The Skeptics' Guide to EM

MAY 25, 2024

He has been involved in ED-based clinical research examining ways to improve care for patients with alcohol use disorder in the ED for over two decades. Case 1: A patient presents to the ED with nausea, vomiting and some abdominal pain complaining of alcohol withdrawal. This is an SGEM HOP but with a twist.

ED 254

ED Emergency Department ICU ALS 254

EMOttawa

JANUARY 9, 2025

From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED).

ED 113

ED Emergency Department Critical Care 113

The Skeptics' Guide to EM

NOVEMBER 16, 2024

With emergency department (ED) volumes rising, administrators are eager to explore AI-driven solutions to improve patient safety and reduce staff burnout. They want to know how CHARTWatch integrates with electronic health records (EHRs), whether it can adapt to their patient ED population, and how clinicians respond to using the tool.

ICU 277

ICU Emergency Department ALS EMS 277

Emergency Medicine Cases

MAY 28, 2024

Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr. Katie Lin and Dr. What can we do in the ED to prevent rebleeding in patients with subarachnoid hemorrhage?

ED 130

ED EMS 130

EM Board Bombs

MARCH 10, 2025

-Case- A 30-year-old woman at 34 weeks gestation arrives at the ED complaining of a pounding headache, blurry vision, and swelling in her hands and face over the past few days. Her blood pressure reads 168/102 mmHg, has bilateral 2+ pitting edema of the lower extremities, and she has 3+ proteinuria on urine dipstick. -Evaluation-

ED 52

ED 52

REBEL EM

JULY 1, 2024

The AVAPS mode is as effective and safe as BPAP S/T in treating patients with hypercapnic respiratory failure in the ED.” Clinical Take Home Point: I n patients presenting to the ED with hypercapnic respiratory failure, AVAPS did lead to a faster improvement in pH and PaCO2 levels compared to BPAP S/T. AVAPS: 0.07 AVAPS: 10.20

ED 129

ED Emergency Department ALS OR 129

St. Emlyn's

FEBRUARY 27, 2024

St.Emlyn's - Emergency Medicine #FOAMed A review of Acute on Chronic Liver Disease (ACLD / decompensated liver disease) in the ED. Liver disease in the ED. How we can improve patient outcomes. FOAMed @stemlyns The post Decompensated. St Emlyn’s appeared first on St.Emlyn's.

ED 128

ED Critical Care 128

EMOttawa

OCTOBER 24, 2024

Historically, it has been used more frequently in the ICU than in Emergency Departments, likely due to provider comfort. […] The post Is there a Precedence for Precedex in the ED? appeared first on EMOttawa Blog.

ED 125

ED Critical Care ICU Emergency Department 125

St. Emlyn's

MAY 24, 2024

stemlyns #FOAMed The post JC: Serratus Anterior Plane Blocks for rib fractures in the ED. St.Emlyn's - Emergency Medicine #FOAMed JC: Review of an RCT of serratus anterior plane blocks in the emergency department for chest/rib injury. Is this now a standard of care? St Emlyn’s appeared first on St.Emlyn's.

ED 128

ED Emergency Department 128

ALiEM

JANUARY 13, 2025

Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. A 55-year-old female presented with the complaint of my right eye popped out. She endorsed right eye blurred vision and severe pain.

Emergency Department 169

Emergency Department ED ALS OR 169

The Skeptics' Guide to EM

DECEMBER 16, 2023

Case: A 57-year-old Chinese woman presents to the emergency department (ED) with chest pain. Background: Patient experiences of care are associated with health outcomes and may impact perspectives of ED care and the patient recovery process.(1-5) 6-7) We looked at deaf and hard-of-hearing patients in the ED on SGEM#383.

Emergency Department 322

Emergency Department ED ALS OR 322

EMDocs

SEPTEMBER 30, 2024

Today’s video evaluates inhaled corticosteroids (ICS) for asthma in the ED setting. EBM Updates: Inhaled Corticosteroids for Asthma in the ED Background : Asthma is a common ED issue, with patient presentations ranging from needing a medication refill to severe exacerbation in respiratory failure.

