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 328

Operating Room Emergency Department ALS ED 328

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

ALS 337

ALS Emergency Department OR EMS 337

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 343

Critical Care ALS ED Emergency Department 343

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 321

Emergency Department ALS ED OR 321

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 261

ALS Emergency Department ED OR 261

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

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

Pediatric EM Morsels

APRIL 19, 2024

Trauma season is at hand and like all other pediatric emergency departments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. We see all different flavors of upper extremity injuries. The minority of parents would have wanted clinic follow up (6%) and reimaging (14%).

ALS 290

ALS ACS Emergency Department ED 290

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 231

Emergency Department ACS Coronary ALS 231

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 258

Life Support Advanced Life Support Emergency Department ALS 258

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

The Skeptics' Guide to EM

NOVEMBER 11, 2023

Date: November 2, 2023 Reference: Coventry et al. Emerg Med J. first appeared on The Skeptics Guide to Emergency Medicine. Date: November 2, 2023 Reference: Coventry et al. Emerg Med J. Reference: Coventry et al. Emerg Med J. Which clinical features best predict occult scaphoid fractures?

ALS 301

ALS Emergency Department ED OR 301

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center. CREDIT: Dr. P.

Operating Room 98

Operating Room Epinephrine ALS ED 98

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 194

Overdose Emergency Department ALS ED 194

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 284

ALS Emergency Department ED OR 284

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

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 214

Emergency Department Overdose ALS ED 214

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 217

Emergency Medical Services Emergency Department EMS ALS 217

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 237

ED ALS Emergency Department OR 237

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 185

Emergency Department ALS ED OR 185

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

JULY 29, 2023

Date: July 21, 2023 Reference: McDonald et al. AEM July 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: July 21, 2023 Reference: McDonald et al. Reference: McDonald et al. He has midline neck tenderness but no limb numbness or paresthesia.

Emergency Medical Services 239

Emergency Medical Services ALS EMS Emergency Department 239

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 226

ICU Defibrillator Paramedic CPR 226

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. His fever was 103°F this morning and he received ibuprofen. He has also had abdominal and back pain. Warm gel helps with the child’s comfort. Use a linear high frequency probe.

E-9-1-1 246

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

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 217

Emergency Medical Services ALS Emergency Department ED 217

The Skeptics' Guide to EM

DECEMBER 14, 2024

He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate of FOAMed. He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate of FOAMed. Dr. Damian Roland Case: A 3-year-old boy arrives at the emergency department (ED) with a high fever, rapid breathing, and lethargy.

ALS 252

ALS Emergency Department ED OR 252

The Skeptics' Guide to EM

OCTOBER 20, 2018

[display_podcast] Date: October 17th , 2018 Reference #1: Aycock, Westafer et al. Ann Emerg Med 2018 (CRD42017056195) Reference #2: Weisbord SD, Gallagher M, Jneid H, et al; PRESERVE Trial Group. first appeared on The Skeptics Guide to Emergency Medicine. Reference: Aycock, Westafer et al. mg/dL within 3 days.

Coronary 180

Coronary Emergency Department ALS OR 180

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.

ICU 255

ICU ED Critical Care ALS 255

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 186

Emergency Department ALS ICU OR 186

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

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 89

Emergency Department ED EMR OR 89

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

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

The Skeptics' Guide to EM

OCTOBER 10, 2020

Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department, specifically the use of ketamine. Reference: Friedman et al. Reference: Friedman et al.

Emergency Department 130

Emergency Department ALS ED OR 130

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

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

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 133

Emergency Department ALS OR ED 133