The Skeptics' Guide to EM

JUNE 1, 2024

Reference: Tavender E, et al. His research focuses on the pre-hospital care of children by EMS. He is the principal investigator for EMSC State Partnership in Washington, DC and is also involved in various multi-center EMS studies with the Pediatric Emergency Care Applied Research Network (PECARN). Reference: Tavender E, et al.

Emergency Medical Services 207

Emergency Medical Services Emergency Department EMS ALS 207

EMDocs

MARCH 2, 2024

We’ll keep it short, while you keep that EM brain sharp. A 58-year-old female with a history of diabetes, hypertension, and chronic back pain presents to the ED with severe headache and nausea.  An Pediatr (Engl Ed). 2019 Bernstein AL, Cassidy J, Duchynski R, Eisenberg SS. Int J Crit Illn Inj Sci. 2017 Surg Neurol Int. 

EMS 114

EMS E-9-1-1 OR ED 114

EMDocs

JUNE 8, 2024

We’ll keep it short, while you keep that EM brain sharp. A 27-year-old male presents to the ED for left eye pain after being hit in the face with a spare car part while working under the hood of his car. What is the diagnosis, and how do we manage it from the ED? Lu, Kevin, et al. Review of Optometry , 15 Jan.

EMS 81

EMS Allergic Reaction Emergency Department ED 81

EMDocs

MAY 25, 2024

We’ll keep it short, while you keep that EM brain sharp. link] Haidar H, Menon A, Al Duhirat E. The post EM@3AM: Sialadenitis appeared first on emDOCs.net - Emergency Medicine Education. She is breathing comfortably but seems to experience significant pain at the associated site of swelling. Am Fam Physician. Sialadenitis.

EMS 80

EMS E-9-1-1 OR ED 80

EMDocs

JULY 3, 2023

Authors: Mikalah Ward, MD (EM Resident Physician, University of Kentucky); Susan Owens, MD (EM Attending Physician, University of Kentucky) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. His last known normal was 5 hours prior to ED presentation. Glasgow coma scale (GCS) is 12.

ED 85

ED E-9-1-1 ALS OR 85

ACEP Now

JUNE 21, 2023

emergency medicine (EM) residency training length has been a decades-long dilemma: four vs. three years. First, is three years enough time to become an EM physician? But critical questions remain unanswered when it comes to specialization, career trajectory, and actual competence as an EM physician. 11 What should we take away?

EMS 114

EMS ALS Emergency Medical Services OR 114

REBEL EM

DECEMBER 18, 2023

Post TW, ed. In: Tintinalli JE, Ma OJ, Yealy DM, et al., Rezaie, MD (Twitter/X: @srrezaie ) The post Rosh Review EM Scholar Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. Peritoneal catheter exit-site and tunnel infections in peritoneal dialysis in adults. UpToDate Inc. link] Calvert JH, Cline DM.

EMS 55

EMS ED ALS 55

The Skeptics' Guide to EM

MARCH 2, 2024

Reference: Gibbons et al. Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Reference: Gibbons et al. Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY.

Operating Room 306

Operating Room Emergency Department ALS ED 306

EMDocs

JULY 17, 2023

and is poorly tolerated by patients with obstruction, it should not be a routine part of the ED evaluation for LBO unless it is critical for another diagnosis on the differential. doi:10.3390/cancers13092025 Pisano M, Zorcolo L, Merli C, et al. 2021.03.001 Bauman BD, Witt JE, Vakayil V, et al. Published 2021 Apr 22. 2018;13:36.

E-9-1-1 77

E-9-1-1 ED ALS Operating Room 77

EMDocs

SEPTEMBER 9, 2023

We’ll keep it short, while you keep that EM brain sharp. He presents to the ED with profound difficulty extending his middle and ring finger. A 35-year-old right handed male with no significant past medical history presents with a deep hand laceration. The patient states they suffered a cut with a box cutter at a construction site.

EMS 78

EMS ED ALS Emergency Department 78

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 195

ICU Defibrillator CPR Paramedic 195

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. Case: A 65-year-old man is brought into the emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table.

Emergency Medical Services 183

Emergency Medical Services ALS Emergency Department ED 183

EMDocs

SEPTEMBER 23, 2023

We’ll keep it short, while you keep that EM brain sharp. 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.

E-9-1-1 84

E-9-1-1 EMS ALS OR 84

EMDocs

NOVEMBER 18, 2023

We’ll keep it short, while you keep that EM brain sharp. A 32-year-old female with a history of hypertension and autoimmune hepatitis status post liver transplant 6 weeks prior on tacrolimus and mycophenolate presents to the ED with abdominal discomfort. What are the complications of liver transplant that we see in the ED?