ED 105

ED Emergency Department OR 105

The Skeptics' Guide to EM

OCTOBER 21, 2023

Case: You are in your group meeting and have heard about a case at a nearby emergency department (ED) where the […] The post SGEM#418: I Ain’t Missing You – Spinal Epidural Abscess first appeared on The Skeptics Guide to Emergency Medicine. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals.

Emergency Department 338

Emergency Department ALS ED OR 338

GEDC

FEBRUARY 27, 2025

Cleveland Clinic’s Geriatric Emergency Department (GED) model has significantly reduced hospital admissions and improved care for older emergency department (ED) patients. It operates in all 13 Cleveland Clinic EDs, with positive results: 17% admission rate for those seen by the geriatric team, compared to 55% for those not seen.

ED 40

ED Emergency Department 40

Emergency Medicine Cases

MAY 28, 2024

Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. What can we do in the ED to prevent rebleeding in patients with subarachnoid hemorrhage? Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done.

ED 320

ED EMS 320

EMS 12-Lead

MAY 15, 2024

Crew notifies the received ED of an incoming post-arrest patient and notes a sinus bradycardia on their monitor, as seen in Figure 2. On arrival at the ED, the leads are ripped off the patient and the pacemaker fires in non-demand mode for several minutes, as seen in Figure 7. Pacing was continued in the ED, with identical settings.

Epinephrine 331

Epinephrine Paramedic CPR EMT 331

Core EM

OCTOBER 16, 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

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

The Skeptics' Guide to EM

JANUARY 6, 2024

Case: After your shift in the emergency department (ED) one day, the medical director pulls you aside. July 2023 * Population: ED leadership across the United States. million annual pediatric ED visits. * Excluded: EDs that are not open 24 hours a day or 7 days a week. JAMA Netw Open.

Emergency Department 343

Emergency Department Emergency Medical Services ALS ED 343

EMDocs

DECEMBER 18, 2024

fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

E-9-1-1 105

E-9-1-1 Emergency Department ICU ED 105

Emergency Medicine Cases

NOVEMBER 28, 2023

On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine (..)

EMS 303

EMS ED 303

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Casey currently splits his time between Broome, a small rural hospital in the remote Kimberley region of Western Australia, and a large tertiary ED in sunny Perth. Case: It is a steady Saturday afternoon in your rural emergency department (ED). He has been a guest skeptic on the SGEM multiple times.

Critical Care 347

Critical Care ALS ED Emergency Department 347

The Skeptics' Guide to EM

JULY 6, 2024

The emergency department (ED) evaluation reveals an unremarkable chemistry panel with normal renal function and a white blood cell count of 10,000. Background: We have discussed agitation in the ED on the SGEM several times. They are afebrile and tolerate oral intake. These conflicts can ultimately lead to moral injury [1,2,3].

ED 242

ED ALS Emergency Department OR 242

Emergency Medicine Cases

AUGUST 19, 2024

The post Ep 197 Acute Heart Failure Risk Stratification and Disposition appeared first on Emergency Medicine Cases.

ED 313

ED EMS 313

Emergency Medicine Cases

FEBRUARY 27, 2024

Hans Rosenberg on when to use gabapentinoids for pain control in the ED. Nour Khatib and Hamza Jalal on an approach to paresthesias in the ED. Anand Swaminathan on an update on the appropriate selection of induction agents. Katie Lin on pearls for neuroprotective intubation. Eric Wortmann on preventing burnout in emergency medicine.

EMS 283

EMS ED 283

Emergency Medicine Cases

JULY 30, 2024

In this month's EM Quick Hits podcast: Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient, Megan Landes on providing HIV PEP and PrEP in the ED, Justin Morgenstern & George Kovacs on the PREOXI trial and evidence for pre-oxygenation with NIPPV before intubation in RSI, Brit Long on recognition and management of blast (..)

