ACEP Now

JULY 3, 2025

Acute toxic ingestions are a common reason for presentation to the emergency department (ED) and clinical scenarios range from benign accidental ingestions to large overdoses resulting in hemodynamic instability. mg/kg-1 mg/kg with maximum dose of 50 mg in children. The dose is 25 mg- 100 mg for adults and 0.5

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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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This Podcast Will Kill You

DECEMBER 10, 2024

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. 2016): 1-9. Conficconi, E.,

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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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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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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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ACEP Now

DECEMBER 7, 2024

1 A wide spectrum of severity exists in PE presentations, ranging from mild shortness of breath to cardiac arrest. Approximately 60,000 to 100,000 patients die from pulmonary embolism (PE) each year in the United States, and PE is the third leading cause of cardiovascular mortality.

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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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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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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. Despite this often fundamental lack of understanding, children and adults are often exponentially more likely to utilize emergency services than their peers.

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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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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. 21—It was just after 2 p.m. on Monday, Sept. 17, 2017, and Chris Cartier was sitting at his computer at Quest Diagnostics, working. Every 40 seconds in the U.S., That’s why a swift response is imperative.

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REBEL EM

NOVEMBER 11, 2024

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. 2 Vancomycin, in combination with either piperacillin-tazobactam or cefepime, is commonly used for empiric treatment in these cases. In 2021, Buckley et.

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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 History of Present Illness The collateral history indicates that her symptoms began one week into her journey, but medical care was inaccessible at the time. Bowel sounds are normal.

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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. Evaluate for ≥ 3 B lines in two bilateral lung zones.

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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%). There is a bunch more – so have a listen or watch us on Youtube feed below. You can read all the papers on the links in the show notes right here. doi: 10.1001/jama.2024.20424. 2024.20424. of the IV group).

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JEMS

JUNE 12, 2025

1 Many of these approvals represent entirely new drug classes or treatment approaches. 9 Still, some educators worry that reliance on technology could erode hands-on problem-solving. Since beginning my EMS career in 1993, the U.S. It would be a great display in training centers, simulation labs and EMS stations.]

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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. 7 Approximately 14.6 7 Approximately 14.6

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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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EMDocs

JULY 2, 2025

Background: Tianeptine is an atypical tricyclic antidepressant (Image 1 displays the structure of Tianeptine) primarily used in some European, Asian, and Latin American countries for the treatment of major depressive disorder, and is sold under the name; Coaxil TM or Tatinol TM. Questions: What is tianeptine?

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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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Don't Forget the Bubbles

NOVEMBER 27, 2024

C presents to your emergency department. FIDO was designed to assess the management of young febrile infants presenting to emergency departments in the UK and Ireland , report risk factors for IBI, and apply CDAs that do not exclusively rely on PCT testing. An additional 1 ml of blood was taken for PCT from some infants.

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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.

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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. 2025;26(1):14. Initial wrist radiographs are negative for fracture. J Orthop Traumatol.

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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.

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Don't Forget the Bubbles

JULY 1, 2025

Best wishes, Anke and Jaan 1.Reviews Feasibility and Acceptability of Recommending HPV Vaccine at Ages 9-10 Years. We suggest that this list can help you discover relevant or interesting articles for your local journal club or keep you up to date on the latest paediatric research. Of the 500 characters analysed, only 1.8% JAMA Pediatr.

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EMDocs

DECEMBER 6, 2024

1 The incidence of iron overdose and iron ingestion related deaths has significantly decreased over time, likely attributable to federal regulation. 1 Commercially available formulations of iron have varying elemental components. 1 Table 1: Iron content of various preparations. Be wary of this stage.

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EMDocs

MAY 17, 2025

1 These values can be difficult to quickly assess and measure in a fast-paced clinical scenario. See Figure 1. 9 Current best practice suggests a 1:1:1 administration of PRBC, Platelets, and FFP. Remember the SCALPR mnemonic to identify locations of massive blood loss.

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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. 17 Of course, do not forget your physical exam.

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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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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. 10 As such, emergency physicians need to possess a strong understanding of HIV diagnosis and treatment principles.

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EMDocs

JUNE 14, 2025

CT head/CTA head and neck are unremarkable, but MRI brain reveals that this 23-year-old otherwise healthy female has had a stroke. Question: What is the diagnosis?

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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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EMDocs

APRIL 12, 2025

Answer : Pediatric Aural Foreign Body Background: Foreign bodies are a common presenting complaint in pediatric emergency departments. Typically begin after development of the pincer grip (9 months). 1 ADHD is considered an important risk factor for auricular foreign bodies due to increased impulsivity and inatentiveness.

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Core EM

JANUARY 25, 2024

SUMMARY: Upon initial evaluation of patients in the emergency department with clinical signs of soft tissue infections, consider using POCUS as a valuable tool to gather more information in patients with a high suspicion for the diagnosis and/or are too unstable to undergo CT imaging. REFERENCES: Castleberg E, Jenson N, Dinh VA.

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Pediatric EM Morsels

OCTOBER 27, 2023

Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Broselow does not. x exp[0.02

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Pediatric EM Morsels

JULY 19, 2024

Since tonsillectomy is one of the most common pediatric surgeries in the US (~500,000 per year) and the rate of post-tonsillectomy hemorrhage is about 1-5% , it is a good idea that we all are familiar with how to manage this issue! If bleeding, the only lab that is needed in the Emergency Department is a type and cross.

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