Emergency Medicine Journal

JANUARY 22, 2024

We assessed safety and efficacy data from 10 years (2011–2021) of our N 2 O PPS programme. Methods Prospectively collected data from a sedation registry at a paediatric emergency department (PED) were reviewed. Analgesic potency could be increased by combining N 2 O and intranasal fentanyl (INF).

Emergency Department 40

Emergency Department Outcomes 40

Pediatric EM Morsels

SEPTEMBER 1, 2023

One such vital aspect of pediatric emergency medicine is the appreciation of how psychosocial history impacts a patient’s life and care. As previously mentioned by Dr. Richardson , adolescents use the Emergency Department as their Primary Care resource often. 2011-3798 Borowsky IW, Taliaferro LA, McMorris BJ.

Pediatrics 161

Pediatrics Emergency Department Fractures Infectious Diseases 161

The Skeptics' Guide to EM

AUGUST 17, 2019

Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain.

Emergency Department 52

Emergency Department Academics Fractures Outcomes 52

ALiEM

JANUARY 22, 2024

A 40-year-old male, tailor by occupation, was brought to the Emergency Department with complaints of high-grade fever for the past 11 days. 2011 Oct 18;183(15):E1152. Epub 2011 Sep 12. Fever was documented to be 102°F and was not associated with any chills or rigors. Curr Infect Dis Rep. 2009 Jan;11(1):66-72.

Documentation/Coding 64

Documentation/Coding Academics Emergency Department Hospitals 64

ALiEM

AUGUST 28, 2023

A 44-year-old female presented to the emergency department with the complaint of a “stone under [her] tongue.” Larger, more superficial sialoliths may benefit from excision in the emergency department. The emergency physician made a single 1 cm incision over the calculus and a 0.5 2011 Dec;145(6):935-9.

Dehydration 52

Dehydration Emergency Department Academics Hospitals 52

RebelEM

MAY 15, 2024

Comparison of the MASCC and CISNE scores for identifying low-risk neutropenic fever patients: analysis of data from three emergency departments of cancer centers in three continents. 2011 Jun;153(6):773-9. Epub 2011 Apr 22 Coyne CJ, Le V, Brennan JJ, Castillo EM, Shatsky RA, Ferran K, Brodine S, Vilke GM. Ann Emerg Med.

Infectious Diseases 78

Infectious Diseases Administration Sepsis Anaphylaxis 78

The Skeptics' Guide to EM

OCTOBER 14, 2023

Case: A 5-year-old boy presents to the emergency department (ED) with his parents for fever and fatigue. That episode reviewed the 2011 Fleming et al systematic review for the normal ranges of HR and RR in children from birth to 18 years of age. He has had three days of high fevers at home. Does he have sepsis?”

Pediatrics 94

Pediatrics Sepsis Urgent Care Emergency Department 94

Taming the SRU

JULY 2, 2023

End-Tidal CO2 monitoring has a variety of uses in the Emergency Department. Capnography in the emergency department: a review of uses, waveforms, and limitations." The Journal of emergency medicine 53.6 2011): 544-549. 2011): 189-196. Annals of emergency medicine 63.2 2017): 829-842.

Emergency Department 77

Emergency Department Pediatrics CPR Administration 77

The Skeptics' Guide to EM

JANUARY 20, 2024

Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences. Case: A 4-year-old girl comes to the emergency department complaining of pain with urination.

Pediatrics 66

Pediatrics Anaphylaxis Emergency Department Outcomes 66

ACEP Now

JANUARY 13, 2024

As a member of the Air Force, deployed to Afghanistan in 2011, I have seen war where I should have seen it—in a designated war zone. As an emergency medicine resident, I have seen the toll that workplace violence is taking on our specialty, our patients, and our entire medical community. Ann Emerg Med , 2021;78(4):S8.

Emergency Department 52

Emergency Department Resuscitation Patient Safety Hospitals 52

Pediatric EM Morsels

OCTOBER 27, 2023

Rosenberg 2011, Yamamoto 2009] Not as accurate in obese children (physicians were better at estimating). The PAWPER tape as a tool for rapid weight assessment in a Paediatric Emergency Department: Validation study and comparison with parents’ estimation and Broselow tape. Int J Emerg Med. J Emerg Med.

