The Skeptics' Guide to EM

SEPTEMBER 10, 2017

[display_podcast] Date: September 7th, 2017 Reference: Cohen et al. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. display_podcast] Date: September 7th, 2017 Reference: Cohen et al. He has no “red flags” on your history and physical examination.

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Emergency Department ALS OR 130

ACEP Now

OCTOBER 9, 2023

emergencies, patient’s request). emergencies, patient’s request). However, actual increases in available services in emergency departments based on prior state-level requirements have been mixed. Clinical Case Your next patient is a Spanish-speaking 24-year-old female who begins by telling you that she is embarazada.

Emergency Department 64

Emergency Department E-9-1-1 ALS OR 64

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. ED crowding impairs this mission. Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality.

Emergency Department 52

Emergency Department ED ALS OR 52

ACEP Now

MAY 9, 2024

When seven South Florida gluteal AFT patients died tragically in one year alone, the Florida Board of Medicine issued an emergency regulation restricting fat injection to the subcutaneous space rather than injecting into muscle. Or Helly Larson describing the first week after her Miami BBL as “absolute hell” to a Vox reporter.

Emergency Department 52

Emergency Department Operating Room Critical Care ALS 52

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. Emergency physicians have an opportunity to reduce walkaway rates by improving the timing to get to a decision, either to discharge or to admit.

Emergency Department 52

Emergency Department ED EMS ALS 52

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. J Emerg Nurs. Roppolo LP, Morris DW, Khan F, et al. Click to enlarge.)

Emergency Department 52

Emergency Department Emergency Response ED ALS 52

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. In May 2022, Holly and Joe, two students on the joint QMUL and DFTB PEM MSc , created video presentations on human factors. We’ve incorporated some of our favourite elements from their presentations in this blog post. Take a break.

Emergency Department 91

Emergency Department ED OR CPR 91

The Skeptics' Guide to EM

FEBRUARY 11, 2024

Reference: McLatchie et al and DAShED investigators. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. Reference: McLatchie et al and DAShED investigators.

ED 307

ED Emergency Department ALS OR 307

The Skeptics' Guide to EM

AUGUST 17, 2019

Date: August 9th, 2019 Reference: Daoust et al. Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Volkow et al.

Emergency Department 130

Emergency Department ALS ED OR 130

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 306

Operating Room Emergency Department ALS ED 306

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 127

Emergency Department ALS OR ED 127

ACEP Now

APRIL 5, 2024

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. Vital signs on arrival are: Temperature: 38.8 degrees Celsius Heart rate:128 Blood pressure: 74 over 48 Respiratory rate: 10 Oxygen saturation: 77 percent Physical examination was notable for lethargy and confusion.

OR 73

OR ALS Emergency Department Critical Care 73

Core EM

JANUARY 25, 2024

Lipophilic with adipose deposition, withdrawal symptoms after prolonged infusion Hydromorphone 5 – 15 min 2 – 3 hr 0.5 – 3 mg/hr No active metabolites however parent drug can accumulate in renal failure Morphine 5 – 10 min 3 – 4 hr 2 – 30 mg/hr Active metabolites can accumulate in renal failure Remifentanil 1 – 3 min 3 – 10 min Loading dose: 1.5

Emergency Department 246

Emergency Department ICU Critical Care ALS 246

The Skeptics' Guide to EM

DECEMBER 30, 2023

Reference: Roussel et al. Overnight stay in the emergency department and mortality in older patients, JAMA Intern Med 2023 Date: December 18, 2023 Guest Skeptic: Dr. Chris Carpenter, Vice Chair of Emergency Medicine at Mayo Clinic. Reference: Roussel et al. Case: An 85-year-old patient (Ms.

Emergency Department 275

Emergency Department ED ALS OR 275

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 109

ICU Emergency Department ALS ED 109

The Skeptics' Guide to EM

DECEMBER 2, 2023

Reference: Shaikh N, et al. He is currently involved with clinical trials of vaccines […] The post SGEM#422: And It was all Yellow-Nasal Discharge and Antibiotics in Pediatric Sinusitis first appeared on The Skeptics Guide to Emergency Medicine. Reference: Shaikh N, et al. Her vaccinations are all up to date.

Emergency Department 305

Emergency Department ALS OR ED 305

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. One simple red flag list is called TUNA FISH.

Emergency Department 130

Emergency Department ALS OR EMS 130

The Skeptics' Guide to EM

OCTOBER 28, 2023

Date: October 26, 2023 Reference: Jones et al. Lancet July 2023 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. Date: October 26, 2023 Reference: Jones et al. His twitter handle is @PainFreeED.

