GEDC

FEBRUARY 27, 2025

Cleveland Clinic’s Geriatric Emergency Department (GED) model has significantly reduced hospital admissions and improved care for older emergency department (ED) patients. It operates in all 13 Cleveland Clinic EDs, with positive results: 17% admission rate for those seen by the geriatric team, compared to 55% for those not seen.

ED 72

ED Emergency Department 72

The Skeptics' Guide to EM

NOVEMBER 2, 2024

Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Case: You are hitting the zone in your shift, a veritable disposition machine meeting the constant flow of patients through the emergency department (ED). AEM Oct 2024. Reference: Galili et al. AEM Oct 2024.

Emergency Department 297

Emergency Department ED ALS EMS 297

EM Board Bombs

JUNE 26, 2025

-Case- A 52-year-old woman with a history of heavy menstrual bleeding presents to the ED with progressive fatigue, dizziness, and dyspnea on exertion. Evaluation: Anemia is a common ED finding and can range from an incidental lab result to a life… Source She denies chest pain or syncope.

ED 52

ED OR 52

ALiEM

OCTOBER 30, 2024

Our experience: Traditionally, ED physicians do not like ordering urine drug screens (UDS). In our study, we used COWS alone in the ED, which does utilize restlessness, anxiety, and tachycardia as part of the formula, as the sole evaluation tool for tranq dope withdrawal. Some patients require re-dosing in the ED. 2024.10.006].

E-9-1-1 161

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

ALiEM

JANUARY 13, 2025

Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. A 55-year-old female presented with the complaint of my right eye popped out. She endorsed right eye blurred vision and severe pain.

Emergency Department 169

Emergency Department ED ALS OR 169

ACEP Now

NOVEMBER 7, 2024

About three percent of emergency department (ED) visits are due to skin and soft tissue infections, but data are lacking on the contribution of chronic wounds to this number. Wound management in the ED is only a starting point, and appropriate referral and follow-up are key to an improved outcome. Back to the patient.

ED 97

ED OR Emergency Department Ambulance 97

ACEP Now

NOVEMBER 8, 2024

In: Cone DC, Brice JH, Delbridge TR, Myers B, eds. Effect of a strategy of initial laryngeal tube insertion vs endotracheal intubation on 72-hour survival in adults with out-of-hospital cardiac arrest: a randomized clinical trial. 2018;320(8):769-778. Guyette FX, Wang HE. EMS Airway Management: System Considerations. 3rd Edition.

E-9-1-1 40

E-9-1-1 Emergency Medical Services Emergency Medical Technician AEMT 40

EMDocs

DECEMBER 1, 2024

A 52-year-old male with a history of essential hypertension presents to your South Texas ED for his second visit this week complaining of indolent fever, shortness of breath, pleuritic chest pain, and a rash on his trunk and extremities. We’ll keep it short, while you keep that EM brain sharp.

E-9-1-1 97

E-9-1-1 EMS OR ED 97

The Skeptics' Guide to EM

DECEMBER 28, 2024

Emergency departments (EDs) are often the first point of contact for patients experiencing opioid-related crises, ranging from overdose to withdrawal. This positions EDs as critical spaces for intervention, offering a chance to initiate treatment, provide education, and connect patients with long-term resources.

Emergency Department 223

Emergency Department Overdose ED ALS 223

The Skeptics' Guide to EM

JULY 5, 2025

Case: A ten-year-old boy presents to your emergency department (ED) after being involved in a motor vehicle collision at high speed. His parents were also in the vehicle and are currently being brought to the ED as well. She is passionate about paediatric EM, wellbeing and medical education.

OR 203

OR EMS Emergency Medical Services Emergency Department 203

Emergency Medicine Cases

JUNE 24, 2025

Howard Ovens, on leading from the inside out, we cover foundational principles, practical habits, and transformative insights that can make any member of an ED team a more effective, compassionate, and adaptive leader.

ED 193

ED EMS 193

EMDocs

JULY 9, 2025

Clinical Application in the ED Incorporating VTI into sepsis management requires minimal additional equipment beyond the ultrasound already present in many emergency departments. This assumption expedites the evaluation of a patient’s volume responsiveness and facilitates implementation in the ED setting. F, and SpO₂ 92% on room air.

Emergency Department 83

Emergency Department ALS ICU Critical Care 83

ACEP Now

JUNE 11, 2025

A 55-year-old woman with medical history of well-controlled hypertension and renal cell carcinoma, status post-partial nephrectomy, presented to the emergency department (ED) with sudden-onset, 10-out-of-10 chest pain and pressure. Screening, evaluation, and early management of acute aortic dissection in the ED. Curr Cardiol Rev.

