The Skeptics' Guide to EM

DECEMBER 10, 2022

One-year outcome of surgery compared with immobilization in a cast for adults with an undisplaced or minimally displaced scaphoid fracture: A meta-analysis of randomized controlled trials. Case: A 32-year-old male construction worker presents to the emergency department (ED) after falling on his right dominant hand.

Operations 52

Operations Fractures Military Emergency Department 52

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. Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain.

Emergency Department 52

Emergency Department Academics Fractures Outcomes 52

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. Journal of general internal medicine. 2017 Jun;32:660-6.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Rib fractures account for over 15% of all trauma attendances in the Emergency Department. Among patients with multiple rib fractures, the mortality rate can reach a staggering 33%, and this risk doubles for individuals above the age of 65. ED Physicians are already well-versed in the use of ultrasound.

Fractures 40

Fractures Anaphylaxis Emergency Department Ultrasounds 40

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 Emergency Department Outcomes 40

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%. just be careful with pelvic fractures or any femoral arterial punctures/ devices. Why does it matter? This has a pooled sensitivity of 89% and specificity of 91%.just

Ultrasounds 75

Ultrasounds Shock Fluid Resuscitation Resuscitation 75

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. J Trauma Acute Care Surg.

Fractures 40

Fractures Outcomes Hospitals Emergency Department 40

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. Crit Care Med.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EMDocs

JUNE 8, 2024

Orbital wall fractures: palpate bony structures surrounding the eye, check extra ocular muscle movements to rule out entrapment, obtain CT imaging if suspected [7]. A 32-year-old man presents to the emergency department with eye pain. Overview of Eye Injuries in the Emergency Department.” UpToDate , 30 Oct.

EMS 98

EMS Allergic Reactions Poisoning Emergency Department 98

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Nachi: This month’s team parsed through roughly 1200 articles as well as guidelines from the eastern association for surgery in trauma also known as EAST.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

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. Laboratory Data CT Orbits/Sella w/ IV Contrast : No acute orbital fracture.

Emergency Department 64

Emergency Department Academics Fractures Hospitals 64

Taming the SRU

NOVEMBER 14, 2023

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

Don't Forget the Bubbles

OCTOBER 19, 2023

Over 1,500 children in EDs, aged 1 to 4 with acute hypoxemic respiratory failure needing hospital admission, across 14 emergency departments in Australia and New Zealand were randomly allocated 1:1 to high-flow oxygen therapy OR standard oxygen therapy (approximately 750 children in each group). An x-ray confirms a toddler’s fracture.

Head Injuries 81

Head Injuries Fractures Outcomes Hospitals 81

EM Curious

JULY 24, 2015

Identify the triangle shaped femoral nerve, lateral to the femoral artery, as well as the iliopsoas muscle and the fascia illiaca running over its surface. Get your tip as close as possible to the nerve, and under the fascia illiaca, then inject (well, after aspirating first, of course). Academic Emergency Medicine, 20(6), 584–591.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Trauma CTs showed a "mildly displaced sternal fracture and a small retrosternal hematoma." The patient did well and was discharged.

EKG/ECG 115

EKG/ECG Wellness Fractures Emergency Department 115

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. Jeff: Vascular injuries include coagulation necrosis as well as thrombosis. Jeff: You’re right.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EM Curious

JULY 8, 2015

US GUIDED ULNAR NERVE BLOCK [BLOG]: Boxer's fracture need a reduction? Well, this may not be completely true. Part 1 here. Consider an ultrasound guided ulnar nerve block. Check out the case here and be sure to watch the video tutorial from 5minsono.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

ACEP Now

FEBRUARY 11, 2024

The clavicle is one of the most commonly fractured bones in the human body. Every year, approximately 332,000 people in the United States suffer from a clavicular fracture. The clinician should note the fracture site (either via palpable landmark or ultrasound visualization). Click to enlarge.) for the ED clinician.

Ultrasounds 52

Ultrasounds Fractures Emergency Department Hospitals 52

Don't Forget the Bubbles

JULY 31, 2023

Our team have scoured what’s new (well, mostly new!) A Diagnostic Accuracy Study to Evaluate Standard Rapid Diagnostic Test (RDT) Alone to Safely Rule Out Imported Malaria in Children Presenting to UK Emergency Departments. Radiographs from children with fractures, or disease processes affecting bone growth, were excluded.

Rapid Diagnostic Testing 98

Rapid Diagnostic Testing Resuscitation Emergency Department Pediatrics 98

Don't Forget the Bubbles

OCTOBER 10, 2024

The study excluded complex nail bed injuries, including those with distal phalanx fractures, germinal matrix injury or pulp lacerations, meaning outcomes are only relevant to simple nail bed injuries. Adopting this approach would reduce time in surgery for the child as well as the financial cost of nail bed repair. Arch Dis Child.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

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 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

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

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

Taming the SRU

SEPTEMBER 15, 2023

ETT onto a fiberoptic scope.

CPR 90

CPR Burns Airway Management Wellness 90

Taming the SRU

FEBRUARY 23, 2024

Total RBC count (<500 RBCs in last tube), as well as clearance by the last tube (decrease in RBC count by at least 70% by the last tube), can be used to differentiate between traumatic taps and a SAH. Consider starting more goals of care discussions in the emergency department, not just for patients who are actively dying.

Pediatrics 75

Pediatrics Ultrasounds Fractures Wellness 75

EM Curious

JULY 1, 2015

More FOAMed HARDWARE MALFUNCTION PACEMAKER AND AICD MANAGEMENT IN THE ED [BLOG]: EM Docs brings us some well needed cardiac hardware meducation on the patient with AICD/pacemaker issues presenting to the ED. LITERATURE THAT MAY INTEREST YOU [JOURNALS]: Should we be looking for and treating isolated calf vein thrombosis?

EMS 52

EMS Ultrasounds EKG/ECG Fractures 52

Don't Forget the Bubbles

SEPTEMBER 29, 2024

They may present to the emergency department with a cough, cold or fever. Alternatively, they may have fallen off the monkey bars, so we offer some painkillers, do an X-ray to confirm the fracture, and apply a cast. Explain these signs, and perhaps show the parents so can present to the emergency department if needed.

Emergency Department 52

Emergency Department Dehydration Hospitals Fractures 52

The Skeptics' Guide to EM

JANUARY 8, 2022

Case: A 43-year-old male presents to your emergency department (ED) the day after being involved in an all-terrain vehicle (ATV) accident. CT scans reveal multiple right sided rib fractures and a hemothorax estimated to measure 500cc with no additional injuries.

Fractures 52

Fractures Emergency Department Wellness 52

PEMBlog

JUNE 5, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

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. Clavicular and humeral fractures are more common in passengers than in drivers. He is completely amnestic to the events of the accident.

Forensics 52

Forensics Documentation/Coding Head Injuries Fractures 52

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. He appears well and is triaged to an ESI 4. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

PEMBlog

SEPTEMBER 13, 2023

This harm can manifest through the discomfort of blood draws and urine catheterizations, as well as the radiation exposure involved in head CT scans. Fever First, is there a fever in a previously well child between the ages of 6 months and 5 years? Occult trauma Any trauma that is not seen on your physical (e.g.

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

Protocols work well for adults, but trauma in children requires that we exercise our clinical muscles just a bit more. 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. Traumatized children need your full attention.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

Broome Docs

APRIL 6, 2023

Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments. 2022 Jul 2;400(10345):39-47. doi: 10.1016/S0140-6736(22)01015-7. 2010 Oct 5;182(14):1527-32.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. ng/mL, 0.25-0.5

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89