The Skeptics' Guide to EM

AUGUST 27, 2022

Date: August 23rd, 2022 Reference: Schoenfeld et al. AEM August 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: August 23rd, 2022 Reference: Schoenfeld et al. Reference: Schoenfeld et al.

Emergency Department 100

Emergency Department Naloxone Overdose ED 100

The Skeptics' Guide to EM

JUNE 29, 2019

Date: June 28th, 2019 Reference: Cardona et al. Prospective Validation of a Checklist to Predict Short-term Death in Older Patients After Emergency Department Admission in Australia and Ireland. Date: June 28th, 2019 Reference: Cardona et al. Reference: Cardona et al. AEM June 2019. Guest Skeptic:Dr. AEM June 2019.

Emergency Department 130

Emergency Department ALS OR 130

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. Future articles will highlight solutions and success stories. Patients with sepsis get antibiotics. Patients in DKA get insulin.

Emergency Department 52

Emergency Department ED Naloxone ALS 52

The Skeptics' Guide to EM

APRIL 11, 2020

Date: April 9th, 2020 Reference: Kline et al. Randomized trial of therapy dogs versus deliberative coloring (art therapy) to reduce stress in emergency medicine providers. Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com Case: It has been a hard shift.

Emergency Department 130

Emergency Department ALS OR 130

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.

Emergency Department 130

Emergency Department ALS OR 130

Core EM

JANUARY 8, 2024

Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department. Read More Shaish H, Ream J, Huang C, et al. Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department. years old Mean BMI = 25.5

Emergency Department 100

Emergency Department EMS ED ALS 100

ACEP Now

DECEMBER 11, 2023

Patients with severe agitation are frequently encountered in the emergency department (ED) setting. Emergency departments can be crowded and chaotic, further exacerbating mental health issues. Emergency departments can be crowded and chaotic, further exacerbating mental health issues. Rapid and efficacious.

Emergency Department 52

Emergency Department ALS ED OR 52

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

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

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 ICU 52

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

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 CPR OR 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 303

ED Emergency Department ALS OR 303

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. J Med Toxicol 2022. 11 of those were admitted to the hospital.

Emergency Department 98

Emergency Department ED EMR OR 98

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 301

Operating Room Emergency Department ALS ED 301

The Skeptics' Guide to EM

SEPTEMBER 28, 2024

Date: September 23, 2024 Reference: Essat et al. Annals of Emergency Medicine, May 2024 Guest Skeptic: Dr. Casey Parker is a Rural Generalist from Australia who is also an ultrasounder. Reference: Essat et al. Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis.

Emergency Department 201

Emergency Department ACS Coronary ALS 201

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

ICU 246

ICU Emergency Department Critical Care ALS 246

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. J Crit Care.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

The Skeptics' Guide to EM

NOVEMBER 16, 2024

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.

ICU 142

ICU Emergency Department ALS EMS 142

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

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 297

Emergency Department ALS OR ED 297

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

FEBRUARY 13, 2021

Dennis Ren is a paediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Reference: Mintegi S et al. Pediatrics 2020 Case: A 4-year-old immunized girl presents to the emergency department (ED) with a fever and rhinorrhea for the […] The post SGEM#319: Is it Aseptic Meningitis or More Than This?

OR 130

OR Emergency Department ALS ED 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 221

ALS Emergency Department ED OR 221

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 187

Overdose Emergency Department ALS ED 187

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 129

Emergency Department ALS OR ED 129

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 210

Emergency Medical Services Emergency Department EMS ALS 210

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

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 207

Emergency Department Overdose ALS ED 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 287

Emergency Department ALS OR EMS 287

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

Don't Forget the Bubbles

SEPTEMBER 30, 2024

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. Simpson et al. Simpson et al. Emergency department overcrowding is a complex issue with multiple contributing factors. A 2011-2012 Australian study by Blake et al.

Emergency Department 89

Emergency Department ALS ED OR 89

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. You (or someone in your department) needs to know which assay your ED has, and use the appropriate values for that assay.

E-9-1-1 276

E-9-1-1 ED Coronary ALS 276

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). Paper: Mason JM, et al. Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

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 264

Emergency Department ALS ED OR 264

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 310

Critical Care ALS ED Emergency Department 310