The Skeptics' Guide to EM

JANUARY 27, 2024

Fanaroff et al looked at the ACC/AHA guidelines from 2008-2018 [4]. On top of that, there was no standardization of the nitrate dose or route of administration, so it’s hard to know how to extrapolate the findings to our standard nitrate admin protocols. I was not surprised by this information.

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Administration Academics EKG/ECG EMS 125

RebelEM

JANUARY 18, 2024

to 0.97; p = 0.02 Length of ICU Stay 906 patients Prehospital Abx: 300 pts No Prehospital Abx: 606 pts Pooled Mean Difference 0.11; 95% CI -1.85 to 2.07; p = 0.91 NOT STATISTICALLY SIGNIFICANT Length of Hospital Stay 3325 patients Prehospital Abx: 1680 pts No Prehospital Abx: 1645 pts Pooled Mean Difference: 4.50; 95% CI -3.34 to 12.33; p = 0.26

Sepsis 131

Sepsis Hospitals Administration Outcomes 131

Cook County EM Blog

FEBRUARY 14, 2025

2008), Subdissociative-dose Ketamine versus Fentanyl for Analgesia during Propofol Procedural Sedation: A Randomized Clinical Trial. Ann Emerg Med. 2010 Mar;55(3):258-64. doi: 10.1016/j.annemergmed.2009.07.030. 2009.07.030. Epub 2009 Sep 24. PMID: 19783324. Messenger, D.W., Murray, H.E., Dungey, P.E., Van Vlymen, J. and Sivilotti, M.L.A.

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Emergency Department Dislocations Patient Safety Fractures 52

Dr. Smith's ECG Blog

MAY 31, 2023

In discussing deWinter T waves — I find it helpful to return to the original commentary by deWinter and colleagues ( N Engl J Med 359:2071-2073, 2008 ) — in which they described a “new ECG pattern" without ST elevation that signifies acute occlusion of the proximal LAD ( L eft A nterior D escending ) coronary artery.

EKG/ECG 96

EKG/ECG Outcomes Academics Wellness 96

Ziqitza HealthCare Ltd

JULY 21, 2023

Considering its popularity, the then Government of India introduced the 108 emergency response system to other parts of the country in 2008. It was an instant hit in rural Andhra Pradesh. The service today is changing rural India by making primary healthcare accessible to the people in the remotest part of the state free of cost.

Ambulance Services 98

Ambulance Services Poisoning Operations Hospitals 98

ECG Guru

JUNE 28, 2024

Dr. Robbert de Winter, et al, described this pattern in a letter to the editor of the New England Journal of Medicine in 2008. This is called de Winter T wave pattern, and it is a sign of critical proximal occlusion of the left anterior descending coronary artery. Since then, it has been estimated to occur in about 2%-3.4%

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EKG/ECG Emergency Department EMS 79

Dr. Smith's ECG Blog

FEBRUARY 10, 2023

D e W inter T Waves : In 2008 — Robert J. NOTE: For illustrative purposes — I’ve adapted Figure-1 from the original manuscript by de Winter et al, published in this 2008 NEJM citation. de Winter et al in N Engl J Med 359:2071-2073, 2008. It does not quite meet the original 2008 description for de Winter T waves.

EKG/ECG 52

EKG/ECG 52

Sensible Medicine

MAY 28, 2024

A 2008 Cochrane review found adult depression screening does not improve outcomes. Regardless, the USPSTF concludes there is “moderate certainty that screening for anxiety… has a moderate net benefit”, the rationale for a “B” grade. Since the beginning, these recommendations have drawn criticism.

Military 144

Military Outcomes Psychiatric Wellness 144

EMDocs

DECEMBER 11, 2023

De Winter Sign [4,6] First described in 2008 this pattern be seen in proximal left anterior descending artery occlusion and should be evaluated by emergent angiography. 2008 Nov 6;359(19):2071—2073. Her vital signs are stable. Her ECG is shown below. Source: [link] This case is consistent with the De Winter Sign. Ann Emerg Med.

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EKG/ECG Emergency Department Academics Operations 111

Taming the SRU

APRIL 14, 2024

Biomedical Imaging and Intervention Journal , vol. 4, 1 July 2009, p. e14, www.biij.org/2009/4/e14/. Accessed 9 Apr. Jenkins, John T, and Patrick J O’Dwyer. Inguinal Hernias.” 7638, 31 Jan. 269–272, [link]. Long, Brit. “EM@3AM: EM@3AM: Hernia.” ScienceDirect , www.sciencedirect.com/science/article/pii/S0736467913011396. Strange, Chad D, et al.