Operating Room 59

Operating Room Emergency Medical Services Emergency Department ED 59

EMDocs

JANUARY 8, 2025

Remember, from the ED point of view, if you are confronted with a wide complex regular tachydysrhythmia, assume VTach until proven otherwise! References Tannenbaum L, Bridwell R, Inman B. EKG Teaching Rounds.

CAD 95

CAD EMS Emergency Department ED 95

EM Board Bombs

JULY 9, 2025

-Case- A 22-year-old college student arrives to the ED with fever, headache, photophobia, and neck stiffness. He’s somnolent and slow to answer questions. His roommate mentions he hasn’t left bed all day and had a seizure earlier. Neck stiffness?

ED 52

ED 52

ACEP Now

DECEMBER 7, 2024

A 28-year-old female is brought to the emergency department (ED) by police after a sexual assault. 1 A significant number of patients present to the ED with concerns related to traumatic experiences. 1 A significant number of patients present to the ED with concerns related to traumatic experiences.

Mental Health Services 52

Mental Health Services Emergency Department ED ALS 52

International Journal of Paramedicine

JANUARY 15, 2025

ED-based protocols have already been created to aid in the treatment of patients with this condition. Existing protocols for delirium in the pre-hospital setting were designed for younger adults, who have different etiologies and different levels of tolerance for medications than most older adults.

Ambulance 52

Ambulance ED EMS OR 52

Medic Mindset

NOVEMBER 13, 2024

As an EM physician, he shares how he decides to care for his own patients in the ED who present with rapid atrial fibrillation. Casey Patrick is the EMS medical director of Montgomery County Hospital District (Texas).

Paramedic 98

Paramedic Emergency Department EMS ED 98

EM Board Bombs

JUNE 16, 2025

-Case- A 46-year-old man presents to the ED after being found slumped over in his car. He’s hypotensive (BP 84/52 mmHg), tachycardic, and dyspneic. Jugular veins are distended, heart sounds are muffled, and his skin is cool and clammy.

ED 52

ED 52

EM Board Bombs

MAY 2, 2025

-Case- A 54-year-old man presents to the ED with sudden, severe chest pain that began shortly after an episode of forceful vomiting. He’s diaphoretic, tachycardic, and complains of neck discomfort and shortness of breath. He says the pain radiates to his back and worsens with swallowing.

ED 52

ED 52

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. 13 The treatment of toxic exposures causing hemodynamic instability can represent a unique clinical challenge in the ED.

E-9-1-1 52

E-9-1-1 Overdose Epinephrine Naloxone 52

ACEP Now

JUNE 29, 2025

My goal in this column is to share tips, tricks, and emerging concepts from the intensive care unit (ICU) that you can use on your next shift in the emergency department (ED). For this inaugural column, I wanted to start with a topic near and dear to my heart: push-dose vasopressors in the ED. This column is for you! to one unit once.

Emergency Department 52

Emergency Department E-9-1-1 Epinephrine Critical Care 52

Don't Forget the Bubbles

JULY 7, 2025

The crew are 25 minutes away from the ED. Over two years (2019-2021), over 600 children were screened across the four EDs, with 58 eligible patients found. Conclusions The child arrives at the ED peripherally shut down, with no response to further fluid resuscitation. mL) Child 6–12 years: 300 micrograms IM (0.3

Emergency Department 108

Emergency Department Epinephrine ED BLS 108

ACEP Now

DECEMBER 7, 2024

As emergency departments (EDs) have become the focus of bottlenecks in the entire health care systemfrom insufficient inpatient beds leading to hospital boarding to dwindling access to primary carea siege atmosphere has developed. The majority do not require any additional resources on the part of the ED.

Ambulance 98

Ambulance EMT EMT ED 98

Dr. Smith's ECG Blog

MAY 27, 2025

The PMCardio Queen of Hearts not only recognizes that it is not OMI, but that it is atrial flutter: An ED ECG was recorded: Confirmed Atrial Flutter Again, notice the flutter waves manifest are sharp spikes in V1 There is 2:1 conduction. Look at the spikes in V1 at a rate over 300, which are flutter waves.

STEMI 59

STEMI ED 59

ACEP Now

MAY 10, 2025

A Simplified Protocol for Intralipid Administration in the ED Ultrasound-guided nerve blocks (UGNBs) are becoming more common in emergency medicine practice. Recently, numerous Emergency Department (ED) groups have demonstrated the efficacy of UGNBs for pain control with a low rate of complications. Click to enlarge.

