The Skeptics' Guide to EM

AUGUST 17, 2019

Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain.

Emergency Department 52

Emergency Department Academics Fractures Outcomes 52

Emergency Medicine Journal

JULY 24, 2023

Background Although frequent emergency department (ED) users have been widely studied in cross-sectional settings, there is some evidence suggesting that most frequent ED users do not remain frequent users over multiple consecutive years. million ED visits in the baseline year (2012). million patients, who accounted for 4.5

Emergency Department 40

Emergency Department Outcomes 40

Don't Forget the Bubbles

OCTOBER 10, 2024

Reviewed by: Isabella Davenport Article 2: Does it improve outcomes if you replace the nail in nail bed repair? Children with nail bed injuries were randomly assigned to nail replacement or discarding , with the primary outcomes being secondary infection in 7 days and cosmetic outcome in four months. Arch Dis Child.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

RebelEM

APRIL 29, 2024

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ). 2012 PMID: 21893125.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. Mirza and Sheikh reported perhaps the first unfortunate case in 2012. There have been reports of the Orbeez Challenge leading to serious outcomes. In 2012, one brand of SAP beads – Water Balz – was recalled by the U.S. 2012 Jan;3(1):6.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

The Skeptics' Guide to EM

APRIL 8, 2023

John Brown PhD is a Professor of Health Services Research in Ireland who has been studying rural healthcare issues since 2012. There have been many “temporary” rural emergency department closures during the past last year. It was a stepped-wedge reconfiguration of the entire Danish emergency healthcare system.

Stroke 57

Stroke Emergency Department COPD Academics 57

Cook County EM Blog

APRIL 27, 2022

Effectiveness and safety of droperidol in a United States emergency department. Am J Emerg Med. 2019.09.007 What : Retrospective cohort study of all droperidol administrations between January 2012 and April 2018 at an academic and pediatric emergency department in the US with 77,000 annual visits.

Administration 52

Administration EKG/ECG Emergency Department EMS 52

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Early defibrillation is linked to better outcomes. Ann Emerg Med. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta. of those patients. topics.php?paction=showTopic&topic_id=597)

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EMDocs

MAY 11, 2024

Available from: [link] American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Use of Intravenous tPA for Ischemic Stroke:; Brown MD, Burton JH, Nazarian DJ, Promes SB. Ann Emerg Med. Erratum in: Ann Emerg Med. 2012) 43:2904–9. 2015 Sep;66(3):322-333.e31. doi: 10.1016/j.annemergmed.2015.06.031.

Stroke 110

Stroke EMS EKG/ECG Radiology 110

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. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine; 2012 Jun 27;20(1):1–1. Am J Emerg Med. 2012 Jan;30(1):51–6.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

ACEP Now

AUGUST 25, 2023

Case A critically ill patient presents to the emergency department (ED) requiring an emergent, definitive airway. However, a 2012 systematic review and meta-analysis (SRMA) reported that etomidate was associated with adrenal insufficiency and increased mortality in septic patients. to 1.21]).

Outcomes 52

Outcomes Emergency Department Sepsis Hospitals 52

The Skeptics' Guide to EM

DECEMBER 12, 2020

She is Chair of the Royal College of Emergency Medicine Women in Emergency Medicine group and involved with the RCEM Public Health and Informatics groups. Case: A 52-year-old previously healthy woman presents to your emergency department (ED) with an abscess on her left forearm.

Operations 52

Operations Outcomes Research Academics 52

RebelEM

MARCH 8, 2023

Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. Emergency Department Management: Emergency ophthalmology consultation. Emergency surgical management indicated if concomitant retinal tear, vitreous hemorrhage, or retinal detachment. >10 floaters, (+) LR 8.1-36

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

The Skeptics' Guide to EM

JUNE 5, 2021

Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke: The SKIP Randomized Clinical Trial. JAMA 2021 Case: A 74-year-old woman presents to your emergency department with 1.5 References: * Suzuki et al. JAMA 2021 * Zi et al.

Stroke 52

Stroke Urgent Care Critical Access Outcomes 52

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons. Promoting hot debriefing in an emergency department. Www.Heart.Org.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 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. J Emerg Med. Lee HC et al.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

The Skeptics' Guide to EM

DECEMBER 17, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. years ( 2 ).

