REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. Richards JE et al. NEJM 1994. [2]

E-9-1-1 145

E-9-1-1 Plasma ALS OR 145

The Skeptics' Guide to EM

MAY 30, 2020

Date: May 29th, 2020 Reference: Erramouspe et al. Date: May 29th, 2020 Reference: Erramouspe et al. You wonder what his over-all chance of dying or developing a thromboembolic event when treated with TXA. in adult trauma patients giving a number needed to treat to prevent one death of 67 ( Shakur et al.

ALS 130

ALS EMS OR 130

REBEL EM

JUNE 26, 2023

This could potentially help improve thrombin generation, reduce blood product consumption, but also could increase the risk of thromboembolic events. Click here for Direct Download of the Podcast Paper: Bouzat P et al. Additionally, the use of 4F-PCC resulted in a higher rate of thromboembolic events compared to placebo.

FFP 143

FFP Frozen Plasma ALS Plasma 143

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

NOVEMBER 24, 2018

This turned out to be a very meta event. This turned out to be a very meta event. The highest prevalence of burnout (70%) was reported by emergency physicians (Shanafelt et al 2015). One of the most common reasons cited for burnout is the electronic medical record (EMR) (Shanafelt et al 2016). got seriously ill.

EMR 130

EMR ALS Emergency Department OR 130

The Skeptics' Guide to EM

JULY 22, 2023

Date: July 21, 2023 Reference: Prekker et al. Date: July 21, 2023 Reference: Prekker et al. Intubation FPS is associated with fewer adverse events, most importantly hypoxia, hypotension, and cardiac arrest. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults.

Emergency Medical Services 166

Emergency Medical Services Defibrillator CPR EMS 166

REBEL EM

FEBRUARY 15, 2024

Paper: Freund Y et al. Clinical Take Home Point: In patients with decreased level of consciousness due to acute poisoning a conservative strategy of withholding intubation leads to less ICU admissions, median length of ICU/hospital stay, and a lower risk of adverse events. References: Freund Y et al.

ICU 141

ICU ALS ED OR 141

The Skeptics' Guide to EM

OCTOBER 31, 2018

[display_podcast] Date: October 30th , 2018 Reference: Raskob GE et al. display_podcast] Date: October 30th , 2018 Reference: Raskob GE et al. In non-cancer patients, new oral anticoagulants (NOACs) like rivaroxaban have been shown to be effective in treatment without increasing bleeding events. Reference: Raskob GE et al.

ALS 130

ALS EMS OR 130

The Skeptics' Guide to EM

OCTOBER 10, 2020

Reference: Friedman et al. Reference: Friedman et al. million visits each year in the USA ( Friedman et al Spine 2010 ). However, their use is associated with increased adverse events. These include: acetaminophen ( Williams et al Lancet 2014), muscle relaxants ( Friedman et al JAMA 2015), NSAIDs ( Machado et al

Emergency Department 130

Emergency Department ALS ED OR 130

Pediatric EM Morsels

JULY 21, 2023

Holmes, James F et al. Conzelmann M, Hoidis A, Bruckner T , et al. Endotracheal intubation to reduce aspiration events in acutely comatose patients: a systematic review. Ash, Kristian et al. Performance of the Pediatric Glasgow Coma Scale Score in the Evaluation of Children With Blunt Head Trauma. Acad Emerg Med.

Critical Care 246

Critical Care ALS Life Support OR 246

The Skeptics' Guide to EM

JUNE 4, 2017

[display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. Huber-Wagner et al ( Lancet 2009 ) showed a mortality reduction in a retrospective database study of patients who have had a pan scan. Reference: Sierink et al. Lancet August 2016.

OR 130

OR ALS CPR ICU 130

The Skeptics' Guide to EM

OCTOBER 3, 2020

Reference: Claiborne Johnston S et al. Reference: Claiborne Johnston S et al. Aspirin has been used to prevent a subsequent stroke in patients who suffered an acute ischemic stroke (AIS) or transient ischemic attack (TIA), which occur in approximately 5-10% of patients in the first few months after their primary event.

Emergency Department 100

Emergency Department ALS OR 100

REBEL EM

MAY 29, 2023

Paper: Ibarra-Estrada, M et al. The study was too small to make strong conclusions about adverse events. References: Ibarra-Estrada, M et al. PMID: 36915146 [ Access on Read by QxMD ] Kirov MY et al. PMID: 11588440 Memis D et al. PMID: 12500513 Lopez A et al. PMID: 14707556 Richards-Belle et al.

ICU 145

ICU ALS Epinephrine OR 145

The Skeptics' Guide to EM

OCTOBER 14, 2019

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. Zehtabchi et al published a SRMA of TXA for traumatic brain injuries (TBI). Date: October 14th, 2019 Reference: CRASH-3 Trial Collaborators.

