Taming the SRU

DECEMBER 11, 2023

PATIENT PRESENTATION A young woman with a past medical history of major depressive disorder presented to the emergency room via EMS for a report of intentional ingestion of an unknown substance. EMS reported that she was vomiting profusely on their arrival to the scene but during transport became increasingly lethargic. BMC Psychiatry.

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

Pediatric EM Morsels

MAY 12, 2023

2009 Oct 3;374(9696):1160-70. Epub 2009 Sep 14. The post Closed Head Injury – PECARN for < 3 Months: Rebaked Morsel appeared first on Pediatric EM Morsels. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Erratum in: Lancet.

Head Injuries 130

Head Injuries Fractures Pediatrics EMS 130

Pediatric EM Morsels

JULY 28, 2023

2009 Apr;10(2):155-7. 13406 The post Cerebral Edema and Diabetic Ketoacidosis: Rebaked appeared first on Pediatric EM Morsels. Diabetes Ther. 2010 Dec;1(2):103-20. PMID: 22127748. PubMed] [Read by QxMD] Morales AE1, Daniels KA. Cerebral edema before onset of therapy in newly diagnosed type 2 diabetes. Pediatr Diabetes. PMID: 19261103.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

The Skeptics' Guide to EM

JULY 29, 2023

Emergency Medical Services (EMS) is called and on arrival the patient is walking but has obvious facial trauma and is complaining of some neck pain. As an EMS crew member, you are tasked with deciding what method of spinal motion restriction to use. He has a brief loss of consciousness (LOC) and then awakens and is ambulatory on scene.

Head Injuries 98

Head Injuries EMS Research Emergency Department 98

The Skeptics' Guide to EM

JULY 8, 2023

Managing editor of EM:RAP and Associate Editor at REBEL EM. Managing editor of EM:RAP and Associate Editor at REBEL EM. In 2009, the Cochrane group questioned Roche about the completeness of the data and after four years of requests, finally got access to all the data in 2013 and updated their review in 2014.

CDC 108

CDC Hospitals EMS Emergency Department 108

RebelEM

JANUARY 18, 2024

appeared first on REBEL EM - Emergency Medicine Blog. to 0.97; p = 0.02 Length of ICU Stay 906 patients Prehospital Abx: 300 pts No Prehospital Abx: 606 pts Pooled Mean Difference 0.11; 95% CI -1.85 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 132

Sepsis Hospitals Administration Outcomes 132

ACEP Now

SEPTEMBER 5, 2024

Our state chapter members and leaders are uniquely positioned to follow EMRA’s lead in partnering with local EM residency programs to improve communication of ACEP’s value to EM-bound medical students and EM residents by hosting residency visits or local events relevant to our shared mission.

Leadership 98

Leadership PPE EMS Wellness 98

EMDocs

SEPTEMBER 7, 2023

Fatal Poisoning Among Young Children from Diethylene Glycol-Contaminated Acetaminophen — Nigeria, 2008—2009”. 6, 8 July 2009, pp. Due to the limited availability of laboratory assays for DEG, clinicians should rely on a high index of suspicion, history, and routine lab work for diagnosing DEG toxicity. References: Abubukar et al.

Poisoning 94

Poisoning CDC Administration Emergency Department 94

Emergency Medicine Cases

FEBRUARY 11, 2020

Although the mortality rate in patients with Coronavirus in this outbreak is less than 1% (which pales in comparison to Ebola or SARS), historically these types of outbreaks have occured every 5-6 years (SARS 2003, HINI 2009, Ebola 2014, Coronavirus 2020), so they are somewhat predictable and we should know how to prepare for them in our EDs.

Best Practices 52

Best Practices EMS Research PPE 52

RebelEM

AUGUST 30, 2023

Imaging Gadolinium enhanced MRI – modality of choice, highly sensitive and specific ( Mylona 2009 ). 2009 Aug; 39(1):10-7. Cultured specimen narrows antibiotic coverage Urinalysis/Urine Culture –UTI is a frequent missed source of bacteremia (especially in diabetic patients). J Antimicrob Chemother. Semin Arthritis Rheum.

Infectious Diseases 100

Infectious Diseases Fractures Radiology Radiology 100

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch. 2009;338:b2085.

Hyperthermia / Hypothermia 110

Hyperthermia / Hypothermia Resuscitation CPR EMS 110

Don't Forget the Bubbles

NOVEMBER 22, 2023

Filho EM, Riechelmann MB. 2009) ‘Incidence of propofol-related infusion syndrome in critically ill adults: a prospective, multicenter study’, Critical Care (London, England) , 13(5), p. Paediatric anaesthesia. 1998;8(6):491-9. Folino, T.B. 2023) ‘Propofol’, in StatPearls. Treasure Island (FL): StatPearls Publishing. 2020;96(3):289-309.

