This Podcast Will Kill You

DECEMBER 10, 2024

Randal, et al. Girard-Madoux, Mathilde JH, et al. Racial disparities in pain management of children with appendicitis in emergency departments. Factors associated with potentially missed diagnosis of appendicitis in the emergency department. Nature Reviews Gastroenterology & Hepatology , 20 (9), pp.615-624.

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

EMDocs

DECEMBER 18, 2024

A 36-year-old male presents to the emergency department after being found down at home by his spouse. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. Per the mans wife, the patient is a heavy drinker often consuming two to three pints of vodka daily.

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E-9-1-1 Emergency Department ICU ED 101

ACEP Now

DECEMBER 7, 2024

The use of thrombolytics for acute ischemic stroke may be one of the most controversial topics in emergency medicine during the last several decades. 1 The reason is understandablethrombolytics in stroke is a high-risk, higher-reward treatment. This debate recurs in multiple forums including many previous pieces in ACEP Now.

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E-9-1-1 ED Emergency Department OR 98

EMDocs

NOVEMBER 16, 2024

1-3 Despite its commonality it retains a relatively high rate of complications overall and patients frequently present to the ED for evaluation. 9=11 70% monomicrobial, 25% poly-microbial, 5% culture-negative. 9=11 70% monomicrobial, 25% poly-microbial, 5% culture-negative. of adults over the age of 55). 10% of patients.

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

ACEP Now

DECEMBER 7, 2024

1 A wide spectrum of severity exists in PE presentations, ranging from mild shortness of breath to cardiac arrest. References Silver MJ, Giri J, Duffy , et al. 2023;2(1):100548. Shah IK, Merfeld JM, Chun J, et al. Meyer G, Vicaut E, Danays T, et al. Mathbout MF, Al Hennawi H, Khedr A, et al.

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E-9-1-1 ALS Critical Care OR 52

Don't Forget the Bubbles

JUNE 10, 2025

A recent study highlighted the gap in confidence surrounding paediatric assessment and management, and recommended a combined approach of targeted training and follow-up feedback from emergency departments after handover. The SWAST Feedback Project uses REDCap ( R esearch E lectronic D ata CAP ture) as its data collection platform.

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E-9-1-1 Emergency Department Paramedic Ambulance 62

JEMS

JUNE 23, 2025

1 EMS has always been described as the canary in the coal mine and the tip of the spear simultaneously. While EMS forms the first line of clinical response in time-sensitive crises, ranging from cardiac arrests and strokes to traumatic injuries and behavioral health emergencies, it occupies a paradoxical place in our funding architecture.

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

Don't Forget the Bubbles

JUNE 10, 2025

Despite being a key part of a child’s emergency care journey, they rarely receive feedback on their clinical management or the patient’s outcome once care is handed over in the emergency department. If you want to know how to create a similar project in your own Emergency Department, please read the article below!

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Emergency Department E-9-1-1 Ambulance Paramedic 93

JEMS

JULY 23, 2025

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. The DSM-5 splits Autism Spectrum Disorder into three levels on this basis: Level 1. References 1. Pediatric Emergency Care , 35 (4), 273–277.

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

Don't Forget the Bubbles

DECEMBER 16, 2024

Coverage of the 6-in-1 vaccine measured at 12 months of age in England for Q4 2023 to 2024 Source: ONS under the Open Government License v3.0 Young infants and immunosuppressed individuals are particularly at risk of severe disease, resulting in significant morbidity and associated mortality rates of 1-3 per 1,000 cases.

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

JEMS

JUNE 23, 2025

Patients can lose up to 2 million brain cells every minute of a stroke; every hour without treatment, the brain ages 3 1/2 years. Remember B-E F-A-S-T, the stroke acronym, which stands for Balance, Eyes, Face, Arms, Speech and Time — as in, time to call 9-1-1. 21—It was just after 2 p.m. on Monday, Sept.

First Responder 52

First Responder E-9-1-1 Mobile Integrated Health Community Paramedicine 52

EMDocs

JULY 21, 2025

SCAPE defining features: 1) rapid onset of respiratory distress (<4-6 hours); 2) pulmonary edema with severe dyspnea; 3) abdominal vital signs with SBP > 160 and/or > 120, hypoxic, tachypneic, tachycardic; 4) critically ill, evidence of pulmonary edema. Heidenreich PA, Bozkurt B, Aguilar D, et al. Epub 2022 Apr 1.

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E-9-1-1 ALS Emergency Department OR 89

REBEL EM

NOVEMBER 11, 2024

Article: Chanderraj R, Admon AJ, He Y, et al. What They Did: Investigators performed a retrospective cohort study in the Emergency Department at the University of Michigan between July 1, 2014 through December 31, 2018. Comorbidity Index : Higher in the cefepime group (median 2 vs. 1). In 2021, Buckley et.

