ACEP Now

MAY 5, 2023

What is your role as the emergency physician? Introduction Law enforcement officers frequently accompany emergency department (ED) trauma patients or patients who are under arrest or require assistance. At times, law enforcement officers may request assistance from ED staff to gather information or evidence.

Emergency Department 52

Emergency Department ED Public Safety OR 52

ALiEM

MARCH 18, 2024

Shortly after that, the finger turned purple, so she came to the Emergency Department for evaluation. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. No other complaints or issues.

Emergency Department 306

Emergency Department ED OR 306

Don't Forget the Bubbles

MAY 10, 2023

You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. Synthesise the information into something that makes sense. What information is available, and do I have it? Synthesising the information into something that makes sense What’s going to happen? This is means.:-

Emergency Department 91

Emergency Department ED CPR OR 91

ALiEM

NOVEMBER 17, 2023

A 4-year-old female with no significant past medical history is brought to the Emergency Department by her grandmother for concern for two days of progressive vaginal bleeding. It often presents to the emergency department with complaints of vaginal bleeding, difficulty urinating, or dysuria.

Emergency Department 250

Emergency Department OR 250

Core EM

JANUARY 25, 2024

Analgesic Onset Elimination Half Life IV Infusion Rates Side Effects and Other Information Fentanyl 1 – 2 min 2 – 4 hr 0.7 – 10 μg/kg/hr Rapid onset. We recommend considering fentanyl plus propofol or dexmedetomidine as the routine first options for the choice of analgosedation agents in the emergency department. up to 1.5)

ICU 246

ICU Emergency Department Critical Care ALS 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 in-depth information regarding the Social Media Index.

EMS 246

EMS Emergency Department ED OR 246

The Skeptics' Guide to EM

JUNE 24, 2023

Pilot Testing Fentanyl Test Strip Distribution in an Emergency Department Setting: Experiences, Lessons Learned, and Suggestions from Staff. AEM June 2023 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate.

Overdose 188

Overdose Emergency Department ALS ED 188

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 98

Emergency Department ED EMR OR 98

ALiEM

MAY 29, 2023

Published Dec 9, 2020 Author information Mohamed Elhadi Abdelhameed, MD Emergency Medicine Physician Emergency Department Ibrahim Malik Teaching Hospital | The post Trick of Trade: Dual Foley catheter to control massive epistaxis appeared first on ALiEM. Read the series Buy the print book! Reference Goralnick E.

E-9-1-1 246

E-9-1-1 Epinephrine Emergency Department 246

ACEP Now

DECEMBER 7, 2024

A 28-year-old female is brought to the emergency department (ED) by police after a sexual assault. What is the trauma-informed approach to care for this patient? Given the prevalence of trauma among ED patients, clinicians should assume that all patients would benefit from a trauma-informed approach to care.

Mental Health Services 52

Mental Health Services Emergency Department ED OR 52

The Skeptics' Guide to EM

MAY 25, 2024

Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Reference: Borgundvaag et al. When we combine SGEMHOP with an SGEM Xtra I hope we get some…AMAZING knowledge translation for GRACE4.

ED 191

ED Emergency Department ICU ALS 191

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. In the age of big data, more information sounds like a boon. His vitals are fine…”.

Emergency Department 59

Emergency Department ALS Emergency Medical Services OR 59

Core EM

JANUARY 25, 2024

SUMMARY: Upon initial evaluation of patients in the emergency department with clinical signs of soft tissue infections, consider using POCUS as a valuable tool to gather more information in patients with a high suspicion for the diagnosis and/or are too unstable to undergo CT imaging.

E-9-1-1 246

E-9-1-1 Emergency Department OR 246

ALiEM

APRIL 12, 2023

emDOCs.net – Emergency Medicine Education. Author information Ivan Ivanov, DO Resident Physician Emergency Department South Brooklyn Health | The post Trick of the Trade: Gel-free ultrasound-guided peripheral IV technique appeared first on ALiEM. US Probe: Ultrasound Water Bath for Distal Extremity Evaluation.

Emergency Department 258

Emergency Department ALS ED 258

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. View other cases from this Clinical Image Series on ALiEM.

Emergency Department 246

Emergency Department OR EMS ED 246

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. Ann Emerg Med. 2023;82(1):55-65. doi: 10.1016/j.annemergmed.2023.02.011

Overdose 215

Overdose Critical Care EMS Emergency Department 215

ALiEM

OCTOBER 23, 2023

A 32-year-old man with a history of traumatic globe rupture from a stab wound two months ago, status post repair, presented to the emergency department for worsening right eye pain and green malodorous drainage for the past three days. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 2):1334-1343.

Emergency Department 278

Emergency Department OR 278

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.

Emergency Department 246

Emergency Department ICU ED OR 246

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 in-depth information regarding the Social Media Index.

