ACEP Now

AUGUST 25, 2023

Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain Case A 15-year-old female with sickle cell disease (SCD) presents to your emergency department (ED) with a vaso-occlusive pain episode (VOE) of her legs and back. Evidence-based management of sickle cell disease: Expert panel report, 2014. link] Published 2014.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

Taming the SRU

APRIL 14, 2024

This revealed that ultrasound can improve the ability to reduce an incarcerated inguinal hernia and may decrease the rate of emergency surgery. (1) 1) Table 1 - Study Protocol Table 2 - Results Conclusion Hernias are often encountered in the emergency department as an acute or non-acute finding. EM@3AM: Hernia.”

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

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. BMJ Quality & Safety [Internet] 2014; 23:106-115. Acad Med [Internet] 2014; 89:5:817-827. BMC Health Serv Res [Internet] 2014:14:61 (2014).

Leadership 98

Leadership Patient Safety Academics Research 98

EMergucate

FEBRUARY 7, 2014

This week’s ECG is from a 39 yr old female who presented to the Emergency Department with vomiting, diarrhoea, and … Continue reading →

EKG/ECG 40

EKG/ECG Emergency Department EMS 40

EMergucate

FEBRUARY 15, 2014

This week’s ECG is from a middle aged male who presented to the Emergency Department with abdominal pain. His ‘routine’ … Continue reading →

EKG/ECG 40

EKG/ECG Emergency Department EMS 40

EMergucate

FEBRUARY 21, 2014

Clinical conclusion and interpretation on last week’s ECG case of a middle aged male who presented to the Emergency Department with … Continue reading →

EKG/ECG 40

EKG/ECG Emergency Department EMS 40

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. 2014 AHA/ACC guideline for the management of patients with non-ST elevation acute coronary syndromes.

EKG/ECG 121

EKG/ECG Documentation/Coding Fractures Emergency Department 121

EMDocs

JULY 9, 2024

The emergency department takes care of some of the highest risk patients with the worst access to health care and social services Over the past 20 years, many researchers have created and validated social needs screeners Some examples: iHELP, WE CARE, SEEK, USDA 2-item food insecurity questionnaire Does screening make a difference?

Pediatrics 74

Pediatrics Emergency Department Research Burns 74

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

She is interested in social determinants of health in the emergency department and health policy. Dr. Ian Holley is also a PGY-3 resident in Emergency Medicine at Washington University School of Medicine in St. He is interested in ultrasound and international emergency medicine.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

RebelEM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

PHEM Cast

APRIL 10, 2016

It is obviously a huge topic and there is lots of information to cover; a couple of other recently released podcasts are available which are produced with the Emergency Medicine community in mind, but will no doubt expand your knowledge. The impact of emergency medical services on the ED care of severe sepsis. Am J Emerg Med.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St. 2014 Apr;13(4):364-73. Epub 2014 Feb 13.

Stroke 99

Stroke Outcomes EMS Seizures 99

EMDocs

JANUARY 3, 2024

Case Conclusion Your patient is given an IV dose of furosemide and improves after diuresis over the next few hours in the emergency department. Published May 2014. It is likely that this device and future devices will become more common in patients presenting to the ED. J Invasive Cardiol. 2016;28(7):273-279. Holy Cross Health.

Allergic Reactions 112

Allergic Reactions Hospitals EMS Emergency Department 112

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. Jeff: A 2014 study even showed an up to 80% reduction in the likelihood of developing DM2 postoperatively at the 7-year mark.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

RebelEM

AUGUST 30, 2023

Evaluation and Treatment of Acute Back Pain in the Emergency Department. Orthopedic Emergencies 2015 May; 33(2) 311-26. Simon’s Emergency Orthopedics. New York, NY: McGraw-Hill; 2014 Winters ME, Kluetz P et al. Back Pain Emergencies. Diagnostic Radiology: Musculoskeletal and Breast Imaging.

Infectious Diseases 100

Infectious Diseases Fractures Radiology Radiology 100

The Skeptics' Guide to EM

DECEMBER 28, 2019

Annals of EM, JU, and JACR 2019. Guest Skeptics: Dr. Christopher Moore is an Associate Professor of Emergency Medicine a Yale School of Medicine. Annals of EM , JU, and JACR 2019. Guest Skeptics: Dr. Christopher Moore is an Associate Professor of Emergency Medicine a Yale School of Medicine. NEJM 2014 ).

Radiology 40

Radiology Radiology Ultrasounds Emergency Department 40

EM Curious

JULY 24, 2015

EMS appears with a patient who just wiped out big time on the ice. jps Sources Roberts and Hedges Clinical Procedures in Emergency Medicine. Saunders 2014, Chapter 31 Beaudoin, F. Academic Emergency Medicine, 20(6), 584–591. Impact of ultrasound-guided femoral nerve blocks in the pediatric emergency department.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

EM Curious

JULY 11, 2015

Case by Sean Dyer PGY-3 EM Resident; Peer Reviewed by Dr. Christopher Hogrefe, Assistant Professor in Emergency Medicine at Northwestern University Feinberg School of Medicine The Case A 32 y/o male presents with wrist pain after being involved in a motor vehicle collision this afternoon. Emergency Orthopedics 7th Ed.

