EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. Admission allows for close monitoring, given the risks of perforation, ischemic bowel, and ulceration, as well as appropriate management of the condition and patient symptoms. Stercoral colitis in the emergency department: a review of the literature. In StatPearls.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

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 144

Best Practices Emergency Department Research Outcomes 144

EMDocs

NOVEMBER 19, 2024

1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. Published 2023. Accessed October 23, 2023. Accessed October 23, 2023. Accessed October 23, 2023.

Poisoning 111

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 111

Taming the SRU

JANUARY 1, 2024

For laboratory testing, it is important to be aware that not all values obtained via an intraosseous line correlate well with peripheral venous samples (11). Additional Resources Please see a previous Taming the SRU post for extra tips and trouble-shooting tricks, as well as a video demonstration for IO access. Emerg Med J.

Emergency Department 92

Emergency Department Ultrasounds Administration Burns 92

Pediatric EM Morsels

JUNE 2, 2023

Our patients have varied past medical histories that require us to be well-versed in even the most uncommon disorders (or know where to look things up in a pinch)! You may not make the diagnosis, but detecting the clues is important for the family!

Dehydration 193

Dehydration Shock Pediatrics Emergency Department 193

ALiEM

OCTOBER 30, 2024

The Wounds Common among patients who use xylazine, the necrotic and exudative wounds are still not fully understood [5-8], but are likely due in part to direct cytotoxic effects of the drug and its impurities, as well as possible nutritional deficiencies common in those with dependence. 2023 Jan 1;53(1):140-2. 2022; 06/26/2023.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

EMDocs

JANUARY 25, 2025

Well keep it short, while you keep that EM brain sharp. A 45-year-old outdoor enthusiast presents to the emergency department with fever, headache, myalgias, and malaise. 10^9/L) Moderate (0.50.9 10^9/L) Severe (< 0.5 10^9/L) Generalized leukopenia (i.e. Most common causes of leukopenia Infections: 36.4% Medications: 25.6%

EMS 95

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 95

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. Coach John Wooden was famous for focusing on the fundamentals, sometimes called “little things.”

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Northwestern EM Blog

FEBRUARY 4, 2025

The patient was ultimately discharged from the Emergency Department with primary care and neurology referrals along with seizure precautions and advised to abstain from Kratom use. Treating Kratom toxicity varies based upon the clinical presentation as well as severity of symptoms. Drug Alcohol Depend. 2017 Jul 1;176:63-70.

Seizures 72

Seizures Poisoning Forensics Emergency Department 72

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. Ponmani C, Nijman RG, Roland D, Barrett M, Hulse T, Whittle V, Lyttle MD on behalf of PERUKI.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

PEMBlog

MARCH 4, 2025

In this episode we dive into the resurgence of Mycoplasma pneumoniae an atypical bacterial cause of community-acquired pneumonia thats making waves in pediatric emergency medicine. Well cover its clinical presentation, epidemiology, diagnostic approach, and management, including why standard beta-lactam antibiotics wont work.

Pediatrics 94

Pediatrics Military CDC Hospitals 94

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. Accessed October 10, 2023. J Emerg Nurs. 2023;(3):415-424.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

EM Literature of Note

SEPTEMBER 13, 2024

These are each awful, of course, in their own way from a patient- and parent-oriented standpoint, but they’re also quite awful at the population level, overburdening limited pediatric and emergency department resources. since August 2023. RSV, in particular, is a vicious scourge of young and vulnerable infants.

Emergency Department 87

Emergency Department Pediatrics Administration Wellness 87

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 108

CDC Hospitals EMS Emergency Department 108

Pediatric EM Morsels

JULY 21, 2023

Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. 1976 May 15;1(7968):1031-4. doi: 10.1016/s0140-6736(76)92215-7. PMID: 57446. Jain S, Iverson LM. Glasgow Coma Scale. Updated 2022 Jun 21]. In: StatPearls [Internet].

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

The Skeptics' Guide to EM

JULY 29, 2023

Date: July 21, 2023 Reference: McDonald et al. AEM July 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: July 21, 2023 Reference: McDonald et al. Patterns of change in prehospital spinal motion restriction: a retrospective database review.

Head Injuries 98

Head Injuries EMS Research Emergency Department 98

ALiEM

NOVEMBER 17, 2023

A 4-year-old female with no significant past medical history is brought to the Emergency Department by her grandmother for concern for two days of progressive vaginal bleeding. kg General : Well-appearing 4-year-old female acting appropriately with grandmother and mother at the bedside. C; Wt 18.2 link] Published 2021.

Pediatrics 100

Pediatrics Emergency Department Academics OB/GYN 100

Don't Forget the Bubbles

OCTOBER 12, 2024

doi: 10.1136/archdischild-2023-326773 Two-year-old Moyo is brought to the emergency department because her parents were concerned about noisy breathing. Most children can be discharged from the emergency department after a dose of corticosteroids and an appropriate safety net. Published 2023 Jan 10.

