The Skeptics' Guide to EM

JUNE 8, 2024

Systematic Review, Quality Assessment, and Synthesis of Guidelines for Emergency Department Care of Transgender and Gender-diverse People Recommendations for Immediate Action to Improve Care. WJEM December 2023 Population: Transgender and gender-diverse populations of any age, in any setting, region, or nation.

Best Practices 124

Best Practices Emergency Department Research Outcomes 124

EM Ottawa

NOVEMBER 27, 2023

2023 Oct 12:e2320850. Methodology: 2/5 Usefulness: 2/5 Jansen JO, et al. Editorial: Contemporary Adjuncts to Hemorrhage Control.

Emergency Department 57

Emergency Department Resuscitation Outcomes 57

EMDocs

SEPTEMBER 27, 2023

Additionally, a 2022 study in JAMA found no association between MIPS measures and any meaningful clinical outcomes and moreover physicians who cared for the most medically and socially vulnerable were more likely to receive worse scores (8). References American Medical Association. ” from [link] Seidenwurm, D. Burleson (2014).

Emergency Department 63

Emergency Department Research Outcomes Hospitals 63

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Is this scalp swelling normal?

Emergency Department 152

Emergency Department Hyperthermia / Hypothermia Seizures Pediatrics 152

ACEP Now

OCTOBER 10, 2023

A 76-year-old female presents to the emergency department obtunded with left hemiplegia. Both INTERACT-2 and ATACH-2 showed no statistical difference in their primary outcome between intensively lowering the BP and a less-intensive strategy. Symptoms began just prior to presentation. Her blood pressure (BP) is 195/104 mmHg.

Outcomes 52

Outcomes Stroke Hospitals Emergency Department 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Chest drains are commonly inserted in the Emergency Department (ED) with a complication rate of 30-40%. Training in chest drain insertion is essential in Emergency Medicine (EM) as approximately 25,000 patients undergo in England and Wales undergo this procedure annually.

Emergency Department 40

Emergency Department EMS Research Operations 40

Broome Docs

JANUARY 30, 2023

Association of Chest Pain Protocol-Discordant Discharge With Outcomes Among Emergency Department Patients With Modest Elevations of High-Sensitivity Troponin. Does wound eversion improve cosmetic outcome?: Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs.

Emergency Department 52

Emergency Department Outcomes Ultrasounds Pediatrics 52

Broome Docs

SEPTEMBER 3, 2024

As loud as a construction site: Noise levels in the emergency department. Australas Emerg Care. Epub 2023 Jul 31. PMID: 37532590 Bottom line: Emergency departments are noisy, although not ridiculously so. Epub 2023 Oct 26. … Adams C, Walsan R, McDonnell R, Schembri A. 2024 Mar;27(1):26-29.

Sepsis 109

Sepsis Emergency Department Outcomes Hospitals 109

ACEP Now

MARCH 6, 2024

The Sisyphean task remains to try to keep up—and, in that vein—here is a light round of the emergency medicine literature from 2023. 4 Repeated trials have not shown alteplase to have any signal of better outcomes, nor tenecteplase to have an association with increased adverse events. How Best to Stop the Bleeding in Trauma?

Research 52

Research Airway Management Stroke Outcomes 52

EMDocs

MAY 4, 2024

Consequently, emergency physicians must remain vigilant to identify signs of OMI regardless of the initial computer ECG interpretation. Source Emergency department Code STEMI patients with initial electrocardiogram labeled “normal” by computer interpretation: A 7-year retrospective review. Acad Emerg Med.

Documentation/Coding 78

Documentation/Coding Stroke Emergency Department Pediatrics 78

The Skeptics' Guide to EM

OCTOBER 21, 2023

Date: October 20, 2023 Reference: Cai et al. AEM October 2023. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: October 20, 2023 Reference: Cai et al. AEM October 2023. AEM October 2023. Reference: Cai et al.

Emergency Department 108

Emergency Department Radiology Radiology Hospitals 108

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Case: It is a steady Saturday afternoon in your rural emergency department (ED). Reference: Snelling et al.

Fractures 126

Fractures Ultrasounds Pediatrics Outcomes 126

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Certified interpreter use can improve communication and patient outcomes. An implementation science approach improves language access in the emergency department. One cohort study in a public ED found that 84.5% 45:446-458. Taira B, et al.

