Core EM

SEPTEMBER 24, 2024

Annie: I developed an interest in EM while working as a scribe in the ED during college. In addition to what Charlotte and Nick said, I can envision myself staying calm in the stressful situations that come up in the ED. Nick: Triaging your time and priorities as an ED doc on shift is so challenging.

ED 100

ED EMS Critical Care OR 100

EMOttawa

AUGUST 22, 2024

Assessing patients with pleural effusions in the emergency department (ED) can be challenging and nuanced. This is largely due to the lack of guidelines around pleural effusions in the ED. In part one we focused on imaging, diagnosis, and management of parapneumonic effusions.

ED 60

ED Emergency Department Critical Care EMS 60

EMOttawa

OCTOBER 31, 2024

There is an ED prevalence ranging from 7-24%, with increased mortality rates […] The post Delirium revisited appeared first on EMOttawa Blog. Delirium is often the initial manifestation of an underlying acute illness and can be present before fever, tachypnea, tachycardia, or hypoxia.

ED 116

ED OR EMS 116

REBEL EM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. US, compared with CXR and CT, offers the absence of ionizing radiation and high reproducibility. Emerg Med J. 2023;40(10):700-707.

ED 130

ED E-9-1-1 Emergency Department ALS 130

Emergency Medicine Cases

JUNE 2, 2020

In this month's Waiting to Be Seen blog Dr. Howard Ovens explores The End of The Beginning: What’s Next for EDs in the Pandemic? Many questions have arisen now that we are a few months into the pandemic in North America: How long will ED volumes remain low? What will happen as hospital services ramp up?

ED 130

ED EMS 130

Dr. Smith's ECG Blog

OCTOBER 27, 2024

The cath lab was deactivated by cardiologist on arrival at ED because it was "not a STEMI". He presented to the ED for evaluation chest pain. It was in his central and left chest, radiated to his left arm, and he experienced some cold sweats and nausea prompting him to call 911 and he was brought to ED via ambulance.

STEMI 116

STEMI ED Coronary EMS 116

Emergency Medicine Cases

JANUARY 29, 2019

Are there things we can do in the ED to reduce the risk of violence? We focus on some of the high-risk populations that are often involved in situations that escalate and suffer the consequences of ED responses.

ED 130

ED EMS 130

Emergency Medicine Cases

JANUARY 15, 2019

We often face violence in the ED. Yet the ED is a sanctuary for care and support. Many EDs have a zero-tolerance policy for violence. In this Waiting to Be Seen blog Dr. Howard Ovens examines the issues we face in Emergency Departments as we try to make staff feel safe and ensure patients can access the care they need.

ED 130

ED Emergency Department EMS 130

EMS 12-Lead

AUGUST 18, 2024

David Didlake EMT-P, RN, ACNP @DidlakeDW An adult male self-presented to the ED with palpitations and the following ECG. Readers of the Smith ECG Blog will probably recognize this a very subtle inferior OMI. The VT vs SVT with Aberrancy debate is beyond the scope of this particular blog post. Here is the ECG after 200J.

CAD 147

CAD EMT EMT ACS 147

Dr. Smith's ECG Blog

NOVEMBER 22, 2023

While in the ED, patient developed acute dyspnea while at rest, initially not associated with chest pain. The patient had no chest symptoms until he had been in the ED for many hours and had been undergoing management of his DKA. The patient was under the care of another ED physician. Another ECG was recorded: What do you think?

ED 102

ED Coronary CAD STEMI 102

REBEL EM

JULY 17, 2023

REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED? PMID: Clinical Question: Does a single dose of ketamine or etomidate used for rapid sequence intubation (RSI) of critically adults in the ED impact the SOFA score within 3 days of hospitalization? appeared first on REBEL EM - Emergency Medicine Blog. 95% CI -1.4

ED 98

ED ICU Emergency Department Overdose 98

Emergency Medicine Cases

SEPTEMBER 11, 2018

Jesse McLaren outlines 10 Quality Improvement (QI) opportunities for reducing missed AMIs and the lessons learned from Ontario’s Emergency Department Return Visit Quality Program in this Waiting to Be Seen blog.

ED 130

ED Emergency Department EMS 130

EMOttawa

JANUARY 25, 2024

There is certainly a need for more practical application for the ED doc or initial setup of patients on the vent. With both ER and ICU experience, this post acts as a quick […] The post Mechanical Ventilation Basics appeared first on EMOttawa Blog.

