Emergency Medicine Journal

JANUARY 21, 2025

This study analyses the patterns of emergency service utilisation of the May 2023 flood in Romagna, Italy, and specifically investigates the differences in emergency department (ED) visits and mortality between individuals exposed and not exposed to the flood. to 0.92) and general disorders and minor problems (OR 0.85; 95% CI 0.78

Emergency Department 52

Emergency Department Wellness 52

Pediatric EM Morsels

AUGUST 23, 2024

Concussion – Presentation [ Silverberg, 2023 ] There is no definitive test to diagnose concussion in the ED. Progression through Return to Learn and Return to Sport:[ Patricios, 2023 ] Is individualized and based on the person’s symptoms Typically takes a minimum of 1 week. 2023 Aug;104(8):1343-1355. 2023.03.036.

Seizures 281

Seizures Pediatrics Academics Emergency Department 281

Pediatric EM Morsels

NOVEMBER 3, 2023

This allowed US hospitals to stock the drug to ensure quick treatment of suspected severe cases, rather than having to ship it from the CDC under the prior expanded-access protocol (Thomas 2023). falciparum parasitemia , and no other defined cause of AMS (WHO 2023). falciparum parasitemia , and no other defined cause of AMS (WHO 2023).

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

Pediatric EM Morsels

JANUARY 19, 2024

CDC 2023] In 2021, there were over 2800 cases of congenital syphilis, tripled from 2017. CDC 2023] Pseudoparalysis of Parrot – Presentation and Exam Infant presents with lack of movement of one or both upper extremities, and will cry with palpation. April 11, 2023. Updated 2023 Aug 8]. Accessed January 16, 2024.

Infectious Diseases 271

Infectious Diseases CDC Pediatrics Fractures 271

ACEP Now

DECEMBER 17, 2024

In spring 2023, nearly 95 percent of house staff voted to unionize with the Committee of Interns and Residents (CIR), a branch of the Service Employees International Union (SEIU) and the largest and oldest house staff union in the country. Contract negotiations began in fall 2023, but progress was slow. link] Published May 24, 2023.

Burns 105

Burns Hospitals Documentation/Coding Emergency Department 105

Pediatric EM Morsels

MARCH 15, 2024

Nicotera, 2024; Bacus, 2023 ] The laughing often described as being unmotivated or disproportionate to the emotional context. Bacus, 2023 ] Cases as young as 4 months have been described. 2023 Jun 6;23:100609. 2023 Nov 8. Pathologic uncontrollable laughing without mirth (lacking joy). Can even become status gelasticus.

Seizures 260

Seizures Pediatrics Psychiatric Emergency Department 260

Greater Sydney Area HEMS

NOVEMBER 4, 2023

Airway Registry learning points reflect the challenges described and wisdom shared by Sydney HEMS personnel and guests at the Clinical Governance Airway Registry presentations. Cases are discussed non-contemporaneously, anonymised and amalgamated over a period of time to draw together unifying take-home messages.

Airway Management 144

Airway Management Burns Operations Resuscitation 144

The Trauma Pro

JANUARY 28, 2025

The average cost of a course of treatment in 2023 was $26,787 (ref 6). Thrombotic complications. These do seem to be more common when AA is given. And even after ten years, cost is still a major consideration. Can we justify such an expense if it doesn’t seem to save lives?

Administration 187

Administration Outcomes Hospitals 187

Pediatric EM Morsels

SEPTEMBER 22, 2023

Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. In: Strange and Schafermeyer’s: Pediatric Emergency Medicine. 5 th Edition. McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. Neurogenic Shock. Updated 2022 Feb 10]. In: StatPearls [Internet]. Korean J Neurotrauma.

Shock 304

Shock Pediatrics Dislocations Hyperthermia / Hypothermia 304

Pediatric EM Morsels

DECEMBER 20, 2024

pneumoniae re-emgerged in 2023 after the COVID pandemic. Mycoplasma Pneumonia: Epidemiology According to the CDC , infections from Mycoplasma pneumnoniae have increased in the US, especially in young children. After a prolonged period of low incidence , M.

CDC 164

CDC Seizures Pediatrics EMS 164

Pediatric EM Morsels

SEPTEMBER 8, 2023

Accessed September 06, 2023. Shah A, Sobolewski B, Mittiga MR. Summer Penile Syndrome. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. McGraw Hill; 2021. link] Smith GA, Sharma V, Knapp JF, Shields BJ. The summer penile syndrome: seasonal acute hypersensitivity reaction caused by chigger bites on the penis.

Poisoning 278

Poisoning Pediatrics EMS 278

The Bottom Line

FEBRUARY 7, 2024

What’s new in the Critical Care literature – monthly updates

117

117

Ken Grauer, MD

SEPTEMBER 22, 2023

The May 13, 2023 post ( LA-RA reversal ). The May 30, 2023 post ( LA-RA reversal ). The May 5, 2022 post ( LA-RA reversal ). The May 24, 2022 post ( LA-LL reversal ). The May 26, 2022 post ( LA-LL reversal ). The August 17, 2022 post ( LA-RA reversal ).

