RebelEM

FEBRUARY 24, 2025

RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department. Well, the established cutoff for the distensibility index is 18%. May 2014; PMID: 24495437. For more than just the correctness of terminology, the distensibility index should then be calculated. Why does it matter?

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

ACEP Now

MARCH 11, 2025

Many patients with PE can be discharged directly from the emergency department (ED). The pervasive maxim quick on, quick off for UFH doesnt hold up as well as touted. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. 7 In fact, anticoagulation is continued during CDT and can include LMWH.

Hospitals 52

Hospitals Administration Outcomes Stroke 52

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

Dr. Smith's ECG Blog

AUGUST 4, 2024

Context: a man in his 40s presented to the emergency department with 1 day of sudden onset chest pain. The patient did well. == MY Comment , by K EN G RAUER, MD ( 8/4 /2024 ): == I thought today's case by Dr. Meyers is an important one for emergency providers for a number of reasons. Pericarditis maybe."

EKG/ECG 116

EKG/ECG Wellness Operations Emergency Department 116

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

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: Well that’s kind worrisome. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

The Skeptics' Guide to EM

OCTOBER 10, 2020

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, specifically the use of ketamine. His twitter handle is @PainFreeED.

Emergency Department 52

Emergency Department Research Wellness 52

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

EM Curious

JULY 24, 2015

Identify the triangle shaped femoral nerve, lateral to the femoral artery, as well as the iliopsoas muscle and the fascia illiaca running over its surface. Get your tip as close as possible to the nerve, and under the fascia illiaca, then inject (well, after aspirating first, of course). Saunders 2014, Chapter 31 Beaudoin, F.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

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

ALiEM

MARCH 7, 2024

It is usually large, nodular, well-defined, homogeneous, and slightly hypoechoic (Figure 13) [6]. 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). Dessie et al.,

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. 2014 Apr;13(4):364-73. Epub 2014 Feb 13. His blood pressure (BP) is 220/120 mmHg. What are the next best steps in BP management for this patient? Lancet Neurol.

Stroke 101

Stroke Outcomes EMS Seizures 101

The Skeptics' Guide to EM

JULY 17, 2021

Case: Six-year-old Morten comes into your emergency department (ED) with what looks like pneumonia. His chest X-ray (CXR) confirms your findings, but he is well enough to be treated as an outpatient. There is also high-quality evidence that pre-school children do not routinely need antibiotics.

Pediatrics 52

Pediatrics Emergency Department Wellness 52

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 Burns Outcomes Hospitals 52

PHEM Cast

MARCH 17, 2016

video cast from Emergency Medicine colleagues in the States discussing and demonstrating techniques for optimal bag-valve-mask ventilation. Annals of Emergency Medicine. 2014; 65(4): 349-355. Preoxygenation, reoxygenation, and delayed sequence intubation in the Emergency Department. Weingart SD.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 52

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. They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Pediatr Emerg Care. PMID: 34398861.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). Though traditionally considered the lynchpin of emergency care, technical competency alone cannot meet these complex demands.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Don't Forget the Bubbles

OCTOBER 21, 2024

Olivia, 7, has been brought to the emergency department. She is otherwise completely well. Her mother has brought her to the emergency department because she is worried that Olivia is doing the movements more frequently and would like a brain scan. They only occur when she’s awake. What are tics? Ben-Shlomo Y.

Emergency Department 59

Emergency Department Research Hospitals Wellness 59

EMDocs

JANUARY 3, 2024

10 This procedure has well-described rare complications including infection, blood loss, allergic reaction, arrhythmia, pneumothorax if approaching via the internal jugular vein, embolization of the device, and pulmonary artery perforation or dissection. Published May 2014. 8 The device itself is 2 x 2.5 J Invasive Cardiol.

Allergic Reactions 114

Allergic Reactions Hospitals EMS Emergency Department 114

EMDocs

AUGUST 7, 2023

Physician gestalt and clinical decision-making tools such as the Wells’ ( [link] or Geneva ( [link] scores are helpful when assessing a patient’s pre-test probability, which is categorized as low, moderate, or high risk. 2014 Apr 23-30;311(16):1694]. Ann Emerg Med. Published 2010 Mar 30. 2014;311(11):1117-1124.

