ALiEM

SEPTEMBER 11, 2023

A 29-year-old female with a past medical history of migraine headaches presented to the emergency department (ED) for several hours of bilateral eye pain, redness, and decreased visual acuity. The patient is a contact lens wearer. The night prior to presentation at 18:00, the patient inserted her contacts that she had washed and soaked in a hydrogen peroxide (H2O2) cleaning solution.

Emergency Department 152

Emergency Department ED OR 152

ACEP Now

SEPTEMBER 11, 2023

Ben Mattingly, MD, tries to live by the adage, “One should be adventurous and daring, but not reckless.” The challenge is that the line between adventurous and reckless is often paper-thin. Take, for example, his recent expedition to Nepal to summit Mount Everest. When he arrived at the base camp, he found out three rope-fixing sherpas had just been killed in the famously dangerous Khumbu Icefall.

126

126

First 10 EM

SEPTEMBER 11, 2023

This is a guest post by Dr. Lanujan Kaneswaran. Lanujan is a second-year Family Medicine resident at the University of Toronto. He has a background in medical health informatics and machine learning. His areas of interest include artificial intelligence and machine learning in medicine, and health equity through advocacy and technology. When managing atrial fibrillation […] The post Can we use D-dimer to assess for left atrial clot in atrial fibrillation?

122

122

EMergucate

SEPTEMBER 11, 2023

Answers: Question 1 answer: PH = 7.315, that is mild acidaemia. pCO2 = 48 mmHg. For venous blood, pCO2 level up to 48 mmHg is considered normal (40 for arterial blood).

100

100

EM Literature of Note

SEPTEMBER 11, 2023

Well, PRISMS demonstrated unfavorable results. MARISS tried to ascertain predictors of poor outcome in mild stroke, and intravenous thrombolysis was not associated with an effect on the primary outcome. Now, again, we examine thrombolysis in “mild” stroke, in this case, NIHSS ≤3 – and fail. Like MARISS, this is a retrospective dredge of patients selected by the treating clinicians to receive either intravenous thrombolysis or, in this case, dual-antiplatelet therapy with clopidogrel

OR 118

OR 118

Don't Forget the Bubbles

SEPTEMBER 11, 2023

5-year-old Willow arrives in the ED at 3 a.m. Her mum says she has been waking up screaming on the last few nights, clutching her vulval area and saying it hurts. Her parents have noticed she is scratching her bottom a lot, too, and they’ve had an email from school saying there are cases of threadworms in the reception class. Threadworms ( Enterobius vermicularis , also known as pinworms or seatworms) are the most common helminthic infection in the Western World.

OR 116

OR ED 116

EMergucate

SEPTEMBER 11, 2023

32-year-old man presented to ED with an exacerbation of his asthma. On 3L O2, his arterial blood gases showed the following: PH = 7.

ED 100

ED 100

ACEP Now

SEPTEMBER 11, 2023

Networking and making new friends in the specialty is one of the best parts about ACEP events like the upcoming 2023 Scientific Assembly, but it’s also a bit mysterious. How exactly does one “work the room” and start conversations with strangers? It can feel unnatural, right? The leaders of ACEP’s Young Physician Section have been successful growing their networks, and these are their best tips for how to use your time at ACEP23 to meet new people and connect with peers across the country: “Cont

OR 52

OR 52

The FllightBridge ED

SEPTEMBER 11, 2023

September 11, 2001, and the Mental Health of First Responders The tragic events of September 11, 2001, have left an indelible mark on the world’s…

First Responder 52

First Responder 52

EMCrit Project

SEPTEMBER 11, 2023

Another amazing lecture from Cliff Reid EMCrit Project by Scott Weingart, MD FCCM.

70

70

University of Maryland Department of Emergency Med

SEPTEMBER 11, 2023

When patients fail simple respiratory support therapies like nasal cannula or non-rebreather, it is often a point of debate whether to mo.

OR 58

OR 58

The FllightBridge ED

SEPTEMBER 11, 2023

Since the 2012 Berlin Definition of the Acute Respiratory Distress Syndrome (ARDS), several developments have supported the need for an expansion of the definition, including…

40

40

ACEP Now

SEPTEMBER 11, 2023

The best questions often stem from the inquisitive learner. As educators, we love—and are always humbled by—those moments when we get to say, “I don’t know.” For some of these questions, you may already know the answers. For others, you may never have thought to ask the question. For all, questions, comments, concerns, and critiques are encouraged. Welcome to the Kids Korner.

ALS 52

ALS Emergency Department OR 52

REBEL EM

SEPTEMBER 11, 2023

Background: Point of care ultrasound (POCUS) has a demonstrated sensitivity of 89.8% and specificity of 88.0% for identification of cholelithiasis and has a proven negative predictive value for ruling out other acute biliary pathology such as acute cholecystitis. 1 It is a quickly deployable and easily interpreted study that can be done in real time to guide decisions in the Emergency Department.

ED 61

ED ACS Emergency Department OR 61