EKG/ECG 445

EKG/ECG Wellness 445

EMDocs

NOVEMBER 19, 2024

Published 2023. Accessed October 23, 2023. Accessed October 23, 2023. Accessed October 23, 2023. Accessed October 23, 2023. Accessed October 23, 2023. Innov Clin Neurosci. 2018;15(7-8):20-22. Second-generation antipsychotic medications: Pharmacology, administration, and side effects. Micromedex.

Poisoning 111

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 111

Don't Forget the Bubbles

NOVEMBER 11, 2024

in a 2023 systematic review and meta-analysis. Treasure Island (FL): StatPearls Publishing; June 25, 2023. 2023; 173:158-166.e2. What is the evidence behind targeted temperature management? Kochanek et al. The Brain Trauma Foundation Guidelines were developed in a two-step process. Targeted Temperature Management.

Hyperthermia / Hypothermia 117

Hyperthermia / Hypothermia Pediatrics Outcomes Resuscitation 117

Ken Grauer, MD

AUGUST 26, 2023

These tall T waves are associated with flattening ( straightening ) of the ST segment in the inferior leads — with slight S T elevation in leads V2-thru-V6 ( albeit not enough to qualify as a "STEMI" — Akbar et al, StatPearls, 2023 ). This point is discussed in detail in the March 24, 2023 post of Dr. Smith’s ECG Blog ).

EKG/ECG 361

EKG/ECG EMS Hospitals 361

EMDocs

JANUARY 11, 2025

May 18, 2023) Stercoral Colitis: A Diagnostic Challenge and Therapeutic Approach in an Elderly Patient With Chronic Constipation. 2023 Oct;48(10):3050-3062. Epub 2023 Jun 27. Stercoral colitis in the emergency department: a review of the literature. International journal of emergency medicine, 17(1), 3. Stercoral Colitis.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

Ken Grauer, MD

DECEMBER 29, 2023

A DDENDUM ( 12/30/2023 ) : The Audio Pearl below reviews the concept of "shark fin" ST elevation. — — E CG M edia P EARL # 73 ( 5:40 minutes Audio ) — Reviews the concept of " S hark F in" S T e levation and d epression as a sign of extensive acute infarction.

EKG/ECG 430

EKG/ECG Resuscitation Hospitals Wellness 430

Pediatric EM Morsels

OCTOBER 27, 2023

Available at: [link] (Accessed: 26 October 2023). Available at: [link] (Accessed: 27 October 2023). References: Emergency Medical Services for Children- Enhancing Pediatric Safety (no date) Study Packet for the Correct Use of the BroselowTM Pediatric Emergency Tape. and Seaver, M. Rosenberg, M.S.

Pediatrics 271

Pediatrics Resuscitation Documentation/Coding Wellness 271

Ken Grauer, MD

SEPTEMBER 21, 2024

This is because clinicians ( including too many cardiologists ) have trouble accepting the fact that a young patient can have an acute MI ( See case discussion in the January 9, 2023 post in Dr. Smith's ECG Blog — with links at the bottom of this post to a series of more cases illustrating this phenomenon ).

EKG/ECG 296

EKG/ECG Resuscitation Outcomes Hospitals 296

Pediatric EM Morsels

JUNE 9, 2023

Banc-Husu, 2023 ] Cholestastis Inflammatory conditions Genetic and Metabolic diseases Pediatric cirrhotic liver disease has many complications. Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! 2023 Feb;43(1):100-116. Portal Hypertension in children is a heterogenous disease ]. Semin Liver Dis.

Pediatrics 154

Pediatrics Head Injuries Airway Management Resuscitation 154

Sensible Medicine

JANUARY 30, 2025

In 2023, the Maryland Department of Health (DOH) adopted a standard for return to universal masking in healthcare facilities when hospitalizations with respiratory viruses (covid, influenza, or RSV) reach a level of 10 cases per 100,000 population. A limited mask mandate is returning to my state this week. Maryland has a population of 6.3

CDC 97

CDC Hospitals Academics 97

The Skeptics' Guide to EM

MARCH 8, 2025

December 2023 Date: February 7, 2025 Dr. Lauren Rosenfeld Guest Skeptic: Dr. Lauren Rosenfeld is a PGY-3 emergency medicine resident at George Washington University. December 2023 Population: preterm and term infants of postmenstrual age up to 46 weeks and 0 days. Reference: Pessano S, et al. Cochrane Database Syst Rev.

Outcomes 71

Outcomes Emergency Department Wellness 71

ALiEM

DECEMBER 3, 2024

[Updated 2023 Jul 31]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. link] Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. In: StatPearls [Internet].

