The Skeptics' Guide to EM

OCTOBER 5, 2024

Date: October 2, 2024 Reference: Paxton et al. Case: The family of a 69-year-old woman activated emergency medical services (EMS) for slurred speech that they noticed when she woke up a couple of hours before. Prehospital identification of LVO stroke remains a significant challenge for emergency medical services (EMS) [6].

Emergency Medical Services 288

Emergency Medical Services ALS EMS Paramedic 288

EMDocs

DECEMBER 18, 2024

Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. Gortney J, Raub J, Patel P, et al. Sullivan J, Sykora K, Schneiderman J, et al. Borgundvaag B, Bellolio F, Miles I, et al. Strayer RJ, Friedman BW, Haroz R, et al. Maldonado JR, Sher Y, Ashouri JF, et al. N Engl JMed.

E-9-1-1 105

E-9-1-1 Emergency Department ICU ED 105

The Skeptics' Guide to EM

APRIL 13, 2024

Reference: Albers GW et al. Reference: Albers GW et al. Case: A 70-year-old woman was brought into the emergency department by EMS after her family reported she was having trouble talking. TIMELESS Investigators. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. TIMELESS Investigators.

ALS 343

ALS Emergency Department EMS OR 343

High Performance EMS

AUGUST 9, 2024

Dispatching the right unit to an EMS call was much simpler when all resources had the same capabilities and a response time was the primary measure of success. The following example of a “ priority 2 ” request may search for an ALS unit capable of meeting a particular response time standard directed by evidence-based patient outcomes.

BLS 264

BLS CAD Advanced Life Support Life Support 264

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Date: September 18, 2024 Reference: Dillon et al. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Chris completed his emergency medicine residency and EMS fellowship at UNM. Reference: Dillon et al.

Naloxone 260

Naloxone NARCAN Overdose CPR 260

The Skeptics' Guide to EM

JANUARY 13, 2024

Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Chris Root is an EMS fellow in the Department of Emergency Medicine at the University of New Mexico Health […] The post SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine.

CPR 273

CPR Defibrillator First Responder Epinephrine 273

EMDocs

MAY 11, 2024

We’ll keep it short, while you keep that EM brain sharp. A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. link] Sharma R, Gaillard F, Bell D, et al.

EMS 110

EMS E-9-1-1 ALS OR 110

The Skeptics' Guide to EM

JULY 8, 2023

Date: July 6, 2023 Reference: Hanula R et al. Managing editor of EM:RAP and Associate Editor at REBEL EM. Date: July 6, 2023 Reference: Hanula R et al. Managing editor of EM:RAP and Associate Editor at REBEL EM. JAMA Int Med 2023. JAMA Int Med 2023.

ALS 270

ALS Emergency Department EMS ED 270

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. Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care.

ICU 231

ICU Defibrillator Paramedic CPR 231

The Skeptics' Guide to EM

JULY 29, 2023

Date: July 21, 2023 Reference: McDonald et al. Date: July 21, 2023 Reference: McDonald et al. Emergency Medical Services (EMS) is called and on arrival the patient is walking but has obvious facial trauma and is complaining of some neck pain. Reference: McDonald et al.

Emergency Medical Services 246

Emergency Medical Services ALS EMS Emergency Department 246

Core EM

JANUARY 25, 2024

How and when to reverse anticoagulation in the bleeding EM patient. Fariborz Farsad B, Golpira R, Najafi H, et al. Fariborz Farsad B, Golpira R, Najafi H, et al. Anticoagulant Reversal Strategies in the Emergency Department Setting: Recommendations of a Multidisciplinary Expert Panel. Iran J Pharm Res. 2015;14(3):877-885.

Frozen Plasma 246

Frozen Plasma FFP Plasma Critical Care 246

The Skeptics' Guide to EM

JULY 22, 2023

Date: July 21, 2023 Reference: Prekker et al. NEJM 2023 Guest Skeptic: Dr. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth, Texas, also known as MedStar. Date: July 21, 2023 Reference: Prekker et al.

Emergency Medical Services 245

Emergency Medical Services Defibrillator CPR EMS 245

ALiEM

MAY 17, 2023

There were 132 (46%) EM residency programs with at least one unfilled PGY-1 position, and there were 554 (18.4%) overall unfilled EM positions. Dr. Sara Krzyzaniak (EM program director at Stanford) hosts this important episode with Dr. Michelle Lin (ALiEM/UCSF), reflecting on the whys, hows, and what nexts. Ann Emerg Med.