Ultrasounds 105

Ultrasounds Emergency Department Pediatrics Radiology 105

RebelEM

MARCH 6, 2024

2008 Jul 1;31(7):table of contents. Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. 2007 Nov;30(11):1445-59. doi: 10.1093/sleep/30.11.1445. Erratum in: Sleep. PMID: 18041479; PMCID: PMC2082098. Caffeine Walsh JK, Muehlbach MJ, Schweitzer PK.

Leadership 102

Leadership Hospitals EMS 102

Cook County EM Blog

MARCH 20, 2023

2008 Apr;3(1):27-33. Epub 2008 Feb 2. 2008 Jan;12(1):33-6. 2008 Dec;3(4):340-5. Epub 2008 May 28. High-pressure injection injury of the hand: an often underestimated trauma: case report with study of the literature. Strategies Trauma Limb Reconstr. doi: 10.1007/s11751-008-0029-9. PMID: 18427921; PMCID: PMC2291478.

Fractures 52

Fractures Documentation/Coding Operations Research 52

Pediatric Emergency Playbook

MARCH 1, 2018

2008; 26: 181-198. The infant with acute, unexplained, excessive crying. Pediatrics. 1991; 88 (3): 450-5. Prentiss KA, Dorfman DH. Pediatric Opthalmology in the Emergency Department. Shope TR, Rieg TS, Kathiria NN. Corneal abrasions in young infants. Pediatrics. 2010 Mar;125(3):e565-9. Epub 2010 Feb 8.

Pediatrics 52

Pediatrics Emergency Department 52

Taming the SRU

JANUARY 29, 2024

2008 Aug;6(8):1262-6. Epub 2008 May 15. Epub 2020 Nov 25. Flinterman LE, Van Der Meer FJ, Rosendaal FR, Doggen CJ. Current perspective of venous thrombosis in the upper extremity. J Thromb Haemost. doi: 10.1111/j.1538-7836.2008.03017.x. 1538-7836.2008.03017.x.

Emergency Department 105

Emergency Department Fractures Hospitals Operations 105

PulmCCM

APRIL 29, 2024

In 2008, the U.S. It used to be highly prevalent in U.S. ICUs, and a popular research focus for academics, generating a steady stream of papers. Then, in 2009, the condition disappeared completely. Just kidding! government proposed adding VAP to its “hospital-acquired conditions” list—the ones that it won’t pay for.

Documentation/Coding 52

Documentation/Coding Academics Administration Research 52

PHEM Cast

JULY 14, 2016

British Orthopaedic Association Standards for Trauma (BOAST); 2008. 2008 Apr 15;5(3):214–9. 2008 Apr 22;178(9):1141–52. BOAST2: SPINAL CLEARANCE IN THE TRAUMA PATIENT. Hauswald M, Ong G, Tandberg D, Omar Z. Out-of-hospital spinal immobilization: its effect on neurologic injury. Acad Emerg Med. 2014 Jul 3;14(1):1–5. Emerg Med J.

Fractures 52

Fractures Hospitals Shock Research 52

Cook County EM Blog

FEBRUARY 28, 2025

Anesthesiology 114:1354–1363 Delay JM, Sebbane M, Jung B, Nocca D, Verzilli D, Pouzeratte Y, Kamel ME, Fabre JM, Eledjam JJ, Jaber S (2008) The effectiveness of noninvasive positive pressure ventilation to enhance preoxygenation in morbidly obese patients: a randomized controlled study.

COPD 40

COPD Outcomes Operations Emergency Department 40

PHEM Cast

DECEMBER 1, 2017

Awareness of site for needle thoracocentesis. Emergency Medicine Journal , 22 (11), 788–789. link] Fitzgerald, M., Mackenzie, C. Marasco, S., Hoyle, R., & Kossmann, T. Pleural decompression and drainage during trauma reception and resuscitation. Injury , 39 (1), 9–20. link] Givens, M. Ayotte, K., & Manifold, C. link] Netto, F. Shulman, H.,

Academics 52

Academics Radiology Radiology Resuscitation 52

Don't Forget the Bubbles

AUGUST 30, 2023

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. Overcrowding and limited staffing threaten to increase the length of stay if unnecessary imaging is obtained.

