The Skeptics' Guide to EM

JANUARY 20, 2024

Case: A 4-year-old girl comes to the emergency department complaining of pain with urination. UTIs are one of the most common bacterial infections in childhood that we see in the emergency department [1]. Her research interests include improving the diagnosis of urinary tract infections in children.

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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)? The Journal of Emergency Medicine. Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives. Open Access Emerg Med. 2012.07.056.

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EMDocs

JULY 20, 2024

Spoon Feed An international, multi-center RCT found that administering pantoprazole to intubated ICU patients lowered the rate of upper GI bleeding compared to placebo. Acad Emerg Med. Ann Emerg Med. PMID: 38441515 The post Journal Feed Weekly Wrap-Up appeared first on emDOCs.net - Emergency Medicine Education.

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The Skeptics' Guide to EM

APRIL 22, 2023

Michael Falk is a Pediatric Emergency Medicine attending at Mount Sinai Medical Center and Associate Professor of Emergency Medicine at the Icahn School of Medicine in New York. Case: A 14-month-old boy presents to the emergency department (ED) with two days of upper respiratory symptoms and respiratory distress.

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The Skeptics' Guide to EM

JUNE 22, 2024

Anireddy Reddy is a pediatric intensive care attending physician in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital of Philadelphia. Dr. Anireddy Reddy Case: A 3-year-old girl presents to the emergency department (ED) with fever and respiratory distress. It’s unbalanced.

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The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Reference: Cashen K, Reeder RW, Ahmed T, et al. Pediatric Crit Care Med.

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Broome Docs

SEPTEMBER 3, 2024

Do you still suggest emergency medicine to your students? … Adams C, Walsan R, McDonnell R, Schembri A. As loud as a construction site: Noise levels in the emergency department. Australas Emerg Care. PMID: 37532590 Bottom line: Emergency departments are noisy, although not ridiculously so.

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EMDocs

JUNE 15, 2024

1: PREOXI RCT – Preoxygenation with Noninvasive Ventilation vs. Non-rebreather Mask Spoon Feed Noninvasive ventilation (NIV) was superior to a standard non-rebreather (NRB) oxygen mask for preoxygenation of critically ill ED or ICU patients requiring intubation, with a NNT of 11 to prevent 1 episode of hypoxemia <85%. . #3:

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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.’ 23 (2), pp.

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ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

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ACEP Now

JULY 7, 2024

Should emergency physicians rely on standard textbooks for diagnostic and treatment regimens? 1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). 1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED).

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Critical Care Scenarios

NOVEMBER 15, 2020

A few rapid-fire cases from the emergency department, with Dr. Seth Trueger (@mdaware), emergency physician at Northwestern University and digital media editor for JAMA Network Open. Continue reading "Episode 19: Emergency medicine with Seth Trueger" A few rapid-fire cases from the emergency department, with Dr. .

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REBEL EM

MARCH 23, 2023

The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores. Treatment options for alcohol withdrawal include benzodiazepines such as lorazepam, diazepam, or chlordiazepoxide, gabapentin, and phenobarbital (Buell et al.).

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The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. Date: September 20th, 2021 Reference: Litell et al. mg/dl or 107 umol/L).

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Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. The patient was upgraded to the ICU for closer monitoring. What do you think? ng/mL, BNP 2790, and lactate 3.7.

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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.

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The Skeptics' Guide to EM

MARCH 27, 2021

2020 Case: A 74-year-old woman who suffered a fall earlier today presents to the emergency department (ED) and is found to have five rib fractures to her right thorax, but no other injury. J Trauma Acute Care Surg. She is otherwise well, and her vitals are stable, but she is in some pain. J Trauma Acute Care Surg.

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ACEP Now

MAY 9, 2024

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). After developing encephalopathy and hypoxemic respiratory failure, the patient was transferred to the ICU. Comparative Effectiveness Review, No.

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EMDocs

SEPTEMBER 19, 2023

Propofol utilized for sedation; patient admitted to ICU for EEG monitoring. American College of Cardiology released a new consensus statement, “ Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee “.

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EMDocs

JUNE 27, 2024

Left lower lung field end demonstrates expiratory wheezing on auscultation. Other lung fields unremarkable. smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02 mg/kg, max 0.4 C or 100.4

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EMDocs

MAY 25, 2023

Design: Multi-centered, double-blinded, randomized trial PICO: Population: Inclusion Criteria: Age 2 years and older Must have been treated with a specified minimum dose of certain benzodiazepines for generalized convulsive seizures: Intravenous or rectal diazepam 0.3 mg/kg or 10 mg Intravenous lorazepam 0.1 mg/kg or 4 mg Intravenous midazolam 0.2

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Broome Docs

OCTOBER 31, 2022

Ketamine vs etomidate in ICU intubation ? Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial.

