The Skeptics' Guide to EM

APRIL 8, 2023

There have been many “temporary” rural emergency department closures during the past last year. In Ontario alone there have been approximately 160 emergency departments (ED) temporarily closed since the beginning of 2022. It was a stepped-wedge reconfiguration of the entire Danish emergency healthcare system.

Emergency Department 142

Emergency Department ED Ambulance ALS 142

ACEP Now

NOVEMBER 7, 2024

The pain makes it difficult for him to ambulate unassisted through his home. About three percent of emergency department (ED) visits are due to skin and soft tissue infections, but data are lacking on the contribution of chronic wounds to this number. Today, he notes worsening swelling and a blister forming near his left ankle.

ED 97

ED OR Emergency Department Ambulance 97

EMergucate

MARCH 19, 2019

A 30 year old man is brought to your emergency department at 06:30 am on a winter morning by SJA after his partner rang the ambulance.

Emergency Department 100

Emergency Department Ambulance 100

EMergucate

MARCH 19, 2019

A 30 year old man is brought to your emergency department at 06:30 am on a winter morning by SJA after his partner rang the ambulance.

Emergency Department 100

Emergency Department Ambulance 100

EMergucate

MAY 14, 2019

A 39 year old woman with no significant medical history is brought to the emergency department by ambulance in an acute confusional state. An ECG is performed as part of her assessment.

Emergency Department 100

Emergency Department Ambulance 100

EMergucate

NOVEMBER 10, 2014

A 58 year old man is brought to your Emergency Department by ambulance after a spontaneous epistaxis over the last three hours. The Paramedics confirm that the patient vomitted 500mls fresh blood a…

Emergency Department 100

Emergency Department Ambulance Paramedic EMS 100

EMergucate

MARCH 30, 2014

A 67 year old man is brought to your Emergency Department by ambulance. He is 7 days post right total knee replacement, complaining of feeling generally unwell and a painful right knee. He has had …

Emergency Department 100

Emergency Department Ambulance EMS 100

EMergucate

MAY 11, 2014

A 65 year old man is brought to your Emergency Department by ambulance after a fall at work. He complains of shortness of breath and weakness. On examination he is pale and tachycardic. Describe an…

Emergency Department 100

Emergency Department Ambulance EMS 100

EMergucate

JULY 1, 2014

A 57 year old man is brought in to your Emergency Department by ambulance. He has had shortness of breath for a day and feels unwell. He is sweaty and has significantly increased work of breathing.…

Emergency Department 100

Emergency Department Ambulance EMS 100

EMergucate

AUGUST 28, 2012

Your next patient is an 83 yo man who is brought to the emergency department by ambulance complaining of increasing nausea and feeling lethargic. He has a history of AF so you decide to do an ECG.

Emergency Department 100

Emergency Department Ambulance 100

EMergucate

MAY 20, 2014

A 35 year old man is brought to your Emergency Department by ambulance following a suicide attempt. His wife found him in his car with the engine running at 7.30 am, he had connected a hose from hi…

Emergency Department 100

Emergency Department Ambulance EMS 100

EMergucate

NOVEMBER 18, 2014

A 27 year old female presents to your Emergency Department by ambulance. She has been unwell for 2 days and complains of fever, sore throat and a cough. Vitals: BP 106/50 mmHg PR 135/min T 38.3

Emergency Department 100

Emergency Department Ambulance EMS 100

EMergucate

MARCH 18, 2014

A 60 year old male is brought to your Emergency Department by ambulance. On scene he was found with a GCS 12 and a BSL of 2. On route he received 50mls of 50% dextrose ivi. He was vomiting profusel…

Emergency Department 100

Emergency Department Ambulance EMS 100

The Skeptics' Guide to EM

JANUARY 19, 2019

He is alert and oriented times three with normal vital signs by the time he arrives in the emergency department. They concluded: “For patients treated in the ED for opioid overdose, an observation period of one hour is sufficient if they ambulate as usual, have normal vital signs and a Glasgow Coma Scale of 15”.

