The Skeptics' Guide to EM

SEPTEMBER 2, 2023

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.

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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.

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The Skeptics' Guide to EM

MAY 25, 2024

Reference: Borgundvaag et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. When we combine SGEMHOP with an SGEM Xtra I hope we get some…AMAZING knowledge translation for GRACE4.

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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.

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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.

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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,

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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.

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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).

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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.

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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.

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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.

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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.

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ICU ALS Critical Care Emergency Department 100

FOAMfrat

NOVEMBER 21, 2024

Today, increased mortality rates, higher transfusion requirements, and lengthened ICU stays are recognized as proximate effects of the Trauma Triad. Hypothermia Hypothermia, defined as core temperature less than 35oC (95oF) has been identified in up to 2/3 of trauma patients upon arrival to the emergency department.

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ICU Emergency Department OR Ambulance 111

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.

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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.

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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.

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ICU Emergency Department ALS OR 52

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.

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EMR Emergency Department ICU ALS 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.

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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.

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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%

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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. .

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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.

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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).

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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.

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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.

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ICU ALS Emergency Department ED 100

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

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ACEP Now

MAY 9, 2024

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). After developing encephalopathy and hypoxemic respiratory failure, the patient was transferred to the ICU. Auerbach AD, Lee TM, Hubbard CC, et al.

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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.

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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.

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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.

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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.

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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.

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EMDocs

JUNE 27, 2024

Alkindi S, Al-Busaidi I, Al-Salami B, Raniga S, Pathare A, Ballas SK. Alghamdi FA, Al-Kasim F, Alshhada F, Ghareeb E, Azmet FR, Almudaibigh A, Baitalmal L, Alnawfal B, Alluqmani R. Roy A, Allareddy V, Lee M, Nalliah R, Rampa S, Allareddy V, Rotta A. Critical Care Medicine 41(12):p A191, December 2013. 2020 Feb 12;10(1):2470.

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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.

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ACEP Now

NOVEMBER 14, 2023

One of the most hair-raising presentations to the emergency department (ED) can be massive hemoptysis with respiratory failure. Atchinson PRA, Hatton CJ, Roginski MA, et al. The emergency department evaluation and management of massive hemoptysis. Am J Emerg Med. Ittrich H, Bockhorn M, Klose H, et al.

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REBEL EM

SEPTEMBER 29, 2022

Background: Standard emergency department management of acute pancreatitis has focused on aggressive hydration, analgesia and investigation for an underlying reversible cause (eg gallstones). Article: de-Madaria E et al. PMID: 36103415 Buxbaum JL et al. PMID: 28266591 Ramirez-Maldonado E et al.

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REBEL EM

NOVEMBER 3, 2022

Article: Sharda SC et al. Inclusion: Articles compared the safety and efficacy of etomidate compared to k etamine, in patients of all age groups, as induction agents for RSI in the Emergency Department (ED) and prehospital settings. PMID: 21373823 Jabre P, Combes X, Lapostolle F, et al. Acad Emerg Med.

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