The Skeptics' Guide to EM

NOVEMBER 28, 2020

Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital. Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital. Should they do it?

Infectious Diseases 52

Infectious Diseases Operations Outcomes Wellness 52

ACEP Now

FEBRUARY 11, 2024

He noted spending about five days walking through a jungle, as well as traversing rivers. There was concern for possible cutaneous leishmaniasis (CL), therefore he was admitted to the hospital for infectious-disease and surgical consultations, as well as to complete a punch biopsy the following day. Click to enlarge.)

Infectious Diseases 52

Infectious Diseases CDC Military Emergency Department 52

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. A 2015 meta-analysis of 9 studies consisting of 725 patients published in the International Journal of Infectious Diseases found PCT far superior to CRP, with PCT having a sensitivity of 90 and specificity of 98% [36].

Infectious Diseases 89

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

RebelEM

FEBRUARY 29, 2024

Patient data anonymized when presented to adjudication committee to avoid detection bias Well-balanced patient characteristics between groups. Neurocrit Care 2020 , 32 (1), 272-285. Chest 2020 , 158 (6), 2292-2303. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62

CDC 122

CDC Radiology Radiology Head Injuries 122

EM Literature of Note

SEPTEMBER 13, 2024

Most regions used a strategy in which nirsevimab was provided to new births during RSV season, as well as other young infants born prior to the onset of the season. The two “COVID seasons” of 2020-21 and 2021-22 were excluded from their comparisons.

Emergency Department 87

Emergency Department Pediatrics Administration Wellness 87

ALiEM

MAY 13, 2024

They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Larger abscess with well-circumscribed borders D. Superficial abscess with well-circumscribed borders Table 1. Ann Emerg Med 2020 [5] 2,656 Systematic review of adult and pediatric studies 94.6% (89.4-97.4%)

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Pediatric Education

OCTOBER 8, 2023

The diagnosis of a healthy female was made who would be traveling to an area endemic for several infectious diseases. The pediatrician consulted the Centers for Disease Control website for vaccine recommendations for the Congo which indicated the need for malaria prophylaxis as well as Yellow Fever and Typhoid vaccine.

Infectious Diseases 40

Infectious Diseases Pediatrics Military Wellness 40

ALiEM

AUGUST 14, 2023

Treatment is appropriate antibiotics and improved foley hygiene, foley exchange as well as improved bowel regimen to increase stool transit time. October 9, 2020. References Meekins Pauline, Ramsay Amy, Ramsay Michael. Purple Urine Bag Syndrome. West J Emerg Med. 2012 Dec;13(6):499-500. Scleszka Laura, Swan Tricia. online] EMRA.

Academics 52

Academics Wellness Infectious Diseases 52

Don't Forget the Bubbles

JANUARY 22, 2024

Blood cultures are commonly drawn for certain focal infections such as pneumonia , skin and soft tissue infections (SSTIs), asthma , bronchiolitis as well and UTIs. Emergency Medicine Journal 2020; 37: 851-85 Malhotra A, Maughan D, Ansell J, et al. Magnusen E, Maduemem K, Shafiq A , et al.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

Don't Forget the Bubbles

FEBRUARY 28, 2024

The researchers concluded that oral brivudine offers an effective, well-tolerated therapy in immunocompromised children and could be used as an outpatient treatment. 2020; 64(12):e01426-20. European Journal of clinical microbiology and infectious diseases. Do you believe the results? Antimicrobial Agents and Chemotherapy.

Pediatrics 59

Pediatrics Infectious Diseases Outcomes Research 59

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

Don't Forget the Bubbles

JANUARY 10, 2024

These were presented as hazard ratios and included fever at presentation, previous transfusion ever, haemoglobinuria, malaria, sickle cell disease on enrolment, HIV, evidence of sepsis, malnutrition, shock, hypothermia, and dehydration. Groups were well matched at baseline. Were the study groups similar at the start of the trial?

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

Pediatric EM Morsels

APRIL 5, 2024

(CDC 2024) Generally, most ticks require >24 hours of attachment for there to be a risk of transfer of the infectious agent. This is true of hard ticks , which carry the majority of bacteria and viruses which can infect humans (Rochlin 2020) This is not true when the infectious agent is carried by a soft tick.

CDC 164

CDC Infectious Diseases Pediatrics Shock 164

Pediatric Education

JUNE 25, 2023

Borates can cause skin irritation and there can be some reproductive changes as well. Related Cases Disease: Ear Infections Symptom/Presentation: Ear Pain Specialty: Otolaryngology | Infectious Diseases Age: Teenager To Learn More To view pediatric review articles on this topic from the past year check PubMed.

Infectious Diseases 40

Infectious Diseases Pediatrics Seizures Outcomes 40

Pediatric EM Morsels

FEBRUARY 2, 2024

A “Syndromic” Approach for Diagnosing and Managing Travel-Related Infectious Diseases in Children. Infectious Disease Acquisition in Pediatric International Travelers: A 10-Year Review at a Canadian Tertiary Care Hospital. Glob Pediatr Health. 2021 May; 8:1-16. PMID: 34423077 Flores MS, Hickey PW, Fields JH, Ottolini MG.

Infectious Diseases 164

Infectious Diseases Pediatrics Sepsis Documentation/Coding 164

Pediatric Education

DECEMBER 17, 2023

He complained of neck stiffness, nausea without emesis and general malaise as well. The patient was clinically well enough 5 days later to be discharged and all bacterial testing was negative. Imported rickettsial infections to the United Kingdom, 2015-2020. Rickettsioses in Children – A Review. Indian J Pediatr.

