date: May 1st, 2017 Reference: Poonai et al. Acad Emerg Med May 2017. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. display_podcast] Date: May 1st, 2017 Reference: Poonai et al. Acad Emerg Med May 2017. Guest Skeptic: Dr. . *

Emergency Department 100

Emergency Department ALS OR 100