Pediatrics 126

Pediatrics EKG/ECG Research Operations 126

Taming the SRU

APRIL 14, 2024

4, 1 July 2009, p. e14, www.biij.org/2009/4/e14/. EM@3AM: Hernia.” “Reduction En-Masse of Inguinal Hernia with Strangulated Obstruction.” Biomedical Imaging and Intervention Journal , vol. Accessed 9 Apr. Jenkins, John T, and Patrick J O’Dwyer. Inguinal Hernias.” 7638, 31 Jan. 269–272, [link]. Long, Brit. “EM@3AM:

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

RebelEM

APRIL 29, 2024

Int J Emerg Med 2009 PMID: 20157465 4. Rezaie, MD (Twitter/X: @srrezaie ) The post Don’t Forget About the IO in the Critically Ill Patient appeared first on REBEL EM - Emergency Medicine Blog. World J Emerg Surg 2023 PMID: 36918947 3. Ngo AS, Oh JJ, Chen Y, Yong D, Ong MEH. Ong MEH, Chan YH, Oh JJ, et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Pediatric EM Morsels

AUGUST 18, 2023

From 2001 to 2009, in a pediatric hospital gram negative culture showed a drop in sensitivity to ciprofloxacin from 96% to 93%. PMID: 29356761 The post Fluoroquinolone Use In Children appeared first on Pediatric EM Morsels. Meesters 2018) Resistance is growing (likely from inappropriate / overuse)! Pediatr Infect Dis J.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

RebelEM

MARCH 8, 2023

Retinal Detachment ( Hollands 2009 ) Pathophysiology Posterior vitreous shrinks with advancing age (aka synchysis senilis), pulling on the retina. Symptom characteristics ( Hollands 2009 ) Any flashers/floaters: (+) LR 1.2 Photopsia is from vitreoretinal traction, floaters are from vitreous cells/blood in the eye. and (–) LR 0.9.

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

Taming the SRU

SEPTEMBER 8, 2023

NAC: Jiang SX, Hussaini T, Yoshida EM. 2009 Sep;137(3):856-64, 864.e1. Epub 2009 Jun 12. 2009 Jun;136(7):2159-68. “Acute Liver Failure: Evidence-Based Evaluation and Management.” emDOCs.Net - Emergency Medicine Education, 26 Nov. 2018, www.emdocs.net/acute-liver-failure-evidence-based-evaluation-and-management/.

Radiology 59

Radiology Radiology Ultrasounds EMS 59

RebelEM

FEBRUARY 5, 2024

Sites: Investigators recruited patients at 31 French emergency departments at university and nonuniversity hospitals Duration : June 1, 2009 to March 31, 2015. Practice Updates: While published in 2023, the data from this trial were gathered between 2009 and 2015. Population: Inclusion: Patients between 18–50 years of age.

Outcomes 104

Outcomes Hospitals Research Emergency Department 104

RebelEM

FEBRUARY 22, 2023

Giant Cell Arteritis (arteritic anterior ischemic neuropathy) ( Bagheri 2015 , Hayreh 2009 ) Pathophysiology Giant cell arteritis(GCA) affects that medium-sized and large arteries. Rezaie, MD (Twitter: @srrezaie ) The post REBEL Core Cast 96.0 – Acute Vision Loss I appeared first on REBEL EM - Emergency Medicine Blog.

Emergency Department 52

Emergency Department EMS Wellness 52

EMDocs

MAY 26, 2023

2009 Nov;27(4):655-67, ix. 2009 Jun;21(3):196-202. Summary All right, so that’s it for this episode – hopefully you learned a bit more about how to safely deescalate an agitated child, and how we can keep them and ourselves as providers safe in a stressful environment. Coburn VA, Mycyk MB. Physical and chemical restraints.

Pediatrics 98

Pediatrics Emergency Department Psychiatric Documentation/Coding 98

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. You need to recognize an arrest and activate your EMS system. JAMA 2009 * Jacobs et al.

CPR 52

CPR Academics Resuscitation Hospitals 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). JAMA 2009, Hagihara et al. Jenn Doyle is a paramedic educator at Middlesex-London Paramedic Service. Case: A 51-year-old man experiences a cardiac arrest on the street. He is unsuccessfully shocked.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

The Skeptics' Guide to EM

FEBRUARY 26, 2019

Dr. Hoffman has published a graphic re-analysis of NINDS ( Annals EM 2009 ) and Sayer et al responded in print ( Annals EM 2010 ). We did not re-hash all the trials in our conversation but instead focused on a couple key publications like NINDS and IST-3.

Stroke 52

Stroke EMS Research Outcomes 52

RebelEM

JANUARY 25, 2024

2009 Oct;114(7):1053-64. Epub 2009 Aug 20. appeared first on REBEL EM - Emergency Medicine Blog. Cardinale L, Volpicelli G, Binello F, Garofalo G, Priola SM, Veltri A, Fava C. Clinical application of lung ultrasound in patients with acute dyspnea: differential diagnosis between cardiogenic and pulmonary causes. Radiol Med.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

The Skeptics' Guide to EM

MAY 6, 2023

The American College of Emergency Physicians ( ACEP ) defined the term in 2009 as “acute delirium (not linked to dementia or preexisting pathologies) associated with extreme physical and psychomotor agitation”. The task force came up with a paper that was presented and accepted by the ACEP board in 2009.