EMS 257

EMS ED 257

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. However, the ICU is full and the patient will likely be boarding in your ED for a bit before coming upstairs.

ICU 276

ICU ED Critical Care ALS 276

ACEP Now

NOVEMBER 7, 2024

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. Wound management in the ED is only a starting point, and appropriate referral and follow-up are key to an improved outcome. Back to the patient.

ED 97

ED OR Emergency Department Ambulance 97

Emergency Medicine Cases

APRIL 23, 2024

The post EM Quick Hits 56 – Nitroglycerin in SCAPE, REBOA, Diverticulitis Imaging, CRAO, Penicillin Allergy, Physician Personality appeared first on Emergency Medicine Cases.

EMS 293

EMS Allergic Reaction ED 293

Core EM

JANUARY 25, 2024

A quick primer on hypocalcemia in the ED. Pfenning CL, Slovis CM: Electrolyte Disorders; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. Hypocalcemia in the critically ill patient. J Intensive Care Med 2013; 28:166. Louis, Mosby, Inc., 2014, (Ch) 125: p 1636-53.

Critical Care 246

Critical Care ED ALS OR 246

The Skeptics' Guide to EM

MARCH 2, 2024

Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Case: A 59-year-old man walks into your community emergency department (ED) complaining of chest pain.

Operating Room 332

Operating Room Emergency Department ALS ED 332

EMS 12-Lead

APRIL 9, 2024

At the time of ED arrival he was alert, oriented, and verbalizing only a headache with a normalized BP. The ED activated trauma services, and a 12 Lead ECG was captured. This was deemed “non-specific” by the ED physicians. Thus, the ED admission ECG changes cannot be blamed on LVH. The fall was not a mechanical etiology.

Coronary 290

Coronary ACS CAD ED 290

Emergency Medicine Cases

DECEMBER 19, 2023

Matt DiStefano answer such questions as:when should we suspect a DRUJ injury, why is it important to pick up DRUJ injuries in the ED, and how does it change our management? When it comes to distal radius fractures, how are Colles vs Barton's vs Smith's fractures managed differently in the ED?

ED 264

ED OR EMS 264

The Skeptics' Guide to EM

OCTOBER 19, 2024

Case: You’re working your usual day shift in the emergency department (ED) from 9 am to 5 pm on a Tuesday. In recent years, ketamine has gained popularity in the ED, particularly for treating acute pain. It is used at lower doses than those required for anesthesia (0.1–0.3 mg/kg, 1 mg/kg, and 1.5 mg/kg up to 120 minutes.

OR 250

OR Emergency Department ED ALS 250

Broome Docs

JANUARY 27, 2025

European Journal of Internal Medicine , [link] You can listen to my 27-minute rant on Youtube here: [link] This multinational trial looked at a three-pronged diagnostic protocol in the ED for adults with suspected acute aortic syndromes. The protocol used the ADD score, a POCUS echo protocol and D-dimer to try and exclude AAS in the ED.

ED 101

ED OR ACS Critical Care 101

Core EM

JANUARY 25, 2024

The SQuID Protocol (Subcutaneous Insulin in Diabetic Ketoacidosis): Impacts on ED Operational Metrics. Fidelity was examined by the frequency of required q2h glucose checks, safety by seeing how many patients required rescue dextrose for hypoglycemia, and operational impacts including ED LOS and ICU admission. Image from cited article.

EMS 246

EMS ICU ED OR 246

ALiEM

JUNE 10, 2024

A 10-year-old boy presents to the emergency department (ED) after a high-speed motor vehicle collision. The study enrolled 22,430 children, aged 0–17 years, presenting with blunt trauma across 18 PECARN-affiliated ED in the US. Case Scenario: What would you do? He complains of neck pain and is reluctant to move his head.

Emergency Department 317

Emergency Department ED OR 317