The Skeptics' Guide to EM

JULY 2, 2023

He is the Creator and founder of REBEL EM, a free, critical appraisal blog that tries to cut down knowledge translation gaps of […] The post SGEM#408: Hey, I, Oh I’m Still Alive – Is it due to TXA? There is also the CRASH-2 trial from 2010 which was reviewed with our good friend Dr. Anand Swaminathan ( SGEM#80 ).

EMS 145

EMS Outcomes Hospitals Research 145

RebelEM

MAY 29, 2024

If you treat a posterior bleed at a hospital without ENT, I would transfer as surgical intervention is pretty common REBEL EM: Do Patients with Epistaxis Managed by Nasal Packing Require Prophylactic Antibiotics? REBEL EM: Do Patients with Posterior Epistaxis Managed by Posterior Packs Require ICU Admission?

PPE 104

PPE EMS Hospitals Wellness 104

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. Published 2010.

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

Pediatric EM Morsels

JULY 28, 2023

2010 Dec;1(2):103-20. 13406 The post Cerebral Edema and Diabetic Ketoacidosis: Rebaked appeared first on Pediatric EM Morsels. Low morbidity and mortality in children with diabetic ketoacidosis treated with isotonic fluids. 2013 Sep;163(3):761-6. PMID: 23499379. PubMed] [Read by QxMD] Rosenbloom AL. Diabetes Ther. PMID: 22127748.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

RebelEM

FEBRUARY 24, 2025

Jul 2010; PMID: 20620859. Sep 2010; PMID: 20502865 Teboul JL, et al. Feb 2023; PMID: 36835888 Peer Reviewed By: Mark Ramzy, DO (X: @ MRamzyDO ), Marco Propersi, DO (X: @Marco_Propersi ) The post IVC Distensibility Index vs Collapsibility Index: Using the Correct Index appeared first on REBEL EM - Emergency Medicine Blog.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

University of Maryland Department of Emergency Med

JUNE 21, 2023

Between 2010 and 2020, there were 279 fatalities related to ambulance accidents. In up to 50% of accidents, EMS is not at fault. Click to view the rest

EMS 68

EMS 68

RebelEM

SEPTEMBER 13, 2023

of people who take NSAIDs ( Nzeako 2010 ). This can cause an abundance of leukotrienes and other pro-inflammatory mediators and precipitate angioedema ( Nzeako 2010 ). patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01

Allergic Reactions 105

Allergic Reactions Airway Management Anaphylaxis Emergency Department 105

RebelEM

AUGUST 30, 2023

cases per 100,000 people ( Zimmerli 2010 ) More common in males with M:F of 3:1 Rate is also increasing due to increased number of spinal procedures Typically affects adults, with most cases occurring in patients over 50 years old. 2010 Nov;65 Suppl 3:iii 11-24 PMID: 20876624 Mylona E, et al. N Engl J Med 2010 Mar; 362(11)1022-9.

Infectious Diseases 100

Infectious Diseases Fractures Radiology Radiology 100

RebelEM

JANUARY 24, 2024

2010; 92(17): 2767-75. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 116.0 – Achilles Tendon Rupture appeared first on REBEL EM - Emergency Medicine Blog. PMID: 22538958 Willits K et al. Bone Joint Surg Am. PMID: 21037028 Wallace RG et al. Orthop J Sports Med.

Operations 101

Operations Ultrasounds Fractures Outcomes 101

The Skeptics' Guide to EM

OCTOBER 17, 2020

Salim is probably better known as the creator and founder of the wonderful knowledge translation project called REBEL EM. It is a free, critical appraisal blog and podcast […] The post SGEM#305: Somebody Get Me A Doctor – But Do I Need TXA by EMS for a TBI? Background: The CRASH-2 trial, published in 2010, showed a 1.5%

EMS 52

EMS Head Injuries Outcomes Hospitals 52

RebelEM

JANUARY 9, 2024

You decide she is stable to be discharged home on levofloxacin (See REBEL EM for antibiotic coverage in CAP ) but consider giving her a first dose intravenously. Eur Resp J 2010; 35: 858-64. appeared first on REBEL EM - Emergency Medicine Blog. A CXR demonstrates a right middle lobe opacity. Oral versus i.v.

Infectious Diseases 99

Infectious Diseases Pediatrics EMS Administration 99

Pediatric EM Morsels

JULY 5, 2024

2010; doi:10.1016/j.annemergmed.2010.08.038. The post Pediatric Cervical Spine Injury Risk Stratification: Rebaked Morsel appeared first on Pediatric EM Morsels. Lancet Child Adolesc Health. 2024; Published online June 4, 2024. doi:10.1016/S2352-4642(24)00104-4. Leonard JC, Kuppermann N, Olsen C, et al. Ann Emerg Med. 2010.08.038.

