The Skeptics' Guide to EM

DECEMBER 30, 2023

Overnight stay in the emergency department and mortality in older patients, JAMA Intern Med 2023 Date: December 18, 2023 Guest Skeptic: Dr. Chris Carpenter, Vice Chair of Emergency Medicine at Mayo Clinic. The Canadian Association of Emergency Physicians ( CAEP ) flagged this issue 10 years ago in 2013.

Hospitals 109

Hospitals Emergency Department Fractures Dislocations 109

The Trauma Pro

OCTOBER 4, 2024

years from 2013 to 2016. Clinical outcomes assessed at 60 days included an unplanned return to the emergency department (ED), re-admission, complications, and development of new bleeding confirmed by surgery, ultrasound, or computed tomography (CT) at 60 days post-injury. ” This means they probably did not.

Pediatrics 147

Pediatrics Outcomes Operations Emergency Department 147

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. AEM Feb 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and Assistant Professor at the University of Calgary. Date: February 17, 2023 Reference: Gettel et al.

Emergency Department 52

Emergency Department EMS Administration 52

The Skeptics' Guide to EM

DECEMBER 2, 2023

Case: A 4-year-old girl presents to your emergency department (ED) with fever and nasal drainage. The latest clinical practice guidelines from the American Academy of Pediatrics (AAP) on the diagnosis and management of acute bacterial sinusitis in children was published in 2013 [1]. Her vaccinations are all up to date.

Pediatrics 121

Pediatrics Infectious Diseases Emergency Department Research 121

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. Department of Health and Human Services, Office of Civil Rights. The limited English proficiency population in the United States in 2013. 45:446-458.

Documentation/Coding 82

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 82

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. 2013 Sep 1;88(5):338–40. Karageorgos, S.; Hibberd, O.; Mullally, P.J.W.;

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

EB Medicine

DECEMBER 30, 2019

Emergency Department Treatment Oxygen Keep O2 saturation >90% Clinicians may choose not to use continuous pulse oximetry (weak recommendation due to low-level evidence and reasoning) 1 Fluids IV or NG administration of fluids to combat dehydration, until respiratory distress and tachypnea resolve. All were UTIs.

Emergency Department 40

Emergency Department Allergic Reactions Dehydration Pediatrics 40

ALiEM

NOVEMBER 10, 2023

A 33-year-old male presented to the emergency department with a diffuse pruritic rash that appeared several days after starting Trimethoprim/Sulfamethoxazole (TMP-SMX) for a dental infection. 2013 Apr;168(4):726-32. Epub 2013 Feb 16. Progression stopped after discontinuing TMP-SMX. Br J Dermatol. doi: 10.1111/bjd.12133.

Academics 64

Academics Emergency Department 64

ALiEM

AUGUST 30, 2024

A 5-year-old female presented to the emergency department (ED) with a one-year history of gradually increasing anterior neck swelling. 2013 Mar;34(3):115-24; quiz 125. The patient had no significant past medical history. She also endorsed three weeks of cough and congestion, and one day of muffled voice. Pediatric neck masses.

Pediatrics 64

Pediatrics Ultrasounds Academics Emergency Department 64

Taming the SRU

AUGUST 27, 2024

The following are bullous skin disorders with indications for urgent/emergent intervention, and more likely to present to an Emergency Department. What can you do from the Emergency Department if suspected? What can you do from the Emergency Department if suspected? J Invest Dermatol 2013; 133:1197.

Emergency Department 82

Emergency Department Dehydration Burns Sepsis 82

Pediatric EM Morsels

OCTOBER 27, 2023

Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. PAWPER [Wells 2013, Silvagni 2022] Takes into account body habitus. Int J Emerg Med. J Emerg Med.

Pediatrics 268

Pediatrics Resuscitation Documentation/Coding Wellness 268

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Case: It is a steady Saturday afternoon in your rural emergency department (ED). This includes SGEM#19 way back in 2013 reporting a bandage wrap is a safe alternative to traditional casting for children with greenstick fractures. He has been a guest skeptic on the SGEM multiple times.

Fractures 126

Fractures Ultrasounds Pediatrics Outcomes 126

ACEP Now

OCTOBER 3, 2023

Even figuring out which medical practice staffs a particular emergency department is challenging. As job boards post only about one-fifth of emergency department jobs at any given time, the emergency-physician application process often still relies heavily on word of mouth. Ann Emerg Med. References Kane L.