Documentation/Coding 82

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

The Skeptics' Guide to EM

JUNE 17, 2023

Date: June 15, 2023 Reference: Rees CA et al. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Date: June 15, 2023 Reference: Rees CA et al. Reference: Rees CA et al.

Emergency Department 72

Emergency Department Pediatrics Administration Head Injuries 72

The Skeptics' Guide to EM

JANUARY 20, 2024

Aug 2023 Date: October 30, 2023 Guest Skeptic: Dr. Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences. Reference: Zaoutis T, et al.

Pediatrics 70

Pediatrics Anaphylaxis Emergency Department Outcomes 70

ACEP Now

AUGUST 1, 2023

How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. When those same fundamentals done right achieve great success, they aren’t little at all.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

ALiEM

JULY 17, 2023

The Study In an Annals of Emergency Medicine paper , Preiksaitis et al. sought to identify program factors associated with unfilled post-graduate year 1 (PGY-1) emergency medicine (EM) positions in the 2023 Match [1]. as well as an analysis of the 2023 Match by Pupazan and Cook in Emergency Medicine News [3,4].

EMS 52

EMS Burns Emergency Department Shock 52

ACEP Now

AUGUST 13, 2024

Studies consistently show that having a diverse physician workforce leads to improved patient outcomes, lower mortality, reduced morbidity rates, and, ultimately, a more robust health care system. Dr. Kendall is the chief of clinician engagement at US Acute Care Solutions and has 15 years of emergency department leadership experience.

Leadership 111

Leadership Outcomes Academics Emergency Department 111

EMDocs

NOVEMBER 25, 2023

Source Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. 2023 Apr;98(4):620-627. Epub 2023 Feb 6. #2: 2023 Mar 30;110(4):432-438. 2023 Oct;164(4):892-912. 2023.04.036.

Sepsis 56

Sepsis Emergency Department Pediatrics Academics 56

Don't Forget the Bubbles

NOVEMBER 13, 2023

X-ray (radiography) is the standard imaging technique used in emergency departments. To determine the effectiveness of ultrasound, a recent study compared its diagnostic capabilities to radiography for distal forearm fractures in children and adolescents, with the primary outcome of functional recovery of the arm. N Engl J Med.

Fractures 64

Fractures Ultrasounds Emergency Department Pediatrics 64

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. 2023 May 17:archdischild-2022-325280. What outcomes did they look at? Was the outcome accurately measured to minimise bias?

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

The Skeptics' Guide to EM

OCTOBER 14, 2023

Time to change the reference ranges of children’s physiological observations in emergency care? March 2023 Date: July 12th, 2023 Guest Skeptic: Dr. Vicki Currie is a paediatric emergency medicine registrar in the West Midlands in the United Kingdom. Reference: Brennan L et al. A prospective study. J Paediatr Child Health.

Pediatrics 91

Pediatrics Sepsis Urgent Care Emergency Department 91

The Skeptics' Guide to EM

JUNE 22, 2024

December 2023 Guest Skeptic: Dr. Anireddy Reddy is a pediatric intensive care attending physician in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital of Philadelphia. Dr. Anireddy Reddy Case: A 3-year-old girl presents to the emergency department (ED) with fever and respiratory distress.

Pediatrics 52

Pediatrics Outcomes Emergency Department Resuscitation 52

ACEP Now

AUGUST 25, 2023

Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain Case A 15-year-old female with sickle cell disease (SCD) presents to your emergency department (ED) with a vaso-occlusive pain episode (VOE) of her legs and back. Primary Outcome: Discharged home from the ED Secondary Outcomes: There were several secondary outcomes.

Administration 97

Administration Pediatrics Outcomes Emergency Department 97

Taming the SRU

SEPTEMBER 21, 2023

2023) doi:10.1016/j.annemergmed.2023.05.014. Background Rapid sequence intubation (RSI) is frequently performed under emergent conditions in acutely ill patients. Exclusion criteria were pre-intubation hypotension, use of topical anesthesia, or missing data including primary outcome, patient weight, etomidate / ketamine dose.

Outcomes 90

Outcomes Emergency Department Shock 90

The Skeptics' Guide to EM

APRIL 29, 2023

Date: April 26, 2023 Reference: Han et al. The effect of telemental versus in-person mental health consults in the emergency department on 30-day utilization and processes of care. AEM April 2023 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Han et al.