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EMDocs

JUNE 7, 2023

Disposition is often admission to an intensive care unit (ICU) setting. She is speaking one word at a time and constantly coughing. She complains of dizziness, nausea, and abdominal cramps. On exam, you notice there is a garlic-like odor filling the room. Questions: What is the most likely causative xenobiotic that led to these findings?

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Emergency Medicine Ireland

MARCH 4, 2021

GBS is a clinically important diagnosis for both the emergency department and the ICU. GBS is a clinically important diagnosis for both the emergency department and the ICU. In the ICU the diagnosis is usually fairly easy as they come with a label of possible GBS in the referral.

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EMDocs

AUGUST 15, 2023

His father confirmed the snake was a copperhead. He was initially seen at a regional ED and was administered 10 vials of crotalidae equine immune F(ab’) 2 (ANAVIP®) antivenom before transfer to your referral center. Avoid additional bites to yourself or the patient and move the patient safely away from the snake.

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The Skeptics' Guide to EM

NOVEMBER 16, 2019

Laura Melville ( @lmelville535 ) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Case: A 59-year-old woman comes is brought into your emergency department (ED) by EMS in cardiac arrest. What do you say?

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ACEP Now

DECEMBER 10, 2023

A middle-aged male with squamous cell carcinoma and extensive metastases is brought to the emergency department (ED) after being found unresponsive following a believed suicide attempt (SA) by methadone ingestion. You want to respect patient autonomy, but is it legal to let him die without any emergency resuscitation?

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EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). A right femoral arterial line and triple lumen catheter are placed.

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Don't Forget the Bubbles

AUGUST 28, 2023

One final option is emergent transfer, prior to intubation, to a centre that has ECMO on standby. Five-year-old Ginny presents to the Emergency Department with a syncopal episode. Depending on the location of the mediastinal mass, lying a child flat or using a rapid sequence induction protocol may cause cardiorespiratory arrest.

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REBEL EM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care.

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Don't Forget the Bubbles

OCTOBER 19, 2023

Secondary outcome analysis showed there was no difference in length of hospital stay, ICU stay, or duration of oxygen therapy. The CAP-IT trial recruited children aged six months to 5 years with a diagnosis of community-acquired pneumonia on discharge from the emergency department or ward. days compared to 1.50

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ACEP Now

MAY 4, 2023

A 58-year-old male with a history of alcohol abuse presented to the emergency department (ED) as a category 2 trauma for a fall with a reported flail chest. Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). Click to enlarge.) He denied syncope, head trauma, or any other complaints.

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AAEM RSA

AUGUST 27, 2020

However, the decade since the original Hypothermia after Cardiac Arrest trial had seen significant advances in pre-hospital, emergency department, and critical care that may have contributed to these outcomes. Enrollees were then assigned to either TTM of 33ºC or 36ºC for 36 hours.

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AAEM RSA

JUNE 30, 2021

This path involves seventy-two months split between emergency medicine and internal medicine with additional experience in the critical care setting.[3] 1] Graduates of the combined degree may choose to work solely in either field, enter a subspecialty, pursue additional fellowship experience in critical care, or engage in research.[2]

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NAEMSP

FEBRUARY 15, 2023

Sometimes they may benefit from transport to an emergency department if it is consistent with their care plan/wishes. The patient was dying while intubated in the ICU but was awake enough to engage in discussions with providers through writing about her wishes. Prehosp Emerg Care. PMID: 35490992. Epub 2021 Mar 30.

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EMDocs

OCTOBER 21, 2023

More common in the setting of atherosclerotic lesions than emboli, which typically occur with sudden onset of symptoms. Symptoms may range from days to months prior to stroke onset. As many as two-thirds of patients with BAO experience prodromal symptoms, including TIAs, minor strokes, or other symptoms.

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Dr. Smith's ECG Blog

OCTOBER 19, 2022

A transvenous pacer was placed in the Emergency Department by the emergency physicians. and the 2021 YouTube Review by ICU Advantage on "Temporary Pacemakers: Modes and Basic Settings". A patient had 3rd degree AV block in the ED. What does it mean that the pacing spike comes in the midst of the 5th and 6th native beats?

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