The Skeptics' Guide to EM

FEBRUARY 6, 2021

Their mission is to share knowledge with paramedics, nurses, medical student and also young doctors as they take their first steps in the field of emergency medicine. Each month they post new content and focus two main topics, the medical therapy of the month as well as tricks for dealing with complex emergencies.

Hospitals 40

Hospitals Emergency Department Ultrasounds EMS 40

EMDocs

APRIL 13, 2024

If the hematoma is not drained it can cause disruption of blood supply to the cartilage and subsequent necrosis, as well as an increase in risk of infection. A 21-year-old man presents to the emergency department for pain and swelling in his ear beginning 3 days ago. Published online April 19, 2004.

EMS 82

EMS Emergency Department Pediatrics Wellness 82

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! For children at least 4 years of age who are not well controlled on ICS alone. 2004 Aug;2(3):155-63. No more SABA ! Front Pediatr. 2018 Jun 19;6:170.

Pediatrics 262

Pediatrics Emergency Department Wellness EMS 262

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. Closer to home, the New South Wales Poisons Information Centre (NSWPIC) reported 129 incidents involving water-absorbing beads since 2004. What are the risks of water beads? His older brother, Roy, had found him playing with his toys, and an argument ensued.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. 2004 Jul;15(4):248-250. Am J Emerg Med. C or 100.4 mg/kg, max 0.4

Pediatrics 75

Pediatrics EMS Dehydration Hospitals 75

Northwestern EM Blog

DECEMBER 20, 2021

Written by: Tommy Ng, MD (NUEM ‘24) Edited by: Patricia Bigach, MD (NUEM ‘22) Expert review by : Terese Whipple, MD '20 So your kid won’t walk One of the most common complaints in a pediatric Emergency Department is a child refusing or inability to ambulate. Affects ages 3-8, males to females 2:1 [3].

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting." N Engl J Med [Internet] 2013;368(21):2004–13. Then she began complaining of severe dizziness and quickly went into ventricular fibrillation and resuscitation was initiated by hospital staff.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

Pediatric Emergency Playbook

JANUARY 1, 2017

Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. For children greater than one year who are preverbal, a well performing scale is the FLACC score: Face, Legs, Activity, Cry, Consolability ( Table 3 ).

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

ALiEM

MARCH 7, 2024

It is usually large, nodular, well-defined, homogeneous, and slightly hypoechoic (Figure 13) [6]. Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). Dessie et al.,

Ultrasounds 70

Ultrasounds Pediatrics Emergency Department Radiology 70

Pediatric EM Morsels

JULY 21, 2023

Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. Systematic review showed 85% of studies with substantial reliability with kappa statistic >0.6 J Surg Res. 2019 Sep;241:112-118. doi: 10.1016/j.jss.2019.03.038. 2019.03.038. Epub 2019 Apr 22. PMID: 31022676. 2004;43:215-223.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EMDocs

APRIL 27, 2024

A 67-year-old man with a history of hypertension and diabetes presents to the emergency department with right ear pain for 2 weeks. and Staphylococcus spp. 2 F ungal involvement (usually Aspergillus fumigatus ), especially in immunocompromised patients. His vital signs are normal except for a temperature of 38.2°C Branstetter, B.

EMS 83

EMS Infectious Diseases Radiology Radiology 83

Don't Forget the Bubbles

JULY 17, 2023

2023 Jun 1;76(6):731-736 The Association Between Media-Based Exposure to Nonsuicidal Self-Injury and Emergency Department Visits for Self-Harm. Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study. Baaleman DF, et al. J Pediatr Gastroenterol Nutr. Lee T, et al. 2023 Jun 9.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

EB Medicine

DECEMBER 1, 2018

Jeff: In fact, a meta-analysis on vaccine effectiveness from 2004-2015 found that the pooled effectiveness against influenza B was 54%, against the H1N1 pandemic in 2009 was 61%, and against the H3N2 virus was 33%. Jeff: Of note, EMS providers should use face masks themselves and place them on patients as well. Nachi: Amazing.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

RebelEM

JANUARY 23, 2023

Multicenter study of emergency department visits for insect sting allergies. Multicenter study of emergency department visits for food allergies. 2004 Feb;113(2):347-52. 2004 Feb;113(2):347-52. Patients were randomized in a 1:1 ratio. J Allergy Clin Immunol. 2005 Sep;116(3):643-9. PMID: 16159637.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. ng/mL, 0.25-0.5

Infectious Diseases 86

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 86

Don't Forget the Bubbles

JULY 31, 2023

Our team have scoured what’s new (well, mostly new!) A Diagnostic Accuracy Study to Evaluate Standard Rapid Diagnostic Test (RDT) Alone to Safely Rule Out Imported Malaria in Children Presenting to UK Emergency Departments. Febrile children are a common sight in the paediatric emergency department.

Rapid Diagnostic Testing 98

Rapid Diagnostic Testing Resuscitation Emergency Department Pediatrics 98

Dr. Smith's ECG Blog

OCTOBER 25, 2023

A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergency department after an episode of syncope while standing in line at a grocery store. Written by Sean Trostel MD, peer reviewed by Meyers, Smith, Grauer, etc. He did not have chest pain.

EKG/ECG 115

EKG/ECG Seizures Hospitals Stroke 115

Northwestern EM Blog

JANUARY 24, 2022

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. To reverse these effects as well as refractory hypotension, hydrocortisone is the preferred agent due to both its glucocorticoid and mineralocorticoid properties. Arch Surgery.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2016

The American Academy of Neurology's most recent guidelines, published first in 1994 and revised in 2004. in Pediatric Emergency Care evaluated the safety and efficacy of their institution’s standardized pediatric migraine practice guideline in the emergency department, which used ths cocktail, based on the best evidence available.

Pediatrics 52

Pediatrics Emergency Department Seizures Wellness 52

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. 2004; 199(4):628-635.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

It was extremely well-liked by field personnel, but virtually unknown in hospitals. However, they could be used easily and well with the assist of head-straps which were never sold as part of the complete “kit” but only as an uncataloged “spare part.” Annals of emergency medicine, 14(11), 1085-109 **Support for prehospital ETI.

Resuscitation 40

Resuscitation CPR Documentation/Coding EMS 40

Dr. Smith's ECG Blog

JUNE 18, 2013

This formerly met "criteria" for thrombolytics in the ACC/AHA guidelines of 2004, though of course this amount of ST elevation is very nonspecific. His ECG was repeated at this point: This shows a well developed anterior STEMI. Ann Emerg Med 1998;31(1):3-11. There is 1 mm of ST elevation at the J-point in leads V2 and V3.

EKG/ECG 52

EKG/ECG Outcomes Emergency Department Hospitals 52

Dr. Smith's ECG Blog

APRIL 8, 2015

True Syncope: If, on the other hand, the patient is well, had no other serious symptoms , has a normal sinus rhythm, and normal physical exam , then you need to be certain the syncope was not due to a dangerous brady- or tachydysrhythmia that could recur. The ROSE (Risk Stratification of syncope in the emergency department) Study.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 96

Infectious Diseases Administration Sepsis Anaphylaxis 96