ALiEM

OCTOBER 30, 2024

That discussion can be deferred until the patient is stable, the risk of such an event is mitigated, and other medications can be given for their withdrawal symptoms and pain. Multimodal medication options for fentanyl-xylazine withdrawal management in London et al. PMID 35774687 D’Onofrio G, Chawarski MC, O’Connor PG, et al.

E-9-1-1 161

E-9-1-1 Naloxone Emergency Department ALS 161

The Skeptics' Guide to EM

JULY 6, 2024

Reference: Tjan et al. Conflicts in the ED often stem from clinical decision-making and actions, leading to potential adverse patient events and exacerbating access block issues. Reference: Tjan et al. Conflict in emergency medicine: A systematic review. These conflicts can ultimately lead to moral injury [1,2,3].

ED 242

ED ALS Emergency Department OR 242

EMDocs

DECEMBER 23, 2024

Major adverse cardiac events 40 minutes after giving the antiarrhythmic. The following table shows their results, take a look: Note that procainamide leads with less adverse cardiac events. Procainamide therapy was associated with less major cardiac adverse events and a higher proportion of tachycardia termination within 40 min.

ALS 75

ALS OR STEMI EMS 75

Paramedics Unlimited

APRIL 19, 2018

What is the difference between ALS and BLS Medical Care? In Advanced Life support (ALS) emergencies, a “single” paramedic or ER doctor can not deliver necessary care. Due to the complexity of advanced medical treatment for critical patients, it is advisable to have a team of at least one paramedic and an EMT at your event.

BLS 52

BLS ALS Emergency Medical Technician Advanced Life Support 52

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 245

Emergency Medical Services Defibrillator CPR EMS 245

Core EM

JANUARY 25, 2024

References: Yuan TH, Kerns WP, Tomaszewski CA, et al. von Lewinski D, Bruns S, Walther S, et al. Cole JB, Corcoran JN, Engebretsen KM, et al. Holger JS, Engebretsen KM, Fritzlar SJ, et al. Kerns W, Schroeder D, Williams C, et al. Kline JA, Tomaszewski CA, Schroeder JD, et al. Disposition to ICU. Circulation.

Overdose 246

Overdose ALS Epinephrine Critical Care 246

First Responder Wellness

APRIL 4, 2025

Trauma Exposure: Frequent, Cumulative, and Unique Vulnerability: Traumatic incidents are not one-off events for first respondersthey are part of the job description. Research shows that first responders have significantly higher rates of chronic stress and post-traumatic stress symptoms than the general population (Bonumwezi et al.,

First Responder 81

First Responder Firefighter ALS Paramedic 81

First Responder Wellness

FEBRUARY 25, 2025

Given the high propensity for police officers to be exposed to such events, it is not surprising that we see a higher rate of PTSD in officers than in the general population (Lewis-Schroeder et al., PTSD is a unique mental health condition as it is one of the only disorders that specifically requires a precipitating event.

First Responder 78

First Responder Public Safety ALS OR 78

Pediatric EM Morsels

SEPTEMBER 22, 2023

Pathophysiology Primary injury happens at the time of the traumatic event or shortly after in the high cervical to mid-thoracic spine. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. Main symptoms include hypotension and bradycardia. References Coleman-Satterfield, TT.

E-9-1-1 304

E-9-1-1 Epinephrine ALS EMS 304

The Skeptics' Guide to EM

DECEMBER 7, 2019

Date: October 2nd, 2019 Reference: Ramgopal et al. Changes in the Management of Children With Brief Resolved Unexplained Events (BRUEs). Date: October 2nd, 2019 Reference: Ramgopal et al. Changes in the Management of Children With Brief Resolved Unexplained Events (BRUEs).

CPR 130

CPR ALS OR 130

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

FEBRUARY 19, 2024

Paper: Yerke JR et al. of cases) ≤24hrs vs >24hrs Infusion Duration: 3.8hrs vs 42.4hrs Max Dose: 10mcg/min vs 10mcg/min Extravasation Events: 24 (4.7%) vs 11 (8.7%) Extravasation incidence/1000d of Peripheral Infusion: 176.4 No Extravasation Event vs Extravasation Event Age: 63 vs 67 years BMI: 28.3 CHEST 2024.

ICU 137

ICU EMS ALS OR 137

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 145

FFP Frozen Plasma ALS Plasma 145

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

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

ACEP Now

OCTOBER 29, 2024

Knack SKS, Scott N, Driver BE, Pet al. Thiruganasambandamoorthy V, Kwong K, Wells GA, et al. Development of the Canadian Syncope Risk Score to predict serious adverse events after emergency department assessment of syncope. Freund Y, Cachanado M, Aubry A, et al. Penaloza A, Verschuren F, Meyer G, et al.

Emergency Department 59

Emergency Department ALS Emergency Medical Services OR 59

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

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

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

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

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 123

ALS Emergency Department OR ED 123

The Skeptics' Guide to EM

SEPTEMBER 26, 2020

Reference: Warren et al. Reference: Warren et al. The conclusion from Berman et al was to recommend antacid monotherapy (5). Reference: Warren et al. Date: September 22nd, 2020 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician in Calgary. A randomized double-blind clinical trial. AEM Sept 2020.

Emergency Department 130

Emergency Department ALS ED OR 130

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

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

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 114

Emergency Department ED ALS 114

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 133

ICU Plasma Critical Care ALS 133

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