The Skeptics' Guide to EM

DECEMBER 8, 2017

A Prospective Randomized, Double-Dummy Trial Comparing Intravenous Push Dose of Low Dose Ketamine to Short Infusion of Low Dose Ketamine for Treatment of Moderate to Severe Pain in the Emergency Department. Guest Skeptic: Dr. Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas.

Emergency Department 52

Emergency Department Fractures EMS 52

The Skeptics' Guide to EM

NOVEMBER 2, 2019

Is Buddy Taping as Effective as Plaster Immobilization for Adults With an Uncomplicated Neck of Fifth Metacarpal Fracture? Annals of EM 2019 Guest Skeptic: Martha Roberts is a critical and emergency care, triple certified nurse practitioner, currently living and working in western Massachusetts. A Randomized Controlled Trial.

Fractures 40

Fractures EMS Outcomes Emergency Department 40

ACEP Now

MAY 4, 2023

Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). A 58-year-old male with a history of alcohol abuse presented to the emergency department (ED) as a category 2 trauma for a fall with a reported flail chest. Discussion FIGURE 5: Chest X-ray OF post open reduction and interior fixation of rib fractures.

EMS 52

EMS Fractures Operations Ultrasounds 52

ALiEM

AUGUST 7, 2023

A 10-year-old male with no past medical history presents to the Emergency Department (ED) by EMS for evaluation of an injury sustained while playing tackle football. The patient was forcibly hit by another child against a tree.

Dislocations 98

Dislocations Fractures Academics Emergency Department 98

Taming the SRU

MAY 22, 2023

Ankle fractures are the third most common fracture in the ED [2] and more than 20,000 patients are seen in the ED for ankle sprains each day [3]. As an EM physician, it is important to have an understanding of the spectrum of ankle injuries and how these are appropriately evaluated. Obtain at least 3 views when possible.

Fractures 77

Fractures Dislocations Operations Radiology 77

EM Curious

JULY 8, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Part 1 here.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

The Skeptics' Guide to EM

MARCH 27, 2021

He currently serves as Vice-Chair of the Danish Society for Emergency Medicine and Chair of the Young Doctors in Emergency Medicine in Denmark. Date: March 17th, 2021 Guest Skeptic: Dr. Emil Ejersbo Iversen is an emergency medicine resident at the University Hospital of Zealand, Denmark. Reference: Schuster et al.

Fractures 40

Fractures Outcomes Hospitals Emergency Department 40

RebelEM

APRIL 29, 2024

World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med 2009 PMID: 20157465 4. Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies. Ngo AS, Oh JJ, Chen Y, Yong D, Ong MEH.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

The Skeptics' Guide to EM

OCTOBER 6, 2018

A Multicenter Program to Implement the Canadian C-Spine Rule by Emergency Department Triage Nurses. Annals of EM Oct 2018 Guest Skeptic: Alison Armstrong is an Emergency Department Nurse, TNCC Course Director, Trauma Program Coordinator and Canadian C-Spine Rule Nurse Champion. Reference: Stiell et al.

Emergency Department 52

Emergency Department EMS Fractures 52

Taming the SRU

NOVEMBER 27, 2023

These patients may be discharged with close outpatient follow-up, and should be instructed to return to the Emergency Department if they develop worsening and/or spreading pain and swelling, as this may be indicative of an infectious process. Antibiotics are not indicated [7, 8].

Soft Tissue Injuries 94

Soft Tissue Injuries Emergency Department EMS Fractures 94

ACEP Now

MARCH 15, 2024

A 20-year-old man presents to the emergency department (ED) directly from the scene of a fall from a bicycle, where he lost balance and landed on his outstretched hand. Children and older adults have weaker long bones than young adults and are more likely to sustain a distal radius fracture after a FOOSH than a carpal bone injury.

Fractures 52

Fractures Dislocations EMS Emergency Department 52

Taming the SRU

MAY 23, 2023

As an EM physician, it is important to have an understanding of the spectrum of foot injuries and how these are appropriately evaluated. fractures of the talar body, talar neck, and calcaneus require high-impact trauma). Gross deformities often suggest fracture or dislocation. nonunion, post-traumatic arthritis or deformity).

