The Skeptics' Guide to EM

OCTOBER 1, 2022

Date: September 28th, 2022 Reference: Hartford et al. Date: September 28th, 2022 Reference: Hartford et al. Patients with migraines often present to the ED looking for pain relief. Brown et al , Selbst and Clark ). Reference: Hartford et al. AEM September 2022. AEM September 2022. AEM September 2022.

Emergency Department 130

Emergency Department ALS ED OR 130

Don't Forget the Bubbles

OCTOBER 10, 2024

This time the team from Bristol Royal Children’s Hospital ED tell us what is new in the world of paediatric literature… Led by Dr John Coveney a Paediatric Emergency Medicine Trainee in Bristol who has revived The Journal Club at Bristol Royal Children’s Hospital ED on a monthly basis. Cochrane Database Syst Rev.

ED 75

ED Emergency Department OR ALS 75

The Skeptics' Guide to EM

MAY 2, 2020

Date: April 24th, 2020 Reference: Watanabe et al. This is Bob’s eleventh visit […] The post SGEM#291: Who’s Gonna Drive you to…the ED – with Lights & Sirens? This is Bob’s eleventh visit […] The post SGEM#291: Who’s Gonna Drive you to…the ED – with Lights & Sirens? Date: April 24th, 2020 Reference: Watanabe et al.

ED 100

ED Ambulance Medical Transportation EMS 100

Pediatric EM Morsels

JULY 5, 2024

Using this decision rule would have cut down on ED CT C-spine ordering by >50% in this derivation cohort. I am hopeful it will also improve the flow in the ED.” While plain films for C-spine injury had previously fallen out of routine ED practice, we now have more evidence to support their use in intermediate risk patients.

ALS 161

ALS OR ED Emergency Department 161

EMDocs

JUNE 16, 2023

Podcast: Play in new window | Download (Duration: 13:57 — 19.2MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Management of the child with mental health problems who is boarding in the ED In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

ED 52

ED Mental Health Services Emergency Department Emergency Medical Services 52

The Skeptics' Guide to EM

NOVEMBER 21, 2020

Reference: Pines et al. Reference: Pines et al. Case: You are the medical director of a medium sized urban emergency department (ED). The American College of Emergency Physicians ( ACEP ) has a number of documents discussing APPs in the ED. Reference: Pines et al. AEM November 2020. AEM November 2020.

Emergency Department 130

Emergency Department ALS ED OR 130

ACEP Now

NOVEMBER 7, 2024

The emergency department (ED) was frequently overwhelmed by suicidal adolescents who needed inpatient psychiatric treatment but couldn’t be admitted, because the hospital had no free beds. Many sought help from EDs, which were not and are not set up to provide involved care for such problems.

ED 59

ED Emergency Department ALS OR 59

The Skeptics' Guide to EM

JANUARY 23, 2021

Reference: Pines et al. AEM January 2021 Case: A 50-year-old male presents to the Emergency Department (ED) with left lower quadrant abdominal pain. That SGEMHOP episode asked how the productivity of APPs compare to emergency physicians and what is its impact on ED operations? Reference: Pines et al.

ED 130

ED ALS Emergency Department OR 130

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

male presents to the ED at 6:45 AM with left sided chest dull pressure that woke him up from sleep at 3am. He arrived to the ED at around 6:45am, and stated the pain has persisted. Here is his ED ECG at triage: Obvious high lateral OMI that does not quite meet STEMI criteria. The pain radiated to both shoulders.

Coronary 118

Coronary ACS OR EMR 118

EMDocs

JANUARY 25, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. A CBC, Chem 7m and CT of the soft tissues of the neck are ordered by the departing ED doc whose clinical info for the radiologist is “facial swelling”. Baek BS et al. An INR is not done. References : 1.

ED 72

ED ALS OR 72

ACEP Now

APRIL 2, 2024

3 Case 1: Posterior Stroke Presenting as Food Poisoning A 42-year-old man presents to the emergency department (ED) with sudden onset of severe vertigo, headache, nausea, and vomiting after eating Italian food. On arrival in the ED, symptoms have resolved except for the headache. References Kattah JC, Talkad AV, Wang DZ, et al.

ALS 40

ALS ED Emergency Department OR 40

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 71

ALS Emergency Department ED OR 71

The Skeptics' Guide to EM

JANUARY 16, 2021

Date: January 5th, 2021 Reference: Shipman et al. Date: January 5th, 2021 Reference: Shipman et al. In the emergency department (ED), tetracaine drops are applied prior to slit lamp examination and the pain is completely resolved. The first documented use of topical ophthalmologic anesthetics was in 1818.