EMS 69

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

The Skeptics' Guide to EM

APRIL 13, 2024

Reference: Albers GW et al. Reference: Albers GW et al. Case: A 70-year-old woman was brought into the emergency department by EMS after her family reported she was having trouble talking. When she arrives in your ED, her family tells you she was last seen normal about 12 hours ago. TIMELESS Investigators.

Emergency Department 295

Emergency Department ALS OR EMS 295

EMDocs

APRIL 13, 2024

We’ll keep it short, while you keep that EM brain sharp. A 24-year-old male presents to the ED from a mixed marital arts competition after being struck on the side of the right head by a fist earlier today. Brickman K, Adams DZ, Akpunonu P, et al. Roy S, Smith LP. Am J Otolaryngol 2010; 31:21. Published online April 19, 2004.

EMS 82

EMS E-9-1-1 OR Emergency Department 82

ALiEM

FEBRUARY 5, 2024

Reference Lin M, Phipps M, Chan TM, et al. Alex Rogers MD, J.D. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

REBEL EM

AUGUST 17, 2023

In: Walls RM, Hockberger RS, Gausche-Hill M, et al., Post TW, ed. Rezaie, MD (Twitter: @srrezaie ) The post Rosh Review EM Scholar Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. Rosen’s Emergency Medicine: Concepts and Clinical Practice. Elsevier; 2023:(Ch) 47. Von Fange TJ. UpToDate Inc.

EMS 52

EMS Emergency Department ED ALS 52

The Skeptics' Guide to EM

JULY 29, 2023

Date: July 21, 2023 Reference: McDonald et al. Date: July 21, 2023 Reference: McDonald et al. Emergency Medical Services (EMS) is called and on arrival the patient is walking but has obvious facial trauma and is complaining of some neck pain. Reference: McDonald et al.

Emergency Medical Services 204

Emergency Medical Services ALS EMS Emergency Department 204

REBEL EM

OCTOBER 23, 2023

His parent noticed a dental problem and immediately brought the patient to the ED. Rezaie, MD (Twitter: @srrezaie ) The post Rosh Review EM Scholar Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. The patient was walking his dog when it ran after a squirrel. The physical exam is shown below.

EMS 55

EMS ACS ALS ED 55

EMDocs

OCTOBER 21, 2023

We’ll keep it short, while you keep that EM brain sharp. Median time from ED arrival to diagnosis was 8 hours 24 min in one study, with only 19% being diagnosed within the 4.5-hour References: Gaillard F, Glick Y, Tatco V, et al. Post TW, ed. 61.4.496 Navi BB, Kamel H, Shah MP, et al. hour IV thrombolytic window.

EMS 74

EMS ALS OR ACS 74

EMDocs

AUGUST 12, 2023

We’ll keep it short, while you keep that EM brain sharp. Çalışkan Uçkun A, Yurdakul FG, Ergani HM, et al. link] Alkandari A F, Alawadhi A, Alawadhi F A, et al. doi:10.1055/s-0032-1327007 Zhao W, Wang G, Chen B, et al. 0000000000017823 Rosskopf AB, Martinoli C, Sconfienza LM, et al. McGraw Hill; 2021. J Ultrason.

EMS 69

EMS ALS Emergency Department OR 69

The Skeptics' Guide to EM

MAY 2, 2020

Date: April 24th, 2020 Reference: Watanabe et al. A Contemporary Analysis Using National EMS Information System (NEMSIS) Data. 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. Reference: Watanabe et al.

ED 100

ED Ambulance Medical Transportation EMS 100

ALiEM

OCTOBER 26, 2023

The Problem: Emergency Medicine (EM) in Pakistan has moved from developing to developed stage in the last decade [1]. It is an innovation that is based on a community of practice merged with the need-based assessment of a young EM residency program in a developing country. Originally developed by Marsh et al.,

EMS 161

EMS Emergency Department ALS ED 161

EMDocs

JUNE 3, 2023

We’ll keep it short, while you keep that EM brain sharp. A 53-year-old female with a past medical history significant for hypertension presents to the ED with headache and dizziness. Rosh Review Website Link Further Reading [link] [link] [link] [link] [link] References: Stanislavsky A, Baba Y, Hacking C, et al. 2018;155:301-312.

