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)? References Rosenson J, Clements C, Simon B, et al. The Journal of Emergency Medicine. Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives.

Emergency Department 246

Emergency Department ICU ED OR 246

The Skeptics' Guide to EM

JANUARY 20, 2024

Reference: Zaoutis T, et al. Reference: Zaoutis T, et al. Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences. JAMA Pediatr. JAMA Pediatr.

Emergency Department 187

Emergency Department ALS ICU OR 187

The Skeptics' Guide to EM

SEPTEMBER 14, 2024

Date: September 12, 2024 Reference: Anderson et al. Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergency department. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. A pivotal study by Raja et al. AEM August 2024.

ICU 141

ICU Emergency Department ALS ED 141

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Date: September 11th, 2019 Reference: Putzu et al. Guest Skeptics: Dr. Erin Willard is a PGY-3 Emergency Medicine Resident, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Date: September 11th, 2019 Reference: Putzu et al. You are ready to call the ICU and get her admitted.

ICU 130

ICU Critical Care ALS Emergency Department 130

The Skeptics' Guide to EM

APRIL 22, 2023

Date: April 20, 2023 Reference: Franklin D, et al. JAMA 2023 Guest Skeptic: Dr. Michael Falk is a Pediatric Emergency Medicine attending at Mount Sinai Medical Center […] The post SGEM #401: Hey Ho! Date: April 20, 2023 Reference: Franklin D, et al. Reference: Franklin D, et al. He has a cough, fever of 38.5°C,

ICU 130

ICU Emergency Department ALS ED 130

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Reference: Cashen K, Reeder RW, Ahmed T, et al. Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Reference: Cashen K, Reeder RW, Ahmed T, et al. Background: We often manage patients in cardiac arrest in the ED or the intensive care unit (ICU).

CPR 130

CPR ICU Critical Care Defibrillator 130

The Skeptics' Guide to EM

JUNE 22, 2024

Reference: Peters MJ, et al. December 2023 Guest Skeptic: Dr. Anireddy Reddy is a pediatric intensive care attending physician in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital of Philadelphia. Reference: Peters MJ, et al.

Critical Care 139

Critical Care ICU ALS Emergency Department 139

REBEL EM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

The Skeptics' Guide to EM

JUNE 6, 2020

Date: June 2nd, 2020 Reference: Permpikul et al. Guest Skeptic: Dr. Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory. Date: June 2nd, 2020 Reference: Permpikul et al. Case: It’s another day in your emergency department (ED).

EMR 130

EMR ALS ICU Emergency Department 130

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. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ Kapoor et al.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

The Skeptics' Guide to EM

JULY 16, 2022

Date: July 16th, 2022 Reference: Lamontagne F et al. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. Date: July 16th, 2022 Reference: Lamontagne F et al.

ICU 100

ICU ALS Critical Care Emergency Department 100

The Skeptics' Guide to EM

JANUARY 15, 2022

Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Intensive Care Med 2021 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a professor of Emergency Medical Services at Tacoma Community College’s paramedic program. Reference: Matchett, G.

Emergency Medical Services 109

Emergency Medical Services Firefighter Critical Care Paramedic 109

Critical Care Scenarios

NOVEMBER 15, 2020

A few rapid-fire cases from the emergency department, with Dr. Seth Trueger (@mdaware), emergency physician at Northwestern University and digital media editor for JAMA Network Open. Continue reading "Episode 19: Emergency medicine with Seth Trueger" A few rapid-fire cases from the emergency department, with Dr. .

ICU 100

ICU Life Support Emergency Department ED 100

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Date: September 20th, 2021 Reference: Litell et al. Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona.

EMR 100

EMR Emergency Department ICU ALS 100

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. The patient was upgraded to the ICU for closer monitoring. In fact, Kosuge et al. Stein et al.

E-9-1-1 140

E-9-1-1 ACS Emergency Department Coronary 140

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. Nearly half of all post-AFT patients presenting to our emergency departments required admission and six percent required ICU admission.

Emergency Department 52

Emergency Department Operating Room Critical Care ICU 52

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. Dr. Kluesner is an emergency physician in Iowa City, Iowa, at UnityPoint Health-Iowa Methodist Medical Center. References Morley, Claire, et al. PloS one 13.8

Emergency Department 52

Emergency Department ED ALS Critical Care 52

The Skeptics' Guide to EM

MARCH 27, 2021

Reference: Schuster et al. 2020 Case: A 74-year-old woman who suffered a fall earlier today presents to the emergency department (ED) and is found to have five rib fractures to her right thorax, but no other injury. Reference: Schuster et al. J Trauma Acute Care Surg. J Trauma Acute Care Surg. J Trauma Acute Care Surg.

ICU 100

ICU ALS Emergency Department ED 100

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

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). 2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). Paper: Mason JM, et al. 2022 Sep 7.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

ACEP Now

JANUARY 4, 2025

The photos that Dr. Clarke took from 19781980 provide a glimpse into working in an emergency department in the years the specialty was being established. for a few years working as an emergency physician. Dr. Clarke was then hired as assistant director in the emergency department (ED) at Pomona Valley Hospital, Pomona, Calif.

