The Skeptics' Guide to EM

APRIL 8, 2023

There have been many “temporary” rural emergency department closures during the past last year. In Ontario alone there have been approximately 160 emergency departments (ED) temporarily closed since the beginning of 2022. It was a stepped-wedge reconfiguration of the entire Danish emergency healthcare system.

Stroke 56

Stroke Emergency Department COPD Academics 56

PHEM Cast

APRIL 10, 2016

This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. The impact of emergency medical services on the ED care of severe sepsis. Am J Emerg Med. 2006 Jun 3;332(7553):1295–8. Emergency Medicine Journal.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Pediatric Emergency Playbook

MARCH 1, 2021

Pediatric Constipation in the Emergency Department: Evaluation, Treatment, and Outcomes. JPGN 2006; 43:e1-e13. Saline enemas are generally safe for all ages Be careful with the specific dose — please use your local reference Selected References Freedman SB et al. JPGN 2014;59: 327–333. Tabbers MM et al.

Pediatrics 52

Pediatrics Emergency Department Outcomes 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

She arrives in the emergency department (ED) with decreased level of consciousness and shock. Defibrillation is the treatment of choice in these cases but does not often result in sustained ROSC ( Kudenchuk et al 2006). She has a history of hypertension and non-insulin dependent diabetes mellitus.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

Downeast Emergency Medicine

JULY 17, 2021

Background Renal colic is a commonly encountered diagnosis in the emergency department that is known to cause significant pain. Comparison of intravenous ketorolac at three doses for treating renal colic in the emergency department: A noninferiority randomized controlled trial. Acad Emerg Med. Ann Emerg Med.

Emergency Department 52

Emergency Department Wellness Administration EMS 52

RebelEM

JANUARY 23, 2023

Health care professional involved in patient management and outcome assessment was completely blinded. Multicenter study of emergency department visits for insect sting allergies. Multicenter study of emergency department visits for food allergies. Patients were randomized in a 1:1 ratio. J Allergy Clin Immunol.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

EMDocs

JANUARY 25, 2025

A 45-year-old outdoor enthusiast presents to the emergency department with fever, headache, myalgias, and malaise. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. Philadelphia, PA: Mosby; 2006:384-418. No rash is identified. Curr Opin Hematol. Gedefie, A.,

EMS 80

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 80

PHEM Cast

APRIL 21, 2021

The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Annals of Emergency Medicine 2006; 47(6):548-555 Lewis SR, Butler AR, Parker J, Cook TM, Smith AF. Anesth Analg.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Pediatric Emergency Playbook

APRIL 1, 2016

used BNP in the emergency department to differentiate heart failure from respiratory causes in infants and children with heart failure and those with no past medical history. We could use it to track treatment , and see if we can clear the lactate; decreased lactate levels are associated with a better outcome in adults.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

This was a male in his 50's with a history of hypertension and possible diabetes mellitus who presented to the emergency department with a history of squeezing chest pain, lasting 5 minutes at a time, with several episodes over the past couple of months. Eur Heart J 2001;22:1997–2006. Gottlieb SO, et al. Jernberg T, et al.

EKG/ECG 52

EKG/ECG Documentation/Coding Emergency Department Wellness 52

Pediatric Emergency Playbook

JANUARY 1, 2016

2006; 26(5):1485-500. 2006 Apr;7(2):75-80. Accuracy of a screening instrument to identify potential child abuse in emergency departments. J Emerg Med. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. Radiographics. Pediatr Diabetes. 2012; 43(1): e49–e51.

Head Injuries 40

Head Injuries Pediatrics Shock Sepsis 40

Sensible Medicine

SEPTEMBER 29, 2023

For example, a model that assesses patients presenting to an emergency department with suspected acute coronary syndrome (ACS) was designed so that patients with ACS wrongly labelled as “low risk” and sent home would be just 1% (false negatives) [8]. 2006 Apr;332(7550):1127-9. Resuscitation. 2014;85(5):587-94. [3]

Research 55

Research Hospitals Academics Emergency Department 55

Sensible Medicine

SEPTEMBER 29, 2023

For example, a model that assesses patients presenting to an emergency department with suspected acute coronary syndrome (ACS) was designed so that patients with ACS wrongly labelled as “low risk” and sent home would be just 1% (false negatives) [8]. 2006 Apr;332(7550):1127-9. Resuscitation. 2014;85(5):587-94. [3]

Research 40

Research Hospitals Academics Emergency Department 40

Pediatric EM Morsels

JULY 21, 2023

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. Academic emergency medicine 12.9

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EB Medicine

MAY 3, 2019

This month, we’re moving into uncharted territories for the podcast… we’re talking psychiatry Nachi: Specifically, we’ll be discussing Depressed and Suicidal Patients in the emergency department. The strongest predictor for suicide-related outcomes is history of prior suicidal ideation or suicide attempt. Pretty big numbers.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

EMDocs

JUNE 12, 2024

HypoCa is common in trauma patients and is associated with poor outcomes. We need RCTs to determine if Ca administration in trauma impacts mortality and other patient-centered outcomes. Ionised calcium levels in major trauma patients who received blood in the Emergency Department. Emerg Med J. Emerg Med J.

