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

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 326

Heart Attack STEMI Emergency Medical Services Coronary 326

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 218

ICU Defibrillator Paramedic CPR 218

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 320

Emergency Department Emergency Medical Services ALS ED 320

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

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 314

Emergency Department ALS ED OR 314

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 69

E-9-1-1 ALS Emergency Department Epinephrine 69

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

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 102

ALS Epinephrine Critical Care Emergency Department 102

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

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 188

Emergency Department ICU Critical Care ALS 188

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 331

Emergency Department ALS OR ED 331

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

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

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.

Defibrillator 260

Defibrillator CPR First Responder Life Support 260

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

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

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

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-9-1-1 111

E-9-1-1 ALS Emergency Department OR 111

The Skeptics' Guide to EM

APRIL 20, 2024

A clinical decision tool called the STUMBL score was derived and validated by Battle et al in 2014 [3]. An attempt was made to externally validate this tool in New Zealand by Murkerji et al 2021 [4]. These risks are particularly higher in the elderly [2]. It risks stratified older patients with blunt trauma.

Emergency Department 194

Emergency Department Overdose ALS ED 194

EMOttawa

MAY 13, 2024

Methodology: 4/5 Usefulness: 3/5 von Hellmann R, et al. Ann Emerg Med. 2024 Feb;83(2):132-144. Question and Methods: Systematic review of 18 studies (12 RCT) of adult patients comparing bougie use vs standard of care in tracheal intubations to evaluate first-attempt success.

ALS 109

ALS ED 109

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 119

ALS ACS ED OR 119

ALiEM

MAY 13, 2024

Study N Methods POCUS Sensitivity (95% CI) POCUS Specificity (95% CI) Conclusions Gottleib et al., Lam et al., of cases* Subramaniam et al., Lam et al., of cases* Subramaniam et al., Adams et al., Adams et al., Sivitz et al., Yen ZS, Wang HP, Ma HM, et al. 97.4%) 85.4% (78.9-90.2%)

E-9-1-1 161

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

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

The Skeptics' Guide to EM

JANUARY 20, 2024

Reference: Zaoutis T, et al. Reference: Zaoutis T, et al. Reference: Zaoutis T, et al. Short-course Therapy for Urinary Tract Infections in Children: the SCOUT randomized clinical trial. JAMA Pediatr. Short-course Therapy for Urinary Tract Infections in Children: the SCOUT randomized clinical trial. JAMA Pediatr. JAMA Pediatr.

Emergency Department 169

Emergency Department ALS ICU OR 169

SSCOR

MAY 18, 2024

Your BLS engine company is dispatched to a “difficulty breathing” call and your ALS rescue is still in the process of delivering their previous patient to the hospital. Dispatch is sending the next closest rescue, but the responding unit has just notified you that they are held up by a train.

BLS 74

BLS EMT EMT ALS 74

The Skeptics' Guide to EM

FEBRUARY 3, 2024

Reference: Curry SD, et al. Reference: Curry SD, et al. Reference: Curry SD, et al. Systematic Review of CT Angiography in Guiding Management in Pediatric Oropharyngeal Trauma. Laryngoscope. She is also the director of the Pediatric Otolaryngology […] The post SGEM #429: It’s CT Angio, Hi. I’m the Problem. Laryngoscope.

ALS 157

ALS Emergency Department OR ED 157

Core EM

JANUARY 24, 2024

2017.09.1085 Gómez-Outes A, Alcubilla P, Calvo-Rojas G, et al. doi:10.1186/s13054-019-2492-8 Baugh CW, Levine M, Cornutt D, et al. 2019.09.001 Gilbert BW, Morton L, Huffman JB, et al. 2019.10.013 Patel IJ, Rahim S, Davidson JC, et al. 2019.04.017 Connolly SJ, Milling TJ Jr, Eikelboom JW, et al. J Am Coll Cardiol.

FFP 130

FFP Frozen Plasma Plasma ALS 130

Chicago EMT Training

NOVEMBER 8, 2023

A quick breakdown on the differences between an EMT-B(asic) and an EMT-P(aramedic) Basic Life Support (BLS) vs Advanced Life Support (ALS) So there it is. Most of the 911 calls are BLS rather than ALS. It's encouraging to hear that there is still interest in becoming first responders! Don't get me wrong, an EMT-Bs can do A LOT.

Advanced Life Support 130

Advanced Life Support BLS EMT EMT 130

ALiEM

NOVEMBER 29, 2023

PMID: 34529640 Ayub S, Parnia S, Poddar K, et al. PMID: 24769343 Ehrman-Dupre R, Kaigh C, Salzman M et al. PMID: 36148197 Love JS, Levine M, Aldy K, et al. PMID: 37014353 Ball NS, Knable BM, Relich TA et al. Notes from the Field: Xylazine Detection and Involvement in Drug Overdose Deaths – United States, 2019.

Naloxone 169

Naloxone Overdose ALS Epinephrine 169

FOAMfrat

MAY 19, 2024

The patient will thank you for it; we are only human. References 1. Ostergaard E, Moller LB, Kalkanoglu-Sivri HS, et al. 6. Giribaldi G, Doria-Lamba L, Biancheri R, Severino M, Rossi A, Santorelli FM, et al. Parikh S, Goldstein A, Koenig MK, Scaglia F, Enns GM, Saneto R, et al. Al-Essa MA, Ozand PT.

E-9-1-1 52

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

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

EMDocs

MAY 11, 2024

Rosh Review Website Link Further Reading: FOAMed: [link] [link] [link] [link] [link] [link] [link] References : Turi B, Smith D, Kusel K, et al. Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al. link] Sharma R, Gaillard F, Bell D, et al. Locked-in syndrome.

EMS 79

EMS E-9-1-1 ALS OR 79

The Skeptics' Guide to EM

JUNE 24, 2023

Date: June 16, 2023 Reference: Reed et al. Date: June 16, 2023 Reference: Reed et al. Reference: Reed et al. Pilot Testing Fentanyl Test Strip Distribution in an Emergency Department Setting: Experiences, Lessons Learned, and Suggestions from Staff.

Overdose 176

Overdose Emergency Department ALS ED 176

This Podcast Will Kill You

MAY 7, 2024

Djaoudene, Ouarda, et al. Herasimenka, Aliaksandr, et al. . “Problems and prospects: public health regulation of dietary supplements.” ” Annual review of public health 39 (2018): 403-420. European Medicines Agency: Herbal Medicinal products. link] Broniatowski, David A., ” Scientific reports 13.1 2023): 15964.

ALS 98

ALS OR 98

The Skeptics' Guide to EM

MAY 20, 2023

Date: May 10, 2023 Reference: Harhay MO, et al. Date: May 10, 2023 Reference: Harhay MO, et al. Original trial: Moler FW, Silverstein FS, Holubkov R, et al. Reference: Harhay MO, et al. A bayesian interpretation of a pediatric cardiac arrest trial (THAPCA-OH). NEJM Evidence. NEJM Evidence. N Engl J Med. NEJM Evidence.

CPR 130

CPR ALS Emergency Department EMS 130

The Skeptics' Guide to EM

MARCH 11, 2023

Date: March 8, 2023 Reference: Smida et al. Date: March 8, 2023 Reference: Smida et al. Two large trials, PART by Wang et al and AIRWAYS-2 by Benger et al recently evaluated the King-LT and the iGel respectively as alternatives to endotracheal intubation (ETI) in cardiac arrest. Reference: Smida et al.

CPR 130

CPR Defibrillator BLS Paramedic 130