ALS 130

ALS Emergency Department EMS ED 130

Critical Care Scenarios

NOVEMBER 15, 2020

Takeaway lessons Many decisions in the ED are less about what to do, and more about when to do it. Takeaway lessons * Many decisions in the ED are less about what to do, and more about when to do it. Goals of care starts in the ED, and not with lip service. ICU time and ED time are different. JAMA Intern Med.

ICU 100

ICU Life Support Emergency Department ED 100

EMDocs

NOVEMBER 6, 2024

Br Med J Clin Res Ed. 285.6340.478 Gummin DD, Mowry JB, Beuhler MC, et al. doi:10.1080/15563650.2023.2268981 Wood DM, Webster E, Martinez D, Dargan PI, Jones AL. doi:10.1080/15563650.2023.2268981 Wood DM, Webster E, Martinez D, Dargan PI, Jones AL. Br Med J Clin Res Ed. Farrar J, Yen L, Cook T, et al.

E-9-1-1 78

E-9-1-1 ALS EMS OR 78

REBEL EM

AUGUST 22, 2024

Paper: Lema GMC, De Leacy R, Fara MG, et al. The protocol involved collaboration between the ophthalmology service, ED, and stroke service, including neurology and neuroendovascular teams. Outside eye care providers could refer patients directly to the ED for expedited evaluation. PMID: 32568646 Wang X, Liu Y, Suo Y, et al.

ALS 85

ALS ED OR EMS 85

The Skeptics' Guide to EM

DECEMBER 18, 2021

Date: December 13th, 2021 Reference: Lee et al. Date: December 13th, 2021 Reference: Lee et al. She has worked in five EDs so far, and a man has filled almost every leadership position. Addressing gender inequities: Creation of a multi-institutional consortium of women physicians in academic emergency medicine.

Emergency Department 100

Emergency Department ALS ED OR 100

The Skeptics' Guide to EM

APRIL 24, 2021

Reference: Martel et al. Reference: Martel et al. AEM April 2021 * Population: Emergency department (ED) patients 18 years or old where the treating physician determined the need for parenteral sedation for acute agitation (it needed a patient or staff safety concern, not purely a high agitation score).

Emergency Department 100

Emergency Department ALS Ambulance ED 100

ACEP Now

NOVEMBER 7, 2024

About three percent of emergency department (ED) visits are due to skin and soft tissue infections, but data are lacking on the contribution of chronic wounds to this number. Wound management in the ED is only a starting point, and appropriate referral and follow-up are key to an improved outcome.

ED 52

ED OR Emergency Department Ambulance 52

The Skeptics' Guide to EM

DECEMBER 5, 2020

Date: November 30th, 2020 Reference: Ohle R et al. Date: November 30th, 2020 Reference: Ohle R et al. Over the past decade, some emergency physicians have adopted this examination into their own bedside clinical assessment and documentation. Reference: Ohle R et al. A Systematic Review and Meta-analysis.

ALS 100

ALS Emergency Department ED OR 100

REBEL EM

JUNE 8, 2023

Paper: Singer S, et al. This study chose a relevant topic to analyze that could influence acute management in the ED and has a fairly larger sample size of patients to do so. References: Singer S, et al. PMID: 36108346 Cole JB, et al. PMID: 31270748 Maheshwari K, et al. PMID: 29872882 Jones AE, et al.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

The Skeptics' Guide to EM

OCTOBER 28, 2017

[display_podcast] Date: October 24th, 2017 Reference: Harrison et al. display_podcast] Date: October 24th, 2017 Reference: Harrison et al. That rant relied upon a Cochrane SRMA by Stevens B et al 2013 and a randomized clinical trail published in Pediatrics by Gray L et al 2015. Reference: Harrison et al.

ALS 130

ALS Emergency Department OR ED 130

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The result of this ED capacity strain and less than ideal patient to staff ratios has led to delays in interventions, treatments and care adjustments. Paper: Owyang CG, et al. J Crit Care.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

ACEP Now

OCTOBER 30, 2023

The care of patients with disabilities in the ED requires more attention, as not much data is available. Krahn, et al., highlight some discrepancies in experiences that may result in ED visits. 3 The need for this type of investigation was further highlighted in an article by York, et al. Krahn, et al.,

ED 98

ED ALS OR EMS 98

ACEP Now

JUNE 14, 2024

Transferring patients from one ED to another hospital is an established part of emergency medicine practice. 1 As fresh challenges of the pandemic and hospital operations changed emergency medicine practice, one of the more challenging areas was the movement of admitted patients out of the first emergency department (ED).