Academics 60

Academics Emergency Department Infectious Diseases 60

Pediatric EM Morsels

AUGUST 9, 2024

Hussain, 2023 ] Leads to >300,000 perinatal deaths / year globally. Congenital syphilis differs from syphilis contracted by an “adult” in that: [ Hussain, 2023 ] T. Hussain, 2023 ] Excellent prognosis if treated early. doi: 10.1136/bcr-2023-257694. Epub 2023 Aug 18. From asymptomatic to stillbirth.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

Ken Grauer, MD

JULY 29, 2023

And, in 2023 — virtually any young adult with an episode of VT should have follow-up evaluation including cardiac MRI to rule out mimics of severe underlying cardiac pathology, such as ARVD or sarcoidosis with cardiac involvement. A DDENDUM ( 7/29/2023 ) : I summarize KEY features regarding Idiopathic VT in Figure-4.

EKG/ECG 370

EKG/ECG Resuscitation Documentation/Coding Hospitals 370

Pediatric EM Morsels

JULY 19, 2024

2023 Aug;171:111644. Epub 2023 Jul 6. Shin TJ, Hasnain F, Shay EO, Ye MJ, Matt BH, Elghouche AN. Treatment of post-tonsillectomy hemorrhage with nebulized tranexamic acid: A retrospective study. Int J Pediatr Otorhinolaryngol. doi: 10.1016/j.ijporl.2023.111644. 2023.111644. PMID: 37423163.

Airway Management 290

Airway Management Pediatrics Wellness Operations 290

Ken Grauer, MD

AUGUST 16, 2024

References on Echo for PE Diagnosis: Oh and Park - Korean J Intern Med 38(4):456-470, 2023 — and — Hritani et al - Cleveland Clin J Med 85(11):826-828, 2018 — and — IF you want an excellent 5-minute video review on recognition of the McConnell Sign on Echo — WATCH_this_VIDEO by Dr.

EKG/ECG 380

EKG/ECG Wellness Shock 380

Pediatric EM Morsels

JULY 26, 2024

2023 Jul 17. UpToDate , June 2023, www.uptodate.com/contents/autoimmune-including-paraneoplastic-encephalitis-clinical-features-and-diagnosis?search=anti+nmda+receptor+encephalitis&source=search_result&selectedTitle=1~29&usage_type=default&display_rank=1#H2973236366. Neurol Neuroimmunol Neuroinflamm. doi: 10.1212/NXI.0000000000200013.

Psychiatric 271

Psychiatric Seizures Outcomes Pediatrics 271

Ken Grauer, MD

JANUARY 13, 2024

A bout H CM ( Different Forms of this Entity ): I've excerpted what appears below from My Comment in the December 26, 2023 post in Dr. Smith's ECG Blog. HCM is an "umbrella term" applied to the presence of LVH in the absence of "abnormal cardiac loading conditions" ( Hughes et al — JAHA 9:e015294, 2020 ).

EKG/ECG 399

EKG/ECG Hospitals 399

The Skeptics' Guide to EM

JULY 2, 2023

Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Prehospital Tranexamic Acid for Severe Trauma. Guest Skeptic: Dr. Salim Rezaie is a community emergency physician in San Antonio, TX.

EMS 145

EMS Outcomes Hospitals Research 145

ALiEM

JANUARY 13, 2025

Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. Available at: [link] (Accessed: 04 January 2024). View other cases from this Clinical Image Series on ALiEM.

Academics 67

Academics Emergency Department 67

Ken Grauer, MD

DECEMBER 15, 2023

For review on when despite acute OMI — the initial hs-troponin may come back normal — See the March 24, 2023 post in Dr. Smith’s ECG Blog. The importance of the new OMI ( vs the old STEMI ) Paradigm — See My Comment in the July 31, 2020 post in Dr. Smith's ECG Blog. This case is remarkable for the dynamic ST-T wave changes that are seen.

EKG/ECG 371

EKG/ECG EMS Hospitals 371

RebelEM

JUNE 29, 2023

Back on June 1 st , 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? REBEL EM Blog, June 1, 2023. Resus 2023. Back on June 1st, 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? Available at: HERE Branch KHR et al.

CPR 145

CPR EMS Documentation/Coding Outcomes 145

PulmCCM

JANUARY 15, 2025

According to a 2023 analysis of applications for FDA approval , as late as 2020 manufacturers were complying with a minimum of effort—e.g., JAMA Network Open 2023. In 2013, FDA issued a suggestion that manufacturers test devices on patients “with a range of skin pigmentations.” Nature (news). January 2024.

Academics 81

Academics Documentation/Coding Administration Research 81

The Skeptics' Guide to EM

NOVEMBER 25, 2023

Date: November 22, 2023 Reference: Stopyra et al. AEM November 2023. Date: November 22, 2023 Reference: Stopyra et al. AEM November 2023. AEM November 2023. Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI. Reference: Stopyra et al.

EMS 138

EMS EKG/ECG Research Hospitals 138

St. Emlyn

JULY 14, 2024

In 2023, Dr Zaf Qasim reviewed the UK REBOA trial for us on St Emlyn’s (The UK-REBOA trial – Has the […] The post JC: Prehospital Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Exsanguinating Subdiaphragmatic Hemorrhage appeared first on St.Emlyn's.

Resuscitation 135

Resuscitation Research 135