The Skeptics' Guide to EM

NOVEMBER 16, 2024

Date: October 28, 2024 Reference: Verma et al. Case: The Chief of Emergency Medicine (EM) at a large urban hospital recently approached the AI Committee at Unity Health, intrigued by the CMAJ article describing the apparent success of CHARTWatch in detecting early signs of patient deterioration. Reference: Verma et al.

ICU 142

ICU Emergency Department ALS EMS 142

ACEP Now

DECEMBER 11, 2023

The Emergency Department Benchmarking Alliance (EDBA) is a membership organization composed of high-performance emergency departments (EDs) that share a commitment to quality. EMS arrivals increased; many of those patients (35 percent) were admitted. Boudi Z, Lauque D, Alsabri M, et al. ED boarding.

Emergency Department 52

Emergency Department ED EMS ALS 52

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. Clinical Policy: Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the Emergency Department.

Emergency Department 52

Emergency Department ED Naloxone ALS 52

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

Core EM

JANUARY 25, 2024

How and when to reverse anticoagulation in the bleeding EM patient. Anticoagulant Reversal Strategies in the Emergency Department Setting: Recommendations of a Multidisciplinary Expert Panel. Anticoagulant Reversal Strategies in the Emergency Department Setting: Recommendations of a Multidisciplinary Expert Panel.

Frozen Plasma 246

Frozen Plasma FFP Plasma Critical Care 246

The Skeptics' Guide to EM

JUNE 1, 2024

Reference: Tavender E, et al. 2024 Date: May 29, 2024 Guest Skeptic: Dr. Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washington School of Medicine and Health Sciences in Washington, DC.

Emergency Medical Services 210

Emergency Medical Services Emergency Department EMS ALS 210

The Skeptics' Guide to EM

MARCH 2, 2024

Reference: Gibbons et al. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. 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.

Operating Room 301

Operating Room Emergency Department ALS ED 301

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. REFERENCES: Acute Respiratory Distress Syndrome Network et al.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

EMDocs

MAY 11, 2024

We’ll keep it short, while you keep that EM brain sharp. A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. link] Sharma R, Gaillard F, Bell D, et al.

EMS 88

EMS E-9-1-1 ALS OR 88

REBEL EM

MAY 11, 2023

Background: The emergency department is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines. 5 Paper: Lebin J et al. 5 Paper: Lebin J et al. J Med Toxicol 2022. DOI: 10.1016/j.ajem.2012.12.029

Emergency Department 98

Emergency Department ED EMR OR 98

The Skeptics' Guide to EM

DECEMBER 8, 2017

[display_podcast] Date: November 28th, 2017 Reference: Motov S et al. A Prospective Randomized, Double-Dummy Trial Comparing Intravenous Push Dose of Low Dose Ketamine to Short Infusion of Low Dose Ketamine for Treatment of Moderate to Severe Pain in the Emergency Department.

Emergency Department 130

Emergency Department ALS OR EMS 130

EMDocs

JUNE 8, 2024

We’ll keep it short, while you keep that EM brain sharp. A 32-year-old man presents to the emergency department with eye pain. However, it would be expected to emerge with reduced visual acuity or other visual disturbances such as diplopia. Overview of Eye Injuries in the Emergency Department.” WikEM , Oct.

EMS 80

EMS Allergic Reaction Emergency Department ED 80

The Skeptics' Guide to EM

APRIL 13, 2024

Reference: Albers GW et al. NEJM Feb 2024 Date: April 12, 2024 Guest Skeptic: Dr. Vasisht Srinivasan is an Emergency Medicine physician and neurointensivist at the University of Washington and Harborview Medical Center in Seattle, WA. Reference: Albers GW et al. TIMELESS Investigators. Tenecteplase for Stroke at 4.5

Emergency Department 287

Emergency Department ALS OR EMS 287

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

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. Prehospital Emergency Care. first appeared on The Skeptics Guide to Emergency Medicine. Prehospital Emergency Care. Prehospital Emergency Care. February 2024.

ICU 189

ICU Defibrillator CPR Paramedic 189

ALiEM

FEBRUARY 5, 2024

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 toxicology in the Emergency Department. Reference Lin M, Phipps M, Chan TM, et al. Alex Rogers MD, J.D.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

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

ALiEM

NOVEMBER 3, 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 trauma in the Emergency Department. Reference Lin M, Phipps M, Chan TM, et al. Ann Emerg Med.

Critical Care 211

Critical Care EMS Emergency Department ALS 211

The Skeptics' Guide to EM

JULY 29, 2023

Date: July 21, 2023 Reference: McDonald et al. AEM July 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: July 21, 2023 Reference: McDonald et al. As an EMS crew member, you are tasked with deciding what method of spinal motion restriction to use.

