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

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 345

Emergency Department ED ALS Paramedic 345

The Skeptics' Guide to EM

JULY 20, 2024

Reference: Gibbs et al. Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. NEJM June 2024.

Emergency Department 233

Emergency Department ALS ED OR 233

Core EM

JULY 23, 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 100

ALS 100

Don't Forget the Bubbles

JULY 3, 2024

Lastly, in this month’s issue of JAMA Pediatrics, Gemmill et al. Saranti A, et al. Barlabà A, et al. Nemetz ETA, et al. Kusumi K, et al. Crawford CM, et al. Fundora MP, et al. Roby PR, et al. Jenssen BP, et al. Auger N, et al. Brewster RCL, et al. Forster CS, et al.

ALS 103

ALS ED OR EMS 103

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 294

ALS Emergency Department ED OR 294

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 322

Heart Attack STEMI Emergency Medical Services Coronary 322

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 325

Critical Care ALS ED Emergency Department 325

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 310

Emergency Department Emergency Medical Services ALS ED 310

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.

Emergency Department 322

Emergency Department ALS OR EMS 322

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 309

Emergency Department ALS ED OR 309

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 299

Emergency Department ED ALS OR 299

ALiEM

APRIL 12, 2024

If the catheter appears correctly positioned on AP chest x-ray but is malfunctioning, consider obtaining additional imaging to confirm placement [11]: Lateral view chest-xray, or Chest CT (can also help characterize the pleural effusion) References Gammie JS, Banks MC, Fuhrman CR, et al. doi: [link] Broder JS, Al-Jarani B, Lanan B, Brooks K.

E-9-1-1 183

E-9-1-1 ALS Critical Care Emergency Department 183

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 295

Paramedic ALS EMS OR 295

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 225

ED Emergency Department ALS OR 225

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 217

ICU Defibrillator Paramedic CPR 217

Pediatric EM Morsels

JULY 5, 2024

Baumann F, Ernstberger T, Neumann C, et al. Leonard JC, Harding M, Cook LJ, et al. Leonard JC, Kuppermann N, Olsen C, et al. 2014;133(5) Mathews JD, Forsythe AV, Brady Z, et al. Nigrovic LE, Rogers AJ, Adelgais KM, et al. Slaar A, Fockens MM, Wang J, et al. Pediatr Emerg Care. 2018;34(10):677-686.

ALS 161

ALS OR ED Emergency Department 161

Core EM

JANUARY 25, 2024

Read More emDocs: Post-intubation analgesia/sedation regimens in ED: Pearls & Pitfalls PulmCrit: Internet Book of Critical Care: Sedation References Barr J, Gilles L, Puntillo K, et al: Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. Crit Care Med.

Emergency Department 246

Emergency Department ICU Critical Care ALS 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 256

ALS Emergency Department EMS ED 256

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 246

ALS ACS Emergency Department OR 246

The Skeptics' Guide to EM

JUNE 3, 2023

Date: June3, 2023 Reference: Kotani et al. Date: June3, 2023 Reference: Kotani et al. Reference: Kotani et al. Etomidate as an induction agent for endotracheal intubation in critically ill patients: A meta-analysis of randomized trials. first appeared on The Skeptics Guide to Emergency Medicine.

Critical Care 279

Critical Care ALS Paramedic 279

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 244

Emergency Medical Services ALS EMS Emergency Department 244

The Skeptics' Guide to EM

DECEMBER 2, 2023

Reference: Shaikh N, et al. Reference: Shaikh N, et al. Identifying children likely to benefit from antibiotics for acute sinusitis: a randomized clinical trial. Identifying children likely to benefit from antibiotics for acute sinusitis: a randomized clinical trial.

Emergency Department 330

Emergency Department ALS OR ED 330

The Skeptics' Guide to EM

OCTOBER 14, 2023

Reference: Brennan L et al. Reference: Brennan L et al. That episode reviewed the 2011 Fleming et al systematic review for the normal ranges of HR and RR in children from birth to 18 years of age. Time to change the reference ranges of children’s physiological observations in emergency care? A prospective study.

Life Support 246

Life Support Advanced Life Support Emergency Department ALS 246

The Skeptics' Guide to EM

MARCH 2, 2024

Reference: Gibbons et al. Reference: Gibbons et al. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. AEM February 2024. AEM February 2024. Date: February 28, 2024 Guest Skeptic: Dr.

Operating Room 308

Operating Room Emergency Department ALS ED 308

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 258

CPR Defibrillator First Responder Life Support 258

ALiEM

OCTOBER 11, 2023

Hassoun AER, Ujević I, Jemaa S et al. Alhatali B, Al Lawatia S, Khamis F, Kantur S, Al-Abri S, Kapil V, Thomas J, Johnson R, Hamelin EI, Coleman RM, Kazzi Z. Al-Sulaimani S, Titelbaum NV, Ward RE, Zahran TE, Chalhoub S, Kazzi Z. Chowdhury FR, Nazmul Ahasan HA, Mamunur Rashid AK, Al Mamun A, Khaliduzzaman SM.