Pediatrics 164

Pediatrics Head Injuries Dislocations Research 164

EMDocs

JANUARY 17, 2024

When emergency medical services (EMS) arrived, she was in asystole with an empty, recently full, bottle of benzonatate 100 mg capsules. 3, 7) The accumulating post marketing adverse event reports led to the FDA release of a Drug Safety Communication (DSC) in 2010, over 50 years after initial approval. (9) Pharmacotherapy.

Poisoning 92

Poisoning Seizures Pediatrics EMS 92

RebelEM

JUNE 19, 2023

Read More Core EM: CRASH-2: Tranexamic Acid in Major Trauma References: CRASH-2 Trial Collaborators. Lancet 2010; 376(9734): 23-32. appeared first on REBEL EM - Emergency Medicine Blog. This should continue to make TXA part of standard trauma resuscitation while additional studies are performed.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

JournalFeed

JANUARY 17, 2022

Today, we are talking about race in EM with the authors of a recent op-ed in Annals of Emergency Medicine. We tackle some tough questions about racism and how we can be better allies as EM colleagues. 2010 Nov;60(11):451-6. Epub 2010 Jun 16. It’s a special edition of the JournalFeed Podcast. doi: 10.1055/s-0030-1251980.

EMS 52

EMS Emergency Department 52

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

RebelEM

MAY 25, 2023

Lancet 2010 [10] >20,000 adult trauma patients with SBP <90mmHg Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs Placebo given within 8hrs of injury In-hospital mortality by 28d reduced (14.5% 2010; 376(9734):23-32. Lancet (London, England). PMID: 20554319 The CRASH-3 Trial Collaborators. JAMA Surg 2022.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

RebelEM

MAY 27, 2024

mg/kg) or starting at 12 mg might be more effective for certain populations (Deck 2023, Cabalag 2010). appeared first on REBEL EM - Emergency Medicine Blog. These rates are significantly lower than those in other research (Holdgate 2006). Evidence suggests that a weight-based dosing approach (0.1

Outcomes 137

Outcomes Research Operations Hospitals 137

EMDocs

JUNE 1, 2023

Bradycardia: 18.8% Average ventilator days (8.3 Take Aways: The data do not suggest that targeted hypothermia improves neurological function, reduces death, or reduces hospital length of stay as compared to normothermia. Bradycardia: 18.8% Average ventilator days (8.3

Hyperthermia / Hypothermia 87

Hyperthermia / Hypothermia Outcomes Hospitals Emergency Department 87

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. The methodology was changed in IST-3 when they did not reach.

Stroke 52

Stroke EMS Research Outcomes 52

The Skeptics' Guide to EM

MAY 30, 2020

Case: A 44-year-old male presents to your level 1 trauma center by EMS after a motor vehicle collision. REBEL EM has looked at using TXA for those conditions plus a few others (we will include a table in the show notes). This study published in 2010 showed an absolute mortality reduction of 1.5%

Head Injuries 52

Head Injuries Academics EMS Stroke 52

RebelEM

JUNE 26, 2024

CMAJ 2010; 182(15): 1631-5. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 125.0 – Hyperkalemia appeared first on REBEL EM - Emergency Medicine Blog. Definition: A serum potassium level > 5.5 rhabdomyolysis -> hydration) Remove inciting factors (i.e. furosemide) Dialysis for anuric patients (i.e.

EKG/ECG 58

EKG/ECG Administration Burns EMS 58

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. The Case: A 4-year-old boy born with no past medical history presents in cardiac arrest. Pharmacotherapy.

Seizures 52

Seizures Poisoning Resuscitation Administration 52

Pediatric EM Morsels

AUGUST 18, 2023

Etminan 2019) In Belgium between 2010 – 2013, of the 262 children treated with fluroquinolones while hospitalized, only 17% were used for labelled indications. PMID: 29356761 The post Fluoroquinolone Use In Children appeared first on Pediatric EM Morsels. Meesters 2018) Resistance is growing (likely from inappropriate / overuse)!

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

PHEM Cast

JULY 27, 2021

The Sonosite website has some excellent resources, which you can filter according to specialty, including prehospital using ‘EMS/Air Med/Ambulance’. Intensive Care Med 2010; 36: 1475-83. The radiopaedia website is an amazing resource for all things imaging. Their section on POCUS is here. Cavallaro F, Sandroni C, Marano C, et al.

Ultrasounds 52

Ultrasounds Fractures Resuscitation EMS 52

PHEM Cast

APRIL 10, 2016

And from our buddies at HEFT EM CAST: [link] A bit more detail covering some of the research in an easy to understand way. An amazing podcast on the subject can be found at SMART EM: SMART Testing: Back to Basics As always, any feedback, comments etc. 2010 Apr;38(4):1045–53. Báez AA, Hanudel P, Perez MT, Giráldez EM, Wilcox SR.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

The Skeptics' Guide to EM

JUNE 11, 2017

Guest Skeptic: Dr. Robert Edmonds is an Emergency Medicine staff physician in Newport News, VA and a recent graduate of the University of Missouri-Kansas City EM residency. Lancet 2016. Many physicians are faced with patients with intracerebral hemorrhage on antiplatelets, and how to best manage them.

