EMDocs

NOVEMBER 13, 2024

Literature concerning risk with PPIs is controversial. Presentation: Classic presentation is abdominal pain or tenderness, fever, and altered mental status. Literature suggests 10-33% of patients are asymptomatic or only have mild symptoms. Clinician sensitivity for SBP based on bedside assessment is between 40-75%. increase in mortality.

E-9-1-1 100

E-9-1-1 ALS OR ED 100

EMDocs

NOVEMBER 16, 2024

Answer : Posterior dislocation of a periprosthetic hip Epidemiology: Total Hip Arthroplasty (THA) is the 4 th most common surgical procedures in the United States (2.3% of adults over the age of 55). 1-3 Despite its commonality it retains a relatively high rate of complications overall and patients frequently present to the ED for evaluation.

EMS 96

EMS E-9-1-1 Operating Room Emergency Department 96

This Podcast Will Kill You

DECEMBER 10, 2024

Randal, et al. Girard-Madoux, Mathilde JH, et al. ” World Journal of Gastroenterology: WJG 19.34 (2013): 5607. 2013): 339-354. Surgeons performed appendectomies like it was spring cleaning – when in doubt, cut it out. History Biology Ball, Chad G., ” Canadian journal of surgery 55.2 2012): 125.

E-9-1-1 52

E-9-1-1 ALS Emergency Department OR 52

JEMS

JUNE 23, 2025

While this mechanism has enabled states to draw down billions in additional federal funds, CMS argues that it distorts the fiscal integrity of Medicaid by allowing states to effectively cycle federal dollars back to providers without a commensurate state contribution or measurable expansion of care for enrollees.

EMS 116

EMS E-9-1-1 Community Paramedicine Emergency Medical Services 116

JEMS

JULY 23, 2025

In one study alone, EMR/EMT Students failed to adequately recognize or suspect autism in simulated trauma victims 87% of the time. 2 Only 1% of those studied actively attempted to solicit information from the patient with a suspected Autism Spectrum Disorder (ASD), instead electing to question bystanders. 11 An average lifespan of only 36.2

E-9-1-1 98

E-9-1-1 EMT EMT Public Safety 98

Don't Forget the Bubbles

DECEMBER 16, 2024

The reduced coverage is particularly notable in urban areas like London , where socio-economic and cultural barriers further compound the problem. This contributed to a sharp increase in cases of both diseases in 2024. Health services worldwide were disrupted, with routine immunisation programmes among the hardest hit.

E-9-1-1 57

E-9-1-1 OR ALS Emergency Department 57

EMDocs

JULY 21, 2025

SCAPE differs in several significant ways: rapid onset (hours), respiratory distress, severe HTN, may or may not be systemically volume overload. Meta-analyses demonstrate reduced need for intubation, improved survival, improved respiratory indices (e.g., May use BPAP or CPAP; neither superior to the other. Standard doses of nitroglycerin (0.4

E-9-1-1 87

E-9-1-1 ALS Emergency Department OR 87

JEMS

JUNE 12, 2025

Since beginning my EMS career in 1993, the U.S. Food and Drug Administration has approved over 3,000 new medications, averaging over 110 new drugs yearly. 1 Many of these approvals represent entirely new drug classes or treatment approaches. It would be a great display in training centers, simulation labs and EMS stations.]

Mobile Integrated Health 98

Mobile Integrated Health E-9-1-1 EMS Community Paramedicine 98

FOAMfrat

NOVEMBER 14, 2024

Historically, those battling addiction are treated poorly by healthcare professionals, which directly inhibits them from seeking or complying with care (Van Boekel et al., Accessed November 7, 2013. New York: McGraw-Hill; 2011. The Asam Clinical Practice guideline on Alcohol Withdrawal Management: Erratum. Brouwers, E.

Paramedic 98

Paramedic EMT EMT ED 98

ACEP Now

JUNE 17, 2025

2013 Apr 15;87(8):536. Think about the medical student on rounds whose pockets are stuffed with all manner of items compared to the attending who carries nothing more than a phone, eschewing even a pen or stethoscope to the burden of others. 1,2 Panel a. Additional techniques for diagnosing scabies. Am Fam Physician. Woodley D, Saurat JH.

Emergency Department 52

Emergency Department E-9-1-1 ALS OR 52

Dr. Smith's ECG Blog

JUNE 6, 2020

Birnbaum et al ( Am Heart J 131:38, 1996 ) — studied the predictive value of ST elevation in lead aVL for this purpose. I summarized the conclusions by Birnbaum et al in My Comment at the bottom of the page in the February 4, 2020 post in Dr. Smith’s ECG Blog. Is it important to know whether this is LAD or RCA? First, the 12-lead: 1.

STEMI 40

STEMI ALS OR 40

REBEL EM

FEBRUARY 24, 2025

Jan 2015; PMID: 25559473 Airapetian N, et al. Di Nicol P, et al. Mar 2023; PMID: 36983218 Feissel M, et al. Sep 2004; PMID: 15045170 Luecke T, et al “PEEP and cardiac output.” ” Anaesthesia, Pain, Intensive Care and Emergency MedicineAPICE: Oct 1005; PMID: 16356246 Bilgili B, et al.