E-9-1-1 204

E-9-1-1 ALS OR 204

Pediatric EM Morsels

MAY 24, 2024

Sources Adelgais KM, Kuppermann N, Kooistra J, et al. Holmes JF, Lillis K, Monroe D, et al. Holmes JF, Yen K, Ugalde IT, et al. Miglioretti DL, Johnson E, Williams A, et al. Accuracy of the Abdominal Examination for Identifying Children with Blunt Intra-Abdominal Injuries. 2014;165:1230-1235. doi:10.1016/j.jpeds.2014.08.014.

ALS 161

ALS EMS Emergency Department OR 161

Don't Forget the Bubbles

NOVEMBER 5, 2023

Gorga SM, et al. Opel DJ, et al. Vial T, et al. Harris J, et al. Chiriac A, et al. Clarke P, et al. Wang T, et al. Prasad V, et al. Jensen ET, et al. Persaud N, et al. Græsholt-Knudsen T, et al. Walter L, et al. Balıkçı BB, et al. Hernández-Bou S, et al.

E-9-1-1 104

E-9-1-1 ALS Emergency Department OR 104

The Skeptics' Guide to EM

DECEMBER 30, 2023

Reference: Roussel et al. Reference: Roussel et al. Overnight stay in the emergency department and mortality in older patients, JAMA Intern Med 2023 Date: December 18, 2023 Guest Skeptic: Dr. Chris Carpenter, Vice Chair of Emergency Medicine at Mayo Clinic. Case: An 85-year-old patient (Ms.

Emergency Department 279

Emergency Department ED ALS OR 279

The Skeptics' Guide to EM

JUNE 1, 2024

Reference: Tavender E, et al. Reference: Tavender E, et al. Triage tools for detecting cervical spine injury in paediatric trauma patients. Cochrane Database Syst Rev. Clinical Question: Which triage tools or Clinical Decision Rules (CDRs) are most effective for detecting cervical spine injuries in pediatric trauma patients?

Emergency Medical Services 198

Emergency Medical Services Emergency Department EMS ALS 198

Don't Forget the Bubbles

JANUARY 1, 2024

Musolino AM, et al. Chidini G, et al. Pawlowski TW, et al. Weiss SL, et al. Hua LL, et al. Delany C, et al. Kuehn LM, et al. Woods CR, et al. Montini G, et al. Redline S, et al. Hazkani I, et al. Yildirim I, et al. Hennefield L, et al. Lock JD, et al.

ALS 98

ALS OR ED 98

Don't Forget the Bubbles

OCTOBER 4, 2023

Formentin C, et al. Jørgensen RM, et al. Harris J, et al. Bhatia S, et al. Vivarelli M, et al. Morello W, et al. McGowan EC, et al. Hirata K, et al. Shaikh N, et al. Wald ER, et al. Poddighe D, et al. Greenhow TL, et al. Amer R, et al. Gleason JL, et al.

E-9-1-1 108

E-9-1-1 ALS Emergency Department OR 108

REBEL EM

APRIL 29, 2024

A study by Lee et al ( 7) compared femoral CVC placement to IO and demonstrated a first-pass success pass rate with IO of 90.3% References: 1 Astasio-Picado Á et al. Ong MEH, Chan YH, Oh JJ, et al. Iserson KV et al. PMID: 8913236 7 Lee PM et al. 9 Zhang W et al. 2023 PMID: 37502742 11 Schwalbach KT et al.

ALS 105

ALS Epinephrine Critical Care Emergency Department 105

Don't Forget the Bubbles

JUNE 14, 2023

Lava SAG, et al. Hsiao W, et al. Mullaly R, et al. Puoti MG, et al. Stenson EK, et al. Bruinsma RA, et al. Rivetti G, et al. van Gameren-Oosterom HBM, et al. Lester TR, et al. Mansell H, et al. Fernandes AER, et al. Wolstencroft J, et al. Roodbol J, et al.

ALS 115

ALS ACS ED OR 115

Don't Forget the Bubbles

MAY 8, 2024

Dell KM, et al. Eisen S et al. Fielder AR, et al. Bm MV, et al. Toepfner N, et al. Toniutti M, et al. Meoli M, et al. Ashton JJ, et al. Ding G et al. Tanti DC, et al. Ahlqvist VH, et al. Chiang HL, et al. Wong J, et al. Fuller S et al. Koenis MM et al.

E-9-1-1 65

E-9-1-1 ALS Emergency Department Epinephrine 65

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 306

ED Emergency Department ALS OR 306