Infectious Diseases 40

Infectious Diseases Pediatrics Sepsis Wellness 40

Pediatric EM Morsels

OCTOBER 6, 2023

(Forster, 2021) Transmission is by Fecal-Oral route (Chiodini 2018) Incubation period 6-30 days after exposure (Chiodini 2018) Salmonella typhi produces an endotoxin although its clinical significance is not yet well understood (Gibani 2019) Two typhoid vaccines are available for those > 6 m/o and are 50-80% effective. 2016; 15: 32.

Pediatrics 164

Pediatrics CDC Seizures Documentation/Coding 164

Pediatric Education

APRIL 21, 2024

The past medical history showed no bruising or bleeding problems, no pulmonary problems and he had otherwise been well. doi:10.1155/2020/6414719 Author Donna M. He also said that since this had happened he had been more nauseated. He was current with his immunizations but had not yet received his seasonal influenza vaccine.

Pediatrics 40

Pediatrics Infectious Diseases Radiology Radiology 40

Pediatric EM Morsels

DECEMBER 6, 2024

Responsible for a variety of diseases in humans, including the well-known “ fifth disease ” in children, but it can also lead to more severe complications in certain individuals, particularly those with compromised immune systems, or with underlying hematologic disorders. ” CDC , 20 May 2020, [link].

Blood Transfusions 164

Blood Transfusions Infectious Diseases CDC Pediatrics 164

Don't Forget the Bubbles

FEBRUARY 24, 2025

They were a well-grown, term infant born in good condition. The Pediatric Infectious Disease Journal 37(3):p 202-205, March 2018. 2020 Oct;40(10):1506-1512. The other investigations are unremarkable, including a normal CT head. Before this admission, there was no significant past medical history. Sounding familiar?

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

EMDocs

FEBRUARY 8, 2025

Well keep it short, while you keep that EM brain sharp. Empiric treatment with voriconazole 6 mg/kg twice daily intravenously for 2 doses should be started immediately based on Infectious Disease Society of America (IDSA) guidelines. She is well appearing with otherwise normal vital signs. Open Forum Infectious Diseases.

Infectious Diseases 72

Infectious Diseases EMS COPD Research 72

Pediatric Education

JULY 30, 2023

Her family was well-aware of signs and symptoms that the papillomas were recurring and when this occurred she slowly developed a raspy voice. Recurrent respiratory papillomatosis: A 2020 perspective. Over the past 6 months she has only needed 1 surgical treatment and was currently asymptomatic. J Med Virol. 2015;87(8):1413-1417.

Infectious Diseases 40

Infectious Diseases Pediatrics Wellness 40

Mind The Bleep

JANUARY 24, 2025

Fracture reduction and immobilisation : Fracture and/or dislocation reduction can restore alignment and vascular supply as well as reduce pain. The incidence and management of peripheral nerve injury in England (2005-2020). Nerve blocks may be considered and should be performed by experienced clinicians. de Schoulepnikoff, C.,

Dislocations 52

Dislocations Fractures Soft Tissue Injuries Infectious Diseases 52

Don't Forget the Bubbles

SEPTEMBER 23, 2024

This is particularly crucial in younger children who have received a large adult kidney and typically have relatively low creatinine levels when stable and well. Additionally, any child with a kidney transplant might have some degree of chronic kidney disease (CKD). When in doubt, call the team. Frontiers in Pediatrics , 10 , p.1087864.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Mind The Bleep

SEPTEMBER 17, 2024

Management The management is guided by the examination findings which are covered in the respective chapter, this section will delve into the importance of a number of those steps, as well as further long-term care. Always consider management as per ATLS protocol and SEPSIS 6 if relevant. Ensure the wound has been adequately washed out.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

Dr. No

JANUARY 27, 2022

The effect of this rule, as noted, is that the infectious diseases listed, including covid–19, almost always trump other potentially valid underlying causes of death. With the caveats established, Table 1 shows the average annual numbers of deaths for common causes for 2015-2019, and the numbers in 2020 and 2021.

Documentation/Coding 52

Documentation/Coding Infectious Diseases Wellness 52

EMDocs

NOVEMBER 2, 2024

A broad workup is initiated for altered mental status, including an STD panel, which shows a reactive Venereal Disease Research Laboratory (VDRL) and a negative CT head. Consultation with an infectious disease and neurology specialist can be considered to guide treatment and proper disposition. Neurosyphilis.” doi:10.1212/CON.0000000000000982

EMS 115

EMS Infectious Diseases CDC Research 115

Sensible Medicine

SEPTEMBER 25, 2024

Varma admits to precisely what I argued: infectious disease public health docs use propaganda and lobbying and corruption to sell products and not well designed randomized trials. He and up to 10 people gathered in a hotel room naked and took Molly.

Infectious Diseases 145

Infectious Diseases Administration Hospitals Research 145

EMDocs

NOVEMBER 25, 2024

volvulus as well as improvements in the diagnosis and treatment of this morbid disease. Patients from endemic regions with signs and symptoms suggestive of onchocerciasis will require multidisciplinary consultation, including ophthalmology, dermatology, and infectious disease. Vision 2020: update on onchocerciasis.

Infectious Diseases 73

Infectious Diseases Emergency Department EMS Administration 73

EMDocs

JANUARY 6, 2025

She receives IV calcium gluconate and bicarbonate as well as oral potassium binders for hyperkalemia. Case Resolution The patient and family remain in isolation and receive risk stratification assessment for a notifiable disease of public health concern. Hypoglycemia is managed with IV dextrose. 12 Table 1.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75