The Skeptics' Guide to EM

APRIL 19, 2025

Reference: Kareemi et al Artificial intelligence-based clinical decision support in the emergency department: a scoping review.AEM April 2025. Date: April 15, 2025 Guest Skeptic:Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case:It may be April, but as you sit in your departmental meeting with your emergency physician colleagues, you all note that the winter surge of patients hasnt stopped.

Emergency Department 79

Emergency Department Outcomes Operations Administration 79

PEMBlog

APRIL 22, 2025

Autism spectrum disorder (ASD) is commonaffecting approximately 1 in 68 childrenand increasingly recognized in pediatric emergency departments (EDs). While we pride ourselves on providing high-quality care for all children, we must acknowledge that the noisy, fast-paced, and unpredictable environment of the ED can be especially distressing for autistic patients.

Pediatrics 89

Pediatrics Emergency Department Administration Hospitals 89

ACEP Now

APRIL 22, 2025

On a recent shift, I cared for a stroke patient with a story that, on the surface, was one that we hear all too often in Emergency Medicine. Mrs. A, as well call her, arrived hypertensive and aphasic with a hemiparesis and left-sided neglect. Family told EMS that she had no known past medical history, yet the paramedics suspected that she likely hadnt seen a doctor in many years.

Mobile Clinics 98

Mobile Clinics Stroke Ultrasounds Leadership 98

Emergency Medicine Cases

APRIL 21, 2025

In this month's EM Quick Hits podcast: Zafar Qasim & Andrew Petrosoniak on whole blood transfusion in trauma, Justin Morgenstern on calcium pre-treatment to prevent diltiazem-induced hypotension, Kiran Rikhraj on dynamic LV outflow tract obstruction, Anand Swaminathan on resuscitative thoracotomy, Andrew Tagg on uterine casts, and Jesse McLaren on scale & proportionality in occlusion MI ECG interpretation.

Blood Transfusions 82

Blood Transfusions EMS Resuscitation EKG/ECG 82

Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

Outcomes

EM Ottawa

APRIL 24, 2025

In part 1 of this 2-part series on medicolegal risk in Emergency Medicine, we looked at two legal cases, with a primary focus on civil litigation and college complaints. In this section, we focus on risk assessment, documentation, and advice from lawyers and CMPA experts, with some frequently asked questions to conclude. Check out part […] The post Law and Order: Navigating Medicolegal risk in Emergency Medicine Part 2 appeared first on EMOttawa Blog.

Documentation/Coding 76

Documentation/Coding Wellness Hospitals 76

Mind The Bleep

APRIL 22, 2025

Faltering growth (also known as failure to thrive ) describes when a child is not growing as expected. This may reflect underlying poor health or nutrition. By routinely assessing a childs height and weight throughout childhood, growth measurements can be plotted over time on centile charts and faltering growth can be identified. As causes and management of faltering growth differ by age, this article will address faltering growth in infants (children <1 year old).

Sepsis 52

Sepsis Dehydration Shock Ultrasounds 52

JournalFeed

APRIL 19, 2025

The JournalFeed podcast for the week of April 14-18, 2025. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Thursday Spoon Feed: The authors created The Sudbury Vertigo Risk Score for ED patients presenting with vertigo that may better identify those at risk for serious neurologic conditions like stroke.

Stroke 52

Stroke 52

Emergency Medicine Cases

APRIL 22, 2025

In this ECG Cases blog Dr. Jesse McLaren guides us through 6 illustrative cases delving into overall impression in identifying occlusion MI. He discusses how using multiple OMI findings such as acute Q wave, subtle STE, reciprocal STD, hyperacute T waves, and reciprocal TWI to contribute to your overall impression, can double the sensitivity of STEMI criteria for acute coronary occlusion.

EKG/ECG 53

EKG/ECG EMS 53

EMDocs

APRIL 19, 2025

We always work hard, but we may not have time to read through a bunch of journals. Its time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: New Sudbury Vertigo Risk Score Derivation Spoon Feed The Sudbury Vertigo Risk Score helps identify patients at risk for stroke, has remarkable sensitivity for serious neurologic pathology, but has yet to be validate

Emergency Department 47

Emergency Department Stroke 47

Sensible Medicine

APRIL 22, 2025

In the coming weeks Vinay, John, and I (Adam) will be getting together in person. We are meeting to work on what we think will be some really valuable Sensible Medicine content. Since we will have some time together, we thought it would be a good time to gather some more questions to answer. Same rules as last time: the comments are open to all paid subscribers to pose questions.

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The Bottom Line

APRIL 23, 2025

Whats new in the Critical Care literature monthly updates

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91

Emergency Medicine Journal

APRIL 22, 2025

Dignity in emergency care The very essence of quality in emergency care is predicated on our understanding of vulnerability and respect for the dignity of our patients. These two principles of bioethics are often inextricably linked and can so easily be compromised despite our best intentions in the maelstrom and crowding of today’s emergency departments.

