REBEL EM

JULY 1, 2024

Paper: Goren NZ et al. Advocates feel that AVAPS is a more comfortable pressure support mode, which varies according to the patient’s needs (This is like PRVC for mechanical ventilation). There are very limited studies however in the literature on the AVAPS mode of NIPPV. Balkan Med J 2021. AVAPS: 0.07 AVAPS: 10.20 AVAPS: 0.07 AVAPS: 10.20

ED 133

ED Emergency Department ALS OR 133

EMS 12-Lead

MAY 15, 2024

We will be using redacted information from different cases where paramedics attempted TCP in the field. After 13 minutes of ALS resuscitation, pulses were palpated indicating a return of spontaneous circulation. Pacing was continued in the ED, with identical settings. Patient was transferred to comfort care and died in the ED.

Epinephrine 331

Epinephrine Paramedic CPR EMT 331

Core EM

JANUARY 25, 2024

Background: The immediate post intubation period in the ED is a critical time for continued patient stabilization. The reality of ever increasing ED volumes and longer boarding times to the ICU makes it imperative for emergency physicians to learn how to manage these critical patients. mg/kg over several minutes 0.02 – 0.1 up to 1.5)

ICU 246

ICU Emergency Department Critical Care ALS 246

ALiEM

JUNE 15, 2023

Goldfrank’s Toxicologic Emergencies, 11e New York, NY: McGraw-Hill; 2019 Morimoto M, Tatsumi K, Yuui K, et al. PMID 29855084 De Silva HA, Fonseka MM, Pathmeswaran A et al. Retrieved Jun 5, 2023. Nelson LS, Goldfrank LR. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. Lancet 2003; 361 (9373): 1935-8.

ALS 246

ALS ED OR 246

The Skeptics' Guide to EM

JUNE 24, 2023

Date: June 16, 2023 Reference: Reed et al. Date: June 16, 2023 Reference: Reed et al. Case: A 27-year-old right hand dominant patient presents to the emergency department (ED) with a 2.5 Individuals can then use that information to decide if or how much of the drug to use. Reference: Reed et al.

Overdose 198

Overdose Emergency Department ALS ED 198

EMDocs

JULY 25, 2024

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. Chuck Pilcher, MD, FACEP Editor, Medical Malpractice Insights Editor, Med Mal Insights The challenge of suicide evaluation in the ED “I’ve changed my mind. If you have a story to share click here.

ED 104

ED ALS Emergency Department OR 104

Don't Forget the Bubbles

MARCH 21, 2025

Thats exactly what Shane George et al. George S, Williams T, Humphreys S, et al. A total of eleven intensive care units (ten PICUs and one non-maternity NICU) and four emergency departments (EDs) took part in the study. Recruitment took place across ten PICUs, one NICU, and four EDs in Australia, New Zealand, and Switzerland.

ICU 108

ICU Critical Care ED OR 108

REBEL EM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. Article: Arvig MD, Lassen AT, Gæde PH, et al. US, compared with CXR and CT, offers the absence of ionizing radiation and high reproducibility. Emerg Med J. 2023;40(10):700-707.

ED 129

ED E-9-1-1 Emergency Department ALS 129

ALiEM

APRIL 12, 2023

Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. 20 – Local Anesthetics, Ed(s): Hugh C. Author information Ivan Ivanov, DO Resident Physician Emergency Department South Brooklyn Health | The post Trick of the Trade: Gel-free ultrasound-guided peripheral IV technique appeared first on ALiEM. 2022 Jan 6;8(1):42.

Emergency Department 258

Emergency Department ALS ED 258

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

EMS 12-Lead

MARCH 30, 2024

We will be using redacted information from different cases where paramedics attempted TCP in the field. On ED arrival ROSC is achieved. The University of Maryland found that capture occurred in only 42-78% of patients, dependent on pad positioning (Moayedi et al, 2022). They are unable to feel a pulse and resume CPR.

CPR 312

CPR Paramedic Ambulance Epinephrine 312

ALiEM

FEBRUARY 5, 2024

Reference Lin M, Phipps M, Chan TM, et al. You will need to create a free, 1-time login account. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. Ann Emerg Med. 2023;82(1):55-65. doi: 10.1016/j.annemergmed.2023.02.011

Overdose 215

Overdose Critical Care EMS Emergency Department 215

REBEL EM

JUNE 5, 2023

Background Information: Opioid overdose deaths have been increasing in the past twenty years. These statistics make the ED a crucial treatment initiation point to prevent further morbidity and mortality from opioid overdoses. The national number of overdose deaths from any opioid has increased 62.5% PMID 33392580.

