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

EMOttawa

JANUARY 9, 2025

From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED).

ED 120

ED Emergency Department Critical Care 120

Don't Forget the Bubbles

MARCH 10, 2025

Challenging working conditions in health services, especially in emergency departments (ED), lead to high levels of stress and burnout. Most people working in ED have first-hand experience of the impact of working somewhere short-staffed or with a high staff turnover. Take home message References Darbyshire, D., Brewster, L.,

ED 104

ED Emergency Department EMS OR 104

ALiEM

JANUARY 27, 2025

Case Question: What findings on the CT image and laboratory studies immediately available in the ED led you to the diagnosis? Heterophile monospot and EBV titers often are not available as STAT labs and return after the ED evaluation. Infectious mononucleosis In: Post TW, ed. N Engl J Med. 2010 May 27;362(21):1993-2000.

ED 273

ED OR 273

The Skeptics' Guide to EM

MAY 25, 2024

He has been involved in ED-based clinical research examining ways to improve care for patients with alcohol use disorder in the ED for over two decades. Case 1: A patient presents to the ED with nausea, vomiting and some abdominal pain complaining of alcohol withdrawal. This is an SGEM HOP but with a twist.

ED 251

ED Emergency Department ICU ALS 251

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

APRIL 1, 2025

Date: April 1, 2025 This is another SGEM Xtra. I was asked to give a public lecture for the Gateway Centre of Excellence in Rural Health. The topic was the zombie idea that emergency department crowding is due to non-urgent patients.You can click on this LINK and get a PDF copy of my slides.

ED 278

ED Emergency Department 278

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

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

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

EMOttawa

JUNE 19, 2025

In part 1 we explored the physiology, mechanism […] The post Navigating Twists, Turns and Tears: BCVI in the ED (Part 2) appeared first on EMOttawa Blog. By identifying high-risk patients early, we can decrease the risk of stroke by up to 15% with the use of aspirin.

ED 102

ED Emergency Department Critical Care 102

Don't Forget the Bubbles

MAY 26, 2025

Why is peer-assisted learning important in the ED? The post Peer-assisted learning in the ED appeared first on Don't Forget the Bubbles. By cycling through this process, trainees develop the skills and mindset needed to improve and adapt continually a crucial trait for any emergency clinician. 2017 Jan;92(1):70-75.

ED 83

ED Emergency Department OR 83

American Ambulance Association

APRIL 30, 2025

The post EMS Week Op-Ed Writing Structure Guide & Checklist appeared first on American Ambulance Association. This content is for AAA members only. Please either Log In or Join!

ED 130

ED EMS Ambulance OR 130

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

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 9, 2025

-Case- A 31-year-old woman rushes into the ED with her lips swelling and a rapidly spreading rash. She was stung by a bee while jogging, and within minutes developed hives, throat tightness, and shortness of breath. On arrival, her vitals are notable for HR of 118 bpm, a BP 82/50 mmHg, and she’s wheezing audibly.

Epinephrine 52

Epinephrine ED 52

St. Emlyn's

MAY 24, 2025

St.Emlyn's - Emergency Medicine #FOAMed Emergency departments (EDs) often seem to shift from calm to crisis in an instant. This article explores ED crowding through the lens of complexity science and self-organised criticality, explaining how minor changeslike a few extra patientscan trigger disproportionate chaos.

ED 83

ED Emergency Department 83

EMOttawa

OCTOBER 24, 2024

Historically, it has been used more frequently in the ICU than in Emergency Departments, likely due to provider comfort. […] The post Is there a Precedence for Precedex in the ED? appeared first on EMOttawa Blog.

ED 131

ED ICU Critical Care Emergency Department 131

Emergency Medicine Cases

JANUARY 7, 2025

She reached out to me after listening to Episode 200 How EM Experts Think Part 1 as a longtime supporter of EM Cases, to highlight the importance of recognizing challenges that female-identifying EM physicians may face before, during and after ED shifts.

EMS 297

EMS ED 297

The Skeptics' Guide to EM

MAY 3, 2025

Case: A 6-week-old boy is brought by his parents to your emergency department (ED) for fever. Unfortunately, its expensive, and not all EDs have access to it or can receive the results promptly to help with decision making. His older sister has been sick with upper respiratory symptoms for the past week but seems to be recovering.

