The Skeptics' Guide to EM

DECEMBER 8, 2017

A Prospective Randomized, Double-Dummy Trial Comparing Intravenous Push Dose of Low Dose Ketamine to Short Infusion of Low Dose Ketamine for Treatment of Moderate to Severe Pain in the Emergency Department. Guest Skeptic: Dr. Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas.

Emergency Department 52

Emergency Department Fractures EMS 52

RebelEM

DECEMBER 5, 2023

up to 23% ( Lieberman 2005 , Rohacek 2014 , Tole 2007 , Grunau 2014 ). While the evidence is not strong, those who have been undertreated, experienced delays in treatment, or required multiple injections of epinephrine are more prone to experience a recurrence of symptoms ( Ellis 2007 , Liu 2020 ).

Anaphylaxis 81

Anaphylaxis Allergic Reactions Emergency Department EMS 81

PEMBlog

MAY 17, 2023

Most children who present to Pediatric Emergency Departments these days with mental health concerns – including agitation – have a known psychiatric problem or diagnosis. J Inherit Metab Dis 2007; 30:631. Psychiatric emergencies. West J Emerg Med. Chun TH, Sargent J, Hodas GR. 2019 Mar;20(2):409-418.

Psychiatric 80

Psychiatric Pediatrics Emergency Department Best Practices 80

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? An implementation science approach improves language access in the emergency department. Association of limited English proficiency and increased emergency department waiting room lengths of stay. Annals of Emergency Medicine.

Documentation/Coding 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

Taming the SRU

NOVEMBER 14, 2023

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. Clinical scoring tools have improved diagnostic performance in assessing suspected appendicitis in the emergency department.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

RebelEM

FEBRUARY 21, 2024

A 2007 review of the literature concluded that there was no difference in analgesia between IM ketorolac and PO ibuprofen ( Arora 2007 ). Can J Emerg Med 2007; 9(1): 30-2. NSAID use and efficacy in the emergency department: single doses of oral ibuprofen versus intramuscular ketorolac.

Administration 63

Administration Emergency Department EMS Research 63

Pediatric EM Morsels

JULY 21, 2023

Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. 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. Gill MR, Reiley DG, Green SM. 2004;43:215-223. Rowley G, Fielding K. 1991;337:535-538.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. Thorough history taking and detailed examination can aid in diagnosis. Most paediatric neck lumps are benign, although they may require specific investigations and management.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

Pediatric Emergency Playbook

MARCH 1, 2018

Emerg Med Clin North Am. 2007 Nov;25(4):1137-59. Pediatric Opthalmology in the Emergency Department. Pediatrics. 2009; 123(3):841-8 Herman M, Le A. The crying infant. The infant with acute, unexplained, excessive crying. Pediatrics. 1991; 88 (3): 450-5. Prentiss KA, Dorfman DH. 2008; 26: 181-198.

Pediatrics 52

Pediatrics Emergency Department 52

RebelEM

AUGUST 28, 2023

A 2007 review of the literature concluded that there was no difference in analgesia between IM ketorolac and PO ibuprofen ( Arora 2007 ). Can J Emerg Med 2007; 9(1): 30-2. NSAID use and efficacy in the emergency department: single doses of oral ibuprofen versus intramuscular ketorolac.

Administration 52

Administration Emergency Department EMS Research 52

ALiEM

JANUARY 22, 2024

A 40-year-old male, tailor by occupation, was brought to the Emergency Department with complaints of high-grade fever for the past 11 days. 2007 Dec;21(4):997-1011, ix. Fever was documented to be 102°F and was not associated with any chills or rigors. Early empiric treatment with Doxycycline is life-saving. doi: 10.1016/j.idc.2007.08.002.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Unsuspected Critical Illness Among Emergency Department Patients Presenting for Acute Alcohol Intoxication. Annals of Emergency Medicine. J Emerg Med. Ann Emerg Med. Lancet Neurol.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

PEMBlog

MAY 24, 2023

Alice Kuo and Ilene Claudius Podcast EIIC: Safe Control of the Agitated Patient Webinar Series with Dr. Emerg Med Clin North Am. Structured team approach to the agitated patient in the emergency department. Emerg Med Australas. West J Emerg Med. Eur J Emerg Med. 2007 Oct;14(5):265-8. 2009.07.003.

Emergency Department 59

Emergency Department Pediatrics Psychiatric Administration 59

EMDocs

MAY 26, 2023

Emerg Med Clin North Am. Structured team approach to the agitated patient in the emergency department. Emerg Med Australas. Use and avoidance of seclusion and restraint: consensus statement of the american association for emergency psychiatry project Beta seclusion and restraint workgroup. West J Emerg Med.

Pediatrics 98

Pediatrics Emergency Department Psychiatric Documentation/Coding 98

The Skeptics' Guide to EM

MAY 21, 2017

Background: Heroin use has been increasing in the USA since 2007 (1). Some heroin users may refuse further treatment or transport to the emergency department after receiving naloxone in the field and awaking. If transported to hospital, they may also refuse further treatment or observation in the emergency department.

Emergency Department 52

Emergency Department Administration Academics EMS 52

ACEP Now

AUGUST 1, 2023

How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. When those same fundamentals done right achieve great success, they aren’t little at all.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

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. Routine serum testing and urine toxicology testing are not recommended for psychiatric patients presenting to the emergency department.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

EMDocs

SEPTEMBER 25, 2023

actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department. Okubo M, Gibo K, Hagiwara Y, Nakayama Y, Hasegawa K; Japanese Emergency Medicine Network Investigators. Int J Emerg Med. ” The American Journal of Emergency Medicine 49 (2021): 48-51.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

ACEP Now

AUGUST 12, 2024

A 35-year-old male presented to the emergency department complaining of chest pain that started 1.5 5 Studies looking at this phenomenon in the emergency department setting for patients presenting with chest pain are lacking. Dr. Young is an emergency physician at Saint Francis Hospital and Medical Center, Hartford, Conn.

