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National Assessment of Pediatric Readiness of US EmergencyDepartments during the Covid-19 Pandemic. July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC. Are general emergencydepartments ready to care for children?
Case: The Chief of Emergency Medicine (EM) at a large urban hospital recently approached the AI Committee at Unity Health, intrigued by the CMAJ article describing the apparent success of CHARTWatch in detecting early signs of patient deterioration. Background: There are many ways to define artificial intelligence.
GRACE-3 guidelines included emergency physicians, oto-neurologists, neuro-otologists, and patient advocates. Dizziness Background Acute dizziness represents ~1-3% of ED visits and has a disproportionately high cost, resource use, and length of stay, largely due to imaging (much of which is unnecessary). Only about 3.2-6%
A 36-year-old male presents to the emergencydepartment after being found down at home by his spouse. Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. This series provides evidence-based updates to previous posts so you can stay current with what you need to know.
Well keep it short, while you keep that EM brain sharp. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. A 75-year-old woman who is bedridden after a stroke presents to the ED from a nursing facility with abdominal pain and constipation. Annals of emergency medicine, 82(1), 3746.
The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. AEM February 2024.
Dr. Casey Patrick is the EMS medical director of Montgomery County Hospital District (Texas). As an EM physician, he shares how he decides to care for his own patients in the ED who present with rapid atrial fibrillation. There should be a 2-hour limit before you can give Diltiazem, or rate control, in the EmergencyDepartment.
Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the EmergencyDepartment: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Annals of EM 2024. Annals of EM 2024. It is used at lower doses than those required for anesthesia (0.1–0.3
He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 70-year-old woman was brought into the emergencydepartment by EMS after her family reported she was having trouble talking.
Literature Review Few case studies have touched on the subject of terminal extubation performed by EMS providers during the initial patient contact. More commonly, patients are transported to the EmergencyDepartment (ED), where extensive conversations between ED providers and family occur.
If a lack of translation can have tragic consequences, the obligation of an ED to set a new and better standard of care for communicating with patients is now painfully clear. The post WTBS 19 Does Poor Access to Language Services Leave EmergencyDepartments Primed for Tragedy? appeared first on Emergency Medicine Cases.
A Prospective Randomized, Double-Dummy Trial Comparing Intravenous Push Dose of Low Dose Ketamine to Short Infusion of Low Dose Ketamine for Treatment of Moderate to Severe Pain in the EmergencyDepartment. Guest Skeptic: Dr. Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas.
His research focuses on the pre-hospital care of children by EMS. He is the principal investigator for EMSC State Partnership in Washington, DC and is also involved in various multi-center EMS studies with the Pediatric Emergency Care Applied Research Network (PECARN). EMS placed him in a C-collar and brought him to you.
Authors: Amelia Campbell, MD (EM Resident Physician, Carl R. Darnall Army Medical Center) and Alec Pawlukiewicz, MD (EM Attending Physician, Carl R. Case: A 45-year-old woman presents to the emergencydepartment (ED) with itching to bilateral palms. How does cholestasis present? Mayo Clin Proc. Hepatol Commun.
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 EmergencyDepartment. More specifically, we identified 2 AIR and 4 Honorable Mentions.
How and when to reverse anticoagulation in the bleeding EM patient. Anticoagulant Reversal Strategies in the EmergencyDepartment Setting: Recommendations of a Multidisciplinary Expert Panel. Ann Emerg Med. 2020;76(4):470-485. doi:10.1016/j.annemergmed.2019.09.001 2019.09.001 Eikelboom JW, Quinlan DJ, van Ryn J, Weitz JI.
Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the EmergencyDepartment: A Randomized Controlled Trial. Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the EmergencyDepartment: A Randomized Controlled Trial.
Emergency Medical Services (EMS) is called and on arrival the patient is walking but has obvious facial trauma and is complaining of some neck pain. As an EMS crew member, you are tasked with deciding what method of spinal motion restriction to use. He has midline neck tenderness but no limb numbness or paresthesia.
She is also the local director of the difficult airway EMS course at Washington State. Case: EMS arrives with a 58-year-old woman who suffered an out-of-hospital cardiac arrest (OOHCA). When emergencydepartment (ED) staff roll her to remove her clothing her humeral intraosseous (IO) is dislodged. February 2024.
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 EmergencyDepartments as we try to make staff feel safe and ensure patients can access the care they need.
Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the EmergencyDepartment. JAMA Network, 2023 Background Computed tomography of the abdomen and pelvis (CT AP) is the most common diagnostic imaging test to evaluate abdominal pain in the ED. Read More Shaish H, Ream J, Huang C, et al.
Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Managing editor of EM:RAP and Associate Editor at REBEL EM. first appeared on The Skeptics Guide to Emergency Medicine. Managing editor of EM:RAP and Associate Editor at REBEL EM.