Emergency Department 130

Emergency Department EMS ALS OR 130

The Skeptics' Guide to EM

APRIL 2, 2022

Date: March 31st, 2022 Reference: Butt et al. Date: March 31st, 2022 Reference: Butt et al. Children represent one group of patients that are less likely to receive adequate analgesia ( Brown et al , Selbst and Clark ). Reference: Butt et al.

Emergency Department 130

Emergency Department ALS ED OR 130

Broome Docs

DECEMBER 9, 2023

Roussel M, Teissandier D, Yordanov Y, et al. Metronidazole-associated Neurologic Events: A Nested Case-control Study. PMID: 36755492 Freeman JJ, Asfaw SH, Vatsaas CJ, et al. PMID: 37548984 van Maanen R, Martens ESL, Takada T, et al. Adverse events of undiluted intravenous push levetiracetam. JAMA Intern Med.

Emergency Department 120

Emergency Department ED ALS 120

The Skeptics' Guide to EM

JULY 2, 2022

Date: June 30th, 2022 Reference: McGinnis et al. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Date: June 30th, 2022 Reference: McGinnis et al. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Reference: McGinnis et al.

Coronary 100

Coronary Heart Attack ACS CAD 100

The Skeptics' Guide to EM

NOVEMBER 1, 2022

Date: October 27th, 2022 Reference: Hayashi et al. Date: October 27th, 2022 Reference: Hayashi et al. Although minor adverse events, such as brief apnea or hypoxia, are common, significant adverse events are very rare, and the benefits are clear (Bellolio 2016).

ALS 118

ALS Emergency Department OR ED 118

The Skeptics' Guide to EM

JANUARY 14, 2018

[display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. A study from Bindman et al. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

JANUARY 20, 2018

[display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al. display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al. Reference: Sadeghirad B, et al. Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials.

Emergency Department 130

Emergency Department ALS EMS ED 130

The Skeptics' Guide to EM

JULY 27, 2019

Date: July 22nd, 2019 Reference: Yadav et al. Date: July 22nd, 2019 Reference: Yadav et al. AEM July 2019 Guest Skeptic: Dr. Background: Inappropriate antibiotic use exposes patients to opportunistic infections, accelerates the development of antibiotic resistant bacteria and leads to adverse drug events [1].

Emergency Department 130

Emergency Department ED ALS 130

The Skeptics' Guide to EM

JUNE 14, 2017

Thank you to Dr. Manrique Umana for inviting me and the conference organizers for putting on such an amazing and educational event. Thank you to Dr. Manrique Umana for inviting me and the conference organizers for putting on such an amazing and educational event. A number of examples of the KT problem were provided.

Coronary 130

Coronary Emergency Department ALS 130

The Skeptics' Guide to EM

JUNE 12, 2022

Date: June 12th, 2022 Reference: Finfer et al. Date: June 12th, 2022 Reference: Finfer et al. Two large, cluster-randomized trials ( SMART and SALT-ED ) showed a small benefit to the use of balanced crystalloids in preventing a composite outcome of Major Adverse Kidney Events within 30 days (aka MAKE-30).

ICU 132

ICU Plasma Critical Care ALS 132

The Skeptics' Guide to EM

SEPTEMBER 1, 2018

[display_podcast] Date: August 22nd, 2018 Reference: Riskin A, Erez A, Foulk TA, et al. display_podcast] Date: August 22nd, 2018 Reference: Riskin A, Erez A, Foulk TA, et al. Reference: Riskin A, Erez A, Foulk TA, et al. Rudeness and Medical Team Performance. Pediatrics. Rudeness and Medical Team Performance. Pediatrics.

ALS 130

ALS Emergency Department OR EMS 130

The Skeptics' Guide to EM

OCTOBER 3, 2021

Date: September 28th, 2021 Reference: Zampieri et al. Date: September 28th, 2021 Reference: Zampieri et al. In the two large trials, this benefit was seen as a reduction in a composite outcome of major adverse kidney events within 30 days (MAKE-30). Reference: Zampieri et al. Lactated Ringer’s or Plasmalyte 148) over 0.9%

OR 130

OR Critical Care ICU Plasma 130

Don't Forget the Bubbles

AUGUST 23, 2023

This simple intervention aims to acknowledge the tragic and unexpected event humanely and respectfully. The Pause creates an opportunity for loved ones and healthcare workers to respectfully honour the patient and the significant event they have been involved in before moving on to the next task ahead. Kapoor et al. 23 (2), pp.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

ALiEM

OCTOBER 11, 2024

Common inciting events include viral infections, autoimmune diseases, or immunodeficiency syndromes [1]. Provan D, Arnold DM, Bussel JB, et al. Immune thrombocytopenia (ITP) is an acquired autoimmune disorder caused by autoantibodies against platelet antigens. 2019 Dec 10;3(23):3829-3866. doi: 10.1182/bloodadvances.2019000966.

