The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services at Tacoma Community College. Case: During a busy emergency department (ED) shift the paramedic phone rings.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

Don't Forget the Bubbles

MAY 6, 2024

For a deep dive into intubation, see Intubation of the critically unwell Child in the emergency department – Don’t Forget the Bubbles (dontforgetthebubbles.com) For all things neonatal (lines and tubes), see Neonatal lines and tubes – Don’t Forget the Bubbles (dontforgetthebubbles.com) Why does it matter?

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

The Skeptics' Guide to EM

APRIL 28, 2018

Case: A 72-year-old gentleman presents to your emergency department. He has been generally unwell for around one week, with a worsening cough, shortness of breath […] The post SGEM#216: Pump It Up – Corticosteroids for Patients with Pneumonia Admitted to Hospital first appeared on The Skeptics Guide to Emergency Medicine.

Hospitals 40

Hospitals Emergency Department Outcomes Shock 40

Taming the SRU

AUGUST 30, 2023

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. 2011 Jan;3(1):118-27. In 7 studies with 4164 patients, PCT with a cut-off > 0.1 ng/mL, 0.25-0.5

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

EMDocs

DECEMBER 6, 2024

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. 6 Severe toxicity and shock are typically seen with serum iron concentrations above 500 g/dL and serum iron concentrations above 1000 g/dL are associated with significant mortality. McGraw Hill; 2016.

Poisoning 75

Poisoning Fluid Resuscitation Seizures Resuscitation 75

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Western Journal of Emergency Medicine, 12(4), 571. Western Journal of Emergency Medicine , Vol 15 Issue 6 has five articles related to pregnancy. Critical care medicine, 33(10), S259-S268. Preeclampsia/ Eclampsia - Emergency Department Resources. {3 abstracts} Luckett-Gatopoulos, S. Nguyen, H. M., & Healy, D.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

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. 2011; 364(3):255-264.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

They used REBOA for refractory hemorrhagic shock due to either blunt or penetrating injury. Pediatric emergency department thoracotomy: a large case series and systematic review. Pediatric emergency department thoracotomy: A 40-year review. 2011 Dec;71(6):1869-72. Brenner et al. J Pediatr Surg. J Surg Res.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

PEMBlog

JANUARY 17, 2024

2011 Mar;127(3):e573-80. Epub 2011 Feb 21. Clin Infect Dis 2011; 52:e18. Full blown sepsis and toxic shock syndrome. Now, some facilities have a short stay unit, like in their emergency department. Randomized controlled trial of cephalexin versus clindamycin for uncomplicated pediatric skin infections.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

RebelEM

NOVEMBER 3, 2022

Albert 2011, Jabre 2009) However, the existing literature comparing etomidate and ketamine is conflicting. Inclusion: Articles compared the safety and efficacy of etomidate compared to k etamine, in patients of all age groups, as induction agents for RSI in the Emergency Department (ED) and prehospital settings.

Outcomes 52

Outcomes Emergency Department Sepsis Operations 52

Pediatric Emergency Playbook

DECEMBER 1, 2015

It’s a high-flow artery to the face, and if disrupted, the child may have significant bleeding and possibly hemorrhagic shock. J Emerg Med. Electrical Injuries: Shocking or Subtle?” In Avoiding Common Errors in the Emergency Department, 2nd Edition. J Emerg Med. 2011; 40(5):598-604. Horeczko T.

Burns 40

Burns Emergency Department EKG/ECG Shock 40

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. 2011 Mar;123(16):1788-1830.

Ultrasounds 80

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 80

PEMBlog

JUNE 5, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Pediatric Emergency Playbook

JANUARY 1, 2017

neutropenia) ( Babl 2011 , Dokko 2014 ). Unexplained tachycardia may be the early signs of shock. Intranasal ketamine for analgesia in the emergency department: a prospective observational series. Acad Emerg Med. Is there a role for intravenous acetaminophen in pediatric emergency departments?

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

FEBRUARY 12, 2024

First, there can be a poor correlation between venous and arterial gases in states of shock, hemodynamic instability, or extremes of acid-base disturbances, due to poor cardiac output/circulatory failure impairing venous and arterial flow, with associated poor gas exchange as well as hypercapnia and acidemia at the tissue level (8).

Emergency Department 93

Emergency Department Resuscitation COPD Shock 93

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 mg/kg (of 0.1 2x maintenance rate

Psychiatric 87

Psychiatric Seizures Emergency Department Pediatrics 87

Mind The Bleep

JUNE 17, 2023

A study in 2011 of 258 children admitted to hospital with pneumonia found that 8.5% Kirovski I, 2011) It’s important to think about the possibility of an empyema or bad pneumonia in a child with difficulty in breathing, fever and abdominal pain. Open Access Emergency Medicine , 283-291. Annals of Paediatric Surgery.

Shock 93

Shock Wellness Emergency Department Ultrasounds 93

Taming the SRU

APRIL 26, 2023

Mil Med 2011. J Emerg Med 2016. Classification of sepsis, severe sepsis and septic shock: the impact of minor variations in data capture and definition of SIRS criteria. Evidence-Based Heatstroke Management in the Emergency Department. West J Emerg Med 2021. Epstein Y, Yanovich R. Heatstroke. TamingtheSRU.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52

ALiEM

OCTOBER 30, 2024

Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. 2011 Dec;6:1-4. Emergency department-initiated buprenorphine for opioid dependence with continuation in primary care: outcomes during and after intervention.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

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. 2011 Jun;153(6):773-9. Epub 2011 Apr 22 Coyne CJ, Le V, Brennan JJ, Castillo EM, Shatsky RA, Ferran K, Brodine S, Vilke GM. Ann Emerg Med.

Infectious Diseases 87

Infectious Diseases Administration Sepsis Anaphylaxis 87

EMDocs

JANUARY 4, 2024

Cardiogenic shock and hypotension can occur (systolic heart failure with reduced ejection fraction.) 10,12 Refractory shock or malignant arrhythmias occur in < 5% of patients. Case Follow-up: The patient required a dose of lorazepam in the emergency department. American Journal of Emergency Medicine.

Seizures 65

Seizures EKG/ECG Poisoning Shock 65

Mind The Bleep

JUNE 17, 2023

A study in 2011 of 258 children admitted to hospital with pneumonia found that 8.5% Kirovski I, 2011) It’s important to think about the possibility of an empyema or bad pneumonia in a child with difficulty in breathing, fever and abdominal pain. Open Access Emergency Medicine , 283-291. Annals of Paediatric Surgery.

Shock 52

Shock Wellness Emergency Department Ultrasounds 52

EMDocs

OCTOBER 5, 2024

A 62-year-old female patient with a history of recurrent urinary tract infections (UTIs) presents to the emergency department with fever, chills, and dysuria. Pressors where indicated for septic shock (typically Norepinephrine starting at 0.05 Microb Drug Resist 2011; 17:267. IV fluid resuscitation as needed.

EMS 73

EMS Infectious Diseases Sepsis Hospitals 73

The Skeptics' Guide to EM

JUNE 15, 2018

Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals 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. He was found unresponsive alone in a hot vehicle. link] Kakoki, K.,

Hyperthermia / Hypothermia 67

Hyperthermia / Hypothermia EMS Stroke Seizures 67

EMDocs

JANUARY 20, 2025

Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. 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. Andrews et al.

Dehydration 59

Dehydration Fluid Resuscitation Sepsis Resuscitation 59