Pediatrics 244

Pediatrics Resuscitation Documentation/Coding Wellness 244

Taming the SRU

FEBRUARY 12, 2024

HISTORY OF PRESENT ILLNESS A female in her 30s arrives to the emergency department via emergency medical services. She arrives in the emergency department agitated and unable to answer questions appropriately. The patient is agitated on a backboard with C-collar in place. N Engl J Med. Sep 8; 365(10): 883-91.

Administration 71

Administration Fractures Anaphylaxis Emergency Department 71

RebelEM

FEBRUARY 12, 2024

There are greater than 2 million annual emergency department visits for suspected renal colic in the US, and Ct scanning is performed for more than 90% of patients who receive a diagnosis of kidney stone. 2011; 18(7):699-707. What Your Gut Says: We need a CT report to diagnose a kidney stone. 2002; 225(2):441-449.

Radiology 61

Radiology Radiology Emergency Department Ultrasounds 61

Taming the SRU

SEPTEMBER 25, 2023

Musculoskeletal injuries are a common occurrence, representing a substantial number of Emergency Department visits on an annual basis. 1) Oftentimes, Emergency Physicians are the first provider patients encounter after an injury. 2011 Jan-Feb;50(1):62-7. References 1. J Am Acad Orthop Surg Glob Res Rev. J Foot Ankle Surg.

Fractures 91

Fractures Operations Emergency Department EMS 91

Greater Sydney Area HEMS

FEBRUARY 20, 2024

It is currently the subject of future research and publication in the emergency department setting. 2011; 106 : 732–737. [iv] At the very least, knowledge of it as an option in the armamentarium of retrieval and critical care providers is important. i] Leibowitz A, Oren-Grinberg A, Matyal R. The Lancet.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

ACEP Now

MAY 9, 2024

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). Radecki (@emlitofnote) i s an emergency physician and informatician with Christchurch Hospital in Christchurch, New Zealand. Ann Emerg Med.

Research 52

Research Emergency Department Infectious Diseases Hospitals 52

RebelEM

SEPTEMBER 13, 2023

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 Angioedema in the Emergency Department: An Evidence Based Review. Emergency Medicine Practice. of people who take NSAIDs ( Nzeako 2010 ).

Allergic Reactions 91

Allergic Reactions Airway Management Anaphylaxis Emergency Department 91

RebelEM

SEPTEMBER 11, 2023

1 It is a quickly deployable and easily interpreted study that can be done in real time to guide decisions in the Emergency Department. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Acad Emerg Med. 2011 Mar;18(3):227-35. PMID: 21401784.

Ultrasounds 69

Ultrasounds Radiology Radiology Emergency Department 69

The Skeptics' Guide to EM

NOVEMBER 1, 2022

AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency department (ED) with his first time anterior should dislocation after trying to recreate one of his favourite scenes in the movie Lethal Weapon.

Dislocations 58

Dislocations Ultrasounds Emergency Department 58

PulmCCM

JUNE 12, 2023

Temperature management (or fever avoidance) should begin immediately after cardiac arrest (ideally in the emergency department, for out-of-hospital arrests) and continued for at least 72 hours.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

RebelEM

JUNE 5, 2023

One study from a county in Massachusetts found that of all nonfatal opioid doses seen in the emergency department from 2011-2015, 1 in 20 patients subsequently died within one year of initial visit with 66% of these deaths being directly related to an opioid overdose (4). Ann Emerg Med. PMID 33392580. PMID 33392580.

Emergency Department 75

Emergency Department Hospitals Outcomes Research 75

The Skeptics' Guide to EM

JULY 17, 2021

Case: Six-year-old Morten comes into your emergency department (ED) with what looks like pneumonia. This is because most pneumonias in this age-group are caused by viral pathogens ( Bradley et al 2011 ). Bradley et al 2011 ). He is the co-founder of website lead of Don’t Forget the Bubbles ( DFTB ).

Pediatrics 52

Pediatrics Emergency Department Wellness 52

RebelEM

MARCH 23, 2023

The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores. of symptom-triggered phenobarbital versus symptom-triggered lorazepam in the emergency department (n=44). A randomized, blinded clinical trial (Hendey et al.)

Emergency Department 52

Emergency Department Outcomes Hospitals Burns 52

Pediatric EM Morsels

JULY 21, 2023

Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. 2011 Apr;48(4):331-2. J Surg Res. 2019 Sep;241:112-118. doi: 10.1016/j.jss.2019.03.038. 2019.03.038. Epub 2019 Apr 22. PMID: 31022676. Gill MR, Reiley DG, Green SM. 2004;43:215-223. Rowley G, Fielding K. 1991;337:535-538.