ALS 64

ALS E-9-1-1 Critical Care OR 64

Don't Forget the Bubbles

FEBRUARY 24, 2025

Since the introduction of the Pertussis vaccination in pregnancy, from 2013 to the end of October 2024, there have been 31 deaths in infants under 3 months with confirmed Pertussis (eleven of which occurred in 2025). In a prospective multi-centre study, Berger et al. They had a two-day history of reduced feeding.

ALS 57

ALS Critical Care OR Life Support 57

EMDocs

MARCH 24, 2025

The patient denies any current symptoms but states that he just wants to get checked out. He has no chronic medical conditions, does not take any medications, and does not use any drugs or alcohol. Vital signs are within normal limits, with BP 110/70 mmHg, HR 60 bpm, RR 18 breaths/min, O2 saturation 98% on RA, T 37 C.

E-9-1-1 80

E-9-1-1 ALS ED OR 80

EMDocs

FEBRUARY 22, 2025

A 37-year-old male comes in with facial trauma after his head slammed into the steering wheel during an MVC. He was able to walk away from the scene with no loss of consciousness, nausea, or vomiting. However, he has a headache that has become more painful. He was transported from the scene by EMS. VS include BP 120/80, HR 99, T 98.2,

E-9-1-1 62

E-9-1-1 EMS Plasma OR 62

REBEL EM

DECEMBER 4, 2024

MD Calc: CHA2DS2-VASc for Atrial Fibrillation Stroke Risk References Yealy D, Kosowsky JM: Dysrhythmias, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. PMID: 25701296 Chevalier P et al. PMID: 12535819 Michael JA et al. PMID: 10092714 Stiell IG et al.

Emergency Department 81

Emergency Department ALS ED EMS 81

ACEP Now

APRIL 9, 2025

When I was an inpatient pharmacy manager in 2013, my hospital was visited by the California Department of Public Health (CDPH), concerned about droperidol and ECG monitoring, or rather, lack thereof. Fast forward to now, and it seems droperidol is still a favorite punching bag for CDPH. Despite all the buzzwords (Evidence-based medicine!

Emergency Department 52

Emergency Department ALS ED OR 52

EMDocs

MAY 31, 2025

per 100,000 person-years in North America 11 UC has a higher prevalence than CD UC prevalence in the United States is 1.0% (95% CI 0.5,1.4%; 1.9 per 100,000 person-years in North America 11 UC has a higher prevalence than CD UC prevalence in the United States is 1.0% (95% CI 0.5,1.4%; 1.9

E-9-1-1 74

E-9-1-1 EMS ALS Emergency Department 74

This Podcast Will Kill You

JULY 1, 2025

This episode, we aren’t asking you to taste the rainbow, but we are scrutinizing the artificial dyes that give it its color. When you’re munching on brightly colored candies or dipping a french fry in purple ketchup, what exactly is it you’re tasting? ” Heliyon (2024). Ardila-Leal, Leidy D., ” Molecules 26.13 (2021): 3813. Edinger, T.

E-9-1-1 52

E-9-1-1 ACS ALS OR 52

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Reference: Snelling et al. Reference: Snelling et al. This includes SGEM#19 way back in 2013 reporting a bandage wrap is a safe alternative to traditional casting for children with greenstick fractures. Reference: Snelling et al. Ultrasonography or radiography for suspected pediatric distal forearm fractures.

Critical Care 344

Critical Care ALS ED Emergency Department 344

The Skeptics' Guide to EM

JANUARY 6, 2024

Reference: Remick KE, et al. Reference: Remick KE, et al. Two previous studies conducted assessing the state of nationwide pediatric readiness were conducted in 2003 and 2013. Reference: Remick KE, et al. National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. JAMA Netw Open.

Emergency Department 340

Emergency Department Emergency Medical Services ALS ED 340

Core EM

JANUARY 25, 2024

J Intensive Care Med 2013; 28:166. Pfenning CL, Slovis CM: Electrolyte Disorders; in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. Diagnosis and management of hypocalcaemia. UpToDate; Jul 17, 2020. Accessed April 29, 2022. link] Kelly A, Levine MA. Louis, Mosby, Inc.,

Critical Care 247

Critical Care ED ALS OR 247

Core EM

JANUARY 25, 2024

A study by Duniec et al. Here are a handful of these studies and their conclusions: Nomura et al., Here are a handful of these studies and their conclusions: Nomura et al., of scans conducted and in <5 minutes in 100% of scans Ferre et al., times more attempts when adjusted for BMI Gottlieb et al.,

ALS 246

ALS Critical Care OR 246

The Skeptics' Guide to EM

DECEMBER 15, 2018

Date: December 13th , 2018 Reference: Murata et al. Date: December 13th , 2018 Reference: Murata et al. They published an epic paper to determine the transit time of a Lego head ( Tagg et al ). Eur J Paediatr Neurol 2013) that concluded antipyretics were ineffective in reducing the recurrence of febrile seizures in children.

