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 329

Operating Room Emergency Department ALS ED 329

Emergency Medicine Cases

APRIL 2, 2024

In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. The post ECG Cases 49 – ECG and POCUS for Dyspnea and Chest Pain appeared first on Emergency Medicine Cases.

Emergency Department 329

Emergency Department OR STEMI EMS 329

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. hours from onset of symptoms.

ALS 343

ALS Emergency Department OR EMS 343

NAEMSP

JANUARY 19, 2025

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 Emergency Department (ED), where extensive conversations between ED providers and family occur.

EMS 52

EMS Emergency Department CPR ED 52

The Skeptics' Guide to EM

DECEMBER 8, 2017

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 Emergency Department. Guest Skeptic: Dr. Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas.

Emergency Department 130

Emergency Department ALS OR EMS 130

EMDocs

MARCH 4, 2024

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 emergency department (ED) with itching to bilateral palms. How does cholestasis present?

Emergency Department 105

Emergency Department E-9-1-1 ALS OR 105

The Skeptics' Guide to EM

JUNE 1, 2024

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.

Emergency Medical Services 219

Emergency Medical Services Emergency Department EMS ALS 219

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

First 10 EM

SEPTEMBER 23, 2024

I definitely talk to people about smoking, but aside from brief counseling and occasionally prescribing nicotine replacement for […] The post Smoking cessation in the emergency department (The COSTED trial) appeared first on First10EM.

Emergency Department 96

Emergency Department OR EMS 96

NAEMSP

OCTOBER 9, 2024

However, a recent survey revealed that many patients with adrenal insufficiency are hesitant to give themselves their injections, and many Emergency Medicine and EMS Clinicians are unaware of the appropriate treatment for this condition. She had oral hydrocortisone available and handed EMS a sheet explaining her condition.

EMS 122

EMS Crisis Prevention Emergency Department BLS 122

The Skeptics' Guide to EM

JULY 29, 2023

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.

Emergency Medical Services 246

Emergency Medical Services ALS EMS Emergency Department 246

The Skeptics' Guide to EM

APRIL 27, 2024

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 emergency department (ED) staff roll her to remove her clothing her humeral intraosseous (IO) is dislodged. February 2024.

ICU 231

ICU Defibrillator Paramedic CPR 231

ALiEM

FEBRUARY 5, 2024

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 Emergency Department. More specifically, we identified 3 AIR and 5 Honorable Mentions.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

ALiEM

NOVEMBER 3, 2023

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 trauma in the Emergency Department. More specifically, we identified 3 AIR and 5 Honorable Mentions.

Critical Care 211

Critical Care EMS Emergency Department ALS 211

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

Core EM

JANUARY 8, 2024

Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department. Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department. Intravenous (IV) and oral contrast improve diagnostic accuracy of CT AP.

Emergency Department 100

Emergency Department EMS ED ALS 100

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

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. Patient is on rivaroxaben, carvedilol, and dofetilide (to suppress atrial fib -- rhythm control).

OR 129

OR Emergency Department Ambulance EMS 129

FOAMfrat

DECEMBER 26, 2024

IF YOU OR A LOVED ONE NEEDS HELP, CALL 988 OR SEEK CARE AT A LOCAL EMERGENCY DEPARTMENT. WE, AS EMS PROFESSIONALS, SHALL PROVIDE COMPASSIONATE, APPROPRIATE CARE TO ALL PATIENTS. TRIGGER WARNING: TOPICS OF SUICIDE MAY BE HARD FOR SOME PEOPLE TO READ ABOUT. THIS ARTICLE IS COVERING THE MEDICAL ASPECTS OF CHEMICAL SUICIDES.

Epinephrine 116

Epinephrine First Responder OR Emergency Management 116

Pediatric EM Morsels

AUGUST 23, 2024

Concussions are commonly encountered in the Emergency Department. The post Return to Learn / Return to Sport after Concussion appeared first on Pediatric EM Morsels. We have previously discussed an approach to the question of when a patient “ can return to sport.” Br J Sports Med. 2023 Jun;57(11):695-711.