Emergency Department 52

Emergency Department ED Ambulance OR 52

EMDocs

SEPTEMBER 23, 2023

A 36-year-old female presents to the ED after experiencing an episode of sudden syncope. Rosh Review Website Link References Antzelevitch C, Brugada P, Borggrefe M, et al. Priori SG, Napolitano C, Gasparini M, et al. Chen Q, Kirsch GE, Zhang D, et al. Wilde AA, Antzelevitch C, Borggrefe M, et al. Circulation.

E-9-1-1 84

E-9-1-1 EMS ALS Defibrillator 84

ACEP Now

FEBRUARY 11, 2024

1,2 In the emergency department (ED), the focus of treatment is pain control and immobilization unless there is a clear indication for surgery, such as open fractures, skin tenting, or neurovascular compromise. Conclusion Clavicular fractures are common injuries in the ED. for the ED clinician. for the ED clinician.

E-9-1-1 52

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

ACEP Now

APRIL 2, 2024

An 18-year-old woman presented to the emergency department (ED) with symptoms of nausea, vomiting, diarrhea, and abdominal pain. Before arriving at our ED, the patient sought care at an urgent care clinic, where she was prescribed ondansetron without improvement. References Katibi OS, Olaosebikan R, et al. Am J Trop Med Hyg.

Plasma 40

Plasma ALS Emergency Department ED 40

ACEP Now

JUNE 6, 2023

A medical student reports a murmur, not documented by either the emergency physician or the cardiologist. In the ED, his troponin, ECG, and chest X-ray (CXR) are normal. An aortic dissection is discovered when he bounces back to the ED. He arrives in the ED stating, “I can’t move my legs.” References Hansen MS, et al.

ACS 85

ACS ALS ED OR 85

The Skeptics' Guide to EM

MAY 11, 2019

Date: May 6th, 2019 Reference: Sceats et al. Date: May 6th, 2019 Reference: Sceats et al. Case: An 18-year-old woman presents with a Grade 1 appendicitis (Tominaga et al J Trauma Acute Care Surg 2016). Background: The first documented appendectomy was done by Claudius Amyand in 1735. Reference: Sceats et al.

Critical Care 130

Critical Care ALS ED OR 130

Dr. Smith's ECG Blog

JUNE 17, 2024

In fact, Kosuge et al. Stein et al. This is a paper worth reading : Marchik et al. Kosuge et al. Witting et al. This does not contradict the conclusions of Kosuge et al. found normal ECGs in only 3 of 50 patients with massive PE, and 9 of 40 with submassive PE. of patients with PE and 3.3% of controls.

E-9-1-1 138

E-9-1-1 ACS Emergency Department Coronary 138

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. However, rapid initiation of treatment is actually patient-centered care that can both lead to better outcomes and limit ED boarding.

Emergency Department 52

Emergency Department ED Naloxone ALS 52

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

ALS 98

ALS ED OR CPR 98

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. ED crowding impairs this mission. Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality.

Emergency Department 52

Emergency Department ED ALS OR 52

ACEP Now

NOVEMBER 7, 2023

3 These regulations have led to widespread practices of EHI, such as test results and clinical documentation, being shared with patients in real time. In turn, concerns have arisen regarding when information blocking is appropriate and what ethical issues emergency department (ED) physicians must consider prior to information blocking.

ED 52

ED ALS OR Emergency Department 52

REBEL EM

JUNE 22, 2023

Article: Bramante CT et al. Population: Adults aged 30-85 years of age with BMI > 25 ( > 23 in those identifying as Asian or Latino) who had COVID-19 symptoms for fewer than 7 days and a documented SARS-CoV-2 positive PCR or antigen test within 3 days of enrollment without prior SARS-CoV-2 infection.

ALS 145

ALS OR EMS ED 145

ACEP Now

JUNE 7, 2023

The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. EDs weathered attacks from a variety of sources in recent years. ED leaders worked to develop new physician documentation and coding guidelines that needed to be implemented at the beginning of 2023.

Emergency Department 52

Emergency Department ED EMS Ambulance 52