Fractures 57

Fractures Dislocations Operations EMS 57

The Skeptics' Guide to EM

DECEMBER 17, 2022

Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home. EMS have already splinted an obvious mid-shaft femoral fracture, but he continues to be tachycardic and hypotensive.

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

She is interested in social determinants of health in the emergency department and health policy. Dr. Ian Holley is also a PGY-3 resident in Emergency Medicine at Washington University School of Medicine in St. He is interested in ultrasound and international emergency medicine.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

EM Curious

JULY 24, 2015

EMS appears with a patient who just wiped out big time on the ice. It's a bit of a departure from what we've described above--he mainly goes right at a shaft fracture--but it's the same general idea: As always, these posts are for EDUCATIONAL PURPOSES ONLY. Academic Emergency Medicine, 20(6), 584–591. Maybe he's broken his hip?

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

Don't Forget the Bubbles

MAY 17, 2023

Hegeman EM, et al. Schwindt EM, et al. Invasive bacterial infection in children with fever and petechial rash in the emergency department: a national prospective observational study. Distribution and pattern of hand fractures in children and adolescents. Pediatr Infect Dis J. 2023 Apr 18. Eur J Pediatr. Pediatrics.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

The Skeptics' Guide to EM

NOVEMBER 9, 2019

Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals. He also hosts a great #FOAMed blog and podcast called TOTAL EM. first appeared on The Skeptics Guide to Emergency Medicine. He also hosts a great #FOAMed blog and podcast called TOTAL EM.

Ultrasounds 52

Ultrasounds Fractures Pediatrics Radiology 52

Taming the SRU

FEBRUARY 5, 2024

Traumatic brain injury (TBI) accounts for millions of Emergency Department visits annually. While moderate and severe TBI is often managed on an inpatient basis, patients presenting with mild TBI, or concussion, are often managed solely by Emergency physicians.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

EM Curious

JULY 1, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest.

EMS 52

EMS Ultrasounds EKG/ECG Fractures 52

The Skeptics' Guide to EM

APRIL 8, 2023

There have been many “temporary” rural emergency department closures during the past last year. In Ontario alone there have been approximately 160 emergency departments (ED) temporarily closed since the beginning of 2022. It was a stepped-wedge reconfiguration of the entire Danish emergency healthcare system.

Stroke 55

Stroke Emergency Department COPD Academics 55

EM Curious

JULY 11, 2015

Case by Sean Dyer PGY-3 EM Resident; Peer Reviewed by Dr. Christopher Hogrefe, Assistant Professor in Emergency Medicine at Northwestern University Feinberg School of Medicine The Case A 32 y/o male presents with wrist pain after being involved in a motor vehicle collision this afternoon. Emergency Orthopedics 7th Ed.

Dislocations 52

Dislocations Emergency Department Fractures Outcomes 52

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. I sent this to the Queen of Hearts So the ECG is both STEMI negative and has no subtle diagnostic signs of occlusion.

EKG/ECG 124

EKG/ECG Documentation/Coding Fractures Emergency Department 124

The Skeptics' Guide to EM

JULY 17, 2018

Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine Case: You’re working in a small rural emergency department when a seven-year-old girl comes in by EMS with a head injury. Dad, on the other hand, may need something for anxiety.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

Taming the SRU

FEBRUARY 23, 2024

Consider starting more goals of care discussions in the emergency department, not just for patients who are actively dying. Consider alternative pathways that can facilitate a quicker disposition such as utilizing CCTAs for chest pain patients. The intensity of the care plan while inpatient tends to follow that started in the ED.

Pediatrics 74

Pediatrics Ultrasounds Fractures Wellness 74

ACEP Now

MAY 6, 2023

Case A 35-year-old male is brought to the emergency department (ED) following a single-motor-vehicle collision in which two people were ejected and pronounced dead at the scene. EMS reports starring and significant damage to the windshield and show you a picture (Figure 1). Imaging and lab studies are ordered. Click to enlarge.)