Emergency Department 85

Emergency Department 85

EMCrit

APRIL 24, 2025

Fall from standing with some pretty concerning symptoms of spinal cord injury. EMCrit Project by Scott Weingart, MD FCCM.

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Core Medical Group

APRIL 25, 2025

Welcome back Chris Leo! He's a passionate recruiter connecting clinicians with their dream jobs. Explore his journey and dedication to personalized healthcare recruitment in this blog.

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The Bottom Line

APRIL 23, 2025

Whats new in the Critical Care literature monthly updates

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Emergency Medicine Journal

APRIL 22, 2025

Background The role of video laryngoscopy in critically ill patients requiring emergency tracheal intubation remains controversial. This systematic review and meta-analysis aimed to evaluate whether video laryngoscopy could improve the clinical outcomes of emergency tracheal intubation. Methods We searched the PubMed, Embase, Scopus and Cochrane databases up to 5 September 2024.

Outcomes 69

Outcomes Emergency Department Operations Hospitals 69

ECG Guru

APRIL 24, 2025

Sometimes a single Holter ECG can tell a whole story. Here we see a single-channel ECG, each line representing about 30 seconds. The ECG is from a 56-year-old man with severe ischemic cardiomyopathy who had an ICD implanted a few months ago due to recurrent ventricular tachycardia. The explanation of what can be seen on this ECG can be found on the 2nd image.

EKG/ECG 52

EKG/ECG Shock 52

Ultrasound Gel

APRIL 21, 2025

New series alert! GEL World is about bringing together the global ultrasound community. In this first episode, we travel to Ireland with ultrasound champion Dr. Cian McDermott. [link] New series alert! GEL World is about bringing together the global ultrasound community. In this first episode, we travel to Ireland with ultrasound champion Dr. Cian McDermott.

Ultrasounds 52

Ultrasounds 52

EMergucate

APRIL 20, 2025

The following 66yr old man went to the GP for a health check up, the GP found him to be bradycardic and referred him to ED.

EKG/ECG 52

EKG/ECG EMS 52

Emergency Medicine Journal

APRIL 22, 2025

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.

Research 52

Research 52

Board Bombs

APRIL 20, 2025

Let's tackle an oral boards-style EM case. Watch Blake as he is quizzed by Iltifat on the fly. Learn high-yield strategies, pitfalls, and what examiners expect on the EM Oral Boards. Let's tackle an oral boards-style EM case. Watch Blake as he is quizzed by Iltifat on the fly. Learn high-yield strategies, pitfalls, and what examiners expect on the EM Oral Boards.

EMS 52

EMS 52

The Trauma Pro

APRIL 22, 2025

I found an interesting paper published a couple of years ago that purports to examine individual surgeon outcomes after trauma laparotomy. This was presented at the annual AAST meeting in 2021 and then published in the Journal the following year. Everyone seems to be giving this paper a pass. I won’t be so easy on it. Let me provide some details.

Resuscitation 113

Resuscitation Outcomes Operations Shock 113

EMDocs

APRIL 21, 2025

Welcome to the emDOCs Videocast please subscribe to our YouTube channel. These videos will cover post summaries, take homes on clinical condition, and EBM/guideline literature updates. Today we focus on providing a prescription for patients with asymptomatic hypertension (HTN) from the ED setting. Article #1: Todd BR, Xing Y, Zhao L, et al. Antihypertensive prescription is associated with improved 30-day outcomes for discharged hypertensive emergency department patients.

Emergency Department 60

Emergency Department Outcomes Stroke Hospitals 60

Emergency Medicine Journal

APRIL 22, 2025

This month’s update is by the Emergency Departments (EDs) from R Jolad Hospital, Lagos and University College Hospital, Ibadan, in Nigeria. We used a multimodal search strategy, drawing on free, open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlighted the main findings, key limitations and clinical bottom line for each paper.

Emergency Department 52

Emergency Department Hospitals Outcomes 52

PulmCCM

APRIL 24, 2025

Email cut off? Click the title to view the whole post online or in the Substack app. -Ed. ARDS, Mechanical Ventilation Inhaled volatile anesthetics vs propofol for sedation in vented patients (SESAR Trial) All sedatives have side effects; other than limiting sedation to the minimal necessary dose during mechanical ventilation, the optimal approach (if one exists) has always been unclear.

Sepsis 52

Sepsis Shock Hospitals Academics 52

Ken Grauer, MD

APRIL 25, 2025

== INTRO: I have added this Tab on Technical "Misadventures" to the Menu at the top of every page in this ECG Blog: Where to find this LINK in the Top Menu! All-too-often lead reversals, unsuspected artifact, and other "technical misadventures" go unrecognized with resultant erroneous diagnostic and therapeutic implications. In the hope of facilitating recognition of these cases I am developing an ongoing listing on this page with LINKS to examples that Ive published in this ECG Blog, as we

EKG/ECG 291

EKG/ECG Hyperthermia / Hypothermia Wellness 291

Pediatric EM Morsels

APRIL 25, 2025

We have previously discussed our “love” of rashes ! Ok, maybe we are still lukewarm when it comes to skin eruptions, but we cannot deny the important clues that we may decipher from a good derm exam! This is especially true when we are facing the complaint of weakness and muscle pain. There are a lot of considerations on our list when we are pondering the child who complains of muscle weakness !

