This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
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.
A 36-year-old male presents to the emergencydepartment after being found down at home by his spouse. Gortney J, Raub J, Patel P, et al. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. Management of drug and alcohol withdrawal. N Engl JMed. 2003; 348:1786-1795.
Date: August 30, 2023 Reference: Griffey et al. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. This is the last show for […] The post SGEM#414: The SQuID Protocol first appeared on The Skeptics Guide to Emergency Medicine.
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. It was found that patients exposed to deep sedation in the ED had an independent higher incidence of continued deep sedation on ICU day one ( Fuller, 2019 ).
[display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Fever in the EmergencyDepartment Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the EmergencyDepartment at Redcliffe Hospital in Australia.
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.
Reference: Borgundvaag et al. Guidelines for Reasonable and Appropriate Care in the EmergencyDepartment (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergencydepartment. When we combine SGEMHOP with an SGEM Xtra I hope we get some…AMAZING knowledge translation for GRACE4.
Are you using phenobarbital instead of benzodiazepines as the first-line monotherapy for patients in alcohol withdrawal in the EmergencyDepartment (ED)? References Rosenson J, Clements C, Simon B, et al. The Journal of Emergency Medicine. Management of Alcohol Withdrawal in the EmergencyDepartment: Current Perspectives.
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.
Date: September 12, 2024 Reference: Anderson et al. Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergencydepartment. 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.
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.
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,
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).
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.
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 emergencydepartment (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care.
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 emergencydepartment (ED).
In most EmergencyDepartments, 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 EmergencyDepartment, he initiated ‘ The Pause.’ Kapoor et al.
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.
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.
A few rapid-fire cases from the emergencydepartment, 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 emergencydepartment, with Dr. .
Date: September 20th, 2021 Reference: Litell et al. Most emergencydepartment 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.
Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the EmergencyDepartment 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.
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 EmergencyDepartment. Nearly half of all post-AFT patients presenting to our emergencydepartments required admission and six percent required ICU admission.
Emergencydepartments (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
Reference: Schuster et al. 2020 Case: A 74-year-old woman who suffered a fall earlier today presents to the emergencydepartment (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.
[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.
Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the EmergencyDepartment (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.
The photos that Dr. Clarke took from 19781980 provide a glimpse into working in an emergencydepartment 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 emergencydepartment (ED) at Pomona Valley Hospital, Pomona, Calif.
As loud as a construction site: Noise levels in the emergencydepartment. Australas Emerg Care. PMID: 37532590 Bottom line: Emergencydepartments 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.
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%
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.
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.
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 emergencydepartment pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. 2022 Sep 5.
Background: Standard rapid sequence intubation (RSI) in the emergencydepartment 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
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.
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 emergencydepartment with acute musculoskeletal pain.
Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergencydepartment (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.
1 History and physical examination have been the cornerstone of seizure diagnosis in the emergencydepartment (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.
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.
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.
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%).
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.
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.
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 EmergencyDepartment increased mortality. Emerg Med J. Laan DV, Vu TD, Thiels CA et al.
We organize all of the trending information in your field so you don't have to. Join 5,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content