Core EM

JANUARY 25, 2024

Analgesic Onset Elimination Half Life IV Infusion Rates Side Effects and Other Information Fentanyl 1 – 2 min 2 – 4 hr 0.7 – 10 μg/kg/hr Rapid onset. We recommend considering fentanyl plus propofol or dexmedetomidine as the routine first options for the choice of analgosedation agents in the emergency department. up to 1.5)

ICU 246

ICU Emergency Department Critical Care ALS 246

The Skeptics' Guide to EM

JUNE 24, 2023

Date: June 16, 2023 Reference: Reed et al. Pilot Testing Fentanyl Test Strip Distribution in an Emergency Department Setting: Experiences, Lessons Learned, and Suggestions from Staff. She is the cofounder of […] The post SGEM#407: Here We Go Test Strips for Fentanyl first appeared on The Skeptics Guide to Emergency Medicine.

Overdose 198

Overdose Emergency Department ALS ED 198

EMDocs

MARCH 4, 2024

Darnall Army Medical Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, (@long_brit) Disclaimer: The views expressed in this post are those of the authors and do not reflect the official policy or position of the Department of the Army, DoD, or the US Government.

Emergency Department 105

Emergency Department E-9-1-1 ALS OR 105

ALiEM

FEBRUARY 9, 2024

Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. References Writing Committee, Kontos MC, de Lemos JA, et al. 2022.08.750 Collet JP, Thiele H, Barbato E, et al.

E-9-1-1 276

E-9-1-1 ED Coronary ALS 276

ALiEM

APRIL 12, 2023

Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. emDOCs.net – Emergency Medicine Education. 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.

Emergency Department 258

Emergency Department ALS ED 258

Don't Forget the Bubbles

MAY 10, 2023

You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. Synthesise the information into something that makes sense. What information is available, and do I have it? Synthesising the information into something that makes sense What’s going to happen? This is means.:-

Emergency Department 91

Emergency Department ED CPR OR 91

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

ACEP Now

NOVEMBER 8, 2024

First, research suggests a higher number of emergency department visits among individuals with ASD. About 30 percent of children with ASD need treatment in an emergency department, and this number increases to nearly 70 percent for those aged 15–18. But what exactly are neurodivergence and neurodiversity?

Emergency Department 52

Emergency Department ED OR ALS 52

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. Am J Emerg Med 2013 , 31 (4), 734-742.

Emergency Department 97

Emergency Department ED EMR OR 97

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. Ann Emerg Med.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. Study N Sensitivity Specificity Comments Pereda et al., Balk et al., Tsou et al., PMID: 14722643 Pereda MA, Chavez MA, Hooper-Miele CC, et al.

E-9-1-1 246

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

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

Pediatric EM Morsels

OCTOBER 27, 2023

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. 2010) ‘140: Does physician estimates of pediatric patient weights lead to inaccurate medication dosages’, Annals of Emergency Medicine , 56(3), p. Academic Emergency Medicine, 14: 500-501.

E-9-1-1 271

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

The Skeptics' Guide to EM

AUGUST 24, 2024

Date: August 19, 2024 Reference: Partyka et al. JAMA Surg 2024 Guest Skeptic: Dr. Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Reference: Partyka et al.

Emergency Department 136

Emergency Department ALS OR ED 136

The Skeptics' Guide to EM

AUGUST 22, 2020

He is also the CME editor for Academic Emergency Medicine. Reference: Carpenter et al. Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases. He is also the CME editor for Academic Emergency Medicine. Reference: Carpenter et al.

ACPE 130

ACPE Emergency Department ALS OR 130

The Skeptics' Guide to EM

JANUARY 29, 2022

Date: January 25th, 2022 Reference: Beyde et al. Efficacy of empiric antibiotic management of septic olecranon bursitis without bursal aspiration in emergency department patients. AEM January 2022 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Beyde et al.

Emergency Department 130

Emergency Department ALS ED 130

The Skeptics' Guide to EM

MAY 19, 2018

[display_podcast] Date: May 16, 2018 Reference: Freund et al. Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events
 Among Low-Risk Emergency Department Patients: The PROPER Randomized Clinical Trial. display_podcast] Date: May 16, 2018 Reference: Freund et al. Reference: Freund et al.

Emergency Department 130

Emergency Department ALS Coronary OR 130

The Skeptics' Guide to EM

AUGUST 19, 2023

Mike Pallaci is a Professor of Emergency Medicine (EM) for the Northeast Ohio Medical University, and an Adjunct Clinical Professor of […] The post SGEM#413: But Even You Cannot Avoid…Pressure – Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage first appeared on The Skeptics Guide to Emergency Medicine.

EMS 186

EMS ALS Emergency Department OR 186

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. The Journal of Emergency Medicine.

E-9-1-1 183

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

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

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. The patient’s pain was resolved when they saw the patient in the emergency department. Zubaidi A, Al-Saif F, Silverman R. He describes the pain as stabbing. 2009;15(4):407.