Airway Management 85

Airway Management Emergency Department Administration Hospitals 85

RebelEM

FEBRUARY 24, 2025

RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department. Well, the established cutoff for the distensibility index is 18%. Mar 2023; PMID: 36983218 Feissel M, et al. ” Anaesthesia, Pain, Intensive Care and Emergency MedicineAPICE: Oct 1005; PMID: 16356246 Bilgili B, et al.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

ACEP Now

AUGUST 22, 2023

Regardless of the domain, somewhere an expert panel has convened to issue a pronouncement informing all of the ideal care of patients under their specialty umbrella, indirectly extending to their care in the emergency department. 2-4 A fourth is planned for publication in late 2023, and will address non-opioid substance dependence.

Emergency Department 98

Emergency Department Academics Critical Access Research 98

Broome Docs

FEBRUARY 22, 2024

2023 Mar 30;110(4):432-438. PMID: 36946338 Bottom line: This is a well done RCT that demonstrates pretty convincingly that you should not bother trying to but fingernails back on after nail bed repair (and my guess is you definitely shouldn’t be removing them either). 2023 Nov 11. 2023 Oct 1;80(10):1047-1054. 2023 Oct 12.

Emergency Department 89

Emergency Department Psychiatric Resuscitation Wellness 89

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Emergency Department (ED) crowding has dominated discourse around Emergency Medicine (EM) in recent years and is now well recognised as contributing towards patient harm. Less is known about the implications of crowded departments on staff. Because you’ve got patients in, well, everywhere.’

Emergency Department 40

Emergency Department Wellness EMS Patient Safety 40

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 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

ACEP Now

AUGUST 14, 2024

Rate Versus Rhythm in the ED The 2023 AHA/ACC guideline doesn’t give explicit recommendations or preference regarding initial rate or rhythm control strategy for new-onset AF patients who are hemodynamically stable. as well as conversion to sinus rhythm (OR 1.75; 95 percent CI 1.08-2.84).7 In fact, few studies compare the two classes.

Emergency Department 105

Emergency Department Outcomes Research Wellness 105

EMDocs

SEPTEMBER 14, 2024

Source Use of Glucagon-Like Peptide-1-Agonists and Increased Risk of Procedural Sedation and Endotracheal Intubation in the Emergency Department. Ann Emerg Med. The AI performed well in both accuracy and in improving sensitivity. Ann Emerg Med. 2023-064364. 2024 Aug;84(2):226-227. DOI: 10.1016/j.annemergmed.2024.03.007.

Emergency Department 96

Emergency Department Resuscitation Pediatrics EKG/ECG 96

ALiEM

OCTOBER 23, 2023

A 32-year-old man with a history of traumatic globe rupture from a stab wound two months ago, status post repair, presented to the emergency department for worsening right eye pain and green malodorous drainage for the past three days. There was a well-healed scar on the bottom eyelid. Indian J Otolaryngol Head Neck Surg.

Academics 111

Academics Emergency Department Ultrasounds Wellness 111

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. There are well preserved R-waves in Wellens waves. What do you think? ng/mL, BNP 2790, and lactate 3.7.

EKG/ECG 139

EKG/ECG Emergency Department Shock Ultrasounds 139

PEMBlog

OCTOBER 18, 2023

The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. Initially in the emergency department he was generally well-appearing with normal vital signs. Infants with NTED generally remain well-appearing and do not meet toxic shock syndrome (TSS) criteria. 2023; 40( 2): 349- 351.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

Broome Docs

APRIL 6, 2023

2023 Jan 21. Am J Emerg Med. 2023 Feb;64:206.e1-206.e3. 2023 Jan 30. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments. 2023 Jan 13;76(2):185-191. 2023 Feb 03;: PMID: 36367144 Justin’s excellent critical appraisal and Full write up here.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

EMDocs

JUNE 2, 2023

You should always follow your local practice guidelines and recommendations as well as adhere to approved medications in your facility. Document what you gave and why, as well as the impact. If a patient has a PRN on their med list do that! Route of administration If the patient is cooperative, offer oral medications first.

Psychiatric 93

Psychiatric Pediatrics Emergency Department Administration 93

ALiEM

APRIL 12, 2023

The thin alcohol layer serves to eliminate any air bubbles under the adhesive cover as well as minimizes residual adhesive material sticking to the probe when removing the cover. Accessed April 5, 2023. Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. emDOCs.net – Emergency Medicine Education.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

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

Taming the SRU

DECEMBER 11, 2023

1,2] Patients at risk for suicide often interact with emergency medical care. Suicide-related behavior (SRB) accounts for 1% of all Emergency Department (ED) visits; additionally, greater than 8% of patients visiting emergency departments are likely experiencing suicidal ideation at the time of the encounter.[3-5]

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. Production levels increased steadily back to baseline, achieving normal supply levels in February 2023. West J Emerg Med.

Radiology 99

Radiology Radiology Emergency Department Hospitals 99

ALiEM

JUNE 1, 2023

Are you using phenobarbital instead of benzodiazepines as the first-line monotherapy for patients in alcohol withdrawal in the Emergency Department (ED)? Well not exactly. The Journal of Emergency Medicine. Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives. 2012.07.056.

Emergency Department 98

Emergency Department Administration Seizures Hospitals 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. 2023 and Kovarik et al., Clin Ophthalmol.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

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