EKG/ECG 52

EKG/ECG Emergency Department Hospitals 52

The Skeptics' Guide to EM

MARCH 18, 2023

Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. She is also the […] The post SGEM #397: Give a Little Bit…of Oseltamivir to Pediatric Patients Admitted with Influenza first appeared on The Skeptics Guide to Emergency Medicine. JAMA Pediatr. JAMA Pediatr. JAMA Pediatr.

Pediatrics 40

Pediatrics Infectious Diseases Administration Outcomes 40

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. Trends in opioid prescriptions among part D medicare recipients from 2007 to 2012. Opioid-Prescribing Patterns of Emergency Physicians and Risk of Long-Term Use. On ED presentation, he was experiencing 10 out of 10 pain level.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Wellness 52

The Skeptics' Guide to EM

JANUARY 7, 2018

Chris Carpenter is from Washington University, Deputy Editor of Academic Emergency Medicine and faculty member of Emergency Medicine and Critical Care course. Case: A 35-year-old female presents to your emergency department three-hours after the onset of a severe frontal headache.

Emergency Department 40

Emergency Department Academics Outcomes 40

EMDocs

MAY 11, 2024

Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. 2007 Jan 27;369(9558):293-8. Clinical Policy: Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department. Ann Emerg Med.

Stroke 110

Stroke EMS EKG/ECG Radiology 110

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. Fluroquinolones +/- anti-pseudomonal beta-lactams are the antimicrobials of choice for initial management. His vital signs are normal except for a temperature of 38.2°C link] Franco-Vidal, V., Blanchet, H.,

EMS 105

EMS Infectious Diseases Radiology Radiology 105

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. Diagnosing ectopic pregnancy in the emergency setting. Academic Emergency Medicine, 14: 755-758. Pages 501-508, ISSN 1521-6934. O'Brien, E.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

EMDocs

JUNE 16, 2023

And now we’re here at our destination, the place we know and love, the emergency room to talk about what we should be doing for the growing volume of children with mental health problems boarding in the emergency department. McEnany, Olutosin Ojugbele, Julie R. Doherty, Jennifer L. McLaren, JoAnna K. 10.1542/peds.2020-1174

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

Taming the SRU

MARCH 14, 2023

Case 1 Fussy 1 month old A 1-month-old (ex-34 week premature) infant comes to your emergency department for fussiness. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. More on this below as we work through a few cases…. Neurosurg Focus.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

EMDocs

JANUARY 4, 2024

Case Follow-up: The patient required a dose of lorazepam in the emergency department. Ann Emerg Med. Epub 2007 Sep 4. The patient’s mother believes the patient thought the pills were acetaminophen, and she was taking them for abdominal pain. She was admitted on a cardiac monitor with serial EKGs every four hours.

Seizures 92

Seizures EKG/ECG Poisoning Shock 92

The Skeptics' Guide to EM

SEPTEMBER 7, 2018

Ben Lawton is a paediatric emergency physician in Brisbane Australia. He divides his time between a tertiary children’s hospital and a community hospital that is busy enough to have its own paediatric emergency department. He is part of the Don’t Forget the Bubbles team.

Dehydration 40

Dehydration Pediatrics Hospitals Academics 40

Don't Forget the Bubbles

MAY 29, 2023

Bad manners in the Emergency Department: Incivility among doctors. Burnout and Workplace Incivility Among Emergency Medical Services Practitioners: A Preliminary Report , Prehospital Emergency Care [Internet] 2023 Okuyama A, Wagner C, Bijnen B. Internet] 2007; 505:1181–1197. BMJ Open [Internet] 2020;10: e035471.

Leadership 98

Leadership Patient Safety Academics Research 98

ALiEM

MARCH 7, 2024

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). Point-of-care ultrasound for the detection of hydronephrosis in emergency department patients with suspected renal colic.

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

RebelEM

DECEMBER 1, 2022

Background: Pneumothorax management is a common clinical condition in the emergency department (ED) occurring in patients of varying ages and caused by multiple etiologies, including spontaneous, traumatic, and iatrogenic pneumothorax. Regardless of the cause, a thoracostomy is often required for treatment (Currie 2007 ).

Outcomes 52

Outcomes Hospitals Research Critical Access 52

RebelEM

JANUARY 23, 2023

2007 Jul-Aug;28(4):418-26. 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. The effectiveness of IV cetirizine was determined to be statistically non-inferior. PMID: 17883909.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 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. 2007; 16:27-33.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Don't Forget the Bubbles

DECEMBER 16, 2024

Clear history taking In the Emergency Department, healthcare professionals should prioritise thorough history-taking when assessing potential suspected cases. European Centre for Disease Prevention and Control. Measles facts [Internet]. cited 2024 Oct 24] WHO. Risk assessment for measles resurgence in the UK: 2023 [Internet].

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. 2007 Jul 18;2007(3):CD000277. A non-contrast head computed tomography (CT) demonstrates a diffuse hyperdensity consistent with subarachnoid hemorrhage (SAH). PMID: 9566366.

Stroke 99

Stroke Outcomes EMS Seizures 99