High Performance EMS

AUGUST 9, 2024

In fact, sending advanced life support (ALS) providers that are in short supply to one of these calls can leave citizens exposed when a critical request is received after that resource is committed. If available, the supervisor is added to effectively create an ALS transport ambulance.

BLS 264

BLS CAD Advanced Life Support Life Support 264

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Reference: Snelling et al. Reference: Snelling et al. Reference: Snelling et al. Ultrasonography or radiography for suspected pediatric distal forearm fractures. He is also a fully-fledged ultrasonographer. Ultrasonography or radiography for suspected pediatric distal forearm fractures.

Critical Care 340

Critical Care ALS ED Emergency Department 340

The Skeptics' Guide to EM

NOVEMBER 11, 2023

Date: November 2, 2023 Reference: Coventry et al. Date: November 2, 2023 Reference: Coventry et al. One of the best systematic reviews and meta-analyses on the topic discussing the diagnostic accuracy of the history, physical examination and imaging is by Carpenter et al from AEM 2014 [1]. Reference: Coventry et al.

ALS 321

ALS Emergency Department ED OR 321

The Skeptics' Guide to EM

NOVEMBER 25, 2023

Date: November 22, 2023 Reference: Stopyra et al. Date: November 22, 2023 Reference: Stopyra et al. Reference: Stopyra et al. Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI. AEM November 2023. first appeared on The Skeptics Guide to Emergency Medicine. AEM November 2023.

Heart Attack 340

Heart Attack STEMI Emergency Medical Services Coronary 340

The Skeptics' Guide to EM

JUNE 8, 2024

Reference: Kruse et al. Reference: Kruse et al. Systematic Review, Quality Assessment, and Synthesis of Guidelines for Emergency Department Care of Transgender and Gender-diverse People Recommendations for Immediate Action to Improve Care.

Emergency Department 356

Emergency Department ED ALS Paramedic 356

The Skeptics' Guide to EM

OCTOBER 21, 2023

Date: October 20, 2023 Reference: Cai et al. Date: October 20, 2023 Reference: Cai et al. Reference: Cai et al. Implementation of a Clinical Management Tool for Spinal Epidural Abscess Early Diagnosis. AEM October 2023. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals.

Emergency Department 329

Emergency Department ALS ED OR 329

ALiEM

OCTOBER 30, 2024

Multimodal medication options for fentanyl-xylazine withdrawal management in London et al. PMID 35774687 D’Onofrio G, Chawarski MC, O’Connor PG, et al. PMID 28194688 D’Onofrio G, O’Connor PG, Pantalon MV, et al. D’Onofrio G, Hawk KF, Perrone J, et al. PMID 36995717 London K, Li Y, Kahoud JL, et al. 2024 study [16].

E-9-1-1 161

E-9-1-1 Naloxone Emergency Department ALS 161

The Skeptics' Guide to EM

OCTOBER 28, 2023

Date: October 26, 2023 Reference: Jones et al. Date: October 26, 2023 Reference: Jones et al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial placebo-controlled trial. Many pharmacologic treatments have been tried with limited efficacy.

ALS 263

ALS Emergency Department ED OR 263

The Skeptics' Guide to EM

JANUARY 6, 2024

Reference: Remick KE, et al. Reference: Remick KE, et al. Reference: Remick KE, et al. National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. JAMA Netw Open. Pediatric Readiness of Emergency Departments first appeared on The Skeptics Guide to Emergency Medicine. JAMA Netw Open.

Emergency Department 335

Emergency Department Emergency Medical Services ALS ED 335

ACEP Now

JANUARY 5, 2025

References Grasl S, Mekhail P, Janik S, et al. Dharmawardana N, Chandran D, Elias A, et al. Ker K, Edwards P, Perel P, et al. Arora R, Saraiya S, Niu X, et al. Dermendjieva M, Gopalsami, A, Glennon N, et al. Andreae MC, Cox RD, Shy BD, et al. Andreae MC, Cox RD, Shy BD, et al. 2022 ;279(3):1601-1607.

Operating Room 98

Operating Room Epinephrine ALS ED 98

The Skeptics' Guide to EM

DECEMBER 16, 2023

Reference: Punches et al. Reference: Punches et al. Reference: Punches el al. Patient Perceptions of Microaggressions and Discrimination Towards Patients During Emergency Department Care. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. AEM Dec 2023.

