Emergency Medicine Journal

JANUARY 21, 2025

A short systematic review was undertaken to assess whether intradermal sterile water injections (ISWI) provide effective pain relief in adult patients presenting to the Emergency Department (ED) with renal colic. MEDLINE, Embase, Cochrane and Google Scholar databases were searched, identifying seven relevant studies. Study information, patient characteristics, key results and methodological weaknesses were tabulated.

Emergency Department 52

Emergency Department Research 52

Dr. Smith's ECG Blog

JANUARY 21, 2025

I was reading ECGs on the system and saw all of these, from one patient. I read them without clinical context and looked at the clinical context later. A 70-something dialysis patient presented and coronary disease had missed dialysis and then presented with acute onset of shortness of breath. He denied chest pain. There was mild hypoxia prehospital, lowest saturation 90%, On arrival, BP was 140/84, pulse 122, O2sat 100% and the patient had increased work of breathing.

EKG/ECG 55

EKG/ECG Hospitals Wellness 55

PEMBlog

JANUARY 21, 2025

The concurrent circulation of influenza, respiratory syncytial virus (RSV), COVID-19, and norovirus during peak viral seasons presents a diagnostic challenge in pediatric emergency settings. Differentiating these pathogens based on clinical presentation is crucial for targeted management, minimizing unnecessary diagnostic tests, and optimizing healthcare resources.

Rapid Diagnostic Testing 52

Rapid Diagnostic Testing Pediatrics Dehydration Outcomes 52

Science Based Medicine

JANUARY 21, 2025

I’m at that age, 67 going in 68, where it is reasonable to yell at the clouds. Which, come to think of it, may be a good title for another collection of my SBM essays. Aging does indeed suck, but it is, usually, better than the alternative. As we, and by we I mean my family and me, age we get the […] The post Old Doctor Yells At Clouds first appeared on Science-Based Medicine.

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Emergency Medicine Journal

JANUARY 21, 2025

Background Extreme weather events due to human activities have significantly increased the frequency and severity of hydrological disasters like floods, impacting human health and healthcare systems worldwide. This study analyses the patterns of emergency service utilisation of the May 2023 flood in Romagna, Italy, and specifically investigates the differences in emergency department (ED) visits and mortality between individuals exposed and not exposed to the flood.

Emergency Department 52

Emergency Department Wellness 52

RebelEM

JANUARY 21, 2025

Background: The current standard care for evaluating pulmonary embolism (PE) advises against D-dimer testing in patients with a high clinical probability. European and American guidelines emphasize a sequential diagnostic approach based on pretest probability assessment using either a formal clinical decision instrument (e.g., Wells’ , Revised Geneva ) or clinical gestalt.

EMS 45

EMS Research Wellness Outcomes 45

The Skeptics' Guide to EM

JANUARY 18, 2025

Date: January 7, 2025 Dr. Dara Kass Guest Skeptics: Dr. Dara Kass is an emergency medicine physician, public health leader, and advocate passionate about equity and healthcare reform. She founded FemInEM, promoting gender equity in emergency medicine, and champions organ donation reform after donating part of her liver to her youngest son. Dr. Kass is dedicated to expanding reproductive healthcare access and educating the public on healthcare policy.

Academics 45

Academics Emergency Department EMS Outcomes 45

Emergency Medicine Journal

JANUARY 21, 2025

Background Growing numbers of avoidable low-acuity visits to emergency departments (ED) are a major health policy concern globally and are thought to contribute to ED crowding. This study explores the differences in the utilisation of low-acuity ED visits between culturally and linguistically diverse (CaLD) migrants and English-speaking background (ESB) population.

Emergency Department 52

Emergency Department 52

Sensible Medicine

JANUARY 21, 2025

Sensible Medicine is spoiled with great submissions. A challenge we face is needing to pass on articles which are interesting, thoughtful, and well-argued but which fall outside our lane – articles that are not even “medicine adjacent” This article, the second we have published by Charles Silver, pushes the edge of the envelope. I think there is enough of the intersection of medicine and society for us to publish this, especially as public health and politics seems to be gettin

Shock 54

Shock Wellness 54

Ken Grauer, MD

JANUARY 18, 2025

The ECG in Figure-1 was obtained from an older woman who presented to the ED ( E mergency D epartment ) because of a syncopal episode. She was asymptomatic at the time this ECG was recorded. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? Is there AV block? If so What kind? Figure-1: The initial ECG in today's case. ( To improve visualization I've digitized the original ECG using PMcardio ).