Hyperthermia / Hypothermia 100

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 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. Stuckey, T., Zimetbaum, P.

EKG/ECG 134

EKG/ECG Documentation/Coding Wellness Emergency Department 134

Taming the SRU

JANUARY 29, 2024

She was concerned that this was not improving and decided to come to the emergency department (ED). Hospital Course The patient was initiated on a therapeutic heparin drip in the emergency department with vascular surgery consultation. 2006 Apr;17(3):225-6. She had not had any blood clots previously.

Emergency Department 93

Emergency Department Fractures Hospitals Operations 93

Don't Forget the Bubbles

JULY 5, 2023

Haematology specialist clinics are key to manage the chronic side of the disease, while ED doctors should be able to act rapidly on the common acute emergencies. Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

EMDocs

JUNE 27, 2024

2006 Jul;134(1):109-15. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort.

Pediatrics 88

Pediatrics Dehydration EMS Hospitals 88

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. 2006; 26:1485-1500.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

PHEM Cast

MARCH 3, 2019

Long-term pain prevalence and health-related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomised controlled trial. Emergency Medicine Journal. Emerg Med J. Ketamine for paediatric sedation/analgesia in the emergency department. Emerg Med J.

Emergency Department 52

Emergency Department Head Injuries Pediatrics Hospitals 52

EMDocs

NOVEMBER 16, 2024

13 Management: Dislocation As with all dislocation, early reduction improves outcomes. 9,23 Disposition: Dislocation : If successfully reduced in the emergency department may discharge with strict mobility restrictions and Orthopedic follow up. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006 Feb-.

EMS 88

EMS Dislocations Fractures Operations 88

RebelEM

MAY 15, 2024

Comparison of the MASCC and CISNE scores for identifying low-risk neutropenic fever patients: analysis of data from three emergency departments of cancer centers in three continents. Application of the MASCC and CISNE Risk-Stratification Scores to Identify Low-Risk Febrile Neutropenic Patients in the Emergency Department.

Infectious Diseases 86

Infectious Diseases Administration Sepsis Anaphylaxis 86

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergency department! Obesity: Obesity, whether before or after transplant, is linked to worse outcomes.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

EMDocs

DECEMBER 16, 2023

An 18-month-old boy presents to the emergency department with loss of consciousness. Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. The American Journal of Emergency Medicine., link] Swee, duS.,

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia EMS Stroke Seizures 80

EMDocs

JANUARY 20, 2024

Takotsubo syndrome is often exceedingly difficult to distinguish from acute myocardial infarction in the emergency department, as there is significant overlap in many clinical and diagnostic features. 2006 Jul;27(13):1523-9. Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy. Vital signs show T of 99.0°F

EMS 85

EMS Fluid Resuscitation Shock EKG/ECG 85

EMDocs

NOVEMBER 25, 2024

Vision loss carries a high degree of morbidity and is associated with higher all-cause mortality, 4 and it is our role as emergency providers to recognize potentially reversible causes of such adverse outcomes. 2006) River Blindness: A Success Story under Threat? 7 Approximately 14.6 million from partial or complete blindness.

Infectious Diseases 63

Infectious Diseases Emergency Department EMS Administration 63

EMDocs

NOVEMBER 4, 2024

A comprehensive, patient-centered approach to pain management ensures effective treatment across these diverse pain syndromes, ultimately improving patient outcomes. Am J Emerg Med. The Treatment of Acute Pain in the Emergency Department: A White Paper Position Statement Prepared for the American Academy of Emergency Medicine.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Dr. Smith's ECG Blog

APRIL 8, 2015

Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. These premonitory symptoms were negative predictors of adverse outcomes in EGSYS. 2) Boston syncope rule: J Emerg Med. The ROSE (Risk Stratification of syncope in the emergency department) Study.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

RebelEM

FEBRUARY 3, 2025

Whereas the 2006-2019 Model Development Data set was randomly split 9:1 into a training set and an internal validation set. Outcomes: Primary Outcome : Performance Characteristics of the AI Model in detecting STEMI. Furthermore, the model was not trained on all comers in the emergency department, many of whom do not have ACS.

EKG/ECG 78

EKG/ECG Emergency Department Outcomes Hospitals 78

EMDocs

JANUARY 20, 2025

13 While there is good data that early antibiotics for patients in septic shock reduce mortality 18-19 the role of early and aggressive volume resuscitation and its impacts on patient-centered outcomes remain unclear. 48 in 2006 enrolled 58 patients divided into two groups. Inwald et al. The first study was by Edna et al.

Dehydration 69

Dehydration Fluid Resuscitation Sepsis Resuscitation 69