ALS 205

ALS ED Emergency Department OR 205

ACEP Now

JULY 3, 2025

The emergency department (ED) at Scripps Mercy Hospital San Diego is a different breed of ED. Doing Things Differently The ED at Scripps Mercy Hospital San Diego does not have a PIT process. In fact, their patient flow model is more typical of a low-volume ED (see Figure 1). Click to enlarge. Click to enlarge.

ED 52

ED Emergency Department Naloxone Critical Care 52

The Skeptics' Guide to EM

JUNE 8, 2024

Case: A 16-year-old nonbinary youth on testosterone blockers and oestrogen has come into your emergency department (ED) having twisted their ankle while playing soccer. You don’t see a large number of trans patients in your ED and you wonder if there might be specific recommendations that can guide your care of this adolescent.

Emergency Department 358

Emergency Department ED ALS Paramedic 358

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

Emergency Medicine Cases

JANUARY 7, 2025

In this Part 2 of our 2-part podcast series on How EM Experts Think with Dr. Reuben Strayer, Dr. Mike Betzner and Dr. Scott Weingart we dive deep into the nuances of practicing smarter, faster, and better in the ED. We answer questions like: How should we employ hypothetico-deductive reasoning in our daily practice of Emergency Medicine?

EMS 256

EMS ED OR 256

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

The Skeptics' Guide to EM

APRIL 5, 2025

Case: You are approached by the medical director of your emergency department (ED). Background: Pediatric triage is a fundamental component of emergency medicine, serving as the first critical step in managing acutely ill or injured children in the emergency department (ED). Reference: Sax DR, et al.

Emergency Department 210

Emergency Department ED ALS OR 210

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

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

EMOttawa

JULY 3, 2025

Vision Loss in the ED appeared first on EMOttawa Blog. The numbers on your alarm clock blur into nothingness, or half of your vision seems to have vanished altogether. Panic sets in as you make your way to the emergency department. The doctor tells you: “This is […] The post Code Blind: Eye’m losing it!

ED 74

ED Emergency Department OR 74

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

The Skeptics' Guide to EM

DECEMBER 16, 2023

Case: A 57-year-old Chinese woman presents to the emergency department (ED) with chest pain. Background: Patient experiences of care are associated with health outcomes and may impact perspectives of ED care and the patient recovery process.(1-5) 6-7) We looked at deaf and hard-of-hearing patients in the ED on SGEM#383.

Emergency Department 318

Emergency Department ED ALS OR 318

The Skeptics' Guide to EM

OCTOBER 21, 2023

Case: You are in your group meeting and have heard about a case at a nearby emergency department (ED) where the […] The post SGEM#418: I Ain’t Missing You – Spinal Epidural Abscess first appeared on The Skeptics Guide to Emergency Medicine. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals.

Emergency Department 334

Emergency Department ALS ED OR 334

Emergency Medicine Cases

MAY 28, 2024

Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. What can we do in the ED to prevent rebleeding in patients with subarachnoid hemorrhage? Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done.

ED 348

ED EMS 348

Emergency Medicine Cases

NOVEMBER 28, 2023

On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine (..)

EMS 321

EMS ED 321

Emergency Medicine Cases

FEBRUARY 27, 2024

Hans Rosenberg on when to use gabapentinoids for pain control in the ED. Nour Khatib and Hamza Jalal on an approach to paresthesias in the ED. Anand Swaminathan on an update on the appropriate selection of induction agents. Katie Lin on pearls for neuroprotective intubation. Eric Wortmann on preventing burnout in emergency medicine.

EMS 311

EMS ED 311

Emergency Medicine Cases

JULY 30, 2024

In this month's EM Quick Hits podcast: Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient, Megan Landes on providing HIV PEP and PrEP in the ED, Justin Morgenstern & George Kovacs on the PREOXI trial and evidence for pre-oxygenation with NIPPV before intubation in RSI, Brit Long on recognition and management of blast (..)

EMS 284

EMS ED 284