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 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

The Skeptics' Guide to EM

MARCH 6, 2021

Background: Epistaxis is a common Emergency Department (ED) complaint with over 450,000 visits per year and a lifetime incidence of 60% ( Gifford 2008 , Pallin 2005 ). The episode included the Dundee protocol for adult epistaxis management from 2012. You apply direct pressure for 10 minutes, but the bleeding continues.

EMS 52

EMS Emergency Department Outcomes 52

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. Background: We have covered sepsis many times on the SGEM since 2012.

Sepsis 40

Sepsis Emergency Department COPD Hospitals 40

The Skeptics' Guide to EM

MARCH 4, 2023

Case: Jim is a 50-year-old male who presents to the emergency department with anterior epistaxis. The episode included the Dundee protocol for adult epistaxis management from 2012. Lastly, the primary outcome was different than the previous two RCTs claiming efficacy. He denies nose picking. Trauma (CRASH-2): 1.5%

Outcomes 40

Outcomes EMS Emergency Department Hospitals 40

The Skeptics' Guide to EM

AUGUST 5, 2023

Computerized tomography (CT) is commonly used in the emergency department in the diagnosis of TBI. Annals of Emergency Medicine 2014. Population: Children less than 18 years of age presenting with head injury to a level 2 pediatric trauma center in the United States between 2012-2013.

Head Injuries 40

Head Injuries Pediatrics Fractures Outcomes 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

PEMBlog

MAY 11, 2023

Acad Emerg Med, 2017 This was a single-center (one academic Pediatric Emergency Department) randomized double-blind trial of J-Tip versus EMLA – topical anesthetic (TA) cream for pain relief in 66 infant LPs. Pediatr Emerg Care. 2012 Jul;28(7):687-90. Acad Emerg Med. doi: 10.1097/PEC.0b013e31825d210b.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Academics 52

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. In 7 studies with 4164 patients, PCT with a cut-off > 0.1 ng/mL (strongly recommended against antibiotics), 0.1-0.25

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

EM Guide Wire

NOVEMBER 2, 2020

Nebulized Mg sulfate treatment shows no significant effect on respiratory function or hospital admission High-Dose Magnesium Sulfate Infusion for Severe Asthma in the Emergency Department Efficacy Study All patients of 6–16 years old who failed to improve after 2 hours of standard therapy for asthma. final FEV1 was 51.1%

Pediatrics 52

Pediatrics Anaphylaxis Emergency Department Administration 52

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? 1 Low-dose non-contrast abdominal CT has become the gold standard for diagnosis as it has become readily available in emergency departments nationwide, with some studies touting sensitivity and specificity of 97% and 95%, respectively.2

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

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 131

EKG/ECG Documentation/Coding Wellness Emergency Department 131

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…. Lancet Neurol.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

The Skeptics' Guide to EM

SEPTEMBER 15, 2018

Intervention: Malpractice claims involving trainees (residents) in an emergency department setting over a three-year period from 2009-2012. Outcomes: Coded information covering a number of domains. Comparison: Malpractice claims not involving trainees in the same time period.

Documentation/Coding 40

Documentation/Coding Teamwork Hospitals Emergency Department 40

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 2012; Volume 60, Issue 6, Pages 749–754.e2 J Trauma 2003; 54:444-453 Mort TC. Anesth Analg.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

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]. 2012 05;9(5):1-13. [5] Resuscitation. 2014;85(5):587-94. [3]

Research 60

Research Hospitals Academics Emergency Department 60

Pediatric Emergency Playbook

JANUARY 1, 2016

Accuracy of a screening instrument to identify potential child abuse in emergency departments. J Emerg Med. 2012; 43(1): e49–e51. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. Child Abuse & Neglect. 2014; (38): 1275–1281.

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]. 2012 05;9(5):1-13. [5] Resuscitation. 2014;85(5):587-94. [3]

Research 40

Research Hospitals Academics Emergency Department 40

EMDocs

FEBRUARY 12, 2024

There is well-documented evidence that low systolic blood pressure, a low Glasgow Coma Score (GCS), and a high Injury Severity Score (ISS) are known predictors of poor outcomes, and in combination with serum lactate provide adequate prognostic value. Int J Emerg Med. Eur J Emerg Med. Emerg Med J. Open Access Emerg Med.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

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. Epidemiology of total hip arthroplasty: demographics, comorbidities and outcomes.

EMS 98

EMS Dislocations Fractures Operations 98