ACEP Now

OCTOBER 29, 2024

On a busy day shift in the emergency department, our seasoned triage nurse comes to me after I finish caring for a hallway patient, “Hey, can you come see this guy in the triage room? This is the essence of emergency medicine. His vitals are fine…”. In the age of big data, more information sounds like a boon.

Emergency Department 59

Emergency Department ALS Emergency Medical Services OR 59

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. An emergent ophthalmology consult is needed to plan for operative repair.

Emergency Department 161

Emergency Department OR ED 161

The Skeptics' Guide to EM

MAY 19, 2018

Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events
 Among Low-Risk Emergency Department Patients: The PROPER Randomized Clinical Trial. Case: A 47-year-old woman presents to the emergency department with a 24-hour history of chest pain and shortness of breath. JAMA February 2018.

Emergency Department 130

Emergency Department ALS Coronary OR 130

The Skeptics' Guide to EM

JANUARY 14, 2018

Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. Of course we were skeptical and wanted to review the evidence.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

OCTOBER 10, 2020

Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. 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.

Emergency Department 130

Emergency Department ALS ED OR 130

The Skeptics' Guide to EM

APRIL 2, 2022

Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. AEM March 2022 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Reference: Butt et al.

Emergency Department 130

Emergency Department ALS ED OR 130

ACEP Now

APRIL 5, 2024

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. Vital signs on arrival are: Temperature: 38.8 degrees Celsius Heart rate:128 Blood pressure: 74 over 48 Respiratory rate: 10 Oxygen saturation: 77 percent Physical examination was notable for lethargy and confusion.

OR 73

OR ALS Emergency Department Critical Care 73

The Skeptics' Guide to EM

OCTOBER 14, 2019

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. first appeared on The Skeptics Guide to Emergency Medicine. Date: October 14th, 2019 Reference: CRASH-3 Trial Collaborators.

Emergency Department 130

Emergency Department EMS ALS OR 130

The Skeptics' Guide to EM

APRIL 10, 2021

He is a GP by training but works in Emergency Department, Anaesthesia, Internal Medicine and Paediatrics. He has a wonderful #FOAMed blog and podcast called Broomedocs and also work […] The post SGEM#326: The SALSA Study: Hypertonic Saline to Treat Hyponatremia first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 130

Emergency Department Coronary ED OR 130

The Skeptics' Guide to EM

JANUARY 20, 2018

Background: Patients present commonly to their primary care providers (PCPs) and to the emergency department (ED) with complaints of a sore throat. The ibuprofen did not help and he is requesting antibiotics so he can get back to work sooner. In the US, adults accounted for 6.6 million visits annually to PCPs and EDs for sore throat.

Emergency Department 130

Emergency Department ALS EMS ED 130

The Skeptics' Guide to EM

OCTOBER 3, 2020

Date: October 2nd, 2020 Guest Skeptic: Dr.Barbra Backus is an emergency physician at the Emergency Department of the Erasmus University Medical Center in Rotterdam, the Netherlands. She is the creator of the HEART Score and an enthusiastic researcher. Reference: Claiborne Johnston S et al. Reference: Claiborne Johnston S et al.

Emergency Department 100

Emergency Department ALS OR 100

NAEMSP

OCTOBER 9, 2024

In the emergency department, a lack of awareness about Addison’s disease led to delayed steroid administration. In the emergency department, the patient was evaluated and safely discharged. These cases highlight the impact of adrenal insufficiency on patients, especially during encounters with emergency care systems.

EMS 122

EMS Crisis Prevention Emergency Department BLS 122

Pediatric EM Morsels

NOVEMBER 17, 2023

Cuffed Endotracheal Tubes show no difference in immediate post-extubation adverse events (i.e Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Acad Emerg Med. In a systematic review of 10 RCTs comparing cuffed vs. uncuffed ETTs. 1.70) and 0.78 (0.46–1.35),

E-9-1-1 183

E-9-1-1 Operating Room Emergency Department ALS 183

REBEL EM

NOVEMBER 20, 2023

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12]. Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. 2023;e2320850.

OR 91

OR Emergency Medical Technician CPR Emergency Medical Services 91

International Journal of Paramedicine

JULY 8, 2024

However, ketamine may be associated with adverse clinical events including a higher intubation rate. The primary endpoint was incidence of endotracheal intubation occurring during transportation and within one hour after arrival to the emergency department (ED). versus 2.9%, respectively; p = 0.383).

Emergency Department 98

Emergency Department Ambulance ED OR 98

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. Click to enlarge.) are caused by a behavioral crisis. Click to enlarge.)

Emergency Department 52

Emergency Department Emergency Response ED ALS 52

The Skeptics' Guide to EM

JULY 2, 2022

Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Coronary 100

Coronary Heart Attack ACS CAD 100

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ & Liska, H.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

The Skeptics' Guide to EM

NOVEMBER 24, 2018

[display_podcast] Date: November 24th, 2018 As you may know, I was invited to give a keynote address on burnout at the Australasia College of Emergency Medicine 2018 Annual Scientific Meeting (#ACEM18) in Perth, Australia. This turned out to be a very meta event. This turned out to be a very meta event. got seriously ill.

EMR 130

EMR ALS Emergency Department OR 130

ALiEM

OCTOBER 26, 2023

The Learners The target learners were EM residents and physicians practicing in the emergency department. In order to avoid connectivity issues with Wifi, the event administrators broadcasted from an ethernet-connected computer. Internet connection: A stable internet connection is a must. Read more publications from the series.

EMS 161

EMS Emergency Department ALS ED 161

The Skeptics' Guide to EM

NOVEMBER 1, 2022

AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency […] The post SGEM#381: Put Your Hand on My Shoulder and Reduce It first appeared on The Skeptics Guide to Emergency Medicine.