EMS 130

EMS ALS 130

The Skeptics' Guide to EM

OCTOBER 19, 2024

Date: October 7, 2024 Reference: Nguyen et al. Annals of EM 2024. Reference: Nguyen et al. Annals of EM 2024. Guest Skeptic: Dr. Brendan Freeman is an emergency medicine physician, assistant professor of emergency medicine, and medical education fellow at Staten Island University Hospital. mg/kg nebulized or 0.3

OR 248

OR Emergency Department ED ALS 248

EMDocs

JUNE 22, 2024

We’ll keep it short, while you keep that EM brain sharp. According to EMS, she was in labor at home and delivered the newborn shortly after they had loaded her into the ambulance. The post EM@3AM: Amniotic Fluid Embolism appeared first on emDOCs.net - Emergency Medicine Education. Electronic address, p. link] j.ajog.2016.03.012

EMS 111

EMS Ambulance FFP ICU 111

ACEP Now

JANUARY 5, 2025

Special thanks to Dr. Kevin Wasko, guest expert on the EM Cases podcast on this topic, who inspired this column. References Grasl S, Mekhail P, Janik S, et al. Dharmawardana N, Chandran D, Elias A, et al. Ker K, Edwards P, Perel P, et al. Arora R, Saraiya S, Niu X, et al. Andreae MC, Cox RD, Shy BD, et al.

Operating Room 98

Operating Room Epinephrine ALS ED 98

The Skeptics' Guide to EM

JUNE 1, 2024

Reference: Tavender E, et al. His research focuses on the pre-hospital care of children by EMS. He is the principal investigator for EMSC State Partnership in Washington, DC and is also involved in various multi-center EMS studies with the Pediatric Emergency Care Applied Research Network (PECARN). Reference: Tavender E, et al.

Emergency Medical Services 219

Emergency Medical Services Emergency Department EMS ALS 219

The Skeptics' Guide to EM

MARCH 2, 2024

Reference: Gibbons et al. Reference: Gibbons et al. He will need to be transferred to the tertiary care center which is 35 minutes away by ground EMS if it is a dissection. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study.

Operating Room 329

Operating Room Emergency Department ALS ED 329

ACEP Now

JUNE 21, 2023

emergency medicine (EM) residency training length has been a decades-long dilemma: four vs. three years. First, is three years enough time to become an EM physician? But critical questions remain unanswered when it comes to specialization, career trajectory, and actual competence as an EM physician. 11 What should we take away?

EMS 114

EMS ALS Emergency Medical Services OR 114

The Skeptics' Guide to EM

JANUARY 9, 2021

Date: January 5th, 2021 Reference: Grunau et al. JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

Pediatric EM Morsels

APRIL 19, 2024

Davidson JS, Brown DJ, Barnes SN, et al. West S, Andrews J, Bebbington A, et al. Symons S, Rowsell M, Bhowal B, et al. The post Rebaked Morsel: Pediatric Buckle and Greenstick Forearm Fractures appeared first on Pediatric EM Morsels. J Pediatr Orthop. 2018;Volume 00(00):DOI:10.1097/BPO.0000000000001169. 0000000000001169.

ALS 290

ALS ACS Emergency Department ED 290

EMDocs

SEPTEMBER 23, 2023

We’ll keep it short, while you keep that EM brain sharp. Rosh Review Website Link References Antzelevitch C, Brugada P, Borggrefe M, et al. Priori SG, Napolitano C, Gasparini M, et al. Chen Q, Kirsch GE, Zhang D, et al. Wilde AA, Antzelevitch C, Borggrefe M, et al. Dumaine R, Towbin JA, Brugada P, et al.

E-9-1-1 105

E-9-1-1 EMS ALS Defibrillator 105

NAEMSP

OCTOBER 9, 2024

However, a recent survey revealed that many patients with adrenal insufficiency are hesitant to give themselves their injections, and many Emergency Medicine and EMS Clinicians are unaware of the appropriate treatment for this condition. She had oral hydrocortisone available and handed EMS a sheet explaining her condition.

EMS 122

EMS Crisis Prevention Emergency Department BLS 122

EMDocs

MARCH 2, 2024

We’ll keep it short, while you keep that EM brain sharp. Bernstein AL, Cassidy J, Duchynski R, Eisenberg SS. The post EM@3AM: Pneumocephalus appeared first on emDOCs.net - Emergency Medicine Education. Kim TK, Yoon JR, Kim YS, Choi Y, Han S, Jung J, Park IS.  2022 Jun 29;22(1):252. Zasler ND, Katz DI, Zafonte RD.