ICU 141

ICU ED OR Critical Care 141

EMS 12-Lead

MAY 15, 2024

TCP in the ROSC Patient: False Electrical Capture at 75mA Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the second installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. Pacing was continued in the ED, with identical settings.

Epinephrine 331

Epinephrine Paramedic CPR ED 331

EMOttawa

NOVEMBER 14, 2024

Urine drug (or toxicologic) screens are a fairly standard tool used in addictions, psychiatry and the Emergency Department (ED), often employed to detect substance use in patients presenting with altered mental status, trauma, psychiatric or abnormal behaviour.

Emergency Department 71

Emergency Department ED OR 71

REBEL EM

JUNE 5, 2023

These statistics make the ED a crucial treatment initiation point to prevent further morbidity and mortality from opioid overdoses. The benefit of accessibility, availability, and safety of buprenorphine compared to methadone makes it a viable option for opioid use disorder treatment initiation in the ED. PMID 33392580.

Naloxone 98

Naloxone ED Overdose Emergency Department 98

ALiEM

FEBRUARY 5, 2024

8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. More specifically, we identified 3 AIR and 5 Honorable Mentions. Please go to the above link.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

Dr. Smith's ECG Blog

MAY 5, 2024

An undergraduate (not yet in medical school) who works as an ED technician (records all EKGs, helps with procedures, takes vital signs) and who reads this blog regularly arrived at work and happened to glance down and see this previously recorded ECG on a table in the ED. The young ED tech immediately suspected LAD OMI.

ED 114

ED STEMI Coronary Paramedic 114

EMOttawa

FEBRUARY 22, 2024

In 2013, in the United States there were 7 million visits to the emergency department (ED) for lacerations making up a total of 5.2% of ED visits(1).

Emergency Department 89

Emergency Department ED OR 89

EMDocs

JUNE 16, 2023

Podcast: Play in new window | Download (Duration: 13:57 — 19.2MB) Subscribe: Apple Podcasts | Google Podcasts | RSS Management of the child with mental health problems who is boarding in the ED In episode 1 of this series, we discussed differentiating organic vs psychiatric causes of agitation in children.

ED 52

ED Mental Health Services Emergency Department Emergency Medical Services 52

ALiEM

OCTOBER 14, 2023

6 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. More specifically, we identified 3 AIR and 3 Honorable Mentions. Ann Emerg Med. 2023;82(1):55-65.

Critical Care 169

Critical Care EMS Emergency Department ALS 169

EMOttawa

JANUARY 22, 2024

Question and Methods: This double-blinded RCT of 209 patients presenting to the ED with moderate to severe migraines compared high- to low- dose dexamethasone (16 mg vs 4 mg) on sustained headache relief 48 hours post discharge. Methodology: 3.5/5 5 Usefulness: 4/5 Friedman BW, et al. 2023 Oct 3;101(14):e1448-e1454.

ALS 106

ALS ED 106

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Outside his family and work, Jesse pours […] The post SGEM#195: Some Like It Hot – ED Temperature and ICU Survival first appeared on The Skeptics Guide to Emergency Medicine. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia.

ICU 130

ICU ED Emergency Department Critical Care 130

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

He currently practices emergency medicine in New Mexico in the ED, in the field with EMS and with the UNM Lifeguard Air Emergency Services. Background: We’ve discussed out-of-hospital cardiac arrest (OHCA) at least once or twice on the SGEM (see long list at end of blog). Your partner asks if you want to administer naloxone as well.

Naloxone 242

Naloxone NARCAN Overdose CPR 242

REBEL EM

NOVEMBER 21, 2024

A parent presents to the ED with their 6-week-old infant for evaluation of a fever. Rezaie, MD (Twitter/X: @srrezaie ) The post Rosh Review My EMCert Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. The infant was born full term and has no other symptoms. In: Tintinalli JE, Ma OJ, Yealy DM, et al.,

52

52

REBEL EM

JANUARY 23, 2023

Key Secondary Endpoints: 5 (3.9%) patients in the IV cetirizine group returned to any ED or clinic within 24 hours compared to 15 (11.1%) in the IV diphenhydramine group; P=0.04 7 (5.5%) patients in the IV cetirizine group returned to any ED or clinic within 48 hours compared to 19 (14.1%) in the IV diphenhydramine group; P=0.02

Allergic Reaction 52

Allergic Reaction ED E-9-1-1 Emergency Department 52

EMOttawa

DECEMBER 21, 2023

Plenary Talks: Working up the “nerve” to “block” pain in the ED: is it time to change our approach? – Dr Alice Chan Soft Tissue POCUS – Why & How? […] The post Ottawa POCUS Symposium appeared first on EMOttawa Blog.

