The Skeptics' Guide to EM

FEBRUARY 22, 2020

Maia Dorsett is an Emergency and EMS Physician at the University of Rochester Medical Center. Date: January 27th, 2020 Guest Skeptics: Dr. Bringing value, balance and humanity to the emergency department: The Right Care Top 10 for emergency medicine. Reference: Dorsett et al.

Wellness 52

Wellness Emergency Department EMS 52

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. Definitive emotional support is critical to our emotional and psychological well-being. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. & Liska, H. 23 (2), pp.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Systolic function normal by visual assessment only, unable to visualize well for further characterization. The patient did well and was discharged.

EKG/ECG 105

EKG/ECG Wellness Fractures Hospitals 105

EB Medicine

SEPTEMBER 20, 2019

Kirelik is the Medical Director of the Rocky Mountain Pediatric OrthoONE Center for Concussion and is an attending pediatric emergency medicine physician at the Rocky Mountain Hospital for Children in Denver, Colorado. The Berlin 2016 process: a summary of methodology for the 5th International Consensus Conference on Concussion in Sport.

Emergency Department 40

Emergency Department Head Injuries Pediatrics Hospitals 40

Emergency Medicine Journal

MAY 23, 2023

Background Upper gastrointestinal bleeding (UGIB) is a medical emergency with an approximate mortality of 10%, which results in a high hospitalisation rate. The Glasgow-Blatchford score (GBS) is recommended to identify low-risk patients who can be discharged from the emergency department (ED).

Emergency Department 40

Emergency Department Blood Transfusions Hospitals Wellness 40

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 55

Pediatrics Emergency Department Research Burns 55

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. Crit Care Med.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

Don't Forget the Bubbles

JULY 19, 2023

Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation. The Ophthalmology SHO agreed and referred Olivia to you.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

Don't Forget the Bubbles

AUGUST 7, 2023

This prospective cohort study included patients between 0-16 years old, who presented to one of four NHS hospital sites in Greater Manchester (a large metropolitan area in the North of England), consisting of an Urgent Care Centre and three Emergency Departments. Acad Emerg Med. NICE; 2016 [cited 2023 Mar 28]. Pediatrics.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

Dr. Smith's ECG Blog

OCTOBER 12, 2024

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. Vital signs were within normal limits on arrival to the Emergency Department. Am J Emerg Med. 2016 Nov;34(11):2182-2185. Epub 2016 Aug 27. or basilar ischemia.

EKG/ECG 96

EKG/ECG Documentation/Coding Emergency Department COPD 96

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter.

Documentation/Coding 82

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

RebelEM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. Am J Emerg Med. J Med Toxicol. Epub 2019 Jul 3.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

EMDocs

AUGUST 22, 2023

Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. J Emerg Med. Capnography for the nonintubated patient in the emergency setting. Ann Emerg Med. Predictive value of capnography for suspected diabetic ketoacidosis in the emergency department. West J Emerg Med.

Emergency Department 69

Emergency Department Blood Transfusions Resuscitation Sepsis 69

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. Lam et al., 94.7%) 80% (70.0-87.4%)

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

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. While it was < 15% in 1990, by 2016 it reached 40%. That’s almost half of the population.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. 2016 Dec 28;7(Suppl 44):S1150-S1153.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). As may be seen in the table below, there are several themes as well a range of stringency. C., & ESCMID Study Group for Infections of the Brain (ESGIB) (2016). Glennie, L.,

Infectious Diseases 96

Infectious Diseases Seizures Ultrasounds Sepsis 96

PHEM Cast

MARCH 17, 2016

video cast from Emergency Medicine colleagues in the States discussing and demonstrating techniques for optimal bag-valve-mask ventilation. Preoxygenation, reoxygenation, and delayed sequence intubation in the Emergency Department. The Journal of Emergency Medicine. Emergency Medicine Australasia. Oxygenation.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 52

EMDocs

JUNE 8, 2024

Post septal (retrobulbar) is higher risk to vision and requires CT imaging to diagnose as well as thorough exam to check for proptosis, afferent pupillary defect, increased intraocular pressure [7]. A 32-year-old man presents to the emergency department with eye pain. Overview of Eye Injuries in the Emergency Department.”

EMS 82

EMS Allergic Reactions Poisoning Emergency Department 82

The Skeptics' Guide to EM

OCTOBER 1, 2022

Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference. Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. AEM September 2022. AEM September 2022.

