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SGEM#462: Spooky Scary Access – IV or IO for OHCA

The Skeptics' Guide to EM

Date: November 10, 2024 Reference: Couper et al. Reference: Couper et al. The Paramedic 3 Trial: A randomized clinical trial of drug route in out-of-hospital cardiac arrest. October 31, 2024 NEJM Access to the SGEM Podcast episode at this LINK.

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SGEM#473: Did You Ever Have To Make Up Your Mind – Midazolam or Ketamine for Acute Agitation in the Pre-Hospital Setting

The Skeptics' Guide to EM

Reference: Muldowney et al. A Comparison of Ketamine to Midazolam for the Management of Acute Behavioral Disturbance in the Out-of-Hospital Setting. Ann Emerg Med. 2025 Date: April 24, 2025 Guest Skeptic: Dr. Howie Mell received his Medical Doctorate (MD) from the University of Illinois at Chicago, College of Medicine at Rockford.

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SGEM #479: Light Em Up Up Up (CT) or Not for Pediatric Blunt Abdominal Trauma?

The Skeptics' Guide to EM

Reference: Arnold CG, et al. Performance of individual criteria of the Pediatric Emergency Care Applied Research Network (PECARN) intraabdominal injury prediction rule. Acad Emerg Med. Imaging modalities like computed tomography (CT) are the gold standard for diagnosis, but CT use must be balanced against the risks of ionizing radiation.

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Tranq dope (fentanyl-xylazine combination): A new horizon in opioid withdrawal treatment

ALiEM

The biggest change has been the gradual replacement of diacetylmorphine (heroin) by fentanyl and other synthetic opioids. Along the same time, a veterinary sedative, xylazine , became popular in Puerto Rico in individuals who used injection drugs [3]. We treat with wound care and reserve surgical management only for limbs that are no longer viable.

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SAEM Clinical Images Series: A Curious Case of Anisocoria

ALiEM

Pecha JD, Yen KG, Moisiuc A, et al. Chabicovsky M, Winkler S, Soeberdt M, et al. Pashaei-Marandi A, Assam JH, Arnold A, et al. A 3-month-old male with no past medical history was brought to the emergency department for evaluation of newly asymmetric pupils. Abdominal : Soft, nontender, nondistended. Neurological : Alert.

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Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center. Managing post-tonsillectomy hemorrhage in the ED can be challenging, especially in rural or resource-limited settings. A patient’s mouth packed with gauze after tonsillectomy surgery. CREDIT: Dr. P.

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The Future of Autonomous EMS Delivery Systems

JEMS

Some conceptual models envision fully autonomous ambulances that transport stabilized patients without needing onboard medical staff. 2 Robotics and AI also play a growing role in autonomous EMS. 3 Benefits of Autonomous EMS Systems Autonomous EMS delivery systems offer numerous advantages. Cost efficiency is another significant benefit. Fredman, D.,

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