Don't Forget the Bubbles

MAY 10, 2023

We’ve incorporated some of our favourite elements from their presentations in this blog post. You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. There were 15 doctors and nurses from three paediatric EDs. And then head back to the paeds ED. Take a break.

Emergency Department 91

Emergency Department ED CPR OR 91

REBEL EM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The result of this ED capacity strain and less than ideal patient to staff ratios has led to delays in interventions, treatments and care adjustments. Paper: Owyang CG, et al. J Crit Care. J Crit Care.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

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

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. How does your medical school support interest in emergency medicine careers?

ED 100

ED EMS Critical Care OR 100

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. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

ED 130

ED E-9-1-1 Emergency Department ALS 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

EMOttawa

FEBRUARY 22, 2024

Lacerations are a common presenting complaint to emergency department. 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

ALiEM

FEBRUARY 5, 2024

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to toxicology in the Emergency Department. Ann Emerg Med. Please go to the above link. 2023;82(1):55-65.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

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

REBEL EM

JUNE 5, 2023

One study from a county in Massachusetts found that of all nonfatal opioid doses seen in the emergency department from 2011-2015, 1 in 20 patients subsequently died within one year of initial visit with 66% of these deaths being directly related to an opioid overdose (4). PMID 33392580.

Naloxone 98

Naloxone ED Overdose Emergency Department 98

REBEL EM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED? appeared first on REBEL EM - Emergency Medicine Blog. Range 5 to 9) Etomidate: 7.0

ED 98

ED ICU Emergency Department Overdose 98

REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

ALiEM

OCTOBER 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to respiratory diseases in the Emergency Department. Ann Emerg Med. Reference Lin M, Phipps M, Chan TM, et al.

Critical Care 169

Critical Care EMS Emergency Department ALS 169

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia. Case: You are working night shift in the emergency department.

ICU 130

ICU ED Emergency Department Critical Care 130

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

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 103

ED Coronary CAD STEMI 103

REBEL EM

SEPTEMBER 9, 2024

A newborn boy presents to the emergency department shortly after a home delivery. Post TW, ed. In: Shaw KN, Bachur RG, eds. Fleisher & Ludwig’s Textbook of Pediatric Emergency Medicine. The mother had routine prenatal care and reports that he was due in 2 days. His heart rate is 80 bpm. UpToDate Inc.

Emergency Department 59

Emergency Department ED EMS 59

ALiEM

APRIL 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to related to procedures in the Emergency Department. More specifically, we identified 2 AIR and 4 Honorable Mentions.

EMS 246

EMS Emergency Department ED OR 246

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

REBEL EM

NOVEMBER 15, 2023

However, data is limited in ED patients. The ED AWARENESS study found a 2.6% “The ED-AWARENESS study: A prospective, observational cohort study of awareness with paralysis in mechanically ventilated patients admitted from the emergency department.” ” Annals of emergency medicine 77.5

Emergency Department 105

Emergency Department ED EMS ALS 105

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. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. This blog, like the paper cited, is dedicated to him. Ann Emerg Med. His name is Ben.

E-9-1-1 135

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

The Skeptics' Guide to EM

APRIL 10, 2021

He is a GP by training but works in Emergency Department, Anaesthesia, Internal Medicine and Paediatrics. He has a wonderful #FOAMed blog and podcast called Broomedocs and also work […] The post SGEM#326: The SALSA Study: Hypertonic Saline to Treat Hyponatremia first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 130

Emergency Department Coronary ED OR 130

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

REBEL EM

MARCH 11, 2024

A 42-year-old man presents to the emergency department after a motor vehicle collision. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. Rezaie, MD (Twitter/X: @srrezaie ) The post Rosh Review MyEMCert Question appeared first on REBEL EM - Emergency Medicine Blog. He has no medical problems.