Dislocations 52

Dislocations Emergency Department Fractures Outcomes 52

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Prerost 2014) In a patient with chronic alcohol use, hallucinations should prompt consideration of acute intoxication, alcoholic hallucinosis, or delirium tremens (DT). Annals of Emergency Medicine.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

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. Recruitment from only emergency departments may not represent the broader clinical context. Cochrane Database of Systematic Reviews 2014, Issue 12.

Outcomes 104

Outcomes Hospitals Research Emergency Department 104

ALiEM

MARCH 7, 2024

Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Dessie et al.,

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

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 Burns Hospitals 52

RebelEM

FEBRUARY 22, 2023

difficult to see due to corneal edema) Emergency Department Management All patients should get emergency ophthalmologic consultation Start with eye drops (see table below) and add systemic medications if severe or refractory symptoms/IOP. Decreased visual acuity, Cup to disc ratio >0.6 Cup to disc ratio >0.6

Emergency Department 52

Emergency Department EMS Wellness 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. 2014 Apr 23-30;311(16):1694].

EMS 94

EMS Wellness Emergency Department 94

ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. EMS physicians report he was found in ventricular fibrillation. Marco is professor of emergency medicine at Penn State Health-Milton S. Heart disease and stroke statistics—2014 update: a report from the American Heart Association.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

Police officers have poor hit probability, ricochets may occur, suppressive fire may be used (“keep ‘em pinned down”), or even ‘spray and pray.” Ballistic injuries in the emergency department. Emergency medicine practice, 13(12), 1-30. Spinal Cord (2014) 52, 504–510; doi:10.1038/sc.2014.56; Gustafson, C.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

The Skeptics' Guide to EM

DECEMBER 16, 2017

Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. Case: Johnny is a 22-year-old male patient who presents to the emergency department via EMS with a seizure.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Seizures Hospitals Stroke 40

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. Point-of-Care Ultrasound on Management of Cellulitis Versus Local Angioedema in the Pediatric Emergency Department. Pediatr Emerg Care. West J Emerg Med.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

RebelEM

DECEMBER 1, 2022

Background: Pneumothorax management is a common clinical condition in the emergency department (ED) occurring in patients of varying ages and caused by multiple etiologies, including spontaneous, traumatic, and iatrogenic pneumothorax. Regardless of the cause, a thoracostomy is often required for treatment (Currie 2007 ).

Outcomes 52

Outcomes Hospitals Research Critical Access 52

RebelEM

DECEMBER 10, 2023

Background: The use of ultrasound is well established for trauma patients in the emergency department, with almost every patient receiving a FAST (Focused Assessment with Sonography in Trauma) examination as part of the “ABC’s” of trauma. Chan KK, Joo DA, McRae AD, Takwoingi Y, Premji ZA, Lang E, Wakai A.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

EMDocs

DECEMBER 18, 2024

A 36-year-old male presents to the emergency department after being found down at home by his spouse. Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. 2014; 28(5): 401-410. Acad Emerg Med. Muncie H, Yasinian Y, Oge L. Outpatient management of alcohol withdrawal syndrome.

Seizures 105

Seizures Hyperthermia / Hypothermia Emergency Department EMS 105

Pediatric EM Morsels

JULY 21, 2023

In emergency medicine, we often use illness scripts and protocols to help drive our decision-making. We had just received a young child from EMS who was post-ictal with decreased mentation. Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. Epub 2014 Sep 8.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EMDocs

JULY 15, 2023

We’ll keep it short, while you keep that EM brain sharp. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. 2014 Jul 15;59(2):e10-52. link] The post EM@3AM: Erysipelas appeared first on emDOCs.net - Emergency Medicine Education.

EMS 91

EMS Infectious Diseases Shock Ultrasounds 91

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.

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

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. Epub 2011 Apr 22 Coyne CJ, Le V, Brennan JJ, Castillo EM, Shatsky RA, Ferran K, Brodine S, Vilke GM. Ann Emerg Med. Epub 2014 May 28.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

EMDocs

SEPTEMBER 25, 2023

Personal take: While discussing this approach with many EM physicians whom we respect, one recurring critique was “We fought so hard to get the right to use paralytics in the ED, why would you want to go backwards.” actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department.

Emergency Department 91

Emergency Department Soft Tissue Injuries Airway Management Operations 91

EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. 1 The rationale for the shift away from normal saline in 2021 derived from multiple trials, including the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) and Saline Against Lactated Ringer’s or Plasma-Lyte in the Emergency Department (SALT ED).

Sepsis 90

Sepsis Fluid Resuscitation Resuscitation Shock 90