The Skeptics' Guide to EM

FEBRUARY 22, 2020

Bringing value, balance and humanity to the emergency department: The Right Care Top 10 for emergency […] The post SGEM Xtra: Right, You’re Bloody Well Right, You’ve got the Bloody Right to Care first appeared on The Skeptics Guide to Emergency Medicine. Reference: Dorsett et al.

Wellness 52

Wellness Emergency Department EMS 52

ALiEM

MAY 13, 2024

They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Larger abscess with well-circumscribed borders D. Superficial abscess with well-circumscribed borders Table 1. 2016 Nov;23(11):1298-1306. Epub 2016 Nov 1. 2016 Feb;169:122-7.e1.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Sensible Medicine

NOVEMBER 28, 2023

Being perfectly honest, not all the articles have aged well. One of these was an article that Vinay Prasad and I wrote back in 2016: Wearables, Smartphones and Novel Anticoagulants: We Will Treat More Atrial Fibrillation, but Will Patients Be Better Off? I am actually embarrassed by a few of them and many are forgettable.

Stroke 82

Stroke Academics Outcomes Administration 82

Sensible Medicine

MARCH 28, 2024

In 2016, Jonathan Reiner said this about Carrie Fisher’s mother, who died very shortly after her daughter. Just 3 examples: #1 #2 #3 Here is the problem: Adjuvant chemotherapy is a well described medical term, but preventive chemotherapy is a colloquialism.

Hospitals 93

Hospitals Outcomes Wellness 93

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 78

Infectious Diseases Administration Sepsis Anaphylaxis 78

Pediatric EM Morsels

JULY 21, 2023

2016 Aug;23(8):878-84. Epub 2016 Aug 1. Borgialli DA, Mahajan P, Hoyle JD Jr, Powell EC, Nadel FM, Tunik MG, Foerster A, Dong L, Miskin M, Dayan PS, Holmes JF, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN). Acad Emerg Med. doi: 10.1111/acem.13014. PMID: 27197686. Holmes, James F et al. 2005): 814–819.

Head Injuries 231

Head Injuries Pediatrics Outcomes Shock 231

Pediatric EM Morsels

OCTOBER 6, 2023

(Forster, 2021) Transmission is by Fecal-Oral route (Chiodini 2018) Incubation period 6-30 days after exposure (Chiodini 2018) Salmonella typhi produces an endotoxin although its clinical significance is not yet well understood (Gibani 2019) Two typhoid vaccines are available for those > 6 m/o and are 50-80% effective. 2016; 15: 32.

Pediatrics 161

Pediatrics CDC Seizures Infectious Diseases 161

EMDocs

FEBRUARY 17, 2024

1,3 Although well-recognized in the drug-user population, the incidence and prevalence of cotton fever are unclear as few publications or epidemiological data exist. 2016) compares vital sign abnormalities and symptom duration between available case reports. 4 True incidence is likely more common than recognized by medical community.

EMS 83

EMS Sepsis Hospitals Wellness 83

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Systolic function normal by visual assessment only, unable to visualize well for further characterization. The patient did well and was discharged. 2016, April 13). RV: Cavity size normal. 1900: RBBB and LAFB are almost fully resolved. 2300: QRS now within normal limits. No other significant injuries were found. Zangouri, V.,

EKG/ECG 92

EKG/ECG Wellness Fractures Hospitals 92

EMDocs

MARCH 14, 2024

6 By the end the of 2016, 32 states had adopted expansion. Adoption rapidly slowed after 2016 as political opposition to the policy, as well as the ACA in general, remained strong in states with Republican-controlled state houses and governors’ mansions.

Administration 79

Administration Outcomes Burns Operations 79

Don't Forget the Bubbles

JANUARY 24, 2024

The first human trials for children with SRSE were conducted in 2014 where 2 patients responded well to the treatment and there have been encouraging results in open label adult trials more recently. 2016 Oct;41:62-5. Epub 2016 Jul 21. 2016 Dec 22;375(25):2457-2467. doi: 10.1016/j.seizure.2016.07.006. 2016.07.006.

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

Emergency Medicine Journal

MAY 23, 2023

A modified GBS (mGBS) and CANUKA score have recently been proposed but have not been well studied. Methods A single-centre retrospective study was performed including patients with suspected UGIB visiting the ED of Saint-Antoine hospital (Paris, France) from January 2016 to December 2018. In-hospital mortality was also collected.

Emergency Department 40

Emergency Department Blood Transfusions Hospitals Wellness 40

Emergency Medicine Journal

NOVEMBER 28, 2023

Background While the role of Extended Focused Assessment with Sonography in Trauma (eFAST) is well defined in the management of severe blunt trauma, its performance in injuries caused by stab wounds has been poorly assessed.