Forensics 52

Forensics Documentation/Coding Fractures Head Injuries 52

Taming the SRU

DECEMBER 6, 2023

ems grand rounds: southwest ohio protocol updates WITH dr. weekley Ideally, medications will be administered IV or IO, therefore endotracheal tube drug administration will be de-emphasized. If there is no improvement in 20 minutes, EMS will call medical control regarding further decisions. Remember who you are and who you represent.

Leadership 57

Leadership Stroke Airway Management Administration 57

EM Guide Wire

MAY 19, 2019

Delayed Identification of Pediatric Abuse-Related Fractures. Teeuw AH, Hoytema van Konijnenburg EM, Sieswerda-Hoogendoorn T, et al. Parents’ Opinions About a Routine Head-to-Toe Examination of Children as a Screening Instrument for Child Abuse and Neglect in Children Visiting the Emergency Department. PEDIATRICS.

Pediatrics 40

Pediatrics Soft Tissue Injuries Fractures Emergency Nursing 40

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum. Annals of Emergency Medicine. J Emerg Med. 2018 Mar;71(3):279-288.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

RebelEM

JANUARY 30, 2023

PSA, also referred to as intravenous sedation in this paper, requires considerable resources, including 1:1 nursing observation, and burdens the emergency department (ED). Canadian Journal of Emergency medicine. Paper: Sithamparapillai A, Grewal K, Thompson C, Walsh C, McLeod S. vs. 91.4%; RR 0.93; 95% CI 0.86–1.01,

Dislocations 58

Dislocations Emergency Department Outcomes Research 58

The Skeptics' Guide to EM

APRIL 20, 2019

Talk Trauma is a two-day conference for nurses, allied health and EMS professionals involved in providing care for the adult and paediatric trauma patient. Case: A 52-year-old man presents to the emergency department via EMS after a motor vehicle collision while driving home from the city.

Emergency Nursing 40

Emergency Nursing Sepsis EMS Fractures 40

Taming the SRU

MARCH 14, 2023

Case 1 Fussy 1 month old A 1-month-old (ex-34 week premature) infant comes to your emergency department for fussiness. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. More on this below as we work through a few cases….

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

EMDocs

SEPTEMBER 16, 2024

Author: Joshua Lowe, MD (EM Attending Physician, San Antonio, TX) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Manpreet Singh, MD (@MPrizzleER); Brit Long, MD (@long_brit) The fluorescent lights above cast a clinical pallor over the bustling ED. The symphony of sounds in the Emergency Department can be overwhelming.

EKG/ECG 79

EKG/ECG Wellness Fractures Emergency Department 79

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Depending on the height of the child and the height of the car, the initial impact will cause a femur fracture, a pelvic fracture, or direct abdominal trauma. Pediatric emergency department thoracotomy: a large case series and systematic review. Pediatric emergency department thoracotomy: A 40-year review.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

EM Curious

JULY 10, 2015

INTRODUCTION Evaluation of the shoulder with ultrasound may appear like a daunting task in the emergency department, however with a strong understanding of the anatomy and an organized approach, the technique will rapidly become more within your realm of comfort.

Leadership 52

Leadership Ultrasounds Dislocations Fractures 52

EMDocs

MARCH 30, 2024

We’ll keep it short, while you keep that EM brain sharp. Answer : Thoracic and Lumbar Spine Trauma Epidemiology: Approximately half of the vertebral injuries that are seen in the emergency department are thoracic and lumbar injuries. A 27-year-old man was brought into the emergency department via EMS after being stabbed.

EMS 101

EMS Fractures Emergency Department Dislocations 101

Taming the SRU

FEBRUARY 22, 2023

Paske et al.

Hospice 40

Hospice EKG/ECG Resuscitation Wellness 40

EMDocs

SEPTEMBER 9, 2023

We’ll keep it short, while you keep that EM brain sharp. A 35-year-old right handed male with no significant past medical history presents with a deep hand laceration. The patient states they suffered a cut with a box cutter at a construction site.

EMS 90

EMS Fractures Soft Tissue Injuries Ultrasounds 90