Emergency Department 281

Emergency Department OR ED EMS 281

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

Pediatric EM Morsels

JUNE 7, 2024

Lucky for us, in 2020 there were some updates made to the NIH Asthma Management Guidelines and we’re going to discuss which ones can help us in the Emergency Department! You’re probably asking yourself… is this really important for us in the Emergency Department to know? No more SABA ! Can we decrease corticosteroid use?

Emergency Department 208

Emergency Department EMS OR 208

The Skeptics' Guide to EM

AUGUST 10, 2024

He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 65-year-old man is brought into the emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table.

Emergency Medical Services 224

Emergency Medical Services ALS Emergency Department ED 224

EMDocs

JUNE 8, 2024

We’ll keep it short, while you keep that EM brain sharp. A 32-year-old man presents to the emergency department with eye pain. 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. 95% occupational injuries occur in males [1].

EMS 98

EMS Allergic Reaction Emergency Department ED 98

EMDocs

NOVEMBER 19, 2024

His roommate found an empty pill bottle on the floor next to him. The bottle contained 100 mg quetiapine tablets, and 50 tablets were unaccounted for. Second-generation antipsychotics (see Table 1 below) improve both positive and negative symptoms of schizophrenia and are less likely to be associated with EPS.

Overdose 111

Overdose EMS Emergency Medical Services OR 111

EMDocs

MAY 11, 2024

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. Vital signs include BP 168/89, HR 96, T 98.3,

EMS 110

EMS E-9-1-1 ALS OR 110

ALiEM

OCTOBER 26, 2023

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.

EMS 161

EMS Emergency Department ALS ED 161

The Skeptics' Guide to EM

JANUARY 9, 2021

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.

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

ALiEM

JULY 20, 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 infectious diseases in the Emergency Department. More specifically, we identified 1 AIR and 5 Honorable Mentions.

Emergency Department 188

Emergency Department EMS OR 188

REBEL EM

NOVEMBER 6, 2024

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)

E-9-1-1 114

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

EMDocs

APRIL 13, 2024

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. The patient denies any loss of consciousness, neck pain, vomiting, or use of blood thinners. RR 15, SpO2 99% on room air.

EMS 104

EMS E-9-1-1 OR Emergency Department 104

Pediatric EM Morsels

OCTOBER 27, 2023

Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. 2020) The Times & Tapes Are a-Changin’: The Latest Broselow-Luten Tape for EMS , EMS World.

E-9-1-1 271

E-9-1-1 Emergency Medical Services Life Support ALS 271

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center. CREDIT: Dr. P.

Operating Room 98

Operating Room Epinephrine ALS ED 98

Pulsara

JANUARY 25, 2024

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!

Emergency Medical Services 114

Emergency Medical Services EMS STEMI Emergency Department 114

Pediatric EM Morsels

MARCH 15, 2024

We encounter seizures commonly in the Emergency Department. While they can be dramatic and devastating, we have learned to become comfortable with the wide variety that may present in children. From the simple febrile seizure to the complex seizure, we know how to stabilize and how to evaluate. Vitamin B6 Deficiency ).

Emergency Department 260

Emergency Department OR EMS 260

Pediatric EM Morsels

JULY 19, 2024

If bleeding, the only lab that is needed in the Emergency Department is a type and cross. The post Post-Tonsillectomy Hemorrhage: ReBaked Morsel appeared first on Pediatric EM Morsels. Get a hold of ENT early as OR management and/or admission are common. Set up suction x2 in the room! Get IV access! 2024 Feb;177:111859.

E-9-1-1 290

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

Pediatric EM Morsels

JUNE 2, 2023

Today we are talking about a rare disease called FPIES (food protein induced enterocolitis syndrome) and how you might encounter these patients in the Pediatric Emergency Department. link] The post Food Protein Induced Enterocolitis Syndrome (FPIES) appeared first on Pediatric EM Morsels.

Emergency Department 193

Emergency Department ALS EMS OR 193