The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Ultrasonography or radiography for suspected pediatric distal forearm fractures. 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. Reference: Snelling et al. Reference: Snelling et al.

Fractures 139

Fractures Ultrasounds Pediatrics Outcomes 139

The Skeptics' Guide to EM

JANUARY 20, 2024

JAMA Pediatr. JAMA Pediatr. 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.

Pediatrics 75

Pediatrics Anaphylaxis Emergency Department Outcomes 75

EMDocs

MAY 4, 2024

. #1: Emergent Cath Lab Activations with “Normal” Computer ECG Interpretations Spoon Feed A significant minority of code STEMI patients have an initial normal computer ECG interpretation. Consequently, emergency physicians must remain vigilant to identify signs of OMI regardless of the initial computer ECG interpretation.

Documentation/Coding 98

Documentation/Coding Stroke Emergency Department Pediatrics 98

The Skeptics' Guide to EM

FEBRUARY 22, 2025

Case: A 62-year-old male presents to the Emergency Department (ED) with fever, confusion, and shortness of breath. Excluded: Pediatric patients, COVID-19 patients, non-diagnostic studies (ie studies evaluating only the prognostic role of MDW), non-English studies and case reports and reviews.

Sepsis 61

Sepsis Infectious Diseases Emergency Department Pediatrics 61

The Trauma Pro

OCTOBER 4, 2024

A pediatric multi-center study of study on adherence to activity restrictions was published last year. Ten Level I pediatric trauma centers in the US tabulated their experience with solid organ injuries over 3.75 And the more people I poll on what they do, the more and very different answers I get. Until now. years from 2013 to 2016.

Pediatrics 113

Pediatrics Operations Outcomes Emergency Department 113

EMDocs

JANUARY 11, 2025

Stercoral colitis in the emergency department: a review of the literature. International journal of emergency medicine, 17(1), 3. Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes. Annals of emergency medicine, 82(1), 3746. In StatPearls.

EMS 97

EMS Sepsis Shock Fluid Resuscitation 97

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. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

The Skeptics' Guide to EM

FEBRUARY 3, 2024

Systematic Review of CT Angiography in Guiding Management in Pediatric Oropharyngeal Trauma. 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. Laryngoscope. Reference: Curry SD, et al.

Pediatrics 69

Pediatrics Radiology Radiology Head Injuries 69

EMDocs

AUGUST 22, 2024

7 This has also been observed in a pediatric patient population. 12 How do we address these disparities in the emergency department? Certified interpreter use can improve communication and patient outcomes. Pediatrics. An implementation science approach improves language access in the emergency department.

Documentation/Coding 104

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

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. IN fentanyl has been safely used to treat pain in pediatric patients. She has a history of similar episodes.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

The Skeptics' Guide to EM

APRIL 2, 2022

Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. AEM March 2022 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Reference: Butt et al.

Pediatrics 52

Pediatrics Emergency Department Outcomes Research 52

The Skeptics' Guide to EM

JUNE 17, 2023

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. She is a Professor of Pediatrics and Interim Chief of the Section of Pediatric Emergency Medicine at the Medical College of Wisconsin.

Emergency Department 74

Emergency Department Pediatrics Head Injuries Administration 74

The Skeptics' Guide to EM

SEPTEMBER 10, 2022

Single-dose dexamethasone is not inferior to 2 doses in mild to moderate pediatric asthma exacerbations in the emergency department. Pediatr Emerg Care. 2022 Guest Skeptic: Dr. Harrison Hayward is a Pediatric Emergency Medicine fellow at Children’s National Hospital. Pediatr Emerg Care.

Pediatrics 52

Pediatrics Emergency Department Urgent Care Hospitals 52

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. Pediatr Rev. J Emerg Med.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

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. Pediatr Nephrol.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

Don't Forget the Bubbles

JULY 19, 2023

Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation. Outcome of pediatric patients referred for papilledema. J Am Assoc Pediatr Ophthalmol Strabismus. Cavuoto KM, Markatia Z, Patel A, Osigian CJ.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

Don't Forget the Bubbles

AUGUST 7, 2023

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. Yes Was the outcome accurately measured to minimize bias?

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

The Skeptics' Guide to EM

FEBRUARY 5, 2022

JAMA Pediatrics 2022 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. JAMA Pediatrics 2022 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC.

Pediatrics 52

Pediatrics Emergency Department Hospitals Outcomes 52

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. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: Am J Hematol. 2023 Apr;98(4):620-627. doi: 10.1002/ajh.26837.