EMS 40

EMS Hospitals 40

Cook County EM Blog

MAY 29, 2023

As resuscitation measures are underway, you obtain collateral from EMS and parents. Upon EMS arrival, the patient was in cardiac arrest. EMS shows you the prescription bottle with a handful of capsules remaining. From 2004 to 2009, prescriptions in the US increased by 50%.

Seizures 52

Seizures Poisoning Resuscitation Administration 52

The Skeptics' Guide to EM

JULY 9, 2022

They published their findings in Annals of EM 2009. Any brief comments on this reanalysis? Hoffman and Schrieger stirred things up a bit with their graphic reanalysis of the NINDS trial using the NIHSS score.

Stroke 52

Stroke Emergency Department EMS Outcomes 52

PulmCCM

JUNE 10, 2024

” Time-Limited Trials of Critical Care Time-limited trials of intensive care were suggested at least as far back as 2009 as a method of bridging the divide between clinicians and families' perspectives and expectations for ICU care. Kruser JM, Nadig NR, Viglianti EM, Clapp JT, Secunda KE, Halpern SD. 2009 Fall;20(3):212-9.

COPD 45

COPD Outcomes Hospitals EMS 45

Don't Forget the Bubbles

MAY 29, 2023

Workplace Incivility Among Nationally Certified EMS Professionals and Associations with Workforce-Reducing Factors and Organizational Culture, Prehospital Emergency Care. Academy of Management Learning & Education [Internet] 2009: 8:2:301–303. Journal of Interpersonal Violence [Internet]. 2021:36:1–2, NP448–NP473 Available at.

Leadership 98

Leadership Patient Safety Academics Research 98

ACEP Now

MAY 6, 2023

EMS reports starring and significant damage to the windshield and show you a picture (Figure 1). FIGURE 1: EMS Photo of damaged windshield showing star/spider web pattern from impact of occupant. Sudbury, Massachusetts: Jones and Bartlett; 2009. He is completely amnestic to the events of the accident. Click to enlarge.)

Forensics 52

Forensics Documentation/Coding Head Injuries Fractures 52

EMDocs

JULY 9, 2024

2009 Mar;123(3):858-64. Published January 29, 2024. link] Dubowitz H, Feigelman S, Lane W, Kim J. Pediatric primary care to help prevent child maltreatment: the Safe Environment for Every Kid (SEEK) Model. Pediatrics. doi: 10.1542/peds.2008-1376. PMID: 19255014.

Pediatrics 75

Pediatrics Emergency Department Research Burns 75

RebelEM

JUNE 5, 2023

Drug Alcohol Depend 2009; 104:73. Rezaie, MD (Twitter: @srrezaie ) The post REBEL Cast Ep117: Low Dose vs Standard Dose Take-Home Buprenorphine From the ED appeared first on REBEL EM - Emergency Medicine Blog. Retrieved February 28, 2023, from [link] Bell JR, Butler B, Lawrence A, et al. PMID 19443138.

Emergency Department 97

Emergency Department Hospitals Outcomes EMS 97

Dr. Smith's ECG Blog

JULY 7, 2013

He had walked into the ED (did not use EMS). Apr 28, 2009. A man in his 60's presented after 4 days of chest pain, with some increase of pain on the day of presentation. Exact pain history was difficult to ascertain. There was some SOB. Here is his ECG: There is atrial fibrillation at a rate of 95. J Am Coll Cardiol 53(17):1503-9.

Ultrasounds 52

Ultrasounds EKG/ECG Emergency Department Shock 52

ALiEM

MAY 13, 2024

J Emerg Med 2009 [9] 50 Prospective cohort study of children <18yrs comparing clinical assessment to POCUS 90% (77-100%) 83% (70-97%) POCUS changed management in 22% of cases. Lam SHF, Sivitz A, Alade K, Doniger SJ, Tessaro MO, Rabiner JE, Arroyo A, Castillo EM, Thompson CA, Yang M, Mistry RD. Epub 2009 Aug 8. Adams et al.,

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Advocacy for Trauma Care and EMS Development. Development of EM Residencies. Organized EM supporting Rapid Sequence Intubation and other airway advances. Organized EM supporting Rapid Sequence Intubation and other airway advances. EM begins to "Own the Airway" (emergent). EDNA->ENA. Touchstone, Mike.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

ACEP Now

FEBRUARY 11, 2024

Dr. Kelly is an emergency medicine attending physician and regional EMS medical director/division chief of prehospital and disaster medicine at Baystate Health in Springfield, MA. Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016. References Tyring S, Douglas J, Corey L.

Emergency Department 52

Emergency Department CDC Hospitals EMS 52

EM Curious

JULY 24, 2015

EMS appears with a patient who just wiped out big time on the ice. Our inaugural post today: femoral nerve blocks. The Case Let's say we do a little time warp, and we are unfortunately six months into the past, stuck in the dredges of frigid winter. He's gripping his thigh with his hands, and he is screaming. Maybe he's broken his hip?

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52