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Emergency Department Pediatrics Infectious Diseases Research 130

RebelEM

SEPTEMBER 13, 2023

of people who take NSAIDs ( Nzeako 2010 ). patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01

Allergic Reactions 103

Allergic Reactions Airway Management Anaphylaxis Emergency Department 103

Don't Forget the Bubbles

JULY 24, 2023

2008 Jun;56. References Brown R, Hussain M, McHugh K, Novelli V, Jones D. Discitis in young children. The Journal of Bone and Joint Surgery British volume. 2001 Jan;83-B. Cottle L, Riordan T. Infectious spondylodiscitis. Journal of Infection. Cushing AH. Diskitis in Children. Clinical Infectious Diseases. 1993 Jul 1;17(1).

Radiology 98

Radiology Radiology Infectious Diseases Pediatrics 98

Mind The Bleep

NOVEMBER 6, 2023

Figure 2 – Teardrop sign (Cobb et al 2008) Key aspects of management: CT scan Specialist input may include surgery, steroids, antibiotics, nasal decongestants and ice packs. 37(9):787-93 Cobb, Murthy, Saiet et al (2008) The tear-drop sign: a trap door for the unwary? May involve facial bones. Curr Eye Res.

Fractures 52

Fractures Radiology Radiology Emergency Department 52

Pediatric Emergency Playbook

APRIL 1, 2018

2008; 51(3):21-24. References Baracco R et al. Pediatric Hypertensive Emergencies. Curr Hypertens Rep. 2014; 16:456. Pediatric Hypertension in the Emergency Department. Ann Emerg Med. Chandar J et al. Hypertensive crisis in children. Pediatr Nephrol. 2012; 27:741-751. Dionne JM et al.

Pediatrics 52

Pediatrics Emergency Department 52

Pediatric Emergency Playbook

OCTOBER 1, 2019

Am J Otolaryngol 2008; 29:83. Management of congenital anomalies of the neck. Facial Plast Surg Clin North Am 2001; 9:131. Lin ST, Tseng FY, Hsu CJ, et al. Thyroglossal duct cyst: a comparison between children and adults. Mandell DL. Head and neck anomalies related to the branchial apparatus. Otolaryngol Clin North Am 2000; 33:1309.

Pediatrics 52

Pediatrics 52

Sensible Medicine

MAY 25, 2023

Jindal served as governor of Louisiana, 2008-16, and a U.S. .” The USPSTF might beg to differ about the significant unmet need, but we can all agree about the sizable new market. Investors take note. The co-author is not a physician or scientist, but is no stranger to the health care industry. He serves on the board of U.S.

Documentation/Coding 87

Documentation/Coding Academics Wellness 87

PEMBlog

AUGUST 14, 2024

2008 Aug;21(4):457-61. Anesth Analg. 2002 Aug;95(2):461-6, table of contents. doi: 10.1097/00000539-200208000-00042. PMID: 12145072. Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine: a review of clinical applications. Curr Opin Anaesthesiol. doi: 10.1097/ACO.0b013e328305e3ef. 0b013e328305e3ef. PMID: 18660652. Pediatr Crit Care Med.

Pediatrics 59

Pediatrics Wellness 59

PHEM Cast

DECEMBER 12, 2016

Injury; 2008 (39): 967-969. Practice Management guidelines for ED Thoracotomy. J Am Coll Surg. 2001, 193 (3): 303-309. When should we stop resuscitative efforts after blunt traumatic arrest. Joint Position Statement of Nat Assoc EMS Physicians and ACS Committee on Trauma.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

Pediatric Emergency Playbook

JUNE 1, 2019

1) 2008, pp S25-S34. Lerner EB, Schwartz RB, Coule PL, et al. Mass Casualty Triage: An Evaluation of the Data and Development of a Proposed National Guideline." Disaster Medicine and Public Health Preparedness 2(Suppl.