EMS 96

EMS Wellness Emergency Department 96

Don't Forget the Bubbles

SEPTEMBER 23, 2023

Facilitator-in-chief’ is my role when leading the ED Musos virtual choir and orchestra, and this also applies to my job in the hospital as Director of the Emergency Department. I love emergency medicine because, as Dan Sandberg once said, it is ‘ the most interesting 15 minutes of every other speciality ’.

Leadership 136

Leadership Teamwork Hospitals Emergency Department 136

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. 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. ng/mL, 0.25-0.5

Infectious Diseases 89

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

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.

EKG/ECG 130

EKG/ECG Documentation/Coding Wellness Emergency Department 130

Pediatric Emergency Playbook

DECEMBER 1, 2016

If the otherwise healthy child one month and older is: Euvolemic Not hypoxic Well appearing He can likely go home. The short answer is that the American Academy of Pediatrics, the UK’s National Institute for Health and Care Excellence, as well as the Canadian Pediatric Society currently recommend against them. 2014 Jan 20;(1):CD009609.

Pediatrics 40

Pediatrics Emergency Department Hospitals Wellness 40

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

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

If you think your patient is the perpetrator, he may well be an innocent, or even an off-duty or undercover officer. 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; Do not compromise your care. Gustafson, C.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Advanced Emergency Nursing from AENJ

NOVEMBER 7, 2015

In my opinion, hypnosis is a little-understood but potentially valuable technique for the emergency department. Why isn't hypnosis used more in emergency departments? " Well, then, what to do? An hypnotic suggestion: review of hypnosis for clinical emergency care. Hypnosis in the emergency department.

Emergency Department 40

Emergency Department Pediatrics Emergency Nursing Seizures 40

Don't Forget the Bubbles

MARCH 19, 2024

Becasue paediatric emergency departments are accessible out-of-hours they become the de facto place of safety with access to immediate support. In 2014, 71% (397) of emergency removals of children by police occurred out-of-hours or at weekends. More ACEs can lead to increased rates of common childhood illnesses.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 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 Pediatr Surg 2014; 49:1619.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Dr. Smith's ECG Blog

JUNE 18, 2013

His ECG was repeated at this point: This shows a well developed anterior STEMI. Usefulness of automated serial 12-lead ECG monitoring during the initial emergency department evaluation of patients with chest pain. Ann Emerg Med 1998;31(1):3-11. His first troponin was normal. The peak troponin I was over 100.

EKG/ECG 52

EKG/ECG Outcomes Emergency Department Hospitals 52

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

Dr. Smith's ECG Blog

APRIL 22, 2022

A prospective validation of the HEART score for chest pain patients at the emergency department. External validation of the emergency department assessment of chest pain score accelerated diagnostic pathway (EDACS-ADP). Am J Emerg Med 2020 3. Case Rep Emerg Med 2014 7. Int J Cardiol 2013 2.

EKG/ECG 52

EKG/ECG Emergency Department Wellness Hospitals 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. This feature of the study limits generalizability as well as applicability.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

Dr. Smith's ECG Blog

JANUARY 10, 2020

Here is the parasternal short axis, performed by a real expert in emergency department point of care cardiac ultrasound: There does not appear to be an anterior wall motion abnormality. I may well have also been convinced this patient had acute myocarditis given the findings we have been told. BUT — “ Y a g otta b e t here”.

EKG/ECG 40

EKG/ECG Ultrasounds Emergency Department Wellness 40

Pediatric Emergency Playbook

APRIL 1, 2016

Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. 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.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Dr. Smith's ECG Blog

JULY 3, 2018

While in the emergency department, he undergoes an additional ECG: 00:49 - Not much change Second ECG with measurements and calculations Magnified view of second ECGs measurements and calculation It is still "negative" for LAD occlusion (less than 23.4) He reports nausea as well. . - The ST elevation from today is ~0.2

EKG/ECG 52

EKG/ECG Documentation/Coding Administration Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Methods STEMI activations between January 2014 and April 2018 at the University of Arizona Medical Center were identified. Am J Med 2019, 132(5):622-630. Miranda DF, Lobo AS, Walsh B, et al.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52