EMS 119

EMS E-9-1-1 OR ED 119

The Skeptics' Guide to EM

OCTOBER 17, 2020

Salim is probably better known as the creator and founder of the wonderful knowledge translation project called REBEL EM. It is a free, critical appraisal blog and podcast […] The post SGEM#305: Somebody Get Me A Doctor – But Do I Need TXA by EMS for a TBI? Reference: Rowell et al. Reference: Rowell et al.

EMS 130

EMS Emergency Medical Services ALS OR 130

ALiEM

FEBRUARY 5, 2024

Reference Lin M, Phipps M, Chan TM, et al. Alex Rogers MD, J.D. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

ALiEM

OCTOBER 26, 2023

The Problem: Emergency Medicine (EM) in Pakistan has moved from developing to developed stage in the last decade [1]. It is an innovation that is based on a community of practice merged with the need-based assessment of a young EM residency program in a developing country. Originally developed by Marsh et al.,

EMS 161

EMS Emergency Department ALS ED 161

EMDocs

APRIL 13, 2024

We’ll keep it short, while you keep that EM brain sharp. Brickman K, Adams DZ, Akpunonu P, et al. doi:[link] The post EM@3AM: Auricular Hematoma appeared first on emDOCs.net - Emergency Medicine Education. The patient denies any loss of consciousness, neck pain, vomiting, or use of blood thinners.

EMS 104

EMS E-9-1-1 OR Emergency Department 104

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.

Overdose 111

Overdose EMS Emergency Medical Services ALS 111

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

EMDocs

MAY 25, 2024

We’ll keep it short, while you keep that EM brain sharp. link] Haidar H, Menon A, Al Duhirat E. The post EM@3AM: Sialadenitis appeared first on emDOCs.net - Emergency Medicine Education. She is breathing comfortably but seems to experience significant pain at the associated site of swelling. Jauch EC, Hall G, Knoop KJ.

EMS 98

EMS E-9-1-1 OR ED 98

ALiEM

NOVEMBER 3, 2023

Reference Lin M, Phipps M, Chan TM, et al. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. Ann Emerg Med. 2023;82(1):55-65. doi: 10.1016/j.annemergmed.2023.02.011

Critical Care 211

Critical Care EMS Emergency Department ALS 211

Pediatric EM Morsels

SEPTEMBER 22, 2023

To celebrate the end of trauma season ( is it ever really over? ), we here at the Ped EM Morsels Bakery have cooked up a morsel to remind you that pediatric trauma can be even more difficult than you think. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Never fear. 5 th Edition.

E-9-1-1 304

E-9-1-1 Epinephrine ALS EMS 304

EMDocs

APRIL 27, 2024

We’ll keep it short, while you keep that EM brain sharp. link] Al Aaraj MS, Kelley C. Al-Noury, K., & Lotfy, A. link] The post EM@3AM: Malignant/Necrotizing Otitis Externa appeared first on emDOCs.net - Emergency Medicine Education. He says the pain is worse at night and when he is chewing. The Lancet.

EMS 105

EMS ED OR ALS 105

EMDocs

OCTOBER 21, 2023

We’ll keep it short, while you keep that EM brain sharp. References: Gaillard F, Glick Y, Tatco V, et al. 61.4.496 Navi BB, Kamel H, Shah MP, et al. Goldmakher GV, Camargo EC, Furie KL, Singhal AB, Roccatagliata L, Halpern EF, et al. link] Nael K, Khan R, Choudhary G, Meshksar A, Villablanca P, Tay J, et al.

EMS 97

EMS ALS OR ACS 97

EMDocs

JUNE 8, 2024

We’ll keep it short, while you keep that EM brain sharp. Lu, Kevin, et al. The post EM@3AM: Traumatic Iritis appeared first on emDOCs.net - Emergency Medicine Education. A 27-year-old male presents to the ED for left eye pain after being hit in the face with a spare car part while working under the hood of his car. WikEM , Oct.

EMS 98

EMS Allergic Reaction Emergency Department ED 98

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. Case: A 65-year-old man is brought into the emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table.

Emergency Medical Services 224

Emergency Medical Services ALS Emergency Department ED 224