ED 52

ED Emergency Department Ambulance CPR 52

Broome Docs

SEPTEMBER 3, 2024

As loud as a construction site: Noise levels in the emergency department. Australas Emerg Care. PMID: 37532590 Bottom line: Emergency departments are noisy, although not ridiculously so. Cook D, Deane A, Lauzier F, et al. Burton C, Mooney C, Sutton L, et al. 2024 Mar;27(1):26-29. doi: 10.1016/j.auec.2023.07.004.

E-9-1-1 95

E-9-1-1 Emergency Department ICU ALS 95

REBEL EM

OCTOBER 5, 2023

Paper: Dequin P, Meziani F, Quenot J, et al. ClinicalTrials.gov: NCT02517489 7 Clinical Question: In adult patients with severe community-acquired pneumonia admitted to the ICU, does early hydrocortisone treatment, compared to standard therapy, reduce mortality at 28 days? ICU-acquired infections were observed in: 9.8%

Critical Care 94

Critical Care ICU E-9-1-1 ALS 94

The Skeptics' Guide to EM

NOVEMBER 16, 2019

Date: November 6th, 2019 Reference: Lascarrou et al. NEJM Oct 2019 Guest Skeptic: Dr. Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Reference: Lascarrou et al.

ALS 100

ALS CPR ICU EMS 100

ACEP Now

OCTOBER 15, 2023

Intravenous insulin infusions typically require treatment in highly monitored settings, such as an intensive care unit (ICU) or step-down unit for safety and due to the frequency and intensity of monitoring. ICU and step-down beds are a limited resource and generate higher hospital charges. ElSayed NA, Aleppo G, Aroda VR, et al.

ICU 80

ICU ALS ED Emergency Department 80

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

REBEL EM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. Click here for Direct Download of the Podcast Paper: Knack SKS et al. References: Knack SKS et al. Range 5 to 9) Etomidate: 7.0 95% CI -1.4

ED 93

ED ICU Emergency Department Overdose 93

REBEL EM

MARCH 23, 2023

Treatment options for alcohol withdrawal include benzodiazepines such as lorazepam, diazepam, or chlordiazepoxide, gabapentin, and phenobarbital (Buell et al.). Phenobarbital can be used as a monotherapy or in combination with benzodiazepines to treat alcohol withdrawal (Hawa et al.). Paper : Hawa F et al.

ICU 52

ICU Emergency Department ALS OR 52

Broome Docs

MARCH 28, 2024

Great evidence for button battery ingestions (if you are treating a dead pig) Chiew AL, Lin CS, Nguyen DT, Sinclair FAW, Chan BS, Solinas A. Ann Emerg Med. A non-inferiority randomized controlled trial comparing nebulized ketamine to intravenous morphine for older adults in the emergency department with acute musculoskeletal pain.

E-9-1-1 96

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

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Carsten L, et al. Monika BM, Martin D, Balthasar E, et al.

Defibrillator 106

Defibrillator CPR Epinephrine Life Support 106

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). Neurology consultation should be initiated, and the patient should be admitted to the ICU. References Brophy GM, Bell R, Claassen J, et al. Zehtabchi S, Abdel Baki SG, Omurtag A, et al. Ann Emerg Med.

Emergency Department 52

Emergency Department Critical Care ALS ICU 52

EMDocs

SEPTEMBER 25, 2023

Despite the risk of hypotension and bradycardia, propofol has been shown in the ICU setting to be a safe and effective monotherapy intubation agent for hemodynamically unstable patients (19). References: Heffner AC et al. Incidence and factors associated with cardiac arrest complicating emergency airway management. J Emerg Med.

ED 86

ED Emergency Department ALS Paramedic 86

EMDocs

MAY 25, 2023

Reference: Kapur J, Elm J, Chamberlain JM, et al. DOI: 10.1056/NEJMoa1905795 The post 52 in 52 – #36: Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus appeared first on emDOCs.net - Emergency Medicine Education. Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus. N Engl J Med.

Emergency Department 84

Emergency Department ICU OR ALS 84

EMDocs

FEBRUARY 26, 2024

A recent study by Gaborit et al. 16 In another study, a series of six HIV patients with confirmed PJP that were analyzed by Limonta et al. 2 In the three-center study of 82 patients by Benfield et al, treatment response rates were almost comparable between TMP-SMX (73%) and clindamycin-primaquine (68%).

E-9-1-1 108

E-9-1-1 ED ALS OR 108

Broome Docs

OCTOBER 31, 2022

Ketamine vs etomidate in ICU intubation ? Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. The PEACH trial: No body had a fit, so… we have no clue Peter-Derex L, Philippeau F, Garnier P, et al. Emerg Med J. 2018 Sep 11;362:k3843. doi: 10.1136/bmj.k3843. N Engl J Med.

E-9-1-1 52

E-9-1-1 Defibrillator ICU Critical Care 52

EMDocs

OCTOBER 21, 2023

All patients who receive thrombolytics for ischemic stroke should be admitted to a neurosurgical, neurologic, or medical ICU for management and monitoring, as this is shown to decrease mortality and length of stay. References: Gaillard F, Glick Y, Tatco V, et al. 61.4.496 Navi BB, Kamel H, Shah MP, et al. Arch Neurol.

EMS 95

EMS ALS OR ACS 95

Don't Forget the Bubbles

JUNE 30, 2023

They found NO difference in drain failure rates ( 11% pigtail vs 13% chest tube P=0.74), total daily volume drained or length of ICU stay between groups. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality. Emerg Med J. Laan DV, Vu TD, Thiels CA et al.

E-9-1-1 139

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