Emergency Department 59

Emergency Department ED ALS EMS 59

The Skeptics' Guide to EM

DECEMBER 10, 2022

DISCLAIMER: THE VIEWS AND OPINIONS OF THIS BLOG AND PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US MILITARY. Case: A 32-year-old male construction worker presents to the emergency department (ED) after falling on his right dominant hand. He asks if surgery would be a better option?

Emergency Department 130

Emergency Department ALS ED OR 130

FOAMfrat

NOVEMBER 21, 2024

If all of that sounded like nonsense, you can read more about it in my ABG blog. Hypothermia Hypothermia, defined as core temperature less than 35oC (95oF) has been identified in up to 2/3 of trauma patients upon arrival to the emergency department. Lactic acid collects in the blood stream leading to metabolic acidosis.

ICU 111

ICU Emergency Department OR Ambulance 111

The Skeptics' Guide to EM

APRIL 16, 2022

Disclaimer: The views and opinions of this blog […] The post SGEM#365: Stop! It’s Not Always Hammer Time first appeared on The Skeptics Guide to Emergency Medicine. Disclaimer: The views and opinions of this blog and podcast do not represent the United States Government or the US Military.

Emergency Department 100

Emergency Department ALS OR ED 100

REBEL EM

AUGUST 17, 2023

A 24-year-old woman presents to the emergency department with persistent severe pain in her right thigh following a direct blow during a soccer match 2 weeks ago. Rosen’s Emergency Medicine: Concepts and Clinical Practice. Post TW, ed. Femur and hip injuries. In: Walls RM, Hockberger RS, Gausche-Hill M, et al.,

EMS 52

EMS Emergency Department ED ALS 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting." To Emphasize: The reason definitive diagnosis is important in today's case — is that the senior ED physician interpreted ECG #1 as "nothing too exciting".

Emergency Department 52

Emergency Department E-9-1-1 Coronary STEMI 52

Dr. Smith's ECG Blog

JUNE 27, 2024

By Sofiya Diurba MD, reviewed by Meyers, Grauer A woman in her 50s with PMH known RBBB and prior syncopal events presents to the ED for five syncopal events over the last 24 hours. This is her first ECG in the ED: What do you see? See these blog posts. Vital signs were within normal limits at the time of triage.

ED 118

ED OR Emergency Department Emergency Management 118

Dr. Smith's ECG Blog

OCTOBER 24, 2024

She was brought to an Emergency Department for evaluation. She then had several more syncopal episodes the next day, and returned to a different Emergency Department. For "My Take" regarding optimal use of computerized ECG Reports — Check out my ECG Podcast #3 in the July 24, 2024 post in Dr. Smith's ECG Blog ).

Emergency Department 91

Emergency Department OR EMS ED 91

The Skeptics' Guide to EM

JANUARY 20, 2018

BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. million visits annually to PCPs and EDs for sore throat.

Emergency Department 130

Emergency Department ALS EMS ED 130

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice. Case: A 38-year-old male presents to the emergency department (ED) with acute mid epigastric abdominal pain with nausea and vomiting.

ALS 130

ALS Emergency Department OR EMS 130

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. What do you think?

E-9-1-1 137

E-9-1-1 ACS Emergency Department Coronary 137

REBEL EM

FEBRUARY 21, 2024

Clinical Scenario: A 34-year-old woman presents to the ED with back pain. Schwartz and colleagues performed an ingenious trial ( Schwartz 2000 ) Enrolled 64 ED patients with acute pain. Can J Emerg Med 2007; 9(1): 30-2. Ann Emerg Med 1995;26:117-20. Acad Emerg Med; 1998; 5(2): 118-122.PMID: 2019; 36: 401-6.

E-9-1-1 64

E-9-1-1 Emergency Department ALS ED 64

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. Am J Emerg Med.

STEMI 118

STEMI Emergency Department Coronary OR 118

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. On arrival in the emergency department, invasive blood pressure was 35/15mmHg and the patient was in profound cardiogenic shock with severe confusion secondary to brain hypoperfusion.

Coronary 125

Coronary ACS Emergency Department Defibrillator 125