The Skeptics' Guide to EM

DECEMBER 16, 2023

Reference: Punches el al. Clinical Question: How can patient perceptions of microaggressions that occur during an ED visit inform potential interventions and prevent future occurrences? Patient Perceptions of Microaggressions and Discrimination Towards Patients During Emergency Department Care. AEM Dec 2023.

Emergency Department 119

Emergency Department Research Outcomes 119

ALiEM

OCTOBER 11, 2023

Tharwat El Zahran, Bryan Judge, and Louise Kao. Kotipoyina HR, Kong EL, Warrington SJ. More specific therapies have been trialed and may become an option in the future. The American College of Medical Toxicology hosts this Toxicology Visual Pearls series. The post was peer reviewed on behalf of ACMT by Drs. Channels (Austin).

Poisoning 81

Poisoning Burns Wellness Outcomes 81

Dr. Smith's ECG Blog

JANUARY 21, 2023

Case submitted and written by Dr. Mazen El-Baba and Dr. Evelyn Dell, with edits from Jesse McLaren EMS brought a John Doe, in his 30s, who was found in an urban forest near a homeless encampment on a cool fall day. El-Baba, Dell and McLaren. El-Baba, Dell and McLaren ) between severity of hypothermia and the size of Osborn Waves.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Case submitted and written by Mazen El-Baba MD, with edits from Jesse McLaren and edits/comments by Smith and Grauer A 90-year old with a past medical history of atrial fibrillation, type-2 diabetes, hypertension, dyslipidemia, presented with acute onset chest/epigastric pain, nausea, and vomiting. BP was 110 and oxygen saturation was normal.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

SheMD

MAY 18, 2023

Rangel EL, Smink DS, Castillo-Angeles M, Kwakye G, Changala M, Haider AH, Doherty GM. Childbearing and Family Leave Policies for Physicians at US Children's Hospitals. 2022 Dec 14:S0022-3476(22)01125-8. doi: 10.1016/j.jpeds.2022.12.008. 2022.12.008. Epub ahead of print. PMID: 36528054. Pregnancy and Motherhood During Surgical Training.

Academics 52

Academics Pediatrics Outcomes Hospitals 52

ACEP Now

MAY 4, 2023

References Bruner DI, Ventura EL, Devlin JJ. Morgan Leadbetter works at Michigan State University College of Osteopathic Medicine. Dr. Rader works at Ascension Macomb-Oakland Hospital. Dr. Fishman is an associate program director at Ascension Macomb-Oakland Hospital. Scrotal pyocele: uncommon urologic emergency. J Emerg Trauma Shock.

Urgent Care 52

Urgent Care Ultrasounds Sepsis Emergency Department 52

ACEP Now

AUGUST 8, 2023

Growing up in my village of Deir-el-Qamar, or Monastery of the Moon, a reference to a Phoenician temple in the mountains of Lebanon, we had native fig trees everywhere. Rothrock MD, FACEP, FAAP Re: “Toxicology Q&A: The Fig Tree” I read with great interest Dr Hack’s article on the toxicity of fig trees.

Shock 52

Shock Hospitals Wellness 52

Broome Docs

JUNE 20, 2023

PMID: 36942789 ESCAPe: Meduri GU, Shih MC, Bridges L, Martin TJ, El-Solh A, Seam N, Davis-Karim A, Umberger R, Anzueto A, Sriram P, Lan C, Restrepo MI, Guardiola JJ, Buck T, Johnson DP, Suffredini A, Bell WA, Lin J, Zhao L, Uyeda L, Nielsen L, Huang GD; ESCAPe Study Group. Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med.

Emergency Department 135

Emergency Department Sepsis Best Practices 135

Taming the SRU

FEBRUARY 14, 2024

REFERENCES El-Saied S, Puterman M, Kaplan DM, Cohen-Lahav M, Joshua BZ. EDITING AND LAYOUT BY MARTINA DIAZ MCDERMOTT, MD Dr. Diaz is a PGY-4 resident in Emergency Medicine at the University of Cincinnati and the current Resident Editor of Ultrasound of the Month. Otolaryngol--Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg.

Ultrasounds 86

Ultrasounds Emergency Department Wellness 86

ACEP Now

OCTOBER 30, 2023

Yocum AD, Simon EL, Dennison JL. Open Access Emerg Med. 2022; 14: 441–456. Poffenberger C, Backster A, Rotoli J. Emergency physicians’ perspective: caring for persons with disabilities. EM Resident. 2023;50(1):58–59. Esophageal obstruction and death in a nonverbal patient. J Emerg Med. 2021;60(5):e109-e113.

Sexual Assault 98

Sexual Assault Teamwork Outcomes Dehydration 98

Taming the SRU

SEPTEMBER 8, 2023

Darweesh SK, Ibrahim MF, El-Tahawy MA. Role of N-acetylcysteine in non-acetaminophen-related acute liver failure: an updated meta-analysis and systematic review. Ann Gastroenterol. 2021;34(2):235-240. doi: 10.20524/aog.2021.0571. Epub 2021 Jan 4. PMID: 33654365; PMCID: PMC7903568. Clin Drug Investig. 2017 May;37(5):473-482.

Radiology 59

Radiology Radiology Ultrasounds EMS 59

ALiEM

AUGUST 16, 2023

PMID 17272524 El-Husseini A, Azarov N. J Cardiothorac Vasc Anesth. 2014;28(4):1043-1047. doi:10.1053/j.jvca.2013.02.005. 2013.02.005. PMID 23953868 Mack E. Focus on diagnosis: co-oximetry. Pediatr Rev. 2007;28(2):73-74. doi:10.1542/pir.28-2-73. Is threshold for treatment of methemoglobinemia the same for all? Am J Emerg Med. 2010;28(6):748.e5-748.e10.

Poisoning 52

Poisoning Seizures Administration Pediatrics 52

Don't Forget the Bubbles

JUNE 14, 2023

El Helou R, et al. Nailfold Capillaroscopy: A Promising Non-invasive Approach to Predict Retinopathy of Prematurity. York D, et al. 2023 May 12:113478. Bacteremia in Children With Fever and Acute Lower Extremity Pain. Pediatrics. 2023 May 1;151(5):e2022059504. Phase 3 Trial of Epicutaneous Immunotherapy in Toddlers with Peanut Allergy.

Pediatrics 119

Pediatrics Point-of-Care Testing Outcomes Hospitals 119

Don't Forget the Bubbles

SEPTEMBER 27, 2023

link] [link] Innis K, