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. Maenner MJ, Warren Z, Williams AR, et al. Cleve Clin J Med.

Emergency Department 52

Emergency Department ED OR ALS 52

The Skeptics' Guide to EM

MARCH 2, 2019

Date: February 26th, 2019 Reference: Benger et al. JAMA 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the Seattle area and an adjunct faculty […] The post SGEM#247: Supraglottic Airways Gonna Save You for an OHCA?

CPR 130

CPR Firefighter Paramedic Defibrillator 130

ACEP Now

JUNE 7, 2023

The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding. Preliminary results of the survey are being released to help emergency physicians understand that current challenges are occurring nationwide.

Emergency Department 52

Emergency Department ED EMS Ambulance 52

The Skeptics' Guide to EM

FEBRUARY 15, 2020

Date: February 11th, 2020 Reference: Yeh et al. Case: A 32-year-old woman with no previous medical history calls you while a passenger on a […] The post SGEM#284: Might as Well Jump, but We would Recommend a Parachute first appeared on The Skeptics Guide to Emergency Medicine. Date: February 11th, 2020 Reference: Yeh et al.

ALS 130

ALS Emergency Department OR 130

Don't Forget the Bubbles

SEPTEMBER 6, 2023

14-year-old Katy presents to the paediatric Emergency Department (ED), alone, complaining of suicidal ideation. Another study observed that children and young people who received unnecessary medical screening laboratory investigations would have received definitive psychiatric care on average 6.8 Acad Emerg Med.

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Emergency Department ED Overdose ALS 119

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. 9 PFE is only definitively diagnosed on autopsy and a high clinical suspicion must be maintained in high-risk patients. Al Jazeera.

Emergency Department 52

Emergency Department Operating Room Critical Care ICU 52

REBEL EM

MARCH 27, 2023

Background Information: Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. PMID: 19325480 Gajic O, et al.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Birkebaek et al.,

Emergency Department 135

Emergency Department ED OR ALS 135

The Skeptics' Guide to EM

NOVEMBER 1, 2022

Date: October 27th, 2022 Reference: Hayashi et al. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency […] The post SGEM#381: Put Your Hand on My Shoulder and Reduce It first appeared on The Skeptics Guide to Emergency Medicine.

ALS 123

ALS Emergency Department OR ED 123

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

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. Definitive emotional support is critical to our emotional and psychological well-being. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. Kapoor et al.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

The Skeptics' Guide to EM

FEBRUARY 2, 2018

[display_podcast] Date: January 31st, 2018 Reference: Frohlich LC, et al. Guest Skeptic: Dr. Melissa Langhan is an Associate Professor of Pediatric Emergency Medicine at Yale University in New Haven, CT. display_podcast] Date: January 31st, 2018 Reference: Frohlich LC, et al. Reference: Frohlich LC, et al. AEM Dec 2017.

Operating Room 100

Operating Room Emergency Department ALS ED 100

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.

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Epinephrine ALS Critical Care Emergency Department 105

The Skeptics' Guide to EM

DECEMBER 16, 2017

[display_podcast] Date: November 27th, 2017 Reference: Legriel et al. NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. Reference: Legriel et al.

ALS 100

ALS ICU Emergency Department Paramedic 100

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). Second, the outcomes definitions rate and rhythm control at four and 24 hours are far beyond times relevant in emergency medicine in the U.S. Fromm C, Suau SJ, Cohen V, et al.

ALS 105

ALS Emergency Department ED OR 105

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

Dr. Smith's ECG Blog

JANUARY 27, 2024

, tells us that we physicians do not need to even look at this ECG until the patient is placed in a room because the computer says it is normal: Validity of Computer-interpreted “Normal” and “Otherwise Normal” ECG in Emergency Department Triage Patients I reviewed this article for a different journal and recommended rejection and it was rejected.

STEMI 117

STEMI Coronary ACS ED 117

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. References Tsao CW, et al. Benjamin EJ, et al. Kimblad H, et al. Adult cardiac arrest in the emergency department – A Swedish cohort study. Sakai T, et al. Kudenchuk PJ, et al.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

Broome Docs

FEBRUARY 22, 2024

PMID: 36946338 Bottom line: This is a well done RCT that demonstrates pretty convincingly that you should not bother trying to but fingernails back on after nail bed repair (and my guess is you definitely shouldn’t be removing them either). Carson JL, Brooks MM, Hébert PC, et al; MINT Investigators. N Engl J Med. 2023 Nov 11.

Emergency Department 89

Emergency Department ALS OR ED 89

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Schlapbach LJ, Watson RS, Sorce LR, et al. Paediatr Int Child Health.

Emergency Department 78

Emergency Department Critical Care ALS OR 78

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. Çalışkan Uçkun A, Yurdakul FG, Ergani HM, et al. link] Alkandari A F, Alawadhi A, Alawadhi F A, et al. Flexor Tendon Lacerations. In: StatPearls.

EMS 96

EMS ALS Emergency Department ED 96

REBEL EM

AUGUST 30, 2023

REBEL Core Cast 107.0 – Vertebral Osteomyelitis Click here for Direct Download of the Podcast Definition Inflammation of the vertebrae due to a pyogenic, fungal or mycobacterial organism. Graphics Image 1: [link] Image 2: [link] References Berbari EF, Kanj SS, et al. PMID: 26316526 Boody B, et al. Back Pain Emergencies.