OR 130

OR Emergency Department ALS 130

Pediatric EM Morsels

APRIL 7, 2023

Observation, interaction with patient, as well as parent information is key to bring the whole picture together!

ALS 130

ALS OR EMS Critical Care 130

Pediatric EM Morsels

OCTOBER 27, 2023

PAWPER [Wells 2013, Silvagni 2022] Takes into account body habitus. link] Lubitz DS, Seidel JS, Chameides L, Luten RC, Zaritsky AL, Campbell FW. Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Krug 2007] What If the Child is Obese or Emaciated? There are other systems that account for body habitus.

E-9-1-1 274

E-9-1-1 Emergency Medical Services Life Support ALS 274

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Date: February 17, 2023 Reference: Gettel et al. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. Date: February 17, 2023 Reference: Gettel et al. Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019.

Emergency Department 130

Emergency Department ALS ED EMS 130

The Skeptics' Guide to EM

AUGUST 19, 2023

I responded by posting the 2013 SGEM episode on INTERACT-2 ( SGEM#73 ) which showed no statistical difference between intensive (<140 mmHg) and guideline directed (<180 mmHg). Date: August 14, 2023 Reference: Ma et. Date: August 14, 2023 Reference: Ma et. Most EM physicians shared the frustration and made positive comments.

EMS 186

EMS ALS Emergency Department OR 186

The Skeptics' Guide to EM

MAY 14, 2022

Date: May 13th, 2022 Reference: Abril et al. Date: May 13th, 2022 Reference: Abril et al. These include: acetaminophen ( Williams et al Lancet 2014), steroids ( Balakrishnamoorthy et al Emerg Med J 2014) and benzodiazepines ( Friedman et al Ann Emerg Med 2017). An Analysis of Data From Randomized Studies.

ALS 130

ALS Emergency Department ED OR 130

The Skeptics' Guide to EM

OCTOBER 28, 2017

[display_podcast] Date: October 24th, 2017 Reference: Harrison et al. display_podcast] Date: October 24th, 2017 Reference: Harrison et al. That rant relied upon a Cochrane SRMA by Stevens B et al 2013 and a randomized clinical trail published in Pediatrics by Gray L et al 2015. Reference: Harrison et al.

ALS 130

ALS Emergency Department ED OR 130

The Skeptics' Guide to EM

AUGUST 28, 2021

Date: August 27th, 2021 Reference: Gagnon et al. Date: August 27th, 2021 Reference: Gagnon et al. Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. first appeared on The Skeptics Guide to Emergency Medicine.

ED 130

ED Emergency Department ALS OR 130

The Skeptics' Guide to EM

DECEMBER 7, 2019

Date: October 2nd, 2019 Reference: Ramgopal et al. Date: October 2nd, 2019 Reference: Ramgopal et al. The Journal of Pediatrics published a systematic review of literature regarding the Management of ALTE in 2013 and one of the findings was that there was very little agreement in the literature on how to apply the definition.

CPR 130

CPR ALS OR 130

ALiEM

MARCH 7, 2024

Transvere ultrasound views of the bladder: Left – Uterus identified posteriorly in girl; Right – Prostate identified posteriorly in boy (Images courtesy of Dinh et al.) The pain is intermittent, sharp, severe, and associated with 2 episodes of nonbloody, nonbilious emesis. Lay the patient supine when possible.

E-9-1-1 177

E-9-1-1 Emergency Department ALS ED 177

Don't Forget the Bubbles

OCTOBER 25, 2023

Image adapted by Holland JA et al. Image adapted by Holland JA et al. Strabismus alone is a rare sign of a brain tumour in this age group; however, the associated papilloedema is concerning. The fact that fundoscopy has been carried out on this child is a feat. It is often difficult to do this in an ED setting. How is IIH diagnosed?

ALS 123

ALS OR ED 123

The Skeptics' Guide to EM

JULY 3, 2021

Reference: Dankiewicz et al: TTM2 Trial Investigators. Reference: Dankiewicz et al: TTM2 Trial Investigators. This is the original Target Temperature Management (TTM) trial by Nielson et al NEJM 2013. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. This gives a NNT of 4.

Defibrillator 130

Defibrillator Paramedic ALS OR 130

REBEL EM

SEPTEMBER 13, 2023

of people who take NSAIDs ( Nzeako 2010 ). patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 of people who take NSAIDs ( Nzeako 2010 ). Typically involves the mouth, larynx, pharynx, and subglottic tissue ( Kostis 2005 ).

Frozen Plasma 99

Frozen Plasma Allergic Reaction FFP Plasma 99

The Skeptics' Guide to EM

APRIL 24, 2021

Reference: Martel et al. Way back in 2013 we looked at haloperidol for agitation due to psychosis ( SGEM#45 ) and concluded that it was an effective treatment but had common side effects. Reference: Martel et al. Kirsty is also the creator of the wonderful infographics called #PaperinaPic.

Emergency Department 100

Emergency Department ALS ED Ambulance 100