ED 87

ED Emergency Department ALS Epinephrine 87

EM Board Bombs

JUNE 6, 2025

-Case- A 29-year-old man arrives at the ED after a high-speed motorcycle crash. He has a visibly deformed lower leg with exposed bone and active bleeding. His foot is cool but has a weak dorsalis pedis pulse. -Evaluation- -Evaluation- Open fractures are orthopedic emergencies.

ED 52

ED 52

EM Board Bombs

MARCH 10, 2025

-Case- A 30-year-old woman at 34 weeks gestation arrives at the ED complaining of a pounding headache, blurry vision, and swelling in her hands and face over the past few days. Her blood pressure reads 168/102 mmHg, has bilateral 2+ pitting edema of the lower extremities, and she has 3+ proteinuria on urine dipstick. -Evaluation-

ED 52

ED 52

ALiEM

DECEMBER 20, 2024

On the day of presentation, he woke up with a new rash over his face and hands which prompted the ED visit. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. A 3-year-old male with a history of severe atopic dermatitis presented for facial rash and hand pain. Mom had been applying Aquaphor and Vaseline several times a day.

Emergency Department 161

Emergency Department ED OR 161

Don't Forget the Bubbles

MAY 19, 2025

These findings raise an important question: if the OFC, in its current form, doesnt meaningfully impact outcomes but does extend ED stays, is it time to rethink how (or if) we use it? Clinicians rely on red flags to identify high-risk cases, yet recent research has questioned their effectivenessparticularly in the fast-paced ED setting.

Emergency Department 62

Emergency Department ACS EMS OR 62

Dr. Smith's ECG Blog

JANUARY 15, 2025

Our transport time to the ED was 30 min. Unfortunately, the ED declined as it was viewed as an NSTE. Lake County Ambulance obtained ECG within 9 minutes and transmitted to ED. Pt transported to SMMC ED where Dr. Hansen and team obtained ECG now showing ST Elevation and alert activated.

STEMI 52

STEMI ICU ED Ambulance 52

ACEP Now

JANUARY 4, 2025

I was about two months into a family practice internship when I went to visit my uncle whose neighbor happened to be an ED resident, Dr. Clarke said. ED attendings Dr. Gerald Whelan and Dr. Shumary Chow supervising a full arrest in C booththe main trauma roomwith an ED tech administering CPR. Click to enlarge.) Click to enlarge.)

ED 52

ED Emergency Department Ambulance CPR 52

JEMS

JULY 11, 2025

Nancy Caroline’s Emergency Care in the Streets (9th ed.). Let’s give our patients the best chance of survival by controlling the variables so that we can decrease possible downtime in cardiac arrest. References Caroline, Nancy, and American Academy of Orthopaedic Surgeons. Jones & Bartlett Learning, 2022. What Is NEMSIS.”

Mobile Integrated Health 116

Mobile Integrated Health Overdose Community Paramedicine CPR 116

EM Board Bombs

MAY 22, 2025

-Case- A 41-year-old woman presents to the ED with a sudden onset of left-sided facial droop. She woke up this morning and noticed she couldn’t smile on that side, close her left eye fully, or raise her eyebrow. She denies weakness in her arms or legs, no slurred speech, and has no headache.

ED 52

ED OR 52

JEMS

JULY 7, 2025

Of those cases of cath lab activation by EMS, 27were subsequently cancelled by ED clinicians. On arrival, 16 of the 49 remaining patients were taken for emergency cardiac catheterizations bringing the total to 84 or 72% of the patients. Overall, 48 or 41% of the cases met the primary outcome of OMI.

E-9-1-1 98

E-9-1-1 EMT EMT Mobile Integrated Health 98

The Skeptics' Guide to EM

NOVEMBER 16, 2024

With emergency department (ED) volumes rising, administrators are eager to explore AI-driven solutions to improve patient safety and reduce staff burnout. They want to know how CHARTWatch integrates with electronic health records (EHRs), whether it can adapt to their patient ED population, and how clinicians respond to using the tool.

ICU 274

ICU Emergency Department ALS ED 274

REBEL EM

DECEMBER 23, 2024

Applicability to Emergency Medicine: For emergency medicine providers, the greatest challenge with this study is that it did not include or account for ED care. Only fluids administered after admission were considered and only in the subset of patients whose pain could not be controlled adequately in the ED to discharge without an admission.

ALS 122

ALS ED ACS EMR 122