ED 58

ED 58

REBEL EM

SEPTEMBER 9, 2024

Post TW, ed. In: Shaw KN, Bachur RG, eds. Rezaie, MD (Twitter/X: @srrezaie ) The post Rosh Review My EMCert Monthly Question appeared first on REBEL EM - Emergency Medicine Blog. 100% 21% 30% 50% References Fernandes CJ. Neonatal resuscitation in the delivery room. UpToDate Inc. Accessed August 15, 2020.

Emergency Department 59

Emergency Department ED EMS 59

REBEL EM

NOVEMBER 13, 2024

Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 131.0 – Traumatic Arthrotomy appeared first on REBEL EM - Emergency Medicine Blog. cefazolin or cefuroxime) If risk factors for MRSA present, use agent with activity against MRSA (i.e. gentamycin) If concern for fecal or clostridial infection, add high dose penicillin (i.e.

ED 102

ED OR EMS 102

The Skeptics' Guide to EM

NOVEMBER 11, 2023

DISCLAIMER: THE VIEWS AND OPINIONS OF THIS BLOG AND PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US MILITARY. Case: A 24-year-old manual labourer presents to the emergency department (ED) after drinking a few too many beers, having a disagreement with another beer drinker and gets knocked down.

ALS 244

ALS Emergency Department ED OR 244

EMOttawa

JULY 11, 2024

We prepared the ED for the patient’s arrival. It’s Backkkk (Part 1) appeared first on EMOttawa Blog. A 3-year-old girl was being brought in by EMS with an out-of-hospital cardiac arrest. CPR was ongoing, and their ETA was 10 minutes. According to EMS, the patient had […] The post Invasive Group A Strep (iGAS).

CPR 71

CPR EMS ED Critical Care 71

REBEL EM

JUNE 29, 2023

Back on June 1 st , 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? REBEL EM Blog, June 1, 2023. Back on June 1st, 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? Below you will find some of the points we discussed.

CPR 145

CPR ICU EMS ALS 145

Emergency Medicine Cases

FEBRUARY 28, 2022

Does the patient need an anticoagulant started in the ED? and runs through 10 cases to elucidate the nuances of atrial fibrillation management on this ECG Cases blog. If it is atrial fibrillation with a rapid ventricular response without a secondary cause, what is the intervention?

ED 130

ED 130

ALiEM

APRIL 14, 2023

6 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 2 AIR and 4 Honorable Mentions.

EMS 246

EMS Emergency Department ED OR 246

Dr. Smith's ECG Blog

OCTOBER 3, 2024

While statistical likelihood of acute OMI is clearly lower in younger adults — nothing is ruled out by age alone ( as per My Comment in the January 9, 2023 and December 5, 2023 posts in Dr. Smith's ECG Blog ). These were all negative. That said — I would not interpret ST-T wave appearance in lead aVL of today's ECG as a "reciprocal" change.

E-9-1-1 110

E-9-1-1 Coronary ALS ED 110

Dr. Smith's ECG Blog

MARCH 13, 2023

An ED ECG, if recorded with pain, should show LAD OMI. MY Thoughts on the ECGs in Figure-1: As per Dr. Smith — in the setting of a patient with new chest pain — the initial ECG in today's case ( = ECG #1 — obtained by the EMS team prior to ED arrival ) — is diagnostic of ACS ( A cute C oronary S yndrome ) until proven otherwise.

ED 52

ED ACS Coronary Paramedic 52

EMOttawa

MAY 13, 2024

95%CI 1.06 […] The post Effect of Bougie Use on First-Attempt Success in Tracheal Intubations: A Systematic Review and Meta-Analysis appeared first on EMOttawa Blog. Findings: Bougie was associated with increased first-attempt intubation success overall (RR 1.11

ALS 108

ALS ED 108