Emergency Department 313

Emergency Department ED ALS OR 313

Core EM

JANUARY 25, 2024

A study by Duniec 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., of scans conducted and in <5 minutes in 100% of scans Ferre et al., 3, 2018, pp.

ALS 246

ALS Critical Care OR 246

The Skeptics' Guide to EM

APRIL 13, 2024

Reference: Albers GW et al. Reference: Albers GW et al. TIMELESS Investigators. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. TIMELESS Investigators. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection.

ALS 337

ALS Emergency Department OR EMS 337

ALiEM

JANUARY 13, 2025

References Kelly, E.W. and Fitch, M.T. 2013) Recurrent Spontaneous Globe Subluxation: A Case Report and Review of Manual Reduction Techniques. Available at: [link] (Accessed: 04 January 2024). 2021) Spontaneous globe subluxation: A case report and review of the literature – international journal of emergency medicine, BioMed Central.

Emergency Department 169

Emergency Department ED ALS OR 169

The Skeptics' Guide to EM

JANUARY 27, 2024

That 40-patient study by Ferguson et al did show a statistically significant increased likelihood of hypotension in RVMI patients who received nitrates, but to me, the study design was just plain weird. Fanaroff et al looked at the ACC/AHA guidelines from 2008-2018 [4]. I was not surprised by this information.

Paramedic 308

Paramedic ALS EMS OR 308

ALiEM

JUNE 24, 2024

Miyawaki IA, Gomes C, Caporal S Moreira V, et al. PMID 37162718 Kotruchin P, Chaiyakhan I, Kamonsri P, et al. The Single-Syringe Versus the Double-Syringe Techniques of Adenosine Administration for Supraventricular Tachycardia: A Systematic Review and Meta-Analysis. Am J Cardiovasc Drugs. 2023;23(4):341-353.

ALS 286

ALS 286

Core EM

JANUARY 25, 2024

Hosts: Joe Offenbacher, MD Audrey Bree Tse, MD [link] Download Leave a Comment Tags: Anticoagulation , Critical Care , Resuscitation Show Notes Coagulation Cascade: Algorithm for Anticoagulated Bleeding Patient in the ED: Indications for Anticoagulation Reversal: References: Baugh CW, Levine M, Cornutt D, et al. Ann Emerg Med.

Frozen Plasma 246

Frozen Plasma FFP Plasma Critical Care 246

The Skeptics' Guide to EM

JULY 8, 2023

Date: July 6, 2023 Reference: Hanula R et al. Date: July 6, 2023 Reference: Hanula R et al. Wallach et al JAMA Intern Med 2017 , previously reported that subgroup claims are often not corroborated by subsequent studies and rarely confirmed. JAMA Int Med 2023. Managing editor of EM:RAP and Associate Editor at REBEL EM.

ALS 267

ALS Emergency Department EMS ED 267

This Podcast Will Kill You

FEBRUARY 11, 2025

Thomas, Frdric, et al. A molecular phylogenetic framework for the evolution of parasitic strategies in cymothoid isopods (Crustacea). Journal of Zoological Systematics and Evolutionary Research, 46(1), pp.19-23. Carlson, Colin J., “Parasite biodiversity faces extinction and redistribution in a changing climate.” 2017): e1602422.

E-9-1-1 97

E-9-1-1 ALS OR 97

Core EM

MAY 29, 2024

A review by Steinemann et al. Similarly, Miller et al. Multiple studies have demonstrated the effectiveness of in-situ simulation training in trauma care. showed that ISS training led to improvements in team communication, leadership, and resource management [1]. In situ simulation-based trauma team training: A pilot study. Miller, R.

ALS 203

ALS 203

JEMS

APRIL 22, 2025

In a time when first responders, especially medical care providers, are strapped for staff, a local fire department is stepping up to fill that service gap.

ALS 52

ALS Firefighter First Responder Paramedic 52

Pediatric EM Morsels

APRIL 19, 2024

Davidson JS, Brown DJ, Barnes SN, et al. West S, Andrews J, Bebbington A, et al. Symons S, Rowsell M, Bhowal B, et al. One Brace: One Visit: Treatment of Pediatric Distal Radius Buckle Fractures With a Removable Wrist Brace and No Follow-up Visit. J Pediatr Orthop. 2018;Volume 00(00):DOI:10.1097/BPO.0000000000001169. Pediatrics.

