Core EM

JANUARY 25, 2024

Differentiating between the two is difficult as multiple proposed diagnostic criteria have yet to demonstrate sufficient sensitivity or specificity for a definitive diagnosis. The differential diagnosis for this patient includes Ventricular Tachycardia (VT) and Supraventricular Tachycardia (SVT) with aberrancy.

Coronary 246

Coronary Emergency Department ED OR 246

Pediatric EM Morsels

AUGUST 23, 2024

Concussions are commonly encountered in the Emergency Department. Concussion – Presentation [ Silverberg, 2023 ] There is no definitive test to diagnose concussion in the ED. We have previously discussed an approach to the question of when a patient “ can return to sport.”

Emergency Department 281

Emergency Department OR ED EMS 281

ACEP Now

NOVEMBER 8, 2024

First, research suggests a higher number of emergency department visits among individuals with ASD. About 30 percent of children with ASD need treatment in an emergency department, and this number increases to nearly 70 percent for those aged 15–18. Seeing the unseen: neurodiversity in the emergency department.

Emergency Department 52

Emergency Department ED OR ALS 52

ACEP Now

JUNE 7, 2023

The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding. Preliminary results of the survey are being released to help emergency physicians understand that current challenges are occurring nationwide.

Emergency Department 52

Emergency Department ED EMS Ambulance 52

Pediatric EM Morsels

JULY 19, 2024

The definitions, typical healing course, timing of bleed, indications for tonsillectomy and the procedure itself have not changed much since our original morsel. If bleeding, the only lab that is needed in the Emergency Department is a type and cross. CBC, coagulation panels, von Willebrand factor etc are less useful.

E-9-1-1 290

E-9-1-1 Epinephrine OR Emergency Department 290

REBEL EM

NOVEMBER 6, 2024

Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. J Emerg Med. Anatomy, Shoulder and Upper Limb, Radial Nerve. 2023 Nov 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30521261 Gottlieb M, Schiebout J. 2018 Jun;54(6):849-854. doi: 10.1016/j.jemermed.2018.02.011.

E-9-1-1 114

E-9-1-1 ACS OR Emergency Department 114

ALiEM

DECEMBER 18, 2023

A 19-year-old female with a past medical history of epilepsy presented to the emergency department for evaluation of rash and fever. The regiSCAR diagnostic criteria is the most used diagnostic criteria and is based on a scoring system for possible, probable, or definite diagnosis.

Emergency Department 177

Emergency Department OR 177

ALiEM

MARCH 22, 2024

A 53-year-old woman with no significant past medical history presented to the emergency department with a 3-day history of double vision on leftward gaze. Hence, it is critical that a definitive workup is carried out to determine the etiology of the INO. A case series revealed that 1 in 5 patients failed to recover from an INO.

Emergency Department 169

Emergency Department OR 169

REBEL EM

MARCH 27, 2023

Background Information: Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. N Engl J Med. Crit Care Explor.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

Case: You are working the afternoon shift in the paediatric emergency department. Your shift is almost over and the department finally seems to be under control. Emlyn’s blog and podcast since 2012. We appeared on stage at SMACC Chicago doing a parody of Jimmy Fallon’s Tight Pants skit.

Emergency Department 130

Emergency Department ALS OR 130

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

Emergency Department 135

Emergency Department ED OR ALS 135

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. 2022 Sep 7.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

Don't Forget the Bubbles

SEPTEMBER 6, 2023

14-year-old Katy presents to the paediatric Emergency Department (ED), alone, complaining of suicidal ideation. Another study observed that children and young people who received unnecessary medical screening laboratory investigations would have received definitive psychiatric care on average 6.8 Acad Emerg Med.

Emergency Department 119

Emergency Department ED ALS Overdose 119

Core EM

JUNE 3, 2024

Hosts: Jonathan Kobles, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Agitation , psychiatry , Toxicology Show Notes Background/Epidemiology • Definition and Scope : Agitation encompasses behaviors from restlessness to severe altered mental states.

Emergency Department 130

Emergency Department OR 130

EMDocs

DECEMBER 11, 2023

In October 2022, the American College of Cardiology released an updated expert consensus decision regarding the evaluation of chest pain in the emergency department. This included the addition several new STEMI equivalents [4] on ECG that warrant “prompt evaluation for emergency coronary angiography.” J Am Coll Cardiol.

STEMI 120

STEMI Coronary Emergency Department OR 120

Dr. Smith's ECG Blog

JANUARY 27, 2024

, tells us that we physicians do not need to even look at this ECG until the patient is placed in a room because the computer says it is normal: Validity of Computer-interpreted “Normal” and “Otherwise Normal” ECG in Emergency Department Triage Patients I reviewed this article for a different journal and recommended rejection and it was rejected.

STEMI 116

STEMI Coronary ACS ED 116

The Skeptics' Guide to EM

NOVEMBER 1, 2022

AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency department (ED) with his first time anterior should dislocation after trying to recreate one of his favourite scenes in the movie Lethal Weapon.

