ALiEM

OCTOBER 30, 2024

Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids.

E-9-1-1 161

E-9-1-1 Naloxone Emergency Department ALS 161

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

The Skeptics' Guide to EM

OCTOBER 21, 2023

Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Population: Adults attending at continuously-staffed EDs in a health network covering 15 states, 2016-19.

Emergency Department 338

Emergency Department ALS ED OR 338

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Case: It is a steady Saturday afternoon in your rural emergency department (ED). Reference: Snelling et al.

Critical Care 347

Critical Care ALS ED Emergency Department 347

Medic Mindset

NOVEMBER 13, 2024

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 Emergency Department. Casey Patrick is the EMS medical director of Montgomery County Hospital District (Texas).

Paramedic 98

Paramedic Emergency Department EMS ED 98

The Skeptics' Guide to EM

AUGUST 17, 2019

Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

APRIL 13, 2024

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 emergency department by EMS after her family reported she was having trouble talking. CT perfusion showed a 10 mL core and 189 mL penumbra.

ALS 345

ALS Emergency Department OR EMS 345

The Skeptics' Guide to EM

OCTOBER 28, 2023

He is also one of the world’s leading researchers on pain management in the emergency department, specifically the use of ketamine. His twitter handle is @PainFreeED. He states that pain is severe (7/10 in intensity), sharp, constant, non-radiating, and is exacerbated by any movement.

ALS 268

ALS Emergency Department ED OR 268

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. Conflict in emergency medicine: A systematic review. Reference: Tjan et al.

ED 242

ED ALS Emergency Department OR 242

REBEL EM

JULY 1, 2024

Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. There are very limited studies however in the literature on the AVAPS mode of NIPPV. Paper: Goren NZ et al. Balkan Med J 2021. AVAPS: 0.07 AVAPS: 10.20 AVAPS: 0.07

ED 132

ED Emergency Department ALS OR 132

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. ED visits /1000 adults with diabetes [1]. He is otherwise healthy.

ICU 276

ICU ED Critical Care ALS 276

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Date: March 22, 2023 Reference: Hilsden et al.

ED 130

ED Critical Care Emergency Department ALS 130

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.

ED 97

ED OR Emergency Department Ambulance 97

The Skeptics' Guide to EM

AUGUST 28, 2021

Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. Case: A forty-year-old woman presents to the emergency department […] The post SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED?

ED 130

ED Emergency Department ALS OR 130

The Skeptics' Guide to EM

JUNE 1, 2024

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). Population: Children (aged 0 to <18 years) who underwent blunt trauma evaluation in emergency departments. (ED)

Emergency Medical Services 221

Emergency Medical Services Emergency Department EMS ALS 221

The Skeptics' Guide to EM

NOVEMBER 11, 2023

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. Background: Fractures of the scaphoid are the most common carpal fractures presenting to the ED.

ALS 329

ALS Emergency Department ED OR 329

ALiEM

JUNE 1, 2023

Are you using phenobarbital instead of benzodiazepines as the first-line monotherapy for patients in alcohol withdrawal in the Emergency Department (ED)? Is phenobarbital safe for the treatment of EtOH withdrawal in the ED? The Journal of Emergency Medicine. Open Access Emerg Med. Well not exactly.

Emergency Department 246

Emergency Department ICU ED OR 246

St. Emlyn's

JUNE 1, 2024

St.Emlyn's - Emergency Medicine #FOAMed Journal club review of an RCT on the use of nebulised ketamine use in the emergency department. FOAMed @stemlyns The post JC: Is nebulised ketamine an option in the ED? Yet another route for ketamine? Or maybe not?? appeared first on St.Emlyn's.

ED 103

ED Emergency Department OR 103

The Skeptics' Guide to EM

NOVEMBER 19, 2022

Intimate partner violence (IPV) in the Emergency Department (ED). 2022 Nov Guest Skeptics: Dr. Nour Khatib is an emergency physician in Toronto working in community sites Markham Stouffville Hospital and Lakeridge health. Intimate partner violence (IPV) in the Emergency Department (ED).

Emergency Department 102

Emergency Department ED OR 102

REBEL EM

MAY 11, 2023

Background: The emergency department 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 Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal.

Emergency Department 95

Emergency Department ED EMR OR 95

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Managing post-tonsillectomy hemorrhage in the ED can be challenging, especially in rural or resource-limited settings. On exam, you see bright red blood trickling down her left tonsillar fossa.

Operating Room 98

Operating Room Epinephrine ALS ED 98

The Skeptics' Guide to EM

JUNE 17, 2023

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. 1-6] Children with SCD presenting to the ED with VOE require timely and effective pain control. Opioids are the primary therapy.

Emergency Department 186

Emergency Department ALS ED OR 186

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

ALiEM

MARCH 18, 2024

A 30-year-old female with a past medical history of Crohn’s Disease presented to the ED for evaluation of an acutely bruised right 4th finger. Shortly after that, the finger turned purple, so she came to the Emergency Department for evaluation. She denied pain in the hand and has had no problems moving the finger.

Emergency Department 306

Emergency Department ED OR 306

Core EM

JANUARY 25, 2024

We go over the essential and complex topic of vasopressors in the ED.

Epinephrine 246

Epinephrine Critical Care ED Emergency Department 246

Pediatric EM Morsels

APRIL 19, 2024

Trauma season is at hand and like all other pediatric emergency departments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. We see all different flavors of upper extremity injuries. The minority of parents would have wanted clinic follow up (6%) and reimaging (14%).

ALS 290

ALS ACS Emergency Department ED 290

EMDocs

OCTOBER 9, 2023

Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. He states that he recently moved to Texas from Colorado.

ED 110

ED Life Support Advanced Life Support CPR 110

Core EM

JANUARY 25, 2024

The Case A 41-year-old male presents to the ED with constant palpitations for one day. Case Outcome: The patients EKG performed in the ED showed a Wide Complex Tachycardia at a rate of 142 bpm. The differential diagnosis for this patient includes Ventricular Tachycardia (VT) and Supraventricular Tachycardia (SVT) with aberrancy.

Coronary 246

Coronary Emergency Department ED OR 246

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

ALiEM

AUGUST 7, 2023

A 10-year-old male with no past medical history presents to the Emergency Department (ED) by EMS for evaluation of an injury sustained while playing tackle football. The patient was forcibly hit by another child against a tree. The patient is reluctant to abduct the right arm secondary to pain.

Emergency Department 246

Emergency Department OR EMS ED 246

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 106

ED Emergency Department OR 106

Dr. Smith's ECG Blog

MARCH 28, 2024

male with pertinent past medical history including Atrial fibrillation, atrial flutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia. Here is the prehospital ECG: First ED ECG What do you think? SVT with aberrancy?

OR 128

OR Emergency Department EMS Ambulance 128

The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. Reference: Ramesh S, Ayyan SM, Rath DP, Sadanandan DM. AEM April 2024 Date: April 19, 2024 Guest Skeptic: Dr. Suchismita Datta.

Emergency Department 218

Emergency Department Overdose ALS ED 218

Core EM

JANUARY 25, 2024

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%

EMS 246

EMS Emergency Department OR ED 246

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 128

ED E-9-1-1 Emergency Department ALS 128

Core EM

JANUARY 8, 2024

Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department. 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. This was the reference standard.

Emergency Department 100

Emergency Department EMS ED ALS 100

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. But what exactly are neurodivergence and neurodiversity?

Emergency Department 52

Emergency Department ED OR ALS 52