ALS 118

ALS Emergency Department OR ED 118

REBEL EM

JUNE 8, 2023

Epinephrine – 10ug/mL, 10mL syringe Phenylephrine – 100ug/mL, 10mL syringe Phenylephrine bolus doses from 100-200ug and epinephrine 10-20ug administered every 2-5 minutes pursuant to provider order Inclusion Criteria: Adults age >18 years old Received at least one bolus dose of phenylephrine or epinephrine pre-filled syringes Exclusion (..)

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

Dr. Smith's ECG Blog

FEBRUARY 14, 2024

A 41-year-old male who presents to the emergency department with chest pain. I do not think it is possible for a 2nd trop to remain undetectable in a patient then goes on to rule in for acute MI, unless there is a 2nd event. I know of no data on unstable angina/30-day adverse events/acute MI after 2 serial undetectable trops.

ACS 102

ACS Emergency Department OR 102

The Skeptics' Guide to EM

SEPTEMBER 1, 2018

Case: You are working in the emergency department (ED) and have just been involved in a difficult case in the resuscitation room. During the resuscitation, a relative of the patient you have been treating named Rudy makes a derogatory/rude comment about Emergency Medicine (EM) staff.

ALS 130

ALS Emergency Department OR EMS 130

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. Audrey’s academic interests include trauma and resuscitation. Outside of medicine, Audrey likes to play rugby and run.

Epinephrine 130

Epinephrine Emergency Department EMS ALS 130

The Skeptics' Guide to EM

JUNE 12, 2021

Pediatrics 2021 Case: You are working with a medical student at the emergency department when a 2-month-old boy is […] The post SGEM#334: In My Life there’s been Earache and Pain I don’t know if it’s IBI again – in an Afebrile Infant with Acute Otitis Media first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 100

Emergency Department ALS ED OR 100

Pediatric EM Morsels

JULY 21, 2023

Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. We use the GCS score in both trauma and medical patients, but where did this score come from? When is it useful and what does it tell us? Let’s wrap our heads around the Glasgow Coma Scale in children. May have shouts or exclamations.

Critical Care 246

Critical Care ALS Life Support OR 246

EM Literature of Note

SEPTEMBER 24, 2024

However, the unblinded nature of the trial confounds a bit of interpretation of the influence of the crossover event. If typical BIPAP settings aren’t working, why not just IPAP harder ? In actuality, the number of patients intubated in each group were the same – 3.4% in each group.

ED 93

ED Emergency Department OR 93

ACEP Now

NOVEMBER 6, 2024

Native American emergency physicians make up 0.1 emergency departments, according to research published in 2020 in Annals of Emergency Medicine. Three Native American emergency physicians in Oklahoma—three of five in the state—discussed with ACEP Now their approach to health care and how their careers in medicine began.

Emergency Department 98

Emergency Department OR 98

EMDocs

OCTOBER 25, 2024

1: Hypertensive Crisis Averted…New AHA Statement on Asymptomatic Hypertension Spoon Feed This article emphasizes the difference between hypertensive emergency and asymptomatic elevated blood pressure (BP); while hypertensive emergency requires prompt treatment to lower BP, treatment of asymptomatic elevated BP in acute care settings may be harmful.

Defibrillator 69

Defibrillator Emergency Department ALS OR 69

SSCOR

FEBRUARY 15, 2024

In the event of a pandemic or other health emergency, hospital emergency departments and intensive care units can become overwhelmed. Doctors, nurses, and medical personnel are being asked to go above and beyond to protect patients — and to do it quickly.

Emergency Department 59

Emergency Department OR 59

Don't Forget the Bubbles

MAY 24, 2023

Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. One large observational study found a 35-fold higher increase in events leading to death or brain damage in ED intubations. What is the next step in a CICO event? What is a difficult airway?

Emergency Department 98

Emergency Department ED ALS OR 98

Don't Forget the Bubbles

JANUARY 8, 2024

Dr Bourke’s work is not only about deepening academic understanding but also about forging practical approaches to help healthcare professionals navigate the nuanced and often uncertain waters of adolescent care in emergency settings. Mulraney, M., Coghill, D., Sciberras, E., and Sawyer, M., Mulraney, M., Coghill, D., Sciberras, E.,

Emergency Department 105

Emergency Department OR ED 105

The Skeptics' Guide to EM

MARCH 18, 2023

Case: A 5-year-old child presents to the emergency department in the midst of flu season with three days of fever, upper respiratory symptoms, and malaise. Marisu Rueda-Altez is a pediatric infectious disease fellow at Children’s National Hospital in Washington, DC.

ICU 101

ICU Emergency Department OR 101

ACEP Now

AUGUST 12, 2024

Now, I’m no pro, but in the way of credentials I have 1) traveled to regional birding events, 2) keep a pair of binoculars in my glove box, and 3) have no problem picking out the buzzy crescendo of the Northern Parula from a cacophony of forest songs in early May. Like many of you, five years ago, I had no idea what “birding” was.

Emergency Department 116

Emergency Department OR 116

Core EM

JULY 23, 2024

Because most radiation injuries are not immediately life-threatening, patients with isolated radiation injuries will not require immediate attention in mass casualty events. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. Sources of Radiation Cosmic: Radiation generated by the sun and stars.

ALS 130

ALS OR Emergency Department ED 130

Core EM

MARCH 12, 2024

Because most radiation injuries are not immediately life-threatening, patients with isolated radiation injuries will not require immediate attention in mass casualty events. Radioactive sources include medical isotopes, fuel rods, generators, and other industrial sources. Sources of Radiation Cosmic: Radiation generated by the sun and stars.

ALS 130

ALS OR Emergency Department ED 130