The Skeptics' Guide to EM

AUGUST 24, 2024

Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Interests include information systems and digital health, research and education. Reference: Partyka et al.

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Fractures Emergency Department Ultrasounds Radiology 53

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. Am J Emerg Med. Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 23, Issue 4, 2009. 2021 Nov;49:226-232.

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Ultrasounds Operations Radiology Radiology 98

Taming the SRU

APRIL 14, 2024

There is less research in the utility of ultrasound in identifying strangulation, however findings such as lack of peristalsis, edema of the bowel wall, and lack of blood flow on Doppler all seem to be suggestive of strangulation. (8) 8) “Ultrasound may decrease the emergency surgery rate of incarcerated inguinal hernia” by Chen et al. (1)

Ultrasounds 93

Ultrasounds Emergency Department Pediatrics Radiology 93

ACEP Now

SEPTEMBER 3, 2024

Still, this wave of private equity acquisitions in emergency medicine has come crashing down on the heads of many early-career physicians. As of 2022, 1 in 4 emergency departments in the United States were staffed by a private equity-owned physician group. Center for Economic and Policy Research (CEPR). The New Yorker.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

RebelEM

OCTOBER 5, 2023

Pneumonia diagnosis supported by clinical and radiologic criteria. Strengths: The investigators framed a research question centered on patient outcomes, ensuring the study’s relevance and practicality. The researchers applied strict exclusion criteria, likely introducing some selection bias. In the placebo group, 20.5

Research 94

Research Outcomes Administration Shock 94

ACEP Now

MAY 9, 2024

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). Active extravasation of blood into the hematoma was identified, and the patient was referred to interventional radiology. Ann Emerg Med.

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Emergency Department Research Infectious Diseases Hospitals 52

The Skeptics' Guide to EM

NOVEMBER 9, 2019

Case: A 6-year-old boy comes into your emergency department at around midnight with his parents complaining of abdominal pain. Chip is the CEO of an ultrasound education company called Practical POCUS which is based in the United States but is expanding into an international market.

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Ultrasounds Fractures Pediatrics Radiology 52

RebelEM

NOVEMBER 20, 2023

Patients with torso hemorrhage present a clinical conundrum often requiring interventional radiology or surgery, both of which take time to mobilize. Researchers randomly assigned 90 eligible patients over ≈ 4.5 Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation.

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Resuscitation Operations Outcomes Hospitals 91

Taming the SRU

OCTOBER 1, 2023

There are many different types of pneumothorax (PTX), and the management paradigm has shifted in recent years as the research has exploded on this topic. 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. doi:10.1148/radiology.144.4.7111716

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Fractures COPD Hospitals Emergency Department 96

ACEP Now

AUGUST 12, 2024

Some other different features this year include: Integrated Research Forum: Get ready for an electrifying experience at ACEP’s Research Forum, emergency medicine’s premier research event! Emergency Ultrasound Management Course: (Sept. GEDA: The Dementia Friendly Emergency Department: From Vision to Reality (Sept.

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Ultrasounds Research Radiology Radiology 52

Broome Docs

AUGUST 2, 2022

Be wary of low quality before and after research. PMID: 35311942 Bottom line: I include this for interest’s sake only, as it sounds more like science fiction than medicine at this point (at least based on the funding of the emergency departments I work in), but it will be an interesting field to watch over the coming years.

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Sepsis Emergency Department Radiology Radiology 52

PEMBlog

JUNE 5, 2024

It was inspired by a hot-off-the-presses publication from the Pediatric Emergency Care Applied Research Network (PECARN) focused on clinical decision rules for cervical spine imaging in children. Ann Emerg Med. Cervical Spine Injuries are fortunately rare in children. Here is the aforementioned PECARN paper: Leonard, J.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

EMDocs

NOVEMBER 16, 2024

16 US or CT guided biopsy/joint aspiration (typically performed by Orthopedic surgery or Interventional Radiology). 9,23 Disposition: Dislocation : If successfully reduced in the emergency department may discharge with strict mobility restrictions and Orthopedic follow up. 16 CT Accuracy up to 84% in detecting PJI. 2021 Aug 31.

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EMS Dislocations Fractures Operations 94

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. Without a clear definition, tailoring research and audit is difficult.

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Hospitals Sepsis Fractures Emergency Department 78

Don't Forget the Bubbles

OCTOBER 28, 2024

doi: 10.1136/archdischild-2024-327224 Six-year-old Rhaenyra is brought into the emergency department after being hit by a car. This makes comparing data across research trials challenging. Fifteen-minute consultation: a guide to paediatric major haemorrhage Archives of Disease in Childhood – Education and Practice.

Blood Transfusions 72

Blood Transfusions Hyperthermia / Hypothermia Shock Pediatrics 72

Don't Forget the Bubbles

DECEMBER 2, 2024

This single-centre prospective study focused on a quality improvement (QI) project to reduce the overuse of chest X-rays (CXR) in paediatric patients with acute asthma exacerbations (AAE) arriving at the emergency department (ED ). Arch Acad Emerg Med. Pediatric Emergency Medical Journal 2023;10(4):109-117.

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

EMDocs

OCTOBER 17, 2023

World Society of Emergency Surgery guidelines (2020) “What is the best way to make a diagnosis of ALCD? In patients with suspected ALCD, we suggest a complete assessment of the patients using clinical history, signs, laboratorial inflammation markers, and radiological findings (weak recommendation based on very low-quality evidence, 2D).” “In

Radiology 87

Radiology Radiology Operations Best Practices 87

PEMBlog

AUGUST 30, 2023

Research suggests most CXRs are performed because ED clinicians (and many parents) are concerned for the possibility of missing pneumonia or another diagnosis requiring specific management. Pneumonia in Children Presenting to the Emergency Department with an Asthma Exacerbation. Pediatrics. 2022 Jan 1;149(1):e2021051405.

Pediatrics 52

Pediatrics Best Practices Hospitals Emergency Department 52

Taming the SRU

MAY 22, 2023

Most frequent reasons for emergency department visits, 2018. Agency for Healthcare Research and Quality. Musculoskeletal health literacy in patients with foot and ankle injuries: A cross-sectional survey of comprehension. Foot & Ankle Specialist. 9(1):31-36. doi: 10.1177/1938640015593078 Weiss AJ, Jiang J. 2001;220:406-12.

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Fractures Dislocations Operations Radiology 77

Don't Forget the Bubbles

OCTOBER 9, 2023

Stressful situations and busy departments breed uncivil words, gestures, and actions; if not addressed, there can be devastating consequences. The research that does exist shows that doctors experience incivility regularly. focussed on emergency departments. Let’s look at Bradley et al. Klingberg et al. and Whitelaw B.

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Seizures Incident Reporting Research Emergency Department 116

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergency department! Journal of Bone and Mineral Research , 21 (3), pp.380-387. Helenius, I., Salminen, S.,

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Pediatrics Fractures Dehydration Sepsis 52