E-9-1-1 100

E-9-1-1 ALS ED OR 100

Dr. Smith's ECG Blog

AUGUST 9, 2024

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. Bigger et al. Annals of Emergency Medicine , 31 (1), 3–11. Sadowski ZP, Alexander JH, Skrabucha B, et al. Leave it alone.

STEMI 107

STEMI Coronary Heart Attack ACS 107

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

ACEP Now

MAY 10, 2024

1 In the absence of lower UTI symptoms like dysuria, urgency, or frequency, by definition, a patient does not have a UTI and therefore does not need treatment with antibiotics. 2010.0361 Hooton TM, Scholes D, Stapleton AE, et al. doi:10.1056/NEJM200010053431402 Bonkat G, Bartoletti R, Bruyere F, et al. Dtsch Arztebl Int.

ALS 98

ALS Emergency Department OR 98

EMDocs

MARCH 30, 2024

Answer : Thoracic and Lumbar Spine Trauma Epidemiology: Approximately half of the vertebral injuries that are seen in the emergency department are thoracic and lumbar injuries. A 27-year-old man was brought into the emergency department via EMS after being stabbed. J Emerg Med. and 100%, respectively. 2020;6(1):67.

EMS 105

EMS E-9-1-1 Emergency Department Ambulance 105

EMDocs

AUGUST 8, 2023

Cremasteric reflex Classically absent/diminished in torsion, but cannot definitively rule in or out torsion. Management: Definitive therapy = surgical exploration, detorsion, and fixation of the testicle. Just the facts: assessment and management of testicular torsion in the emergency department. 2013;189(5):1859–64.

ALS 95

ALS Emergency Department OR 95

EMDocs

SEPTEMBER 25, 2023

Also known as Facilitated intubation (FI), the use of intubating with only a sedative was an accepted alternative intubation technique prior to those definitive studies in the late 1990s but quickly was abandoned for RSI in all emergent endotracheal intubations (ETI) (8,9). References: Heffner AC et al. Int J Emerg Med.

ED 93

ED Emergency Department ALS Paramedic 93

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

ALS 97

ALS Emergency Department ED OR 97

EMS 12-Lead

APRIL 28, 2022

Upon arrival at the receiving emergency department, however, she precipitously degenerated into VF and could not be resuscitated. 4-6] In figures 1-4, specifically during the episodes of NSVT, there is a mostly regular cadence with preserved definition of both QRS and T. Unfortunately, a post-conversion 12 Lead was not acquired.

E-9-1-1 130

E-9-1-1 ALS Coronary EMS 130

Don't Forget the Bubbles

DECEMBER 16, 2024

The clinical case definition for pertussis is broadly consistent worldwide, with key features including paroxysmal coughing, post-tussive vomiting, inspiratory whoop, apnoea, and a cough lasting at least two weeks. Studies examining the sensitivity and specificity of this case definition highlight its limitations. Epidemiol Infect.

E-9-1-1 59

E-9-1-1 OR ALS Emergency Department 59

Don't Forget the Bubbles

JUNE 30, 2023

Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality. REBOA increased deaths due to bleeding at three hours and 90 days and substantially delayed time to definitive haemorrhage control. Emerg Med J. Laan DV, Vu TD, Thiels CA et al. c) Or, do both?

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

EMDocs

NOVEMBER 18, 2023

doi:10.1007/s00247-020-04811-0 2) Kwong AJ, Ebel NH, Kim WR, et al. Accessed May 7, 2023 5) Oh SY, Lee JM, Lee H, et al. Emergency department visits and unanticipated readmissions after liver transplantation: A retrospective observational study. 2021.11.006 11) Frongillo F, Lirosi MC, Nure E, et al. Am J Emerg Med.

EMS 96

EMS E-9-1-1 ALS Emergency Department 96

FOAMfrat

SEPTEMBER 19, 2024

is positive thanks to the widespread availability of antivenom, relatively short transport times to definitive care, and the U.S.'s Rapid transport to definitive care is crucial. Rattlesnake Envenomation Treatment & Management: Prehospital Care, Emergency Department Care, Consultations.” Accessed 10 July 2024.

Emergency Department 95

Emergency Department Epinephrine OR Plasma 95

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. A Child with Blunt Trauma -- See how the ECG can be definite for myocardial contusion, but subtle, and what happens if you miss it.

ALS 115

ALS Emergency Department OR EMS 115

REBEL EM

DECEMBER 5, 2023

This varied incidence can be due to inconsistent definitions or inclusion of mild reactions. Incidence of clinically important biphasic reactions in emergency department patients with allergic reactions or anaphylaxis. Annals of Emergency Medicine 2014 Jun;63(6):736-44 Lee S, Bellolio F, Hess E, Erwin P, Murad M, Campbell R.

Epinephrine 81

Epinephrine Allergic Reaction Emergency Department Emergency Manager 81

REBEL EM

AUGUST 22, 2022

Background: Traumatic lacerations presenting to the emergency department are, by definition, contaminated (ie non-sterile). Paper: Zwaans JJM et al. Emerg Med J 2022. References: Zwaans JJM et al. Emerg Med J 2022. PMID: 35882525 [ Access on Read by QxMD ] Perelman VS et al. Ann Emerg Med 2004.

Emergency Department 58

Emergency Department ALS ED EMS 58