Wellness 40

Wellness 40

SheMD

NOVEMBER 9, 2023

Step 2: Know your values Some of the biggest contributors to burnout are feeling ineffective and conflicts between action and personal values (Maslach and Leiter, 2016). Being well-rested is a value. What do I want to call my mom and tell her about when it’s going well? Getting paid is a value. Resources Maslach, C.

Leadership 52

Leadership Wellness Research 52

EMDocs

JANUARY 23, 2024

Published February 15, 2016. Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia. J Emerg Med. 2020 Aug;59(2):216-223. doi: 10.1016/j.jemermed.2020.05.001. 2020.05.001. BRASH syndrome: Bradycardia, Renal failure, Av blocker, Shock, and Hyperkalemia.

Shock 86

Shock Dehydration Sepsis EKG/ECG 86

Don't Forget the Bubbles

JANUARY 22, 2024

The campaign started in the United States in 2012, in Canada two years later, and in the United Kingdom in 2016. Choosing Wisely UK was launched in 2016 by the Academy of Medical Royal Colleges to identify tests, treatments, and procedures of questionable value. 2016 ;50(13):826-8. Br J Sports Med. Regan W, Hothi D, Jones K.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

EM SIM Cases

MAY 9, 2023

However, if you find yourself treating a drowning patient in the ED, this case will have you well prepared. WHY IT MATTERS Every year as the weather warms and more people take advantage of water sports and outdoor activities there is increased risk of drowning. When it comes to pediatric drowning, prevention is the best medicine.

Pediatrics 52

Pediatrics CPR Radiology Radiology 52

Taming the SRU

JANUARY 1, 2024

For laboratory testing, it is important to be aware that not all values obtained via an intraosseous line correlate well with peripheral venous samples (11). Additional Resources Please see a previous Taming the SRU post for extra tips and trouble-shooting tricks, as well as a video demonstration for IO access. 2016 Dec 14;20(1):102.

Emergency Department 80

Emergency Department Ultrasounds Administration Burns 80

Don't Forget the Bubbles

AUGUST 21, 2023

The baby’s parents tell you that the baby hasn’t been feeding well for a few days and today has been very sleepy. European Journal of Pediatrics; 2016: 175; 1461-1462 Cox, GF. What are your differentials? Bad bronchiolitis ? Infection/sepsis? Congenital cardiac disease – maybe a duct-dependent lesion? 34; 963 – 969. Bouziri A.,

Pediatrics 98

Pediatrics Outcomes Research Sepsis 98

Emergency Medicine Ireland

OCTOBER 30, 2023

Well, that time has come and it’s time to run through vasopressin. Well this is where the fun beings. A somewhat underwhelming start Second is the VANISH trial by Gordon et al, JAMA 2016. Jama 316 , 509–518 (2016). Well, that time has come and it’s time to run through vasopressin. How does it work?

Shock 52

Shock Sepsis Wellness Outcomes 52

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.

Emergency Department 93

Emergency Department Resuscitation COPD Shock 93

Sensible Medicine

NOVEMBER 14, 2023

He also co-led the team whose work led the CDC to issue a major clarification of its 2016 opioid prescribing guideline and is currently a principal investigator of the only national study to examine individual suicides that occur after the reduction of prescribed opioids. . Criticism of these programs is both well-deserved and unfair.

Research 116

Research CDC Psychiatric Best Practices 116

ACEP Now

FEBRUARY 13, 2024

See below: Fascia iliaca Serratus anterior Erector spinae The risks of opioid medications, especially in the elderly, has been well described. 2016 May;31(5):478-85. We have published how to perform these blocks previously at ACEP Now in Sound Advice , the column managed by Arun Nagdev, MD. J Patient Saf. 2023 Oct 1;19(6):379-385.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Wellness 52

CasesBlog

JUNE 27, 2021

It's a poignant moment in the life of a singer whose career spans 56 years and more than 100 million records sold; the passing of his wife, Linda, in 2016 after 59 years of marriage was devastating and resulted in the longest break between recordings of his career. His performance here brought me to tears and is well worth the wait."

Wellness 52

Wellness 52

Total Medical ComplianceHIPAA

NOVEMBER 7, 2022

Website owners are required to tell visitors what kind of cookies they use, as well as how they use and disclose the visitor’s information collected by their website. Cookies are like flags that allow a website to recognize and remember your device if you return to that site in the future.

Documentation/Coding 93

Documentation/Coding Wellness 93

Ken Grauer, MD

JULY 29, 2023

This young woman did well for a year — but unfortunately suffered another cardiac arrest, from which she could not be resuscitated. Epsilon waves are best seen in leads V1 , V2 — and a bit less well seen in V3,V4. MRI confirmed ARVC. About A RVC/ A RVD. ARVD is a genetic disorder of the myocardium.