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E-9-1-1 ALS ICU Critical Care 93

EMDocs

JANUARY 6, 2025

ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. g/dL, thrombocytopenia of 96 10 9 /L, prothrombin time (PT) of 16.1 1 By the end of 2023, 117.3 million people had been forcibly displaced, representing 1 in 69 individuals or 1.5% seconds (normal 30-40 seconds), creatinine of 3.11

ED 74

ED E-9-1-1 ALS Frozen Plasma 74

JEMS

JUNE 12, 2025

1 Many of these approvals represent entirely new drug classes or treatment approaches. Emerging platforms use AI to personalize learning, simulate high-risk cases, and adapt instruction to individual needs. 9 Still, some educators worry that reliance on technology could erode hands-on problem-solving. References 1.

Mobile Integrated Health 98

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

Broome Docs

DECEMBER 22, 2024

2024 Oct 9. There were no differences in survival (12% with IO vs 10% with IV) or neurologically intact survival (9% vs 8%). Acad Emerg Med. 2024 Nov 1. Piroxicam and paracetamol in the prevention of early recurrent pain and emergency department readmission after renal colic: Randomized placebo-controlled trial.

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E-9-1-1 ACS Paramedic Emergency Department 52

EMDocs

NOVEMBER 25, 2024

Vision loss carries a high degree of morbidity and is associated with higher all-cause mortality, 4 and it is our role as emergency providers to recognize potentially reversible causes of such adverse outcomes. 1 Life Cycle and Pathophysiology Life Cycle Humans are the only hosts for O. 13 Figure 1. PLoS Med 3(9): e371.

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E-9-1-1 ALS Emergency Department OR 71

ACEP Now

JANUARY 5, 2025

The PREOXI trial compared oxygen mask pre-oxygenation versus noninvasive positive-pressure ventilation (NIPPV) in patients requiring intubation in emergency departments (EDs) and intensive care units. 1 The primary outcome was the frequency of observed hypoxemia, defined as any pulse oximetry reading below 85 percent.

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ALS E-9-1-1 ED Emergency Department 40

ACEP Now

DECEMBER 17, 2024

We deal with difficult and traumatizing situations daily, and nowhere is this more apparent than in the emergency department, where sickness, violence, and death are routine. 1 His tragic loss underscores the urgent need for mental health support for residents and fellows. Accessed December 9, 2024. died by suicide.

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E-9-1-1 Emergency Department ALS OR 105

ACEP Now

JUNE 17, 2025

1 The objects we choose to fill a limited space reflect a lot about the lives we lead, the way we think, what we anticipate, and what we prioritize. As they have become a more familiar sight in the emergency department, it’s been an interesting experience to see what others carry in their fanny packs and their motivations for carrying them.

Emergency Department 52

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

REBEL EM

JULY 14, 2025

About 1 in 10 patients will have an occult fracture, and roughly 1 in 10 scaphoid fractures result in nonunion. 1,2 However, the risk of nonunion among patients with MRI-confirmed occult fractures is much lower—around 1 in 30. 7 🧾 Paper Cohen A, Reijman M, Kraan GA, et al. 2025;26(1):14.

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E-9-1-1 ALS OR ED 103

EMDocs

JUNE 28, 2025

Vital signs revealed a BP of 136/76, HR of 88, RR of 9, SpO2 of 94% on room air, and a temperature of 97.6 Answer : Bradypnea Background: Bradypnea is defined as a decreased respiratory rate and varies by age (Table 1) 1 Hypopnea is shallow breathing that occurs during sleep 2 Etiology: Secondary to a number of causes.

EMS 79

EMS E-9-1-1 Overdose ALS 79

Don't Forget the Bubbles

JULY 1, 2025

In a study by Chong et al., Best wishes, Anke and Jaan 1.Reviews Malone JR, et al. Pettoello-Mantovani M, et al. Chong YY, et al. Feasibility and Acceptability of Recommending HPV Vaccine at Ages 9-10 Years. Tietbohl CK, et al. Shuler B, et al. Yli-Piipari S, et al. Rienvichit P, et al.

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E-9-1-1 ALS OR STEMI 98

REBEL EM

FEBRUARY 24, 2025

1 They noticed how spontaneously breathing patients had their IVC collapse with inspiration; and ventilated patients had their IVC dilate during positive pressure ventilation. RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department. Jan 2015; PMID: 25559473 Airapetian N, et al.