EMS 52

EMS Emergency Department Wellness 52

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. I’m Jeff Nusbaum and I’m back with Nachi Gupta for the 30 th episode of EMplify and the first Post-Ponte Vedra Episode of 2019.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). 2 A study of routine EEG in the ED in 2013 found that five percent of ED patients with altered mental status had nonconvulsive seizures (of whom 75 percent were in nonconvulsive status epilepticus). Ann Emerg Med.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

The Skeptics' Guide to EM

AUGUST 28, 2021

Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. Case: A forty-year-old woman presents to the emergency department […] The post SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED?

Emergency Department 52

Emergency Department Research Outcomes 52

Taming the SRU

FEBRUARY 14, 2024

THE CASE A female in her 20’s presented to the emergency department with concern for oral swelling. One factor contributing to this increased cost is the increased usage of computed tomography (CT) in the emergency department to confirm the diagnosis prior to incision and drainage. 2013; 31(1):267.e1-3.

Ultrasounds 95

Ultrasounds Emergency Department Wellness 95

Pediatric Emergency Playbook

SEPTEMBER 1, 2020

2013 November ; 29(4): 569–578 Yeh PC et al. 2013 November ; 29(4): 569–578 Mallet finger in splint. 2013 November ; 29(4): 569–578 Pattni A et al. Seymour Fracture Nellans et al. Pediatric Hand Injuires. Pediatric Hand Fractures. Techniques in Orthopaedics. Nellans et al. Pediatric Hand Injuires. Yeh PC et al. Stat Pearls.

Fractures 52

Fractures Pediatrics Emergency Department 52

Emergency Medicine Journal

NOVEMBER 28, 2023

All NHS111 calls made in the entire Yorkshire region between 1/4/2013-31/3/2017 concerning paediatric patients (1,155,310 calls) were linked with subsequent visits to emergency departments (EDs) within 48 hours. Method and Design We performed a retrospective observational analysis using a large, linked routine UEC dataset.

Emergency Department 40

Emergency Department Research 40

Don't Forget the Bubbles

SEPTEMBER 27, 2023

The parents of two-year-old, previously healthy, Jamie bring him to the Emergency Department with coryzal symptoms, wheezing and difficulty breathing. Respiratory viral panel testing did not reduce antibiotic use in the emergency department. 2013 Feb;18(1):5-10. SpO2 is 88%. Pediatrics. J Clin Virol. 2022.105221.

Emergency Department 84

Emergency Department Pediatrics Point-of-Care Testing Hospitals 84

The Skeptics' Guide to EM

JULY 8, 2023

Case: A 57-year-old woman with hypertension, hyperlipidemia and type-2 diabetes mellitus presents to the emergency department (ED) with fever, cough, myalgias, headache and congestion. Managing editor of EM:RAP and Associate Editor at REBEL EM. It’s flu season and you’ve already seen 15 people with the same symptoms.

CDC 96

CDC Hospitals EMS Emergency Department 96

Mind The Bleep

NOVEMBER 6, 2023

Sight Threatening Conditions in the Emergency Department Open globe injury Key signs without needing a slit lamp: Prolapse of intraocular contents (e.g. Sight Threatening Conditions in the Emergency Department Open globe injury Key signs without needing a slit lamp: Prolapse of intraocular contents (e.g. Serrano et al.

Emergency Department 52

Emergency Department Dislocations Burns Fractures 52

ALiEM

DECEMBER 18, 2023

A 19-year-old female with a past medical history of epilepsy presented to the emergency department for evaluation of rash and fever. 2013 Jun;6(6):31-7. Two days prior to presentation she began to experience fevers with a Tmax of 103°F. The patient endorsed associated pruritus and cervical lymphadenopathy with the rash.

Academics 70

Academics Emergency Department Wellness 70

ACEP Now

OCTOBER 30, 2023

These initiatives aim to equip physicians with an evidence-based approach and effective management strategies for common emergency-department scenarios. ESEM hosted the second Global Network Collaborative Conference on Emergency Medicine in 2013 and organized its first large scientific conference in Dubai in December 2014.

Leadership 52

Leadership Emergency Department Ultrasounds CPR 52

RebelEM

MARCH 8, 2023

Emergency Department Management: Emergency ophthalmology consultation. Emergency surgical management indicated if concomitant retinal tear, vitreous hemorrhage, or retinal detachment. et al, Emergency Medicine Clinical Essentials ed 2. Philadelphia: Elsevier, 2013 (Ch) 26: p.