Emergency Medical Services 193

Emergency Medical Services ALS EMS Emergency Department 193

EMDocs

MARCH 30, 2024

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

EMS 89

EMS E-9-1-1 Emergency Department Ambulance 89

The Skeptics' Guide to EM

JANUARY 9, 2021

Date: January 5th, 2021 Reference: Grunau et al. JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

EMDocs

SEPTEMBER 23, 2023

We’ll keep it short, while you keep that EM brain sharp. A 23-year-old man with no significant medical history presents to the emergency department for evaluation of a syncopal episode. Rosh Review Website Link References Antzelevitch C, Brugada P, Borggrefe M, et al. Priori SG, Napolitano C, Gasparini M, et al.

E-9-1-1 83

E-9-1-1 EMS ALS Defibrillator 83

The Skeptics' Guide to EM

JULY 8, 2023

Date: July 6, 2023 Reference: Hanula R et al. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Managing editor of EM:RAP and Associate Editor at REBEL EM. Date: July 6, 2023 Reference: Hanula R et al. JAMA Int Med 2023. JAMA Int Med 2023.

ALS 237

ALS Emergency Department EMS ED 237

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. Elsevier; 2023:(Ch) 47. Von Fange TJ.

EMS 52

EMS Emergency Department ED ALS 52

EMDocs

NOVEMBER 18, 2023

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

EMS 69

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

EMDocs

NOVEMBER 4, 2023

We’ll keep it short, while you keep that EM brain sharp. link] =2969&sectionid=250456991 Moran GJ, Krishnadasan A, Gorwitz RJ, et al. aureus infections among patients in the emergency department. Skin and Soft Tissue Infections in the Emergency Department. Emerg Med Clin North Am. Ann Emerg Med.

EMS 68

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

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Date: February 17, 2023 Reference: Gettel et al. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. AEM Feb 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and Assistant Professor at the University of Calgary. Reference: Gettel et al.

Emergency Department 130

Emergency Department ALS ED EMS 130

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. NEJM May 2024 Guest Skeptic: Dr. Vasisht Srinivasan is an Emergency Medicine physician and neurointensivist at the University of Washington and Harborview Medical Center in Seattle, WA.

Emergency Medical Services 176

Emergency Medical Services ALS Emergency Department ED 176

EMDocs

AUGUST 12, 2023

We’ll keep it short, while you keep that EM brain sharp. 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. Flexor Tendon Lacerations. In: StatPearls.

EMS 69

EMS ALS Emergency Department OR 69

EMDocs

SEPTEMBER 9, 2023

We’ll keep it short, while you keep that EM brain sharp. e1 Rosh AJ, Kwon NS, Wilburn JM, et al. The emergent evaluation and treatment of hand injuries. Emerg Med Clin North Am. 0b013e3182a0148c Zhao W, Wang G, Chen B, et al. 0000000000017823 Rosskopf AB, Martinoli C, Sconfienza LM, et al. J Emerg Med.

EMS 77

EMS ED ALS Emergency Department 77

Pediatric EM Morsels

APRIL 19, 2024

Trauma season is at hand and like all other pediatric emergency departments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. Davidson JS, Brown DJ, Barnes SN, et al. West S, Andrews J, Bebbington A, et al. Symons S, Rowsell M, Bhowal B, et al. J Pediatr Orthop.

ALS 286

ALS ACS Emergency Department ED 286

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

EMDocs

APRIL 13, 2024

We’ll keep it short, while you keep that EM brain sharp. A 21-year-old man presents to the emergency department for pain and swelling in his ear beginning 3 days ago. Brickman K, Adams DZ, Akpunonu P, et al. doi:[link] The post EM@3AM: Auricular Hematoma appeared first on emDOCs.net - Emergency Medicine Education.

EMS 81

EMS E-9-1-1 OR Emergency Department 81

EMDocs

APRIL 27, 2024

We’ll keep it short, while you keep that EM brain sharp. A 67-year-old man with a history of hypertension and diabetes presents to the emergency department with right ear pain for 2 weeks. link] Al Aaraj MS, Kelley C. Al-Noury, K., & Lotfy, A. He says the pain is worse at night and when he is chewing.

EMS 83

EMS ED OR ALS 83

Broome Docs

OCTOBER 6, 2024

Turgeon AF, Fergusson DA, Clayton L,et al. Mols EM, Haak H, Holland M, Schouten B, Ibsen S, Merten H, Christensen EF, Nanayakkara PWB, Nickel CH, Weichert I, Kellett J, Subbe CP, Kremers MNT; Safer@Home Research Consortium. Emerg Med J. Emergency Medicine Journal Published Online First: 12 September 2024. N Engl J Med.

Critical Care 112

Critical Care ALS Emergency Department EMS 112

EMDocs

OCTOBER 21, 2023

We’ll keep it short, while you keep that EM brain sharp. References: Gaillard F, Glick Y, Tatco V, et al. 61.4.496 Navi BB, Kamel H, Shah MP, et al. Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department. link] Burns JD, Rindler RS, Carr C, et al.

EMS 73

EMS ALS OR ACS 73

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