The Skeptics' Guide to EM

AUGUST 17, 2019

Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Corey Heitz is an emergency physician in Roanoke, Virginia.

Emergency Department 52

Emergency Department Academics Fractures Outcomes 52

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. Endophthalmitis following open-globe injuries. Eye (Lond). 2012 Feb;26(2):212-7.

Emergency Department 64

Emergency Department Academics Hospitals Fractures 64

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 Uptodate.com.

Pediatrics 100

Pediatrics Emergency Department Academics OB/GYN 100

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. Surg Neurol Int.

Sepsis 60

Sepsis Academics Operations Wellness 60

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

ALiEM

OCTOBER 7, 2024

A 52-year-old female with a past medical history of hypertension and prediabetes presented to the emergency department with double vision that started one day prior to arrival. F; O2 saturation 96% on room air General : No acute distress, well-appearing Neurologic : AOx3; Following commands. Speech without dysarthria.

Academics 64

Academics Emergency Department Pediatrics Wellness 64

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

SheMD

MAY 4, 2023

80% of department chair roles in academic medicine are held by men. Article Summary What they looked at: This article aimed to look at career trajectory differences between genders in faculty who have attained academic chair roles in emergency medicine. Why do we care about this article? How does this apply to us?

Leadership 52

Leadership Academics Operations Administration 52

ACEP Now

AUGUST 29, 2023

Our program pairs training at one of the busiest emergency departments in the country at a nationally recognized county, safety-net, Level I Trauma and Regional Burn Center (MetroHealth) with a world-renowned quaternary academic referral center (Cleveland Clinic). How should potential applicants learn more about your program?

Academics 52

Academics Burns Emergency Department Ultrasounds 52

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

ALiEM

JANUARY 22, 2024

A 40-year-old male, tailor by occupation, was brought to the Emergency Department with complaints of high-grade fever for the past 11 days. The patient also complained of shortness of breath for one week associated with a dry cough, as well as an altered sensorium for one day. Eschar: a clue to scrub typhus. doi: 10.1503/cmaj.101929.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

The Skeptics' Guide to EM

AUGUST 22, 2020

Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases. Corey Heitz is an emergency physician in Roanoke, Virginia.

Emergency Department 52

Emergency Department Academics Research Administration 52

The Skeptics' Guide to EM

NOVEMBER 26, 2022

Emergency Department Condition Acuity, Length of Stay, and Revisits Among Deaf and Hard-of-Hearing Patients: A Retrospective Chart Review. AEM November 2022 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine.

Academics 40

Academics Emergency Department Research Outcomes 40

The Skeptics' Guide to EM

APRIL 29, 2023

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. He is also the CME editor for Academic Emergency Medicine. Reference: Han et al.

Psychiatric 40

Psychiatric Emergency Department Urgent Care Academics 40

ALiEM

OCTOBER 16, 2023

An otherwise healthy 34-year-old male presented to the Emergency Department with two weeks of anterior neck pain. Additional Images Physical Exam Vitals : BP 115/80; HR 120; T 101°F; RR 16; O2 sat 97% General : Well appearing in no acute distress HEENT : Poor dentition, mild trismus. The floor of the mouth is unremarkable.

Wellness 60

Wellness Academics Emergency Department Hospitals 60

Taming the SRU

AUGUST 4, 2024

We discussed some practices to push learners outside of their comfort zone and promote learning, based on their level as well as their goals for the shift.

Emergency Department 85

Emergency Department Dislocations Documentation/Coding Burns 85

Taming the SRU

JUNE 12, 2023

Although not every person seeks health care for these injuries, the majority of those that do end up in the emergency department. In 2008, this led to greater than 316,000 emergency department (ED) visits and about 9,500 hospitalizations [1]. Academic Emergency Medicine. Annals of Emergency Medicine.

Infectious Diseases 102

Infectious Diseases Emergency Department Administration Academics 102

ALiEM

DECEMBER 18, 2023

A 19-year-old female with a past medical history of epilepsy presented to the emergency department for evaluation of rash and fever. 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.

Academics 70

Academics Emergency Department Wellness 70

ALiEM

OCTOBER 20, 2023

A 50-year-old Caucasian female with a history of hypertension, coronary artery disease, and insulin-dependent diabetes mellitus presents to the emergency department with a complaint of painful sores on the top of her left foot. Additional Images Physical Exam Vitals : T 37.2°C; Indian J Endocrinol Metab. 2012 Jul;16(4):614-20.

Academics 64

Academics Emergency Department Wellness Research 64

ACEP Now

AUGUST 15, 2023

Emergency physicians spend only 5 to 10 percent of their time for personal activities on shift. While there has been ample discussion of “the practice of mindfulness” in health care workers that improves mental well-being, when do we have this time? 13-15 Even the thought of gratitude can positively influence mental wellness.