Naloxone 97

Naloxone ED Overdose Emergency Department 97

ALiEM

JUNE 1, 2023

Are you using phenobarbital instead of benzodiazepines as the first-line monotherapy for patients in alcohol withdrawal in the Emergency Department (ED)? Is phenobarbital safe for the treatment of EtOH withdrawal in the ED? References Rosenson J, Clements C, Simon B, et al. Author information T. Well not exactly.

Emergency Department 246

Emergency Department ICU ED OR 246

REBEL EM

JULY 17, 2023

REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED? Click here for Direct Download of the Podcast Paper: Knack SKS et al. PMID: Clinical Question: Does a single dose of ketamine or etomidate used for rapid sequence intubation (RSI) of critically adults in the ED impact the SOFA score within 3 days of hospitalization?

ED 98

ED ICU Emergency Department Overdose 98

ALiEM

NOVEMBER 22, 2023

Pagel, Mark (ed.). “Evolution of Dietary Specialization and Chemical Defense in Poison Frogs (Dendrobatidae): A Comparative Analysis” The American Naturalist. Tarvin RD, Borghese CM, Sachs W, et al. The poison Dart frog’s batrachotoxin modulates Nav1.8. 2004;577(1-2):245-248. PMID: 15527793 Darst, Catherine R.;

ALS 284

ALS ED OR 284

EMDocs

FEBRUARY 26, 2024

A recent study by Gaborit et al. The ED clinician should inquire about a relevant history of HIV infection, malignancy, high-dose corticosteroid use, chemotherapy, organ transplant, or use of immunosuppressive drugs for other indications. She reports occasional central chest pain exacerbated by coughing. and specificity of 71.4%).

E-9-1-1 110

E-9-1-1 ED ALS OR 110

ALiEM

APRIL 12, 2024

Case A 48 year-old male with a history of hypertension and polysubstance abuse presented to the emergency department (ED) for shortness of breath and was found to have a left sided parapneumonic pleural effusion (Figure 1). doi: [link] Broder JS, Al-Jarani B, Lanan B, Brooks K. doi: [link] Vetrugno L, Guadagnin GM, Barbariol F, et al.

E-9-1-1 183

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

The Skeptics' Guide to EM

FEBRUARY 26, 2022

Date: February 21st 2022 Reference: Kim et al. Date: February 21st 2022 Reference: Kim et al. Case: You are in discussion with your emergency department (ED) manager about the number of patients boarding for hours to days and you are both aware that many of these patients are attending with mental health crises.

ED 130

ED ALS Emergency Department OR 130

EMDocs

NOVEMBER 19, 2024

10 Table 1: Second-Generation Antipsychotics and Associated Adverse Effects Adapted from: UpToDate 8 with additional sources Micromedex 9 and Riboldi, et al 11 *SL=sublingual, IM=intramuscular, PO=oral, ODT=orally disintegrating tablets, ER=extended release, IR=immediate release. +to Gummin DD, Mowry JB, Beuhler M, et al. Juurlink D.

Overdose 111

Overdose EMS Emergency Medical Services OR 111

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

ACEP Now

NOVEMBER 8, 2024

Neurodivergence refers to the unique way in which an individual’s brain processes and responds to certain information, differing from the typical or average brain. One common myth is that neurodivergent individuals are intellectually disabled or incapable of understanding complex information. bandwidth” and “deep dive”).

Emergency Department 52

Emergency Department ED OR ALS 52

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Practice using the Broselow tape and looking at what information is and is not included on the tape so that it’s of most benefit when you need it. 2012.05.028 Silvagni D, Baggio L, Mazzi C, et al. Know your tools!

E-9-1-1 271

E-9-1-1 Emergency Medical Services Life Support ALS 271

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 164

ALS OR ED Emergency Department 164

EMDocs

AUGUST 22, 2024

6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. 6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits. One cohort study in a public ED found that 84.5%

Emergency Department 104

Emergency Department ALS E-9-1-1 ED 104

ALiEM

SEPTEMBER 27, 2023

Hoffman et al. Koppaka V, Thompson DC, Chen Y, et al. Author information Kylee Brooks, MD Emergency Medicine Resident Department of Emergency Medicine Carolinas Medical Center | The post ACMT Toxicology Visual Pearls: Mushroom Mishap appeared first on ALiEM. Encyclopedia of Toxicology (Third Edition), Academic Press.