Sepsis 68

Sepsis Emergency Department Pediatrics Academics 68

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Pediatric Crit Care Med.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

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

The Skeptics' Guide to EM

MAY 20, 2023

A bayesian interpretation of a pediatric cardiac arrest trial (THAPCA-OH). Guest Skeptic: Dr. Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. A bayesian interpretation of a pediatric cardiac arrest trial (THAPCA-OH). Date: May 10, 2023 Reference: Harhay MO, et al.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

Don't Forget the Bubbles

MAY 6, 2024

Acad Pediatr. Outcomes included clinical status when urine culture was available, subsequent antibiotic treatment within seven days and subsequent UTI within 30 days. The primary outcome was the successful intubation on the second attempt. Pediatric Critical Care Medicine , 25 (3), pp.e117-e128. 2024;24(1):111-118.

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. International Consensus Criteria for Pediatric Sepsis and Septic Shock.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Taming the SRU

DECEMBER 20, 2023

1) However, from 4-24 hours of displacement the Emergency Department clinician may still attempt bedside replacement. found that imaging confirmation of 237 patients in a pediatric ED did not reduce complication rate and did prolong ED stay). (4) The western journal of emergency medicine. Translational pediatrics.

Pediatrics 81

Pediatrics Emergency Department EMS Outcomes 81

Don't Forget the Bubbles

JUNE 19, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Were the predictor variables and the outcome evaluated in a blinded fashion? Were the predictor variables and the outcome evaluated in the initial sample?

CPR 124

CPR Research Documentation/Coding Outcomes 124

The Skeptics' Guide to EM

MAY 7, 2017

Point-of-care ultrasound for non-angulated distal forearm fractures in children: test performance characteristics and patient-centered outcomes. Acad Emerg Med May 2017. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Acad Emerg Med May 2017.

Fractures 40

Fractures Pediatrics Ultrasounds Academics 40

The Skeptics' Guide to EM

MAY 11, 2024

March 2023 Date: May 7, 2024 Guest Skeptic: Dr. Brian Lee is a pediatric emergency medicine attending at the Children’s Hospital of Philadelphia and Assistant Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Comparison: No fingernail replacement.

Pediatrics 65

Pediatrics Outcomes Emergency Department Hospitals 65

Don't Forget the Bubbles

MAY 17, 2023

’, ‘ Who can best score postoperative pain: parents or the children? ’, ‘ Is functional constipation associated with hypohydration? ’, ‘ Who is best at assessing foreign body aspiration on chest X-ray: pediatric pulmonologists, pediatric residents, or radiologists? ’ Eur J Pediatr. Eur J Pediatr. Eur J Pediatr.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

ACEP Now

MAY 10, 2024

Are we—as emergency physicians—always the best person to go after it? A recent 5-year retrospective study of 1,197 pediatric patients at a single institution studied 759 kids (63.4 A recent 5-year retrospective study of 1,197 pediatric patients at a single institution studied 759 kids (63.4 Ann Oto Rhinol Laryngol.

Pediatrics 52

Pediatrics Emergency Department Poisoning Outcomes 52

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 95

Emergency Department Pediatrics Wellness Fractures 95

The Skeptics' Guide to EM

DECEMBER 15, 2018

Pediatrics. He specialises in Paediatric Emergency Medicine and is a passionate […] The post SGEM#239: Febrile Seizure Recurrence – With or Without You Acetaminophen? first appeared on The Skeptics Guide to Emergency Medicine. Pediatrics. The primary outcome was the FART (Found and Retrieved Time) score.

Seizures 52

Seizures Pediatrics Emergency Department Administration 52

Pediatric Emergency Playbook

NOVEMBER 1, 2017

Ann Emerg Med. Pediatrics. To scan or not to scan: pediatric minor head trauma in your office, clinic or emergency department. Contemporary Pediatrics. JAMA Pediatr. Acad Emerg Med. Children with Arachnoid Cysts who Sustain Blunt Head Trauma: Injury Mechanisms and Outcomes.

Pediatrics 52

Pediatrics Emergency Department Outcomes 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. Increased Computed Tomography Utilization in the Emergency Department and Its Association with Hospital Admission.

Radiology 99

Radiology Radiology Emergency Department Hospitals 99

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. Pediatrics. BMC medicine.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

ACEP Now

OCTOBER 10, 2024

Some groups and practices have explored the option, understand what they’re getting into and have concluded that that they’re going to work together to get better outcomes under a unionized model. There’s no hard line for how many hours you should be measured on in terms of boarding or in terms of how long you’re in the emergency department.

Telemedicine 105

Telemedicine Critical Access Hospitals Emergency Department 105

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