EKG/ECG 254

EKG/ECG Wellness 254

Dr. Smith's ECG Blog

JANUARY 18, 2025

I was texted this case by Ankur Kalra , an interventional cardiologist at the University of Indiana. He also did his cardiology fellowship at my institution, Hennepin County Medical Center. He runs the Parallax podcast, and he inteviewed me on that Podcast this year. He says the podcast had over 3000 downloads and "It's our season 6 topper" Here it is: Ep 121: OMI/NOMI: A Paradigm Shift in Myocardial Infarction Diagnosis With Dr Stephen Smith By the way, also don't miss this new OMI review artic

EKG/ECG 92

EKG/ECG Wellness 92

Emergency Medicine Journal

JANUARY 21, 2025

Background Evidence regarding high-dose inhaled corticosteroids (HDICS) in asthma exacerbations in adults is insufficient. This study compares the treatment outcomes of HDICS as add-on therapy to the outcomes of standard treatment in adult patients with acute asthma exacerbation in the ED. Methods This was a single-centre, triple-blind, randomised controlled trial conducted in the ED in Thailand between March 2022 and April 2023.

Hospitals 52

Hospitals Outcomes 52

EMDocs

JANUARY 18, 2025

We always work hard, but we may not have time to read through a bunch of journals. Its time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: When to Start Norepinephrine for Septic Shock? Spoon Feed In a meta-analysis of patients with septic shock, starting norepinephrine earlier had no mortality benefit, though heterogeneity and bias limit clinically rel

Shock 83

Shock Administration 83

PulmCCM

JANUARY 20, 2025

New guidelines on cardiopulmonary resuscitation in adults were published in Circulation in November 2024. They’re 187 pages long. What’s changed, and what do you need to know? Who Writes the CPR Guidelines? The International Liaison Committee on Resuscitation (ILCOR) is comprised of experts on resuscitation around the world. ILCOR is a scientific advisory body to the American Heart Association and similar societies in other countries.

CPR 65

CPR Resuscitation Hyperthermia / Hypothermia Seizures 65

American Medical Compliance

JANUARY 21, 2025

A study published in BMC Geriatrics found that out of 3,693 nursing staff surveyed (with a response rate of 60.1%), 88.8% reported witnessing at least one incident of resident-to-resident aggression in the past year. Resident-to-resident aggression (RRA) is a growing concern in healthcare facilities, particularly in assisted living and long-term care settings.

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Emergency Medicine Journal

JANUARY 21, 2025

Trauma remains a significant cause of mortality and morbidity. Non-compressible torso haemorrhage is one of the key drives of these mortality data. Our contemporary management has focused on damage control resuscitation, with a focus on haemorrhage control, haemostatic resuscitation and permissive hypotension. The evidence for permissive hypotension lacks the robustness as other treatments, such as tranexamic acid.

Resuscitation 52

Resuscitation 52

Don't Forget the Bubbles

JANUARY 20, 2025

Leprosy, also known as Hansen’s disease, is a chronic infectious disease caused by Mycobacterium leprae. It primarily affects the skin, peripheral nerves, upper respiratory tract, and eyes. The disease is named after Dr. Gerhard Armauer Hansen, who discovered the causative bacterium in 1873. Leprosy has been recognized and documented for thousands of years, historically surrounded by severe social stigma and misconceptions.

Infectious Diseases 59

Infectious Diseases Research Documentation/Coding Hospitals 59

Sensible Medicine

JANUARY 20, 2025

Atrial fibrillation is one of the most common reasons people get admitted to a hospital. As Western society grows larger and less active, AF incidence continues to rise. In short, few questions in cardiology are more relevant than the treatment of patients with new-onset AF. There are two paths of treating patients with AF. (After initiation of stroke prevention regimens—often with oral anticoagulation.