ALS 169

ALS OR ED 169

ALiEM

OCTOBER 14, 2023

Reference Lin M, Phipps M, Chan TM, et al. Author information Chris Belcher, MD Editor, ALiEM AIR Series Assistant Professor and Assistant Program Director Department of Emergency Medicine University of Kentucky College of Medicine | Twitter | The post ALiEM AIR Series | Respiratory 2023 Module appeared first on ALiEM. Ann Emerg Med.

Critical Care 169

Critical Care EMS Emergency Department ALS 169

ALiEM

SEPTEMBER 25, 2024

A 24-year-old male with a history of microscopic hematuria presented to the emergency department (ED) with left lower quadrant abdominal pain. He decided to come to the ED today because of the persistent nature of the pain. Zubaidi A, Al-Saif F, Silverman R. His pain started about two weeks ago and has been intermittent.

Emergency Department 141

Emergency Department ED ALS OR 141

ALiEM

NOVEMBER 29, 2023

PMID: 34529640 Ayub S, Parnia S, Poddar K, et al. PMID: 24769343 Ehrman-Dupre R, Kaigh C, Salzman M et al. PMID: 36148197 Love JS, Levine M, Aldy K, et al. PMID: 37014353 Ball NS, Knable BM, Relich TA et al. How do you treat xylazine toxicity? MMWR Morb Mortal Wkly Rep. 2021;70(37):1300-1302. Published 2021 Sep 17.

Naloxone 169

Naloxone Overdose Epinephrine ALS 169

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. His visual acuity is 20/20 bilaterally and he doesn’t wear corrective lenses or contact lenses.

ALS 130

ALS EMS Emergency Department ED 130

ACEP Now

NOVEMBER 7, 2023

Background As Electronic Health Information (EHI) has increased in prominence, the U.S. The 2015 Edition Cures Act sought to promote “transparency, modern standards, and enhanced health IT capabilities by fostering innovation in the health care technology ecosystem to deliver better information to patients, clinicians, and other users.”

ED 52

ED ALS OR Emergency Department 52

Don't Forget the Bubbles

SEPTEMBER 6, 2023

14-year-old Katy presents to the paediatric Emergency Department (ED), alone, complaining of suicidal ideation. Mental health-related ED visits for children and young people are common and have been on the rise during the last decade. Recognising and acknowledging the child’s stress and traumatic experience in the ED is important.

Emergency Department 119

Emergency Department ED Overdose ALS 119

ALiEM

AUGUST 9, 2023

Study N Sensitivity Specificity Comments Pereda et al., Balk et al., Tsou et al., ED Course The patient received antibiotics for pneumonia. PMID: 14722643 Pereda MA, Chavez MA, Hooper-Miele CC, et al. PMID: 25780071 Balk DS, Lee C, Schafer J, et al. PMID: 29696826 Tsou PY, Chen KP, Wang YH, et al.

E-9-1-1 246

E-9-1-1 Emergency Department ALS OR 246

The Skeptics' Guide to EM

AUGUST 24, 2024

Date: August 19, 2024 Reference: Partyka et al. Interests include information systems and digital health, research and education. Interests include information systems and digital health, research and education. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle.

Emergency Department 136

Emergency Department ALS OR ED 136

The Skeptics' Guide to EM

MARCH 28, 2020

Date: March 27th, 2020 Reference: Secko et al. Date: March 27th, 2020 Reference: Secko et al. Background: Despite shoulder dislocations being a very common injury presenting to the ED, it has only been covered once on SGEM#121. Reference: Secko et al.

ALS 130

ALS Emergency Department ED OR 130

The Skeptics' Guide to EM

JULY 23, 2022

Date: July 22nd, 2022 Reference: Perry et al. Date: July 22nd, 2022 Reference: Perry et al. Case: Jack is nine years old, and he presents to emergency department (ED) with an arm injury. Buckles of the distal radius are the most common fracture seen in children and very commonly present to the ED [1-2].

ALS 130

ALS Emergency Department ED OR 130

ALiEM

JANUARY 29, 2024

Case Question: What treatments can you perform in the ED for this diagnosis and do they improve outcomes? Nedelmann, Matt et al. 2015;46:2322–2324 [link] Smith, Austin T et al. This has the potential to expedite consultations with specialty teams and treatment. Ultraschall Med. 2012 Dec;33(7):E263-E267. Epub 2012 Sep 21.

ALS 161

ALS ED OR 161