Don't Forget the Bubbles

MARCH 10, 2025

2021 Sep;38(9):663-672. Epub 2021 Jun 3. Image adapted from: Darbyshire D, Brewster L, Isba R, Body R, Basit U, Goodwin D. Retention of doctors in emergency medicine: a scoping review of the academic literature. Emerg Med J. doi: 10.1136/emermed-2020-210450. PMID: 34083428; PMCID: PMC8380914. What were the aims of the study?

Emergency Department 105

Emergency Department Research EMS Academics 105

Ken Grauer, MD

JUNE 14, 2024

Today's case is also noteworthy in that T-QRS-D is seen in association with RBBB — which has only been described on rare occasions ( See the March 28, 2021 post i n Dr. Smith's ECG Blog ). Prompt cath is therefore advised if the post-ROSC shows an acute STEMI.

EKG/ECG 389

EKG/ECG Wellness Hospitals 389

EMDocs

NOVEMBER 13, 2024

Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases. 2021 Aug;74(2):1014-1048. 2021 Jan;70(1):9-29 Marciano S, Díaz JM, Dirchwolf M, Gadano A. 2021 May;19(5):976-986.e5. Hepatology.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Ultrasounds Shock Hospitals 105

EB Medicine

JANUARY 7, 2025

Discussion on EMIC - Overview of the collaborative - Background and formation during the pandemic in late 2021 2. In this episode, Sam Ashoo, MD interviews Nicholas Stark, MD, MBA & Zaid Altawil, MD about the Emergency Medicine Innovation Collaborative 1.

EMS 82

EMS 82

Pediatric EM Morsels

MAY 5, 2023

Vegan Diets in Children: Basics Vegan Diets avoid/prohibit consumption of any animal products Exclusion of meat, eggs, honey, dairy products, etc This is often adopted due to heightened concern of animal maltreatment, but also for religious reasons or health benefits Roughly 2-5% of Western nation populations follow a vegan based diet (Sutter, 2021) (..)

Pediatrics 130

Pediatrics Documentation/Coding EMS 130

Pediatric EM Morsels

JUNE 2, 2023

2021 Nov 29;92(S7):e2021518. Today we are talking about a rare disease called FPIES (food protein induced enterocolitis syndrome) and how you might encounter these patients in the Pediatric Emergency Department. Update on Food protein-induced enterocolitis syndrome (FPIES). Acta Biomed. doi: 10.23750/abm.v92iS7.12394.

Dehydration 193

Dehydration Shock Pediatrics Emergency Department 193

Ken Grauer, MD

SEPTEMBER 22, 2023

The November 27, 2021 post ( LA-RA reversal ). The March 18, 2020 post ( LA-RA reversal ). The July 28, 2020 post ( RA-LL reversal ). The August 28, 2020 post ( LA-LL reversal ). The November 19, 2020 post ( LA-LL reversal ). The April 17, 2022 post ( Leads V1,V2 misplacement ). The May 5, 2022 post ( LA-RA reversal ).

EKG/ECG 445

EKG/ECG Wellness 445

Pediatric EM Morsels

JULY 21, 2023

Gag reflex is much better predictor (45% vs 6%) [Conzelmann 2021] Positive predictive value of GCS indicating aspiration in intoxication was only 3%. BMJ Open 2021; 11: e053619. doi: 10.1136/bmjopen-2021-053619 Orso D, Vetrugno L, Federici N, D’Andrea N, Bove T. 2021 Jan 1;90(1):21-26. J Trauma Acute Care Surg.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Emergency Medicine Journal

MARCH 25, 2025

Data were gathered for all adults and children with war-related TBIs admitted between June and November 2021. Methods This is a retrospective observational study from the EMERGENCY NGO hospital for civilian war victims in Kabul, Afghanistan.

Military 52

Military Resuscitation Hospitals 52

ACEP Now

DECEMBER 17, 2024

Trends in labor unionization among US health care workers, 2009-2021. The ER docs strike back. link] Published August 28, 2024. Accessed December 7, 2024. Ahmed AM, Kadakia K, Ahmed A, et al. 2022;328(24):2404-2411. Ahmed A, Li X. Labor unionization among physicians in training. 2023;330(19):1905-1906. Thompson SL, Salmon JW.

Burns 105

Burns Hospitals Documentation/Coding Emergency Department 105

Pediatric EM Morsels

MARCH 17, 2023

In the US, the venomous snakes include rattlesnakes , copperheads, cottonmouths/water moccasins , and coral snakes [ CDC, 2021 ] Rattlesnakes live all across the United State s Copperheads inhabit the eastern U.S. If you are managing a snake bite from a snake that does not typically reside in the U.S.,

CDC 130

CDC Poisoning Pediatrics Shock 130

EMDocs

NOVEMBER 19, 2024

of exposures reported to poison control centers in 2021 were related to antipsychotics or sedative-hypnotics with the majority of those exposures occurring in patients 20 years of age or older. 2021 Annual Report of the National Poison Data System © (NPDS) from America’s Poison Centers: 39th Annual Report. Front Psychiatry.