Emergency Department 90

Emergency Department Military Resuscitation Wellness 90

EMDocs

DECEMBER 11, 2023

In October 2022, the American College of Cardiology released an updated expert consensus decision regarding the evaluation of chest pain in the emergency department. This included the addition several new STEMI equivalents [4] on ECG that warrant “prompt evaluation for emergency coronary angiography.” Ann Emerg Med.

EKG/ECG 110

EKG/ECG Emergency Department Academics Operations 110

ALiEM

DECEMBER 8, 2023

A 45-year-old male status-post right nephrectomy secondary to a renal mass presented to the emergency department with right-sided flank pain. Major risk factors for their development include prior abdominal surgeries that weaken the musculature as well as cardiovascular co-morbidities. 2018 Apr;22(2):353-361. Epub 2018 Jan 27.

Academics 60

Academics Emergency Department Outcomes Wellness 60

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Jeff: Well that’s kind worrisome. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

RebelEM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. J Med Toxicol. Epub 2019 Jul 3. Intensive Care Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

EMDocs

JUNE 16, 2023

And now we’re here at our destination, the place we know and love, the emergency room to talk about what we should be doing for the growing volume of children with mental health problems boarding in the emergency department. It’s stressful for the ED clinical staff as well. This has a downstream effect.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

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. Necessity-based system prioritizing CT contrast usage for emergent conditions (modified for ED-relevance). West J Emerg Med.

Radiology 73

Radiology Radiology Emergency Department Hospitals 73

EMDocs

MAY 25, 2023

Study included children, as well as adults. population at large Enrollment was terminated at an interim analysis due to predefined futility criteria that suggested that there was a 1% chance that carrying the trial to completion would demonstrate a most effect or least effective treatment. This increases applicability or ED care.

Seizures 64

Seizures Administration Anaphylaxis Outcomes 64

Dr. Smith's ECG Blog

MARCH 14, 2024

It is well known that NOMI usually has a normal ECG or nonspecific ECG. We also studied 7 years of Code STEMI patients requiring emergent reperfusion, and found that 4% presented with an ECG labeled ‘normal’, often confirmed by the final blinded interpretation.

EKG/ECG 107

EKG/ECG Documentation/Coding Patient Safety Outcomes 107

ALiEM

MARCH 7, 2024

It is usually large, nodular, well-defined, homogeneous, and slightly hypoechoic (Figure 13) [6]. Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). Dessie et al.,

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

The Skeptics' Guide to EM

JANUARY 20, 2018

BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. In the US, adults accounted for 6.6

Academics 52

Academics Emergency Department EMS Administration 52

Don't Forget the Bubbles

JANUARY 31, 2024

Article 1: What predicts parental anxiety in the Paediatric Emergency Department? Predictors of parental anxiety in a paediatric emergency department. Emergency Medicine Journal. Academic Pediatrics 2024 24 1 51-58 What’s it about? Martin, S.R., Heyming, T.W., Fortier, M.A. and Kain, Z.N. 40:715–720.

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

ALiEM

APRIL 17, 2023

A 29 year-old-male with a past medical history of left eye enucleation secondary to a gunshot wound several years prior presents to the Emergency Department (ED) for blurry vision, redness, and concern for a deformity to his right eye. This complication is known as corneal hydrops and causes sudden eye pain and decreased visual acuity.

Academics 52

Academics Emergency Department Wellness 52

Pediatric EM Morsels

JULY 21, 2023

Acad Emerg Med. Academic emergency medicine 12.9 Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. 2016 Aug;23(8):878-84. doi: 10.1111/acem.13014. Epub 2016 Aug 1. PMID: 27197686. Holmes, James F et al. 2005): 814–819. J Surg Res. 2019 Sep;241:112-118.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EMDocs

SEPTEMBER 25, 2023

These clinically challenging intubations prompted emergency clinicians to turn to a KOBI technique and forgoing the use of an NMBA, which are not without risk. Additionally, many if not most emergency physicians do not receive adequate training on topical awake intubations (TAI) (11). Int J Emerg Med. J Emerg Med.

Emergency Department 65

Emergency Department Soft Tissue Injuries Operations Airway Management 65

Downeast Emergency Medicine

DECEMBER 17, 2021

Emergency medicine (EM) was first recognized as a specialty by the American Medical Association (AMA) in 1972. Since that time, EM residencies have grown and evolved to provide academic support and training for graduating medical students interested in pursuing a career in the field.

EMS 52

EMS Academics Operations Emergency Department 52

The Skeptics' Guide to EM

DECEMBER 12, 2020

Case: A 52-year-old previously healthy woman presents to your emergency department (ED) with an abscess on her left forearm. She is systemically well and there is no sign of tracking, so you decide to perform incision and drainage in the ED. Dr. Ladde is in an active academic emergency physician working at Orlando R.

Operations 52

Operations Outcomes Research Academics 52

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. General surgery was consulted, and given the patient's significant comorbidities, he was transferred to a tertiary care academic center for further evaluation and management. coli and rare budding yeasts.

Ultrasounds 78

Ultrasounds Sepsis Radiology Radiology 78