Naloxone 130

Naloxone Overdose Emergency Medical Services Emergency Department 130

Don't Forget the Bubbles

NOVEMBER 29, 2023

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. A 12-year-old male is being transported by ambulance after a road traffic accident. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. Ann Emerg Med.

E-9-1-1 135

E-9-1-1 Emergency Department ED CPR 135

NAEMSP

OCTOBER 9, 2024

In the emergency department, a lack of awareness about Addison’s disease led to delayed steroid administration. In the emergency department, the patient was evaluated and safely discharged. These cases highlight the impact of adrenal insufficiency on patients, especially during encounters with emergency care systems.

EMS 122

EMS Crisis Prevention Emergency Department BLS 122

Core EM

OCTOBER 23, 2024

The Case A 24-year-old man with no past medical or surgical history presented to the emergency department with 5 days of progressively worsening bilateral leg cramping, paresthesias, and multiple falls. He was not able to ambulate without two-person assistance. and tends to occur in men of Asian descent.

Emergency Department 130

Emergency Department Critical Care ICU Ambulance 130

The Skeptics' Guide to EM

FEBRUARY 17, 2018

Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. first appeared on The Skeptics Guide to Emergency Medicine. Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. [display_podcast] Date: February 14th, 2018 Reference: Alam N et al.

Paramedic 100

Paramedic Ambulance Emergency Medical Services ALS 100

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage.

E-9-1-1 139

E-9-1-1 ACS Emergency Department Coronary 139

International Journal of Paramedicine

JULY 8, 2024

Methods: This is a retrospective cohort study of agitated patients with an initial Richmond Agitation-Sedation Scale (RASS) score of at least 3, who were sedated and transported by ambulance to Hartford Hospital.

Emergency Department 98

Emergency Department Ambulance ED OR 98

ACEP Now

JANUARY 4, 2025

Clarke was set to begin a decades-long career in emergency medicine and he brought along his camera. Firsthand Account An ambulance bay at the LA County-USC Hospital in 1978. The photos that Dr. Clarke took from 19781980 provide a glimpse into working in an emergency department in the years the specialty was being established.

ED 52

ED Emergency Department Ambulance CPR 52

The Skeptics' Guide to EM

APRIL 24, 2021

Randomized Double-blind Trial Intramuscular Droperidol, Ziprasidone and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. AEM April 2021 Case: You are sitting minding your own business charting on shift when you become aware of shouting and banging from your ambulance bay. Reference: Martel et al.

Emergency Department 100

Emergency Department ALS Ambulance ED 100

Core EM

JANUARY 25, 2024

Written by: Sadakat Chowdhury MD Edited by: Mak Sarich MD, Jay Lin MD, Jonathan Kobles MD Background: Ultrasound (US) guided nerve blocks offer an applicable option for achieving analgesia in the emergency department. This is a motor sparing block – so it will allow your patients to ambulate.

Epinephrine 246

Epinephrine ED Emergency Department OR 246

ACEP Now

MAY 10, 2024

Patients often seek care in the emergency department (ED) setting when flares of pain affect their ability to ambulate, climb stairs, or even stand up from sitting. In our experience, patients have been able to ambulate comfortably with no motor deficits in approximately 30 minutes. J Emerg Med. Surg Technol Int.

Emergency Department 92

Emergency Department Ambulance ED OR 92

The Skeptics' Guide to EM

JANUARY 7, 2023

Acute management of atrial fibrillation in congestive heart failure with reduced ejection fraction in the emergency department. Acute management of atrial fibrillation in congestive heart failure with reduced ejection fraction in the emergency department. Date: January 4th, 2023 Reference: Hasbrouck et al.

OR 100

OR Emergency Department ALS Ambulance 100

ACEP Now

DECEMBER 6, 2024

His health care focus included hospital efficiency, physician and patient satisfaction, and emergency department (ED) wait times, as well as a host of nonhealth issues. Dr. Morhaim has been assigned to a state commission to address emergency department wait times. Click to enlarge.)