Poisoning 111

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 111

Pediatric EM Morsels

AUGUST 9, 2024

2019, there were 1,875 and this trend has continued to increase (2,157 case in 2020; 2,855 cases in 2021). Early Congenital Syphilis Present before 2 years of age [ Hussain, 2023 ; Foles, 2024; Fang, 2022; Morrisroe, 2021 ] Only ~33% of newborns present with symptoms at birth and can be subtle. 2021 Feb 5;14(2):e240532.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

Pediatric EM Morsels

MAY 10, 2024

Published 2021 Feb 4. [link] Hanson MG, Chan B. The role of point-of-care ultrasound in the diagnosis of pericardial effusion: a single academic center retrospective study. Ultrasound J. 2021;13(1):2. doi:10.1186/s13089-021-00205-x The post Chest Pain in Children: ReBaked Morsel appeared first on Pediatric EM Morsels.

EKG/ECG 271

EKG/ECG Pediatrics Ultrasounds Seizures 271

Emergency Medicine Journal

MARCH 25, 2025

Methods Patients ≥18 years between 2015 and 2021 with a recorded location of either a nursing or care home from the ‘Out-of-hospital Cardiac Arrest Outcomes’ registry for England were included. We present descriptive statistics and compare groups, where appropriate, using a 2 test.

Outcomes 52

Outcomes Hospitals CPR Resuscitation 52

Ken Grauer, MD

SEPTEMBER 8, 2023

ECG Criteria for the diagnosis of MBBB are described by Dhanse et al ( J Clin Diag Research: 10(9), 2016 ) — and Buttner and Cadogan ( LITFL, 2021 ) — and include the following: An ECG pattern consistent with RBBB in the chest leads ( ie, with a widened, predominantly positive QRS in lead V1 ).

EKG/ECG 296

EKG/ECG Research 296

Pediatric EM Morsels

JUNE 16, 2023

2021) Morel-Lavallee lesion , Orthobullets. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment.

Soft Tissue Injuries 154

Soft Tissue Injuries Dehydration Fractures Operations 154

Mount Sinai EM

OCTOBER 10, 2024

2021) of 16 prospective studies with 619 total patients found a sensitivity of 90% and specificity of 85% for elevated ICP, as compared to invasive ICP monitoring. Image Credit: POCUS Toronto Contraindications to Evaluation : Globe rupture The Evidence: A meta-analysis (Ohle et al., A meta-analysis (Aletreby et al.,

Urgent Care 232

Urgent Care Ultrasounds 232

RebelEM

JULY 1, 2024

Balkan Med J 2021. Balkan Med J 2021. Cureus 2021. Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20

COPD 132

COPD Emergency Department Outcomes EMS 132

Pediatric EM Morsels

NOVEMBER 3, 2023

Travel Medicine and Infectious Disease 44 (2021) 102196. falciparum parasitemia , and no other defined cause of AMS (WHO 2023). PMID: 36209409 Comelli A, Guarner ME, Tomasoni LR, Zamboni AF, Pavo BM, Zanotti P, Caligaris S, Matteeli A, Soriano-Arandes A, Castelli F.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

Sensible Medicine

MARCH 14, 2025

The only problem was that the patient population would change over the course of the study – the unscreened population was studied mostly in 2019 and early 2020 while the screened population was mostly late 2020 early 2021. Thus, the results would have to be adjusted.

Sepsis 98

Sepsis Wellness Documentation/Coding Fluid Resuscitation 98

Pediatric EM Morsels

NOVEMBER 17, 2023

2021 Jun;31(6):713-719. Epub 2021 Apr 11. References : To YH, Ong YG, Chong SL, Ang PH, Bte Zakaria ND, Lee KP, Pek JH. Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Paediatr Anaesth. doi: 10.1111/pan.14185. PMID: 33774880.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

RebelEM

FEBRUARY 19, 2024

The 2021 Surviving Sepsis Campaign Guidelines suggest starting vasopressors peripherally rather than delaying infusion until a CVC is placed [2]. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med 2021. CHEST 2024. PMID: 37611862 Evans L et al.

Administration 137

Administration Sepsis EMS Shock 137

Emergency Medicine Cases

SEPTEMBER 26, 2023

The tragic death of his son Ben McKenzie at the age 15 from hypoxic respiratory arrest as a result of anaphylaxis and asthma in 2021 has led Dr. McKenzie on a mission to prevent deaths from anaphylaxis and asthma by educating emergency providers around the world using his AMAX4 algorithm as a framework.

Anaphylaxis 121

Anaphylaxis Resuscitation EMS 121

ALiEM

JANUARY 13, 2025

2021) Spontaneous globe subluxation: A case report and review of the literature – international journal of emergency medicine, BioMed Central. (2013) Recurrent Spontaneous Globe Subluxation: A Case Report and Review of Manual Reduction Techniques. Available at: [link] (Accessed: 04 January 2024).