ALS 122

ALS Emergency Department OR ED 122

The Skeptics' Guide to EM

FEBRUARY 2, 2018

In her spare time, Melissa also enjoys being the fellowship director to an amazing group of PEM trainees. Case: Brian is a 14-year-old male who presents to the emergency department (ED) complaining of acute onset testicular pain. He has vomited twice, but there is no history of any fever or trauma.

Operating Room 100

Operating Room Emergency Department ALS ED 100

ACEP Now

DECEMBER 6, 2024

By some definitions, you could call former Maryland state legislator Dan Morhaim, MD, FACEP, a retired emergency physician. 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. Click to enlarge.)

Emergency Department 98

Emergency Department ED Ambulance OR 98

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Without a clear definition, tailoring research and audit is difficult.

Emergency Department 78

Emergency Department Critical Care ALS OR 78

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

The Skeptics' Guide to EM

DECEMBER 16, 2017

Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. Case: Johnny is a 22-year-old male patient who presents to the emergency department via EMS with a seizure.

ALS 100

ALS ICU Emergency Department Paramedic 100

Dr. Smith's ECG Blog

SEPTEMBER 8, 2023

A 50 year old presented to the emergency department of a remote rural community (where the nearest cath lab is a plane ride away) with one hour of mild chest pain radiating to the back and jaw, and an ECG labeled ‘normal’ by the computer interpretation.

OR 128

OR STEMI Coronary Emergency Department 128

REBEL EM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. J Med Toxicol. Epub 2019 Jul 3. Intensive Care Med.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

ACEP Now

AUGUST 14, 2024

grams of IV magnesium to placebo, doses considerably higher than the two grams of magnesium often administered in the emergency department (ED). Second, the outcomes definitions rate and rhythm control at four and 24 hours are far beyond times relevant in emergency medicine in the U.S. J Emerg Med. Circulation.

ALS 105

ALS Emergency Department ED OR 105

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. and 100%, respectively.

EMS 106

EMS E-9-1-1 Emergency Department Ambulance 106

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. A 41-year-old male with no significant past medical history presents with a deep hand laceration. Examination reveals the following: What is the diagnosis?

EMS 97

EMS ALS Emergency Department ED 97

EMDocs

AUGUST 8, 2023

Cremasteric reflex Classically absent/diminished in torsion, but cannot definitively rule in or out torsion. Management: Definitive therapy = surgical exploration, detorsion, and fixation of the testicle. Just the facts: assessment and management of testicular torsion in the emergency department.

ALS 96

ALS OR Emergency Department 96

Dr. Smith's ECG Blog

JUNE 11, 2024

Emergency department Code STEMI patients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review. Acad Emerg Med 2024;31:296-300 == MY Comment , by K EN G RAUER, MD ( 6/6 /2024 ): == Recognition of repolarization variants can be challenging.

STEMI 112

STEMI Coronary Emergency Department OR 112

REBEL EM

APRIL 29, 2024

World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med 2009 PMID: 20157465 4. Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies. Ngo AS, Oh JJ, Chen Y, Yong D, Ong MEH.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

ACEP Now

AUGUST 1, 2023

Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. So, to that end, I don’t believe there is a “balance” when it comes to board certified emergency physician anything and scope of practice for non-physicians anything.

Emergency Department 98

Emergency Department EMS ED OR 98

GEDC

MAY 29, 2024

EMED Toolkit Spotlight: Louis Stokes Cleveland VA Medical Center In this new spotlight series, GEDC highlights hospitals that have successfully implemented the National Collaboratory to Address Elder Mistreatment’s Elder Mistreatment Emergency Department (EMED) Toolkit.

Emergency Department 52

Emergency Department EMS OR 52

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. ECG 2 What do you think?

E-9-1-1 129

E-9-1-1 OR Coronary ACS 129

REBEL EM

DECEMBER 5, 2023

This varied incidence can be due to inconsistent definitions or inclusion of mild reactions. Incidence of clinically important biphasic reactions in emergency department patients with allergic reactions or anaphylaxis. Annals of Emergency Medicine 2014 Jun;63(6):736-44 Lee S, Bellolio F, Hess E, Erwin P, Murad M, Campbell R.

Epinephrine 81

Epinephrine Allergic Reaction Emergency Department Emergency Management 81

REBEL EM

AUGUST 30, 2023

REBEL Core Cast 107.0 – Vertebral Osteomyelitis Click here for Direct Download of the Podcast Definition Inflammation of the vertebrae due to a pyogenic, fungal or mycobacterial organism. Evaluation and Treatment of Acute Back Pain in the Emergency Department. Orthopedic Emergencies 2015 May; 33(2) 311-26.

E-9-1-1 96

E-9-1-1 ALS ED OR 96

Dr. Smith's ECG Blog

JUNE 27, 2024

Smith comment: Go here for a comprehensive blog post on syncope and link to the most detailed version of the Canadian Syncope Rule: Emergency Department Syncope Workup. Further evidence against there being complete AV block — is the presence of a definite "pattern" to these rhythms, with 2 PR intervals that continually repeat.

ED 119

ED OR Emergency Department Emergency Management 119

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Adult cardiac arrest in the emergency department – A Swedish cohort study. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. Circulation. 2018;137(12). Kimblad H, et al. Resuscitation.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98