ALS 64

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

EMDocs

MARCH 18, 2025

Episode 116: Massive Hemoptysis Definition: Hemoptysis is expectoration of blood from the respiratory tract; ranges from mild with small streaks of blood to cardiopulmonary compromise (1-5). Massive hemoptysis: no clear definition, ranges from 50 mL in a single expectoration to 100 mL in 24 hours to over 1 L in 48 hours.

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E-9-1-1 FFP ALS Critical Care 71

EMDocs

MARCH 24, 2025

1 Over the decades, HIV has transitioned from being a terminal illness to a manageable chronic condition for many individuals due to improved knowledge in the diagnosis and treatment of the disease globally. million (1 million1.7 HIV-1 is more widespread and virulent, driving the global pandemic. 19 Figure 1. million (36.1

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E-9-1-1 ALS ED OR 82

EMDocs

JUNE 14, 2025

A) Cirrhosis B) Portal vein thrombosis C) Splenic abscess D) Splenic hematoma E) Splenic infarction Correct answer: B The spleen resides intraperitoneally within the posterior portion of the left upper quadrant, behind the stomach and adjacent to the lower ribs (9–12). Question: What is the diagnosis?

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E-9-1-1 EMS ALS ED 100

EMDocs

MAY 31, 2025

Physical exam: Appears thin with dry mucous membranes Abdomen is soft, nondistended, and mildly tender diffusely Ulcers present on the uvula and soft palate Labs: WBC 21 10 9 /L, HGB 7.1 Vital signs reveal normothermia, normotension, borderline tachycardia, O2 saturation of 100% on RA, normal respiratory rate, and a weight of 48kg.

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E-9-1-1 EMS ALS Emergency Department 75

Pediatric EM Morsels

OCTOBER 27, 2023

Initially tested in Johannesburg, South Africa: 1 month old to 12 years old Broselow predicted within 10% of weight in 63.6% 2010) ‘140: Does physician estimates of pediatric patient weights lead to inaccurate medication dosages’, Annals of Emergency Medicine , 56(3), p. Academic Emergency Medicine, 14: 500-501. Ann Emerg Med.

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

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. Technique Positioning and Probe Figure 1: Younger children can sit in their parent’s lap and give a hug for lateral and posterior lung scanning. Balk et al.,

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E-9-1-1 ALS Emergency Department OR 246

ALiEM

APRIL 12, 2024

Traditionally large-bore tube thoracostomy has been the standard of care for treating many acute intrathoracic pathologies [1]. Pigtails provide a less invasive and often better tolerated alternative to traditional chest tubes and allow for adequate treatment of pneumothoraces and uncomplicated pleural effusions [1-5]. 1999;3(1):57-61.

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E-9-1-1 ALS Critical Care Emergency Department 184

ALiEM

MARCH 7, 2024

Ultrasound probes from left to right: linear (nenoates), phased array (infants/younger children), and curvilinear (older children/adolescents) Pro tips for performing renal/bladder POCUS on a child [1] Addressing potential anxiety leads to a more efficient and comfortable examination.

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

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. Her symptoms started 1 week ago as a scratch which progressively got more red and painful. Pediatric Soft Tissue POCUS Ultrasound Technique Figure 1.

E-9-1-1 161

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

Don't Forget the Bubbles

AUGUST 30, 2023

The parents of 9-month-old Josie bring her into the Emergency Department with coryzal symptoms and difficulty breathing. A secondary analysis of a nationwide study of Emergency Department attendance in America from 2006 to 2008 found that CXRs increase the average length of stay by 27 minutes. Am J Emerg Med.

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E-9-1-1 Emergency Department ALS OR 130

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Bibl K, Pracher L, Küng E, Wagner M, Roesner I, Berger A, Hermon M, Werther T. Acad Emerg Med. 1994 Jul;125(1):57-62. 2019 Sep;74(9):1186-1190. 2016 Feb;30(1):3-11. Paediatr Anaesth.

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E-9-1-1 Operating Room Emergency Department ALS 190

Broome Docs

SEPTEMBER 3, 2024

In a surprise to no one who reads First10EM, clinical judgment is better than all decision tools for sepsis Knack SKS, Scott N, Driver BE, Prekker ME, Black LP, Hopson C, Maruggi E, Kaus O, Tordsen W, Puskarich MA. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients.

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E-9-1-1 Emergency Department ICU ALS 94

Don't Forget the Bubbles

SEPTEMBER 20, 2023

Do not obtain abdominal radiographs for suspected constipation The parents of 4-year-old Matthew bring him into the Emergency Department with abdominal pain. Functional constipation and nonspecific, generalized abdominal pain are common presenting complaints for children in emergency departments. 2012;161(1):44–50.e502.

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E-9-1-1 Emergency Department ALS ED 133