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

Pediatric EM Morsels

FEBRUARY 2, 2024

Internationally Acquired Severe Systemic Infections in Febrile Pediatric Travelers Presenting to the Emergency Department. Pediatr Emerg Care. In the 1950’s travel accounted for 25 million international tourists. 2021 Dec 1;37(12):e1315-e1320. PMID: 31977776 Lalos S, Farrar D, Science M, Morris S.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

EMDocs

JUNE 7, 2023

Parenteral organophosphorus poisoning in a rural emergency department: a case report. 2013; 6:524. Published 2013 Dec 9. Clin Toxicol (Phila) 51: 838, 2013. She is speaking one word at a time and constantly coughing. She complains of dizziness, nausea, and abdominal cramps. Iran Red Crescent Med J 16: e5072, 2014.

Poisoning 84

Poisoning Airway Management Seizures PPE 84

The Skeptics' Guide to EM

MAY 14, 2022

Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. His twitter handle is @PainFreeED.

Emergency Department 52

Emergency Department Research Wellness 52

Taming the SRU

FEBRUARY 12, 2024

HISTORY OF PRESENT ILLNESS A female in her 30s arrives to the emergency department via emergency medical services. She arrives in the emergency department agitated and unable to answer questions appropriately. The patient is agitated on a backboard with C-collar in place. Blood Coagul Fibrinolysis. Cohen, AT et al.

Administration 79

Administration Fractures Anaphylaxis Head Injuries 79

Northwestern EM Blog

APRIL 15, 2024

While most of the immediate complications of tracheostomy will occur in the ICU, these patients still frequent our emergency department with and without tracheostomy related emergencies. ENT and airways in the emergency department: national survey of junior doctors’ knowledge and skills. Borrowed from: Morris, L.L.,

Emergency Department 98

Emergency Department Resuscitation Pediatrics Outcomes 98

EMergucate

DECEMBER 26, 2013

Following on from last week, this 58 yr old male is brought to your Emergency Department following an out-of-hospital cardiac … Continue reading →

EKG/ECG 40

EKG/ECG Emergency Department Hospitals EMS 40

RebelEM

MARCH 23, 2023

The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores. of symptom-triggered phenobarbital versus symptom-triggered lorazepam in the emergency department (n=44). A randomized, blinded clinical trial (Hendey et al.)

Emergency Department 52

Emergency Department Outcomes Hospitals Burns 52

EMergucate

SEPTEMBER 8, 2013

A 47 yr old female with a history of cardiac failure presents to your emergency department with an unrelated injury, … Continue reading →

EKG/ECG 40

EKG/ECG Emergency Department EMS 40

Mind The Bleep

NOVEMBER 6, 2023

46(7); 605-606 Gardiner (2022) Overview of eye injuries in the emergency department. < [link] Kanski and Bowling (2013) Synopsis of Clinical Ophthalmology, Third Edition Kaur et al. Curr Eye Res. 37(9):787-93 Cobb, Murthy, Saiet et al (2008) The tear-drop sign: a trap door for the unwary? UpToDate. < 2020) Red Eye.

Fractures 52

Fractures Radiology Radiology Emergency Department 52

Northwestern EM Blog

SEPTEMBER 16, 2024

Beyond the emergency department, where else can a SonoPro scan for increased ICP?: Aside from patients in the emergency department, POCUS for elevated ICP can be used in critically ill children in the PICU, adults in the Neurocritical ICU, and on the battlefield with handheld ultrasounds in combat medicine.

Ultrasounds 52

Ultrasounds Emergency Department Academics EMS 52

PHEM Cast

MARCH 3, 2019

Emergency Medicine Journal. Ketamine-propofol combination (ketofol) versus propofol alone for emergency department procedural sedation and analgesia: a randomized double-blind trial. Ann Emerg Med. Emerg Med J. Ketamine for paediatric sedation/analgesia in the emergency department. Emerg Med J.

Emergency Department 52

Emergency Department Head Injuries Hospitals Pediatrics 52

EMergucate

AUGUST 9, 2013

A 83 year old patient presents to your Emergency Department complaining of lethargy, nausea, and vomiting. This is his ECG.

EKG/ECG 40

EKG/ECG Emergency Department EMS 40