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 EmergencyDepartment. More specifically, we identified 3 AIR and 5 Honorable Mentions.
Trauma season is at hand and like all other pediatric emergencydepartments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. The post Rebaked Morsel: Pediatric Buckle and Greenstick Forearm Fractures appeared first on Pediatric EM Morsels. A prospective, randomised trial.
It’s been another trying flu season in the northern hemisphere—for patients and for emergencydepartment (ED) providers. The post WTBS 15 Planning to Fail: Why Warning Patients to Stay Away from the ED Will Never Work appeared first on Emergency Medicine Cases.
Background: The emergencydepartment is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines. Return Encounters in EmergencyDepartment Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal.
Jesse McLaren outlines 10 Quality Improvement (QI) opportunities for reducing missed AMIs and the lessons learned from Ontario’s EmergencyDepartment Return Visit Quality Program in this Waiting to Be Seen blog.
Case: A 65-year-old man is brought into the emergencydepartment (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table. When he arrives at your ED, the family tells you he was doing fine until dinner.
A young woman, 13 days post-tonsillectomy, comes into your rural emergencydepartment (ED) coughing up blood. Managing post-tonsillectomy hemorrhage in the ED can be challenging, especially in rural or resource-limited settings. Dr. Helman is an emergency physician at North York General Hospital in Toronto.
The Problem: Emergency Medicine (EM) in Pakistan has moved from developing to developed stage in the last decade [1]. It is an innovation that is based on a community of practice merged with the need-based assessment of a young EM residency program in a developing country. Read more publications from the series. 2022;38(6):1717.
A 10-year-old male with no past medical history presents to the EmergencyDepartment (ED) by EMS for evaluation of an injury sustained while playing tackle football. The patient was forcibly hit by another child against a tree.
Concussions are commonly encountered in the EmergencyDepartment. Concussion – Presentation [ Silverberg, 2023 ] There is no definitive test to diagnose concussion in the ED. The post Return to Learn / Return to Sport after Concussion appeared first on Pediatric EM Morsels. Br J Sports Med. 2023 Jun;57(11):695-711.
With a new protocol and Pulsara, Metropolitan Emergency Medical Services can now transport eligible pediatric behavioral health patients directly to behavioral health facilities—resulting in a 44% decrease of pediatric behavioral health patients transported to the ED. Download the case study or read on to learn more!
We’ll keep it short, while you keep that EM brain sharp. A 27-year-old male presents to the ED for left eye pain after being hit in the face with a spare car part while working under the hood of his car. What is the diagnosis, and how do we manage it from the ED? Overview of Eye Injuries in the EmergencyDepartment.”
A Multicenter Program to Implement the Canadian C-Spine Rule by EmergencyDepartment Triage Nurses. Annals of EM Oct 2018 Guest Skeptic: Alison Armstrong is an EmergencyDepartment Nurse, TNCC Course Director, Trauma Program Coordinator and Canadian C-Spine Rule Nurse Champion.
To get a sense of how medical students feel about emergency medicine, we interviewed three students who are interested in EM: Nick, a graduating M4 pre-matched into EM residency, Charlotte, an M2 currently planning to pursue EM, and Annie, an M1 considering EM. What sparked your interest in emergency medicine?
To get a sense of how medical students feel about emergency medicine, we interviewed three students who are interested in EM: Nick, a graduating M4 pre-matched into EM residency, Charlotte, an M2 currently planning to pursue EM, and Annie, an M1 considering EM. What sparked your interest in emergency medicine?
JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? first appeared on The Skeptics Guide to Emergency Medicine.
In many emergencydepartments (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 emergencydepartments in Denmark Duration: October 9, 2019 to May 26, 2021.
We’ll keep it short, while you keep that EM brain sharp. A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. Ann Emerg Med. Available at: [link].
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 EmergencyDepartment. Ann Emerg Med. 2023;82(1):55-65. doi: 10.1016/j.annemergmed.2023.02.011
We’ll keep it short, while you keep that EM brain sharp. A 68-year-old male with a history of poorly controlled diabetes presents to the ED with increasing right-sided ear and facial pain, swelling, and difficulty hearing for two weeks. He says the pain is worse at night and when he is chewing. and Staphylococcus spp.
Chris Bond is an emergency medicine physician and Assistant Professor at the University of Calgary. Case: You are an administrator responsible for staffing emergencydepartments (EDs) in a health care system comprising both urban and rural locales. The SGEM has done two previous podcasts on APPs in the ED.
We’ll keep it short, while you keep that EM brain sharp. A 24-year-old male presents to the ED from a mixed marital arts competition after being struck on the side of the right head by a fist earlier today. A 21-year-old man presents to the emergencydepartment for pain and swelling in his ear beginning 3 days ago.
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