OR 152

OR ALS 152

Don't Forget the Bubbles

NOVEMBER 11, 2024

Kochanek et al. explored the evidence in a 2019 systematic review, which forms part of the Brain Trauma Foundation Guidelines, as did Utsumi et al. The guidelines by Kochanek et al. The most recent meta-analysis by Utsumi et al. 2022.01291 Kochanek PM, Tasker RC, Carney N, et al. Three secondary analyses.

ALS 116

ALS Life Support Critical Care OR 116

Pediatric EM Morsels

AUGUST 18, 2023

Myth #1: Musculoskeletal Adverse Events (MAE) This concern is likely the most common reason fluoroquinolones are rarely used in children. Musculoskeletal Adverse Events include: Articular cartilage damage causing arthralgias or arthritis , Tendonitis , and Tendon rupture. Which is a risk of 1 event for 62.5 Binz 2015).

E-9-1-1 130

E-9-1-1 ACS OR ALS 130

REBEL EM

JUNE 8, 2023

Paper: Singer S, et al. From a safety standpoint this is a great thing, but also could be the reason we see such few adverse events Discussion: There is a recent “push” to utilize “Push dose pressors” as the correction of acute hypotension in a variety of clinical scenarios. Am J Emerg Med. 2022 Sep 5.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

Don't Forget the Bubbles

NOVEMBER 22, 2023

A systematic review examined 69 articles (mostly cohort studies and clinical trials) looking at the common adverse events (not just PRIS) following the use of propofol in children and neonates. Vanlander AV, Okun JG, de Jaeger A, Smet J, De Latter E, De Paepe B, et al. References Bray RJ. Propofol infusion syndrome in children.

E-9-1-1 126

E-9-1-1 Critical Care Operating Room ALS 126

REBEL EM

JANUARY 29, 2024

Click here for Direct Download of the Podcast Paper: Aykan AC et al. References: Jaff MR et al. PMID: 21422387 Wan S et al. PMID: 15262836 Sharifi M et al. PMID: 27422214 Wang C et al. PMID: 19741062 Kucher N et al. PMID: 24226805 Piazza G et al. PMID: 26315743 Tapson VF et al. CHEST 2010.

ALS 136

ALS ACS OR CPR 136

ALiEM

OCTOBER 26, 2023

In order to avoid connectivity issues with Wifi, the event administrators broadcasted from an ethernet-connected computer. Originally developed by Marsh et al., Deploying our security teams, a robust registration system, and the waiting room function in Zoom were important strategies for avoiding disturbances to the event.

EMS 161

EMS Emergency Department ALS ED 161

Don't Forget the Bubbles

JULY 22, 2024

Compare this with the Panickar et al. Fortunately, Lee et al. Lee B, Turner S, Borland M, Csonka P, Grigg J, Guilbert TW, et al. Whilst the incidence of adverse events was low in this meta-analysis, this reflects adverse event reporting in RCTs rather than reality. Future of Pre-School Wheeze Whilst Lee et al.

E-9-1-1 105

E-9-1-1 ALS ACS ED 105

REBEL EM

OCTOBER 30, 2023

Paper: Davenport R et al. References: Davenport R et al. Fibrinogen products may also be needed to stabilize clots and stem bleeding. The optimal approach to fibrinogen administration in massive hemorrhage protocols is unknown. Cryoprecipitate Group: 25.3% OR 0.96; 95% CI 0.75 to 1.23; p = 0.74 vs 10%; OR 1.74; 95% CI 1.20

FFP 127

FFP ALS OR EMS 127

REBEL EM

MAY 29, 2024

EMRAP HD: Epistaxis Posterior Pack References Cassisi NJ et al. PMID: 5569677 Zeyyan E et al. PMID: 20938948 Loftus BC et al. PMID: 8170679 Viducich RA et al. Traditional teaching is that these patients are at risk for life-threatening bradydysrhythmias and should go to the ICU Literature here is non-existent.

ICU 101

ICU ALS ACS EMS 101

REBEL EM

MARCH 6, 2024

Melatonin Farahmand S, et al. Morgenthaler TI et al; Standards of Practice Committee of the American Academy of Sleep Medicine. Driving Sleepy Barger LK, Cade BE, Ayas NT, et al. Green W, Gao X, Li K, et al. The Association of Sleep Hygiene and Drowsiness with Adverse Driving Events in Emergency Medicine Residents.

ALS 100

ALS OR EMS 100