Stroke 56

Stroke Outcomes Hospitals Shock 56

33 Charts

JANUARY 19, 2025

Ive been thinking about AI-generated writing and how it’s changing things. One thing that swims in my head: How do you define yourself in an age of AI-generated material? Let’s do a thought experiment involving doctors on LinkedIn. Consider a scenario where each one of the tens of thousands of doctors here begin creating posts twice a day 750 word creations that analyze or break down a timely event or research article.

Research 59

Research 59

Emergency Medicine Journal

JANUARY 21, 2025

Background Rapid identification of individuals with acute respiratory infections is crucial for preventing nosocomial infections. For rapid diagnosis, especially in EDs, lateral flow devices (LFDs) are a convenient, inexpensive option with a rapid turnaround. Several ‘multiplex’ LFDs (M-LFDs) now exist, testing for multiple pathogens from a single swab sample.

Emergency Department 52

Emergency Department Hospitals 52

PEMBlog

JANUARY 20, 2025

Migraines are terrible. In the Emergency Department the “Migraine Cocktail” successfully treats 90+ percent of patients. Prochlorperazine and Toradol to the rescue! Also, it’s hard to make an AI Radiohead inspired song. Lyrics throbbing headache on one side floating zig zags eye to eye lights and sounds irritate Nausea, triptan? is it too late [Chorus] headache worsens treatment time Prochlorperazine plus toradol and you’ll be fine sip a cocktail through your vein preferr

Emergency Department 52

Emergency Department 52

EMDocs

JANUARY 20, 2025

Authors: Anatoliy Goltser, MD (APD, St Josephs Medical Center Stockton) // Reviewed by: Jessica Pelletier, DO, MHPE (APD/Assistant Professor of EM/Attending Physician, University of Missouri-Columbia); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Introduction With the recent severe nationwide shortage of intravenous (IV) fluids due to Hurricane Helene, we feel it is timely to provide a summary of the evidence regarding common uses of IV fluids for patients presenting to the emergency

Dehydration 50

Dehydration Fluid Resuscitation Sepsis Resuscitation 50

Thinking Critical Care

JANUARY 19, 2025

So I’m always glad to spend some time chatting with my buddy Korbin, I always learn something! Here we talk about some nonsensical things we’ve seen and heard related to clinicians’ understanding of the hemodynamic circuit. And Korbin begins to introduce the interface 2.5!!! Lets see what develops with that. Of course, anyone wanting to deepen their understanding and clinical use of hemodynamics and applying interfaces, its what we are focused on for #HR25!!!

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Emergency Medicine Journal

JANUARY 21, 2025

The need to isolate patients with influenza and COVID-19 in emergency departments (ED) requires quick screening tests for these infections. 1 Given mutations and newer variants of these diseases, vaccines and varying incidence, we assessed the diagnostic accuracy of two rapid screening tests in our ED in Spain during periods of higher and lower prevalence according to the Acute Respiratory Infection Surveillance System data. 2 A retrospective cross-sectional observational study was carried out i

Emergency Department 52

Emergency Department Hospitals 52

EM Ottawa

JANUARY 20, 2025

Methodology: 3/5 Usefulness: 3/5 Holmes JF, et al. Lancet Child Adolesc Health. 2024 May;8(5):339-347. Question and Methods:This prospective multicenter cohort study sought to validate the PECARN intra-abdominal injury and traumatic brain injury rules in order to help reduce the inappropriate use of CTs in the emergency department. Findings:The validation cohort demonstrated a sensitivity of 100% […] The post PECARN prediction rules for CT imaging of children presenting to the emergency de

Emergency Department 48

Emergency Department Head Injuries Pediatrics 48

Mind The Bleep

JANUARY 18, 2025

Congratulations on securing your FY1 position! This is an exciting milestone in your medical career. As you prepare for this new journey, one of your key tasks will be navigating the Skilled Worker Visa application process (previously known as the Tier 2 General visa). This guide will walk you through the steps to make your application process as smooth as possible. 1.