Pediatrics 52

Pediatrics Emergency Department Documentation/Coding Research 52

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

Case: You are working the afternoon shift in the paediatric emergency department. Your shift is almost over and the department finally seems to be under control. In 2016, the American Academy of Pediatrics (AAP) reaffirmed their clinical practice guidelines for the diagnosis and management of UTIs.

Pediatrics 52

Pediatrics Emergency Department Sepsis Wellness 52

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. What are the risks of water beads? His older brother, Roy, had found him playing with his toys, and an argument ensued. 2016;11:39-43.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

Taming the SRU

JULY 21, 2023

Eye Pathology Now let’s dive back into some common eye disease processes you may see on a typical day in the emergency department. Patients will often have objective visual acuity impairment as well as a fever or leukocytosis. licensed under a Creative Commons Attribution 3.0 WHAT ARE TREATMENT OPTIONS? Microbial Keratitis.;

Emergency Department 86

Emergency Department EMS Burns Wellness 86

The Skeptics' Guide to EM

OCTOBER 7, 2017

BMJ Nov 2016. He served with the Canadian Forces as a Medical […] The post SGEM#191: No Time for Physio – Roll With It first appeared on The Skeptics Guide to Emergency Medicine. BMJ Nov 2016. Current evidence and clinical standards for acute management of simple sprains (Grade I and II) is limited and not well defined.

Urgent Care 40

Urgent Care Emergency Department Fractures Wellness 40

Taming the SRU

JUNE 11, 2023

End-tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in-hospital mortality and intensive care unit admission. Acad Emerg Med 2023; 10.1111/acem.14703 Enrollment period was from February 2016 to August 2018. Am J Emerg Med. Acad Emerg Med.

Hospitals 86

Hospitals Emergency Department EMS Outcomes 86

Don't Forget the Bubbles

JUNE 30, 2023

You will be running the show today, and you want to use your preparation time well. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality. c) Or, do both?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Don't Forget the Bubbles

JULY 17, 2023

2023 Jun 1;76(6):731-736 The Association Between Media-Based Exposure to Nonsuicidal Self-Injury and Emergency Department Visits for Self-Harm. Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study. Baaleman DF, et al. J Pediatr Gastroenterol Nutr. Lee T, et al. 2023 Jun 9.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

Don't Forget the Bubbles

MAY 24, 2023

Crouzon syndrome, Pierre-Robin sequence, Down syndrome, Beckwith-Wiedemann syndrome) I njuries to the face, mandible, pharynx, or neck S leeping issues such as snoring due to adenotonsillar hypertrophy It’s essential to have a well-planned approach to managing the difficult airway. difficult intubations in neonates and infants. Anaesthesia.

Airway Management 98

Airway Management Teamwork Pediatrics Emergency Department 98

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. See below: Fascia iliaca Serratus anterior Erector spinae The risks of opioid medications, especially in the elderly, has been well described. 2016 May;31(5):478-85. A radiograph is shown (see figure 1). J Patient Saf.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Wellness 52

EM SIM Cases

MAY 9, 2023

However, if you find yourself treating a drowning patient in the ED, this case will have you well prepared. EHS arrived, provided oxygen supplementation, and brought them to your tertiary emergency department, with access to PICU. Pediatric Emergency Care,32 (9), 623-626. Pediatric Drowning Download Hon, K. ,

Pediatrics 52

Pediatrics CPR Radiology Radiology 52

Don't Forget the Bubbles

JULY 22, 2024

The most recent meta-analysis , published in 2016 (comparing eleven studies from 1986 to 2009), struggled to reach a consensus because the trials were too heterogeneous to make robust conclusions. 2016 Aug;51(8):868–76. Annals of Emergency Medicine. 2016 May;67(5):593-601.e3. Pediatr Pulmonol.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

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

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. F Heart Rate 138 bpm Blood Pressure 102/61 Respiratory Rate 32 Oxygen Saturation (room air) 100% He is well appearing but has increased work of breathing.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Don't Forget the Bubbles

JANUARY 31, 2024

Article 1: What predicts parental anxiety in the Paediatric Emergency Department? Predictors of parental anxiety in a paediatric emergency department. Emergency Medicine Journal. The authors looked for common agents and their ability to reduce pain as well as any associated adverse events. Martin, S.R.,

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

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

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. Phenobarbital Versus Lorazepam for Management of Alcohol Withdrawal Syndrome: A Retrospective Cohort Study.

Emergency Department 52

Emergency Department Outcomes Burns Hospitals 52