Psychiatric 40

Psychiatric Emergency Department Urgent Care Academics 40

The Skeptics' Guide to EM

FEBRUARY 3, 2024

March 2023 Date: January 30, 2024 Guest Skeptic: Dr. Alexandra (Ali) Espinel is an Associate professor of pediatrics and otolaryngology at Children’s National Hospital and George Washington University. For Pediatric Oropharyngeal Trauma first appeared on The Skeptics Guide to Emergency Medicine. Reference: Curry SD, et al.

Pediatrics 65

Pediatrics Radiology Radiology Head Injuries 65

Don't Forget the Bubbles

MAY 8, 2024

An interesting study (JAMA Pediatrics) shows the benefits of newborn screening for spinal muscular atrophy (SMA), as initiating disease-modifying therapy earlier improves clinical outcomes. These findings advocate for expanding newborn screening programs to enhance outcomes for children with SMA. 2024 Apr 25:archdischild-2023-326533.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

The Skeptics' Guide to EM

APRIL 22, 2023

Date: April 20, 2023 Reference: Franklin D, et al. JAMA 2023 Guest Skeptic: Dr. Michael Falk is a Pediatric Emergency Medicine attending at Mount Sinai Medical Center […] The post SGEM #401: Hey Ho! Date: April 20, 2023 Reference: Franklin D, et al. He is interested in simulation and medical education.

Hospitals 52

Hospitals Pediatrics Emergency Department Outcomes 52

ACEP Now

OCTOBER 15, 2023

1 The emergency department remains an important frontier for work in judicious prescribing, but opiate analgesia remains a valuable tool for the initial treatment of a variety of presentations. The treatment response for any six-week program is of limited relevance to the acute treatment provided in the emergency department.

Emergency Department 52

Emergency Department Outcomes CDC Research 52

The Skeptics' Guide to EM

APRIL 8, 2023

Date: April 4th, 2023 Reference: Vaughan and Browne. Reconfiguring emergency and acute services: time to pause and reflect. 2023 Apr Guest Skeptics: Dr. Louella Vaugh is an internist practising as a hospitalist physician at an academic centre in London, UK with a special interest in smaller, rural and remote healthcare.

Stroke 55

Stroke Emergency Department Academics COPD 55

RebelEM

JUNE 5, 2023

One study from a county in Massachusetts found that of all nonfatal opioid doses seen in the emergency department from 2011-2015, 1 in 20 patients subsequently died within one year of initial visit with 66% of these deaths being directly related to an opioid overdose (4). PMID 33392580. mg tablet) 1 Buprenorphine 0.5

Emergency Department 95

Emergency Department Hospitals Outcomes EMS 95

The Skeptics' Guide to EM

JULY 8, 2023

Date: July 6, 2023 Reference: Hanula R et al. JAMA Int Med 2023. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. first appeared on The Skeptics Guide to Emergency Medicine. Date: July 6, 2023 Reference: Hanula R et al. JAMA Int Med 2023.

CDC 97

CDC Hospitals EMS Emergency Department 97

PulmCCM

OCTOBER 23, 2023

Read in JAMA Does Paxlovid Improve Covid-19 Outcomes in the Omicron Era? absolute risk reduction in the composite outcome among the immunocompromised or those with significant medical conditions. absolute risk reduction in the composite outcome among the immunocompromised or those with significant medical conditions.

Hospitals 98

Hospitals Emergency Department COPD CDC 98

RebelEM

JULY 24, 2023

Ann Emerg Med 2023. Population: Patients > 14 years of age who underwent RSI with either etomidate or ketamine from the National Emergency Airway Registry (NEAR). Outcomes: Primary: Postintubation hypotension (SBP < 100 mm Hg) 15 minutes post-intubation. Emerg Med J. mg/kg 1.33 mg/kg 1.33 2022;206:449-458.

Resuscitation 98

Resuscitation Outcomes Emergency Department EMS 98

Don't Forget the Bubbles

AUGUST 7, 2023

2023 Mar;59(3):480-486 Who were the patients? 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.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department.

EKG/ECG 121

EKG/ECG Documentation/Coding Emergency Department Outcomes 121