Emergency Department 141

Emergency Department ED ALS OR 141

REBEL EM

JULY 1, 2024

Paper: Goren NZ et al. Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. References: Goren NZ et al. PMID: 34462252 Abubacker AP et al. Balkan Med J 2021. AVAPS: 0.07 AVAPS: 10.20 AVAPS: 0.07

ED 133

ED Emergency Department ALS OR 133

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

Pediatric EM Morsels

SEPTEMBER 20, 2024

Diarrhea is one of the most common complaints in the pediatric emergency department, especially in the summer and early fall. A thorough review of vital signs, physical exam findings and a complete blood count with differential, renal function panel and urinalysis offer valuable information in the patient being worked up for HUS.

Emergency Department 164

Emergency Department ACS ALS EMS 164

EMDocs

DECEMBER 23, 2024

Lets look at a few and make an informed decision. Now lets walk through them quickly: Ho et al (4) looked at termination of VT in 15 min or hemodynamic deterioration. Gorgels et al (5) looked at procainamide vs lidocaine and again and primary outcome was VTach termination. Multiple studies, including Gorgels et al.

ALS 75

ALS OR STEMI EMS 75

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? They are proficient in both the patient’s language and English, ensuring accurate and precise communication without omitting or altering critical information. 19 Listed below are tools you can use to inform language justice interventions in your ED.

Emergency Department 104

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

The Skeptics' Guide to EM

OCTOBER 26, 2019

Date: October 22nd, 2019 Reference: Iyengar R et al. Date: October 22nd, 2019 Reference: Iyengar R et al. The bottom line was that this paper opens the door for further research to try to narrow the criteria in the CCHR to further reduce unnecessary head CT imaging in the emergency department. Reference: Iyengar R et al.

Emergency Department 130

Emergency Department ALS OR 130

Don't Forget the Bubbles

AUGUST 30, 2023

The parents of 9-month-old Josie bring her into the Emergency Department with coryzal symptoms and difficulty breathing. A secondary analysis of a nationwide study of Emergency Department attendance in America from 2006 to 2008 found that CXRs increase the average length of stay by 27 minutes. Am J Emerg Med.

E-9-1-1 131

E-9-1-1 Emergency Department ALS OR 131

Don't Forget the Bubbles

SEPTEMBER 6, 2023

14-year-old Katy presents to the paediatric Emergency Department (ED), alone, complaining of suicidal ideation. Overall, the evidence suggests that screening laboratory tests offer little information above a careful history and examination. Acad Emerg Med. link] Donofrio JJ, Santillanes G, McCammack BD, et al.

Emergency Department 119

Emergency Department ED Overdose ALS 119

The Skeptics' Guide to EM

APRIL 8, 2023

There have been many “temporary” rural emergency department closures during the past last year. In Ontario alone there have been approximately 160 emergency departments (ED) temporarily closed since the beginning of 2022. The SGEM advocated for having the evidence to inform/guide our decisions.

Emergency Department 142

Emergency Department ED Ambulance ALS 142

Don't Forget the Bubbles

MARCH 21, 2025

But does it hold up in the unpredictable world of emergency paediatric intubation ? Thats exactly what Shane George et al. set out to explore in the Kids THRIVE study investigating whether NHF apnoeic oxygenation could improve intubation outcomes in critically unwell children needing emergency airway management.

ICU 108

ICU Critical Care ED OR 108

ALiEM

NOVEMBER 29, 2023

PMID: 34529640 Ayub S, Parnia S, Poddar K, et al. Xylazine Intoxication in Humans and Its Importance as an Emerging Adulterant in Abused Drugs: A Comprehensive Review of the Literature. PMID: 24769343 Ehrman-Dupre R, Kaigh C, Salzman M et al. PMID: 36148197 Love JS, Levine M, Aldy K, et al. MMWR Morb Mortal Wkly Rep.

Naloxone 169

Naloxone Overdose Epinephrine ALS 169

The Skeptics' Guide to EM

JANUARY 16, 2021

Date: January 5th, 2021 Reference: Shipman et al. Glaucomflecken” on Twitter and […] The post SGEM#315: Comfortably Numb with Topical Tetracaine for Corneal Abrasions first appeared on The Skeptics Guide to Emergency Medicine. Date: January 5th, 2021 Reference: Shipman et al.

ALS 130

ALS EMS Emergency Department ED 130

ACEP Now

AUGUST 22, 2023

There is no shortage of guidelines, protocols, or quality measures across emergency medicine. Regardless of the domain, somewhere an expert panel has convened to issue a pronouncement informing all of the ideal care of patients under their specialty umbrella, indirectly extending to their care in the emergency department.

Emergency Department 98

Emergency Department ALS ED OR 98

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. Core EM.

Overdose 111

Overdose EMS Emergency Medical Services OR 111

Pediatric EM Morsels

MAY 24, 2024

One of the most difficult and most satisfying parts of pediatric emergency medicine is using one’s history, exam and clinical tools to make an informed decision and spare children from unnecessary pain , uncomfortable exams, painful procedures and medical imaging. Sources Adelgais KM, Kuppermann N, Kooistra J, et al.

ALS 164

ALS EMS Emergency Department OR 164

The Skeptics' Guide to EM

MARCH 22, 2019

Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia. Case: The emergency department is backing up. Your medical team is great, but you […] The post SGEM#250: Scribes – I Want to Break Free (from the EMR) first appeared on The Skeptics Guide to Emergency Medicine.

EMR 130

EMR Emergency Department Ambulance ED 130