Pediatrics 144

Pediatrics Outcomes Research EMS 144

Emergency Medicine Journal

APRIL 22, 2025

A short systematic review was undertaken to establish whether the use of a nasal clip is superior to manual compression as first aid in patients presenting to the ED with epistaxis. A systematic keyword search of EMBASE, MEDLINE, Cochrane and Google Scholar databases returned two relevant papers. The author, year, country of publication, patient group studied, study type, key findings and weaknesses are tabulated.

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Don't Forget the Bubbles

APRIL 21, 2025

Take a moment to appreciate the irony. We spend so much time learning a new language during medical training that it grants us access to an exclusive club. That language gets fine-tuned through more training and further specialization. At the same time, as we sit through standardized patient or observed structured clinical examinations, we are often evaluated and critiqued based on the clarity of the language we use to communicate with our patients.

Outcomes 131

Outcomes Pediatrics Best Practices Academics 131

Ken Grauer, MD

APRIL 19, 2025

The lead II rhythm strip shown below in Figure-1 was obtained from an older man who was on multiple medications and, who presented to the hospital with shortness of breath. QUESTION: The concern regarding this rhythm strip was whether this patient was having intermittent episodes of Torsades de Pointes or of PMVT ( P oly M orphic V entricular T achycardia )?

EKG/ECG 273

EKG/ECG Seizures Hospitals 273

Dr. Smith's ECG Blog

APRIL 25, 2025

This was written by Hans Helseth. Paramedics arrived at the house of a 59 year old man after his caretaker called 911 for altered mental status. He was lethargic and slow to respond to questions. He was found to be hypotensive with systolic pressures in the 70s and 80s. An EKG was recorded: What do you think? This EKG shows the same 2.5 seconds as recorded by all 12 leads, so it is not ideal for rhythm analysis.

EKG/ECG 104

EKG/ECG Hyperthermia / Hypothermia Sepsis Hospitals 104

Emergency Medicine Journal

APRIL 22, 2025

Background Female patients with lower limb fractures experience pain and loss of dignity when manoeuvered onto a bedpan. Poor bladder management, including urinary catheterisation for convenience, can lead to longer hospital stays and eventual loss of independence. Staff at Great Western Hospital Emergency Department modify disposable male urinal bottles to accommodate the female perineum without need to reposition the patient.

Fractures 52

Fractures Ambulance Services Trauma Department Emergency Department 52

EMDocs

APRIL 25, 2025

Originally published at The Pediatric EMS Podcast on March 5, 2035. Reposted with permission. Please visit their site HERE to see all the amazing podcasts or subscribe to their RSS HERE. This is the Pediatric EMS Podcast with the mission to provide case-based discussion with evidence-based recommendations by content experts in prehospital pediatric medicine in order to advance the care of children outside the hospital.

Pediatrics 97

Pediatrics EMS Head Injuries Hyperthermia / Hypothermia 97

Northwestern EM Blog

APRIL 22, 2025

Written by: Sasha Becker (NUEM 27) Edited by: Mike Tandlich (NUEM 24 ) Expert Commentary by: David Zull, MD Expert Commentary The emergency physician should be an expert regarding STEMI equivalents. This is the advanced course. Hyperacute T waves Hyperacute T waves refer to tall broad based symmetric T waves (not pointy Ts as seen in hyperkalemia). The hyperacute T wave may sometimes encroach upon the QRS leading to an upsloping ST segment.

Shock 96

Shock Hospitals Wellness 96

Dr. Smith's ECG Blog

APRIL 21, 2025

Written by Pendell Meyers An elderly patient experienced a week of shortness of breath on exertion, with acute worsening including near syncope and severe fatigue. She called EMS, who recorded this ECG on the way to the hospital: What do you think? On arrival at the Emergency Department, she appeared critically ill, and had severe hypotension but was alert and oriented and able to follow commands.

EKG/ECG 94

EKG/ECG Ultrasounds EMS Emergency Department 94

Emergency Medicine Journal

APRIL 22, 2025

Introduction The pericapsular nerve group (PENG) block provides analgesia for patients with hip fractures and claims to provide a sensory-only block without motor weakness. 1 2 It targets the accessory branches of the femoral and obturator nerve as they course past the psoas muscle to innervate the anterior hip. However, recent studies have shown quadriceps weakness associated with the PENG block. 3 4 One theory is that anaesthetic spreads via accidental rupture of the iliopectineal bursa, allow

Fractures 52

Fractures 52