Emergency Department 98

Emergency Department ED Ambulance OR 98

EMDocs

MARCH 30, 2024

Answer : Thoracic and Lumbar Spine Trauma Epidemiology: Approximately half of the vertebral injuries that are seen in the emergency department are thoracic and lumbar injuries. A 27-year-old man was brought into the emergency department via EMS after being stabbed. J Emerg Med. Diagnosis includes imaging.

EMS 105

EMS E-9-1-1 Emergency Department Ambulance 105

Mile High Ambulance

MARCH 15, 2017

We are appreciative to remain Rose Medical Center’s primary ambulance provider. We welcome the opportunity to serve Rose’s free-standing Emergency Department (FSED) at Stapleton as the new primary provider, as well as a back-up provider for Swedish Medical Center and Swedish Medical Center’s (FSED) at Belmar.

Ambulance 52

Ambulance Emergency Department 52

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. Clinical scoring tools have improved diagnostic performance in assessing suspected appendicitis in the emergency department.

Emergency Department 105

Emergency Department ALS OR Ambulance 105

EMDocs

JUNE 9, 2023

EMS Environment Ok, we’ve got the patient calmed down and gotten them into the ambulance. If you have restraints in your ambulance, are those restraints appropriately sized for pediatric patients? NASEMSO: Clinical care and restraint of agitated or combative patients by emergency medical service practitioners.

Emergency Medical Services 98

Emergency Medical Services EMS Emergency Department Ambulance 98

ACEP Now

OCTOBER 9, 2023

The other night I stood in the trauma bay, listening to rain patter against the automatic doors, awaiting an ambulance. Wearing a cut-up trauma sheet as a hijab, she walked out of our emergency department several hours later, intact and not traumatized. with a professional focus on the care of critically ill patients.

Heart Attack 126

Heart Attack Life Support Emergency Department Ambulance 126

Dr. Smith's ECG Blog

OCTOBER 20, 2024

His wife contacted the ambulance service after the patient experienced an episode of loss of consciousness. The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. Written by Magnus Nossen The patient in today's case is a male in his 70s with hypertension and type II diabetes mellitus.

Coronary 128

Coronary ACS Emergency Department Defibrillator 128

Dr. Smith's ECG Blog

MARCH 28, 2024

male with pertinent past medical history including Atrial fibrillation, atrial flutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia.

OR 129

OR Emergency Department Ambulance EMS 129

AAEM RSA

MAY 7, 2021

Schreyer, MD CMQ FAAE Originally published: Common Sense January/February 2021 The advent and broad availability of ridesharing services, such as Lyft and Uber, are changing the way patients access medical services, and emergency departments (EDs) are taking notice. Academic Emergency Medicine. 1996;3(11):1046-1050. 2019.10.013.

EMR 52

EMR Emergency Medical Services Ambulance Emergency Department 52

Don't Forget the Bubbles

JUNE 30, 2023

Grabbing a pristine white table napkin to apply pressure to the wound, Ranulf’s class teacher and expedition leader called the ambulance as chaos descended on the restaurant. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality. The trauma call goes out.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

ACEP Now

JUNE 14, 2024

1 As fresh challenges of the pandemic and hospital operations changed emergency medicine practice, one of the more challenging areas was the movement of admitted patients out of the first emergency department (ED). emergency departments. What Is the Burden of These Patients on EDs and Ambulance Providers?

Emergency Department 52

Emergency Department ED Ambulance OR 52

International Journal of Paramedicine

OCTOBER 12, 2023

Background: Frequent callers of emergency medical services comprise a disproportionate percentage of emergency department visits. This might free up ambulance services for more urgent calls. This study aims to describe reasons for calling 911 and healthcare services among frequent callers in Ontario.

Overdose 52

Overdose EMS Emergency Medical Services Ambulance 52