Stroke 52

Stroke EMS Outcomes 52

The Skeptics' Guide to EM

JANUARY 19, 2019

Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com Case: A 33-year-old man arrives via emergency medical services (EMS) after initially being […] The post SGEM#241: Wake Me Up Before You Go, Go – Using the HOUR Rule first appeared on The Skeptics Guide to Emergency Medicine.

EMS 52

EMS CDC Emergency Department Hospitals 52

RebelEM

NOVEMBER 30, 2022

Am J Emerg Med 2010; 28:786-789. Rezaie, MD (Twitter: @srrezaie ) The post REBEL Core Cast 91.0 – Testicular Torsion appeared first on REBEL EM - Emergency Medicine Blog. Epidemiology: Most common cause of acute scrotal pain in prepubertal boys Torsion present in 3.2% OR = 58.8 (Ben-Israel PMID: 20837255 Sidler D et al.

Ultrasounds 52

Ultrasounds Pediatrics Operations EMS 52

EMDocs

AUGUST 3, 2023

2010 Aug;48(7):770]. A multicenter comparison of the safety of oral versus intravenous acetylcysteine for treatment of acetaminophen overdose [published correction appears in Clin Toxicol (Phila). Clin Toxicol (Phila). 2010;48(5):424-430. doi:10.3109/15563650.2010.486381 Mant TG, Tempowski JH, Volans GN, Talbot JC.

Poisoning 98

Poisoning Seizures Administration Pediatrics 98

RebelEM

JANUARY 29, 2024

CHEST 2010. appeared first on REBEL EM - Emergency Medicine Blog. Efficacy and Safety of Low Dose Recombinant Tissue-Type Plasminogen Activator for the Treatment of Acute Pulmonary Thromboemolism: A Randomized, Multicenter Controlled Trial. PMID: 19741062 Kucher N et al.

Stroke 136

Stroke Outcomes Hospitals Administration 136

EMDocs

SEPTEMBER 7, 2023

1, 2010, pp. Accessed August 2022. Besenhofer, Lauren M., Inhibition of Metabolism of Diethylene Glycol Prevents Target Organ Toxicity in Rats.” Toxicological Sciences , vol. link] Ballentine, Carol. Sulfanilamide Disaster.” FDA Consumer Magazine , June 1981, [link] Accessed August 2022. Conklin, Laura, et al.

Poisoning 94

Poisoning CDC Administration Emergency Department 94

RebelEM

JANUARY 23, 2023

Despite being highly effective in treating acute allergic reactions, first-generation H1 antihistamines cross the blood-brain barrier and bind to H1 receptors, which can lead to undesirable side effects, including drowsiness, sedation, fatigue, and decreased cognition (Church MK 2010). 2010 Apr;65(4):459-66. Epub 2010 Feb 8.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Urgent Care Emergency Department 52

EMDocs

AUGUST 7, 2023

Schnapp, MD, MEd (Associate Program Director, University of Wisconsin) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF), Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case A 36-year-old pregnant woman at 21 weeks gestation presents to the ED with chest pain. Published 2010 Mar 30.

EMS 96

EMS Wellness Emergency Department 96

RebelEM

NOVEMBER 2, 2022

2010, (Ch) 90: p 1186-1205. EMRAP: C3 Live Paracentesis Video LITFL: Spontaneous Bacterial Peritonitis SinaiEM: SBP Pearls REBEL EM: Should You Give Albumin in Spontaneous Bacterial Peritonitis (SBP)? Louis, Mosby, Inc., References Runyon BA et al. Ascitic fluid analysis in malignancy‐related ascites.

EMS 52

EMS Administration Hospitals 52

RebelEM

MARCH 13, 2023

Does the inclusion of patients pronounced dead on scene and the presence of a physician-based EMS organization affect the pooled mortality rate and survival with favorable neurologic outcomes for prehospital TCA? Subcategory data on EMS system type is still extremely variable, given the range of included EMS systems and regions.

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

EMDocs

JULY 30, 2024

Elsevier; 2010:2153-2217. As no definitive testing could be performed on the material ingested, it could not be confirmed whether the patient’s symptoms were related to a PNU exposure or new onset diabetes, however, PNU exposure was highly suspected. References: Pelfrène AF. Rodenticides. In: Krieger R, ed. Clinical Pediatrics.

Poisoning 75

Poisoning Seizures Fluid Resuscitation Pediatrics 75