ALS 228

ALS Emergency Department ED OR 228

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 184

Overdose Emergency Department ALS ED 184

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 207

Emergency Medical Services Emergency Department EMS ALS 207

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 295

Emergency Department ALS OR EMS 295

The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. A clinical decision tool called the STUMBL score was derived and validated by Battle et al in 2014 [3].

Emergency Department 204

Emergency Department Overdose ALS ED 204

Core EM

JANUARY 25, 2024

link] ) Laboratory Evaluation: Clinical presentation and laboratory findings can help suggest TTP in the emergency department. Patients should undergo comprehensive work-up to rule out alternative causes of thrombocytopenia, evaluate for end-organ damage, and identify underlying infectious or autoimmune etiologies.

Plasma 246

Plasma Frozen Plasma Emergency Department FFP 246

The Skeptics' Guide to EM

OCTOBER 21, 2023

Date: October 20, 2023 Reference: Cai et al. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: October 20, 2023 Reference: Cai et al. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. AEM October 2023.

Emergency Department 271

Emergency Department ALS ED OR 271

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Reference: Snelling et al. New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Reference: Snelling et al. He is also a fully-fledged ultrasonographer.

Critical Care 316

Critical Care ALS ED Emergency Department 316

The Skeptics' Guide to EM

JUNE 17, 2023

Date: June 15, 2023 Reference: Rees CA et al. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Date: June 15, 2023 Reference: Rees CA et al. Reference: Rees CA et al.

Emergency Department 181

Emergency Department ALS ED OR 181

The Skeptics' Guide to EM

JANUARY 20, 2024

Reference: Zaoutis T, et al. Reference: Zaoutis T, et al. Case: A 4-year-old girl comes to the emergency department complaining of pain with urination. UTIs are one of the most common bacterial infections in childhood that we see in the emergency department [1]. Reference: Zaoutis T, et al.

Emergency Department 176

Emergency Department ALS ICU OR 176

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 183

Emergency Medical Services ALS Emergency Department ED 183

The Skeptics' Guide to EM

JULY 6, 2024

Reference: Tjan et al. Conflict in emergency medicine: A systematic review. AEM June 2024 Date: July 5, 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Reference: Tjan et al.

ED 210

ED ALS Emergency Department OR 210

The Skeptics' Guide to EM

JULY 20, 2024

Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. Reference: Gibbs et al. NEJM June 2024. NEJM June 2024.

ALS 234

ALS Emergency Department ED OR 234

The Skeptics' Guide to EM

OCTOBER 14, 2023

Reference: Brennan L et al. Time to change the reference ranges of children’s physiological observations in emergency care? March 2023 Date: July 12th, 2023 Guest Skeptic: Dr. Vicki Currie is a paediatric emergency medicine registrar in the West Midlands in the United Kingdom. Reference: Brennan L et al.

Life Support 228

Life Support Advanced Life Support Emergency Department ALS 228

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? You may be more familiar with the term “limited English proficiency” (LEP), defined as: someone who does not speak English as their primary language and has a limited ability to read, speak, write, or understand English.

Emergency Department 82

Emergency Department ALS E-9-1-1 ED 82

The Skeptics' Guide to EM

DECEMBER 15, 2018

Date: December 13th , 2018 Reference: Murata et al. He specialises in Paediatric Emergency Medicine and is a passionate […] The post SGEM#239: Febrile Seizure Recurrence – With or Without You Acetaminophen? first appeared on The Skeptics Guide to Emergency Medicine. Date: December 13th , 2018 Reference: Murata et al.

OR 130

OR Emergency Department ALS 130

Chicago EMT Training

NOVEMBER 8, 2023

A quick breakdown on the differences between an EMT-B(asic) and an EMT-P(aramedic) Basic Life Support (BLS) vs Advanced Life Support (ALS) So there it is. Most of the 911 calls are BLS rather than ALS. Our goal in prehospital medicine is to bring the emergency department to the patient. So I commend for you that.

Advanced Life Support 130

Advanced Life Support BLS EMT EMT 130

The Skeptics' Guide to EM

JUNE 20, 2020

Dennis Ren is a Pediatric Emergency Medicine fellow at Children’s National Hospital in Washington, DC. Reference: Kuppermann et al. Case: A 5-week-old full term female presents to the Emergency Department […] The post SGEM#296: She’s Got the Fever but Does She Need an LP, Antibiotics or an Admission? JAMA Pediatr.

OR 100

OR Emergency Department ALS ED 100

The Skeptics' Guide to EM

JANUARY 7, 2023

Date: January 4th, 2023 Reference: Hasbrouck et al. Acute management of atrial fibrillation in congestive heart failure with reduced ejection fraction in the emergency department. Date: January 4th, 2023 Reference: Hasbrouck et al. Be critical and evaluate what you believe in.”

Emergency Department 100

Emergency Department OR ALS Ambulance 100

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 195

ICU Defibrillator CPR Paramedic 195