ALS 293

ALS ACS Emergency Department ED 293

The Skeptics' Guide to EM

JULY 29, 2023

Date: July 21, 2023 Reference: McDonald et al. Date: July 21, 2023 Reference: McDonald et al. Reference: McDonald et al. Patterns of change in prehospital spinal motion restriction: a retrospective database review. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM.

Emergency Medical Services 246

Emergency Medical Services ALS EMS Emergency Department 246

The Skeptics' Guide to EM

FEBRUARY 11, 2024

Reference: McLatchie et al and DAShED investigators. Reference: McLatchie et al and DAShED investigators. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. EMJ Nov 2023.

ED 321

ED Emergency Department ALS OR 321

EMOttawa

JANUARY 27, 2025

Methodology 3/5 Usefulness 3/5 Connolly SJ, et al. N Engl J Med. 2024 May 16;390(19):1745-1755. Editorial: Reversing Oral Anticoagulation in Intracerebral Hemorrhage.

ALS 96

ALS 96

The Skeptics' Guide to EM

JANUARY 13, 2024

Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. Resuscitation 2023. Resuscitation 2023. Date: January 11, 2024 Guest Skeptic: Dr.

CPR 270

CPR Defibrillator First Responder Epinephrine 270

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Date: September 18, 2024 Reference: Dillon et al. Reference: Dillon et al. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Network Open. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque.

Naloxone 256

Naloxone NARCAN Overdose CPR 256

EMDocs

DECEMBER 23, 2024

Now lets walk through them quickly: Ho et al (4) looked at termination of VT in 15 min or hemodynamic deterioration. Gorgels et al (5) looked at procainamide vs lidocaine and again and primary outcome was VTach termination. Manz et al (6) looked at ajmaline vs lidocaine for the termination of VT. and Komura et al.,

ALS 75

ALS OR STEMI EMS 75

The Skeptics' Guide to EM

OCTOBER 19, 2024

Date: October 7, 2024 Reference: Nguyen et al. Reference: Nguyen et al. Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Annals of EM 2024. mg/kg nebulized or 0.3

OR 243

OR Emergency Department ED ALS 243

The Skeptics' Guide to EM

JULY 6, 2024

Reference: Tjan et al. Reference: Tjan et al. Conflict in emergency medicine: A systematic review. AEM June 2024 Date: July 5, 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate.

ED 235

ED ALS Emergency Department OR 235

The Skeptics' Guide to EM

APRIL 27, 2024

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care.

ICU 227

ICU Defibrillator CPR Paramedic 227

The Skeptics' Guide to EM

JULY 27, 2024

Reference: Knack et al. A similar review by Sanders et al 2015 concludes that clinica. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. In those that did compare to clinical judgement, physician judgement was superior in 29% and equivalent or mixed in 46%.

ICU 241

ICU ALS Ambulance OR 241

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

Date: August 30, 2023 Reference: Griffey et al. Date: August 30, 2023 Reference: Griffey et al. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta.

ICU 271

ICU ED Critical Care ALS 271

EMOttawa

MARCH 10, 2025

5 Gibbs KW, et al. Methodology: 4/5 Usefulness: 3.5/5 N Engl J Med. 2024 Jun 20;390(23):2165-2177.

ALS 87

ALS Critical Care 87

JEMS

MAY 16, 2025

Shelby County is spending $3.1 million on new ambulances to improve emergency response times. The investment is already making an impact, with the Pelham Fire Department now averaging a six-minute […]

Ambulance 52

Ambulance ALS Emergency Response EMS 52

The Skeptics' Guide to EM

JULY 22, 2023

Date: July 21, 2023 Reference: Prekker et al. Date: July 21, 2023 Reference: Prekker et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. He is board certified in both Emergency Medicine […] The post SGEM#410: Do You See What I See?

Emergency Medical Services 245

Emergency Medical Services Defibrillator CPR EMS 245

Core EM

JANUARY 25, 2024

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. [link] Kelly A, Levine MA. Hypocalcemia in the critically ill patient. J Intensive Care Med 2013; 28:166. Louis, Mosby, Inc., 2014, (Ch) 125: p 1636-53. Swaminathan, A.

Critical Care 246

Critical Care ED ALS OR 246