GEDC

JANUARY 30, 2025

The hospitals patient volume has more than doubled in the past couple of years, and the emergency department has expanded from seven beds to include two surge spots with four beds each. The emergency department receives an estimated 13,000 annual visits, with approximately 5,500 of those visits being older adult patients.

Emergency Department 52

Emergency Department Ambulance OR 52

ALiEM

OCTOBER 30, 2024

Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids.

E-9-1-1 161

E-9-1-1 Naloxone Emergency Department ALS 161

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 334

Emergency Department OR STEMI EMS 334

ALiEM

JANUARY 13, 2025

The patient was discharged from the emergency department with tobradex ointment and ophthalmology follow-up in one week Case Discussion Take-Home Points Immediate reduction of a luxed globe is paramount. Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED.

Emergency Department 169

Emergency Department ED ALS OR 169

The Skeptics' Guide to EM

FEBRUARY 11, 2024

Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. first appeared on The Skeptics Guide to Emergency Medicine. EMJ Nov 2023. EMJ Nov 2023.

ED 330

ED Emergency Department ALS OR 330

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 103

Emergency Department OR EMS 103

ALiEM

DECEMBER 3, 2024

A 26-year-old male with a past medical history of eczema presented to the Emergency Department with a rash for two days. The patient stated he first noticed a rash on his right arm that rapidly spread to his face, chest, and left arm. He reported having similar rashes before but never to this extent. He made a full recovery.

Emergency Department 152

Emergency Department OR 152

ALiEM

JUNE 10, 2024

A 10-year-old boy presents to the emergency department (ED) after a high-speed motor vehicle collision. However, until now, there has been a gap in guidance for clinicians managing pediatric patients at risk for cervical spine injuries. Case Scenario: What would you do? He complains of neck pain and is reluctant to move his head.

Emergency Department 317

Emergency Department ED OR 317

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. CT perfusion showed a 10 mL core and 189 mL penumbra.

ALS 345

ALS Emergency Department OR EMS 345

Medic Mindset

NOVEMBER 13, 2024

There should be a 2-hour limit before you can give Diltiazem, or rate control, in the Emergency Department. He wants paramedics to ask the same question he asks: Is the rapid A-fib the primary problem or secondary to another critical condition like sepsis, PE, DKA, hypovolemia, etc?

Paramedic 98

Paramedic Emergency Department EMS ED 98

The Skeptics' Guide to EM

OCTOBER 21, 2023

Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: October 20, 2023 Reference: Cai et al. AEM October 2023.

Emergency Department 338

Emergency Department ALS ED OR 338

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

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Case: It is a steady Saturday afternoon in your rural emergency department (ED). Reference: Snelling et al.

Critical Care 347

Critical Care ALS ED Emergency Department 347

The Skeptics' Guide to EM

OCTOBER 28, 2023

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.

ALS 268

ALS Emergency Department ED OR 268

ALiEM

JULY 22, 2023

Note that conventional pressure bags may not be readily available in emergency departments and could blow the line you worked hard to secure. Trick of the Trade: Manually provide positive pressure fluids using a 3-way stopcock Attach a 3-way stopcock between the angiocatheter and IV tubing. Interested in Other Tricks of the Trade?

Emergency Department 241

Emergency Department OR Critical Care 241

The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. Reference: Ramesh S, Ayyan SM, Rath DP, Sadanandan DM. AEM April 2024 Date: April 19, 2024 Guest Skeptic: Dr. Suchismita Datta.

Emergency Department 218

Emergency Department Overdose ALS ED 218

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 128

OR Emergency Department Ambulance EMS 128

The Skeptics' Guide to EM

JUNE 1, 2024

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). Population: Children (aged 0 to <18 years) who underwent blunt trauma evaluation in emergency departments. (ED)

Emergency Medical Services 221

Emergency Medical Services Emergency Department EMS ALS 221

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

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior.

E-9-1-1 130

E-9-1-1 OR Coronary ACS 130

The Skeptics' Guide to EM

JUNE 17, 2023

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Date: June 15, 2023 Reference: Rees CA et al. Date: June 15, 2023 Reference: Rees CA et al. He denies any fever or difficulty breathing.

Emergency Department 186

Emergency Department ALS ED OR 186

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

MARCH 18, 2024

Shortly after that, the finger turned purple, so she came to the Emergency Department for evaluation. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger. She denied pain in the hand and has had no problems moving the finger. She denied trauma to the hand or finger.

Emergency Department 306

Emergency Department ED OR 306

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

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

Pediatric EM Morsels

AUGUST 23, 2024

Concussions are commonly encountered in the Emergency Department. We have previously discussed an approach to the question of when a patient “ can return to sport.” It does NOT have structural brain damage visible on standard neuroimaging.

Emergency Department 281

Emergency Department OR ED EMS 281

The Skeptics' Guide to EM

JULY 6, 2024

The emergency department (ED) evaluation reveals an unremarkable chemistry panel with normal renal function and a white blood cell count of 10,000. They are afebrile and tolerate oral intake. An abdominal pelvic CT scan demonstrates uncomplicated left-sided diverticulitis.

ED 242

ED ALS Emergency Department OR 242

ACEP Now

NOVEMBER 8, 2024

First, research suggests a higher number of emergency department visits among individuals with ASD. About 30 percent of children with ASD need treatment in an emergency department, and this number increases to nearly 70 percent for those aged 15–18. But what exactly are neurodivergence and neurodiversity?

Emergency Department 52

Emergency Department ED OR ALS 52

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

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

Core EM

JANUARY 25, 2024

GRACE-3 Methodology: GRACE-3 team consisted of 18 members, including emergency physicians, otoneurologist, neuro-otologist, and patient advocates. Studies have shown that patients’ descriptions of their symptoms can frequently switch between these categories every few minutes.

EMS 246

EMS Emergency Department OR ED 246

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

ALS 329

ALS Emergency Department ED OR 329

Core EM

JULY 23, 2024

It’s a common emergency department presentation, often linked with acute medical or psychiatric emergencies. Significance : Patients with agitation are at high risk for morbidity and mortality, necessitating prompt and effective management to prevent harm to themselves and healthcare providers.

Emergency Department 233

Emergency Department OR 233

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

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. In The Atlas of Emergency Medicine (p.

Emergency Department 177

Emergency Department OR 177

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. His fever was 103°F this morning and he received ibuprofen. He has also had abdominal and back pain. Warm gel helps with the child’s comfort. Use a linear high frequency probe.

E-9-1-1 246

E-9-1-1 Emergency Department ALS OR 246

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. REFERENCES: Castleberg E, Jenson N, Dinh VA.

E-9-1-1 246

E-9-1-1 Emergency Department OR 246