Documentation/Coding 52

Documentation/Coding Academics 52

JournalFeed

JANUARY 18, 2025

The JournalFeed podcast for the week of Jan 13-17, 2025. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Monday Spoon Feed : When compared to working solo as an emergency physician (EP), productivity is positively influenced by the presence of senior residents, minimally affected by junior residents, and negatively impacted or neutral with medical students.

CPR 52

CPR Outcomes 52

Emergency Medicine Journal

JANUARY 21, 2025

This month’s update is by the Emergency Department of the University Hospital of Heraklion, Crete, Greece. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlighted each paper’s main findings, key limitations and clinical bottom line.

Emergency Department 52

Emergency Department Hospitals Outcomes 52

Pediatric Education

JANUARY 19, 2025

Patient Presentation A 10-year-old female came to clinic for her health maintenance visit. There were no concerns and she was playing youth soccer and softball. The past medical history showed a history of Kawasaki disease as a 7 month old, and had been treated with intravenous gamma globulin and aspirin. Her initial and followup echocardiogram were normal.

Pediatrics 40

Pediatrics Operations Wellness 40

Sensible Medicine

JANUARY 19, 2025

Today’s guest column is by Dr. Frederik Schaltz-Buchholzer. He is Danish expert in vaccine science, who is supportive of US reforms. How can be possibly be enthusiastic about RFK Jr? And enthusiastic despite writing, “[Mr Kennedy] focuses on topics that are potentially important/relevant, and then unfortunately often exaggerates or distorts the facts.” So what are the facts, and what are the distortions?

Administration 135

Administration Pediatrics Research Outcomes 135

Science Based Medicine

JANUARY 20, 2025

Even as President Donald Trump is inaugurated today and his pick for HHS Secretary, Robert F. Kennedy, Jr. prepares to face confirmation hearings, there is trouble in "make America healthy" paradise. The post Trouble in (MAHA) paradise? first appeared on Science-Based Medicine.

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Emergency Medicine Journal

JANUARY 21, 2025

Case presentation A 29-year-old man presents to the ED with a foreign body (FB) in his right leg. He was impaled by an organic thorn while doing yard work in his backyard roughly 3 hours prior to presentation. A sample of the type of plant that was inserted into his lower extremity is shown in figure 1. He reports pain with movement of the limb, but no numbness or tingling.

Ultrasounds 52

Ultrasounds Wellness 52

Emergency Medicine Journal

JANUARY 21, 2025

We congratulate Xu et al on developing a machine learning-derived triage tool for major incidents. 1 The use of this technology, together with artificial intelligence, is likely to increase rapidly, and a triage tool that relies on binary questions, rather than quantitative measures or calculations, is intuitively advantageous. However, the proposed tool, while statistically sound, suffers from a lack of face-validity.

Research 52

Research 52

Emergency Medicine Journal

JANUARY 21, 2025

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.

Research 52

Research 52

Emergency Medicine Journal

JANUARY 21, 2025

We begin this month with the Editor’s Choice, which requires a bit of background. In 2015, the European Association of Science Editors convened a group of experts to develop the Sex and Gender Reporting (SAGER) guidelines with the goal of creating more transparency and detail in reporting sex and gender differences in the research. The guidelines recommend that researchers, and the journals they publish in, explain how the studies took into account potential differences in outcomes by sex

Research 52

Research Outcomes 52

Emergency Medicine Journal

JANUARY 21, 2025

Background Sex-based disparities in acute coronary syndrome (ACS) presentations exist and women often have worse outcomes after an ACS event. Calling the emergency medical services (EMS) initiates prehospital diagnosis and treatment and reduces in-hospital time to treatment. This study aims to identify factors affecting the intention to call EMS and EMS usage in Australian women and men.

EMS 52

EMS Hospitals Outcomes 52

Emergency Medicine Journal

JANUARY 21, 2025

Background Female participants are underrepresented in randomised control trials conducted in urgent care settings. Although sex and gender are frequently reported within demographic data, it is less common for primary outcomes to be disaggregated by sex or gender. The aim of this review is to report sex and gender of participants in the primary papers published on research listed on the National Institute of Health and Care Research (NIHR) Trauma and Emergency Care (TEC) portfolio and how these

Urgent Care 52

Urgent Care Research Outcomes 52