EMS 74

EMS ALS OR ED 74

The Skeptics' Guide to EM

JULY 8, 2023

Date: July 6, 2023 Reference: Hanula R et al. Managing editor of EM:RAP and Associate Editor at REBEL EM. Date: July 6, 2023 Reference: Hanula R et al. Managing editor of EM:RAP and Associate Editor at REBEL EM. JAMA Int Med 2023. JAMA Int Med 2023.

ALS 243

ALS Emergency Department EMS ED 243

REBEL EM

JUNE 5, 2023

These statistics make the ED a crucial treatment initiation point to prevent further morbidity and mortality from opioid overdoses. The benefit of accessibility, availability, and safety of buprenorphine compared to methadone makes it a viable option for opioid use disorder treatment initiation in the ED. PMID 33392580.

Naloxone 95

Naloxone ED Overdose Emergency Department 95

EMDocs

NOVEMBER 4, 2023

We’ll keep it short, while you keep that EM brain sharp. He came to the ED because he now has a fever, chills, and nausea along with his testicular pain. link] =2969&sectionid=250456991 Moran GJ, Krishnadasan A, Gorwitz RJ, et al. doi:10.4103/0974-2700.96504 Talan DA, Mower WR, Krishnadasan A, et al. Radiographics.

EMS 68

EMS E-9-1-1 Emergency Department ALS 68

EMDocs

DECEMBER 2, 2023

We’ll keep it short, while you keep that EM brain sharp. A 50-year-old female with no past medical history presents to the ED with a diffuse, constant headache onset a few weeks. The patient describes droopiness of the left eye and double vision associated with specific directional movements of the eye. Oman J Ophthalmol. Kelliny, M.,

EMS 67

EMS Emergency Department OR ED 67

EMDocs

JULY 1, 2023

We’ll keep it short, while you keep that EM brain sharp. A 3-year-old male with no past medical history presents to the ED with one week of daily fevers >102°F associated with four days of rash on the trunk. In: Post TW, ed. In: Post TW, ed. In: Post TW, ed. In: Post TW, ed. C) for the past week.

EMS 66

EMS Coronary ED OR 66

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Date: February 17, 2023 Reference: Gettel et al. Date: February 17, 2023 Reference: Gettel et al. Case: You are an administrator responsible for staffing emergency departments (EDs) in a health care system comprising both urban and rural locales. The SGEM has done two previous podcasts on APPs in the ED.

Emergency Department 130

Emergency Department ALS ED EMS 130

The Skeptics' Guide to EM

MAY 20, 2023

Date: May 10, 2023 Reference: Harhay MO, et al. Date: May 10, 2023 Reference: Harhay MO, et al. Case: You are working at the community emergency department (ED) when you receive a call from the local Emergency Medicine Service (EMS) team that they are bringing a 2-year-old boy who had a cardiac arrest at home.

CPR 130

CPR ALS Emergency Department EMS 130

EMS 12-Lead

MAY 15, 2024

After 13 minutes of ALS resuscitation, pulses were palpated indicating a return of spontaneous circulation. Crew notifies the received ED of an incoming post-arrest patient and notes a sinus bradycardia on their monitor, as seen in Figure 2. Pacing was continued in the ED, with identical settings. Several learning points here.

Epinephrine 331

Epinephrine Paramedic CPR ED 331

ALiEM

OCTOBER 14, 2023

Reference Lin M, Phipps M, Chan TM, et al. 2023.02.011 , PMID 36967275 Sponsors Thank you to the Society of Academic Emergency Medicine (SAEM) and the Council of EM Residency Directors (CORD) for jointly sponsoring the AIR Series! Ann Emerg Med. 2023;82(1):55-65. doi: 10.1016/j.annemergmed.2023.02.011

Critical Care 169

Critical Care EMS Emergency Department ALS 169

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. Date: September 8th, 2021 Reference: Desch et al. The TOMAHAWK Investigators. The TOMAHAWK Investigators.

EMR 130

EMR Coronary Defibrillator Life Support 130

REBEL EM

MAY 20, 2024

A 67-year-old woman with a history of atrial fibrillation on apixaban presents to the ED for epistaxis that began 30 minutes ago. Post TW, ed. In: Tintinalli JE, Ma OJ, Yealy DM, et al., In: Tintinalli JE, Ma OJ, Yealy DM, et al., Her vital signs are within normal limits. How should this patient’s apixaban be managed?

ALS 55

ALS ED EMS 55

Pediatric EM Morsels

SEPTEMBER 22, 2023

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Never fear.

E-9-1-1 300

E-9-1-1 Epinephrine ALS EMS 300