Academics 67

Academics Emergency Department 67

Pediatric EM Morsels

JULY 26, 2024

2021 Oct 9;22(20):10911. search=anti+nmda+receptor+encephalitis&source=search_result&selectedTitle=1~29&usage_type=default&display_rank=1#H2973236366. Wu CY, Wu JD, Chen CC. The Association of Ovarian Teratoma and Anti-N-Methyl-D-Aspartate Receptor Encephalitis: An Updated Integrative Review. Int J Mol Sci.

Psychiatric 271

Psychiatric Seizures Outcomes Pediatrics 271

EMDocs

JANUARY 11, 2025

(May 18, 2023) Stercoral Colitis: A Diagnostic Challenge and Therapeutic Approach in an Elderly Patient With Chronic Constipation. Cureus 15(5): e39179. doi:10.7759/cureus.39179 39179 Panneerselvam, S., Carlson, J. J., & Lin, D. Stercoral Colitis: When Constipation is an Emergency. The American journal of the medical sciences, 361(6), e61e62.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

EMDocs

DECEMBER 19, 2023

McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. McGraw Hill; 2021. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. Accessed August 25, 2022. link] Zafren K, Thurman R, Jones ID. Marine Dermatitis.

Poisoning 105

Poisoning Seizures Anaphylaxis Burns 105

Sensible Medicine

OCTOBER 18, 2023

2021 May 1;320(5):H2101-H2111. Epub 2021 Mar 26. Weissler Snir A, Connelly KA, Goodman JM, Dorian D, Dorian P. Exercise in hypertrophic cardiomyopathy: restrict or rethink. Am J Physiol Heart Circ Physiol. doi: 10.1152/ajpheart.00850.2020. 00850.2020. PMID: 33769918.

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106

The Trauma Pro

JANUARY 8, 2024

However, it is at odds with a paper published in 2021 from George Washington University. 2021 Nov;49:393-398. They advise that the chest ultrasound should be used alone with caution. Bottom line: This is an interesting and relatively large study. false negative rate. T hese are very disparate numbers. EAST 2024, Podium paper 21.

Ultrasounds 113

Ultrasounds Fractures 113

ACEP Now

NOVEMBER 7, 2024

2020;95(9):2021-2034. Emergency Medicine News 2004;26(13):19. Hoversten K, Kiemele L, Stolp A, et.al. Prevention, diagnosis, and management of chronic wounds in older adults. Mayo Clin Proc. The post How to Best Inspect, Protect, and Dress Wounds in the Emergency Dept. appeared first on ACEP Now.

Burns 97

Burns Documentation/Coding Outcomes Emergency Department 97

Emergency Live

OCTOBER 19, 2023

In the case of Corey O’Connell, a young Australian who went missing in 2021, it was drone technology that provided the decisive breakthrough in […] The post Drones and Photogrammetry: help in the Search for Missing Persons appeared first on Emergency Live.

105

105

Pediatric EM Morsels

MAY 12, 2023

2021 Sep;78(3):321-330.e1. Epub 2021 Jun 17. PECARN is highly sensitive for identifying those with clinically important TBI. of these had a CT performed 1 (0.2%) had a clinically important TBI (ciTBI) 10 (5.1%) had any TBI on CT 9 (4.6%) had skull fractures Remember to always watch out for NAT ! Ann Emerg Med. 2021.04.015.

Head Injuries 130

Head Injuries Fractures Pediatrics EMS 130

RebelEM

SEPTEMBER 27, 2023

Mohan 2021 ) Recall that the subsequently alkalemia will shift potassium intracellular. 2021 Sep;61(3):259-264. Epub 2021 Jun 17. As a result, it is essential to replete potassium simultaneously. References Boehnert MT, Lovejoy FH Jr. PMID: 4022081. Mohan S, Backus T, Furlano E, Howland MA, Smith SW, Su MK. J Emerg Med.

Poisoning 104

Poisoning Seizures Administration EKG/ECG 104

PulmCCM

JANUARY 15, 2025

Analysis of Discrepancies Between Pulse Oximetry and Arterial Oxygen Saturation Measurements by Race and Ethnicity and Association With Organ Dysfunction and Mortality. Fingertip oxygen sensors can fail on dark skin — now a physician is suing. Nature (news). January 2024. Fawzy et al.

Academics 81

Academics Documentation/Coding Administration Research 81

RebelEM

APRIL 17, 2023

A repeat search was completed in May 2021 & November 2022. 2021 May 12:34894211015590. Published on October 25, 2021. Accessed on December 3, 2021. Two investigators independently assessed and screened all studies for eligibility. AJR Am J Roentgenol. 2015 May;204(5):1064-8. PMID: 25905942. Ann Otol Rhinol Laryngol.

Ultrasounds 130

Ultrasounds Radiology Radiology Operations 130

Don't Forget the Bubbles

NOVEMBER 29, 2023

2021 May;77(5):532-544. Epub 2021 Jan 21. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. This article is based on: Mayberry, H., Burgart, A.M. and Kanaris, C., Intubated, awake, and paralysed: a never event. Intensive Care Research , 1 (3-4), pp.60-64. W hat is the problem?

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135