Emergency Department 188

Emergency Department EMS OR 188

ALiEM

AUGUST 26, 2024

A 27-year-old male with no past medical history presents to the Emergency Department with right eye pain. Iridodialysis Traumatic iridodialysis is an uncommon ocular emergency with very distinct findings that we can encounter in the Emergency Department. link] doi.org/10.1016/j.mehy.2018.11.013

Emergency Department 177

Emergency Department OR 177

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. Ann Emerg Med. 2023;82(1):55-65. doi: 10.1016/j.annemergmed.2023.02.011

Critical Care 211

Critical Care EMS Emergency Department ALS 211

ALiEM

DECEMBER 9, 2024

A 25-year-old female with no pertinent past medical history presented to an emergency department in Massachusetts with four days of generalized malaise, myalgias, congestion, low-grade fever, and a rash behind her left knee. The patient denied cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, and diarrhea.

Emergency Department 152

Emergency Department ACS EMS OR 152

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. Emerg Med J. DISCLAIMER: THE VIEWS AND OPINIONS OF THIS BLOG AND PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US MILITARY.

ALS 241

ALS Emergency Department ED OR 241

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. View other cases from this Clinical Image Series on ALiEM. appeared first on ALiEM.

Emergency Department 161

Emergency Department OR ED 161

ALiEM

FEBRUARY 9, 2024

Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. 2018.05.040 Featured image adapted from Adobe Firefly Author information Matthew J.W. J Am Coll Cardiol. 2022;80(20):1925-1960.

E-9-1-1 276

E-9-1-1 ED Coronary ALS 276

ALiEM

DECEMBER 20, 2024

Eczema herpeticum: making the diagnosis in the emergency department. J Emerg Med. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. 2011 Feb;40(2):167-9. doi: 10.1016/j.jemermed.2007.11.049.

Emergency Department 161

Emergency Department ED OR 161

Emergency Medicine Cases

DECEMBER 20, 2016

Do they meet a real need for information to guide self-improvement or just scratch our competitive itches? In this month’s guest blog Dr. Amy Cheng, the Emergency Department Director of Quality Improvement at St. What does the evidence say about the true utility of physician performance feedback and scorecards?

Emergency Department 130

Emergency Department OR 130

The Skeptics' Guide to EM

JUNE 10, 2023

Foreword Emergency physicians are many things but one of the most important things we try to be is great diagnosticians. Every shift we use limited information in a busy, chaotic environment to make decisions. The authors start by discussing diagnostic testing in the emergency department (ED).

Emergency Department 179

Emergency Department ED OR 179

The Skeptics' Guide to EM

AUGUST 24, 2024

Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Interests include information systems and digital health, research and education. Reference: Partyka et al.

Emergency Department 130

Emergency Department ALS OR ED 130

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.

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245

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. J Emerg Nurs. Accessed October 10, 2023. Lee H, Yun H, Choi M, Kim H.

Emergency Department 52

Emergency Department Emergency Response ED ALS 52

ALiEM

SEPTEMBER 20, 2024

A 50-year-old male with insulin-dependent Type 2 Diabetes presented to the emergency department with three days of pain and swelling on the right side of his neck. He endorsed progression of his symptoms, reporting that he was now having fevers, myalgias, and intermittent difficulty swallowing solid foods.

Emergency Department 177

Emergency Department OR 177

ALiEM

OCTOBER 23, 2024

Author information Chirag Parikh, DO Emergency Medicine Resident Emergency Department South Brooklyn Health | The post Trick of the Trade: Cut IV extension tubing for 2-person ultrasound guided nerve block appeared first on ALiEM. Read more from the Tricks of the Trade series.

Emergency Department 141

Emergency Department OR 141

The Skeptics' Guide to EM

AUGUST 22, 2020

He is also the CME editor for Academic Emergency Medicine. Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases. He is also the CME editor for Academic Emergency Medicine. I consciously have tried to avoid contributing to the COVID-19 information overload.

ACPE 130

ACPE Emergency Department ALS OR 130

ALiEM

FEBRUARY 2, 2024

Because of the concern for malignancy, a biopsy was performed in the emergency department after the ultrasound and CT scan confirmed there was no extension into the thorax. Furthermore, it has no appearance of an inflammatory reaction that would benefit from topical steroids. The biopsy revealed a pilomatrixoma , or pilomatricoma.

Emergency Department 169

Emergency Department OR 169

ALiEM

SEPTEMBER 25, 2024

A 24-year-old male with a history of microscopic hematuria presented to the emergency department (ED) with left lower quadrant abdominal pain. The patient’s pain was resolved when they saw the patient in the emergency department. His pain started about two weeks ago and has been intermittent. Dis Colon Rectum.

Emergency Department 141

Emergency Department ED ALS OR 141

The Skeptics' Guide to EM

JANUARY 29, 2022

Efficacy of empiric antibiotic management of septic olecranon bursitis without bursal aspiration in emergency department patients. AEM January 2022 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Reference: Beyde et al.

Emergency Department 130

Emergency Department ALS ED 130