Mass Casualty Incidents 52

Mass Casualty Incidents Disaster Management Emergency Department Pediatrics 52

ALiEM

SEPTEMBER 25, 2023

Epub 2008 Feb 15. References Bazan HA, Reiner E, Sumpio B. Management of bilateral phlegmasia cerulea dolens in a patient with subacute splenic laceration. Ann Vasc Dis. 2008;1(1):45-8. doi: 10.3400/avd.AVDcr07002. PMID: 23555338; PMCID: PMC3610218. Chaochankit W, Akaraborworn O. Phlegmasia Cerulea Dolens with Compartment Syndrome.

Ultrasounds 60

Ultrasounds Academics 60

Dr. Smith's ECG Blog

APRIL 17, 2023

Emergency providers need to instinctively recognize this ECG pattern in a patient with new chest pain! == KEY POINTS regarding D e W inter T Waves : In 2008 — Robert J. NOTE: For illustrative purposes — I’ve adapted Figure-1 from the original manuscript by deWinter et al, published in this 2008 NEJM citation. See text ).

EKG/ECG 52

EKG/ECG Documentation/Coding Emergency Department Psychiatric 52

Taming the SRU

NOVEMBER 27, 2023

2008 Sep;122(3):105e-117e. New York: McGraw-Hill Education. [2] 2] Lemmon JA, Janis JE, Rohrich RJ. Soft-tissue injuries of the fingertip: methods of evaluation and treatment. An algorithmic approach. Plast Reconstr Surg. doi: 10.1097/PRS.0b013e3181823be0. 0b013e3181823be0. PMID: 18766028. [3] 3] Leggit JC. Acute and Chronic Paronychia.

Soft Tissue Injuries 105

Soft Tissue Injuries Emergency Department EMS Fractures 105

Dr. Smith's ECG Blog

MAY 2, 2019

Serial ECGs are extremely helpful. == Comment by K EN G RAUER, MD ( 5/4/2019 ): == In 2008 de Winter et al described A New ECG Sign of Proximal LAD Occlusion ( NEJM 359:2071-73, 2008 ), that they found to be present in ~2% of 1,532 patients admitted with acute anterior MI.

Hospitals 52

Hospitals EKG/ECG Wellness EMS 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

The one exception ADDIN EN.CITE McCord 2008 1774 1774 17 McCord, J. style='mso-element:field-begin'> ADDIN EN.CITE McCord 2008 1774 1774 17 McCord, J. Wells, P.J. Hollander, J. de Lemos, J. Gibler, W. Philippides, G. Henry Ford Hospital. ADDIN EN.CITE Pollan 1989 1855 1855 17 Pollan, S. Hollander, J. de Lemos, J. Gibler, W.

Seizures 52

Seizures Administration Outcomes Hospitals 52

EMDocs

JANUARY 25, 2024

2008 Jul; 44(1): 40–42. [link] 2. This is a classic case of “anchoring bias” (i.e., failure to assess the overall presentation and instead jumping to conclusions). References : 1. Spontaneous Spinal Epidural Hematoma. Baek BS et al. J Korean Neurosurg Soc. The Significance of Drug—Drug and Drug—Food Interactions of Oral Anticoagulation.

Poisoning 82

Poisoning Documentation/Coding Patient Safety Hospitals 82

PulmCCM

SEPTEMBER 20, 2024

China’s New Policy on Research Evaluation, Max Planck Institute Five ways China must cultivate research integrity, Nature , November 2019 Analysis of doctoral graduates' attitudes toward academic misconduct and its causes, Wangfang Data, 2008 Nearly half of US Chinese student dismissals due to “academic dishonesty”, The PIE, September (..)

Academics 105

Academics Forensics Research Operations 105

Emergency Medicine Journal

JUNE 20, 2024

Austerity measures introduced in the UK in 2010 following the 2008 recession resulted in major changes and, in some cases, significant cuts to healthcare funding. Health inequalities EDs are increasingly a good barometer of pressure across the NHS and the health of the nation.

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Pediatric Emergency Playbook

AUGUST 1, 2017

J Med Genet 2008; 45:1. J Pediatr Gastroenterol Nutr 2008; 46:13. 2008; 15-21. 2008; 22-28. 2010; 149(3):386-391. Hirschprung Disease Amiel J, Sproat-Emison E, Garcia-Barcelo M, et al. Hirschsprung disease, associated syndromes and genetics: a review. Arshad A, Powell C, Tighe MP. Hirschsprung's disease. J Pediatr Surg.

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Pediatrics Ultrasounds Resuscitation Sepsis 52