Head Injuries 231

Head Injuries Pediatrics Outcomes Shock 231

Dr. Smith's ECG Blog

MAY 20, 2024

Diagnosis of Type I vs. Type II Myocardial Infarction in Emergency Department patients with Ischemic Symptoms (abstract 102). Annals of Emergency Medicine 2011; Suppl 58(4): S211. The only study I'm aware of that looked at this was mine, in which 4% of Type II MI had New ST Elevation. Murakami MM.

EKG/ECG 110

EKG/ECG Hospitals Wellness Emergency Department 110

The Skeptics' Guide to EM

JUNE 15, 2018

Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals Sepsis 52

ALiEM

MARCH 7, 2024

Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). Point-of-care ultrasound for the detection of hydronephrosis in emergency department patients with suspected renal colic.

Ultrasounds 70

Ultrasounds Pediatrics Emergency Department Radiology 70

Taming the SRU

NOVEMBER 14, 2023

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

Emergency Department 82

Emergency Department Pediatrics Wellness Documentation/Coding 82

ACEP Now

AUGUST 1, 2023

How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. When those same fundamentals done right achieve great success, they aren’t little at all.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Don't Forget the Bubbles

AUGUST 7, 2023

The controversy around what is ‘normal’ in infants’ and children’s vitals was demonstrated in a 2011 systematic review by Fleming et al. Evaluating the Pediatric Early Warning Score (PEWS) System for Admitted Patients in the Pediatric Emergency Department. Acad Emerg Med. What did previous studies show? Pediatrics.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

The Skeptics' Guide to EM

FEBRUARY 13, 2021

Pediatrics 2020 Case: A 4-year-old immunized girl presents to the emergency department (ED) with a fever and rhinorrhea for the […] The post SGEM#319: Is it Aseptic Meningitis or More Than This? first appeared on The Skeptics Guide to Emergency Medicine. Reference: Mintegi S et al. Reference: Mintegi S et al.

Pediatrics 52

Pediatrics Emergency Department Hospitals 52

ACEP Now

OCTOBER 26, 2023

The Case A two-year-old female, seen three days ago at different local emergency department (ED)—Children’s General—presents with fever, headache, and neck pain. References Department of Health and Human Services §164.506. Published 2011. When it comes to sharing important clinical PHI, let’s talk—HIPAA allows it.

Infectious Diseases 52

Infectious Diseases Hospitals Documentation/Coding Administration 52

PHEM Cast

DECEMBER 12, 2016

Emergency thoracotomy in thoracic trauma: a review. Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World Journal of Emergency Surgery; 2006: 1:4. Survival after Emergency Department thoracotomy: review of published data for last 25 years.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

EMDocs

SEPTEMBER 9, 2023

2021.0052 Emergency Department Management of Extensor Tendon Lacerations – Page 3 of 4. Ann Emerg Med. Emergency Medicine Residents’ Association; 2022:10-11. Extensor tendon repair in the emergency department. J Emerg Med. Emergency Orthopedics. Medicine (Baltimore). 2019;98(44):e17823.

EMS 77

EMS Fractures Soft Tissue Injuries Ultrasounds 77

Don't Forget the Bubbles

MAY 29, 2023

Bad manners in the Emergency Department: Incivility among doctors. Burnout and Workplace Incivility Among Emergency Medical Services Practitioners: A Preliminary Report , Prehospital Emergency Care [Internet] 2023 Okuyama A, Wagner C, Bijnen B. Internet] 2011:41(1):41-47. BMJ Open [Internet] 2020;10: e035471.

Leadership 98

Leadership Patient Safety Academics Research 98

PHEM Cast

APRIL 21, 2021

Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Association Between Repeated Intubation Attempts and Adverse Events in Emergency Departments: An Analysis of a Multicenter Prospective Observational Study. Annals of Emergency Medicine 2012; Volume 60, Issue 6, Pages 749–754.e2

Airway Management 52

Airway Management Resuscitation Hospitals EMS 52

Don't Forget the Bubbles

MAY 24, 2023

Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. 2011 May;106(5):617–31 Cook TM. Intubation of the Critically Unwell Child in the Emergency Department. difficult intubations in neonates and infants. Around two-thirds of these were unanticipated.

Airway Management 98

Airway Management Teamwork Pediatrics Emergency Department 98