EKG/ECG 369

EKG/ECG Resuscitation Documentation/Coding Hospitals 369

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). As may be seen in the table below, there are several themes as well a range of stringency. C., & ESCMID Study Group for Infections of the Brain (ESGIB) (2016). WHO - Who Needs an LP in the ED?

Infectious Diseases 86

Infectious Diseases Seizures Ultrasounds Sepsis 86

Dr. Smith's ECG Blog

APRIL 30, 2024

I fully acknowledge some speculation — given that we lack precise timing of these serial tracings, as well as not knowing the corresponding serum K+ level at the time each tracing was recorded. I focus my comments on: i ) The initial rhythm; and , ii ) Reasons for the dramatic changes in ST-T wave appearance between ECG #1 and ECG #2.

EKG/ECG 76

EKG/ECG CPR EMS Wellness 76

Emergency Medicine Journal

NOVEMBER 28, 2023

Method and Design Structured review of PEM studies published in three major journals between 2016-2021. Journals reviewed were Archives of Disease in Childhood, BMJ Emergency Medicine, and the Lancet Adolescent and Child Health; as well as published studies by the Paediatric Emergency Research in the UK and Ireland (PERUKI) Network.

Research 40

Research Burns Wellness 40

ACEP Now

SEPTEMBER 11, 2023

While summitting Carstensz in Indonesia in October 2015, he and his wife led a Wild Med Kilimanjaro Expedition and summited Kili in March 2016. Elbrus, the highest peak in Europe, through contacts on his Indonesia expedition and summited in August of 2016. On that same trip, they put together a trip to Russia climbing Mt.

Wellness 126

Wellness 126

The Injectable Orange

JUNE 20, 2017

While well evaluated, you see the residents go back to the shop floor and struggle to apply any of the lessons that the group agreed had been take homes from the previous sim session. How do they do it so well?” 2016 Mar;18(2):136-42. Well done”……. Debrief2Learn Sept 2016. Eppich (2016). Auerbach, A.

Head Injuries 52

Head Injuries Wellness Documentation/Coding Resuscitation 52

Don't Forget the Bubbles

AUGUST 23, 2023

Definitive emotional support is critical to our emotional and psychological well-being. 2016) “Implementation of a Post-Code Pause: Extending Post-Event Debriefing to Include Silence”. This gives rise to feelings of failure alongside the feelings of grief. Psychological harm occurs. Be kind and care for yourself and those around you.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

Don't Forget the Bubbles

AUGUST 2, 2023

carried out a retrospective chart review of children with CRPS presenting to a paediatric Chronic Pain Clinic in Canada over a 5-year period (2012 to 2016). As well as nonpharmacological treatments included physiotherapy and psychological therapy, 79% were also prescribed medication, most commonly gabapentin. Published 2016 Apr 29.

Psychiatric 98

Psychiatric Pediatrics Outcomes Academics 98

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. 2016 PMID:27075364 13 Astasio-Picado Á et al. Resuscitation. 2021 PMID: 34273470 12 Petitpas F et al.

Resuscitation 104

Resuscitation Administration Emergency Department Hospitals 104

RebelEM

AUGUST 31, 2023

CVC placement under ultrasound guidance has decreased overall complication rates and there is increased awareness of transfusion reactions, alloimmunization, acute lung injury, circulatory overload, as well as infection. Non-inferiority margin was set at 2.5% later adjusted to INR > 3.0) Median hemoglobin: 8.2 g/dl vs 8.5 ICU: 42.6%

Ultrasounds 59

Ultrasounds Outcomes Wellness Research 59

Don't Forget the Bubbles

AUGUST 7, 2023

However, that guidance needs to take into account the influence of emotion, environment, body temperature, as well as the underlying disease process, on vital signs, especially in younger infants. NICE; 2016 [cited 2023 Mar 28]. cited 2023 Mar 28]. Available from: [link] Nijman RG, Jorgensen R, Levin M, Herberg J, Maconochie IK.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

EMDocs

AUGUST 22, 2023

Published 2016 Jan 29. In cardiac arrest, EtCO 2 is dependent on compressions AND the underlying cause. Other organ system involvement & hypotension/low perfusion affect EtCO 2. PMID: 24381677 Bou Chebl R, Madden B, Belsky J, Harmouche E, Yessayan L. BMC Emerg Med. PMID: 26821648 Hemnes AR, Newman AL, Rosenbaum B, et al. Eur Respir J.

Emergency Department 67

Emergency Department Blood Transfusions Resuscitation Sepsis 67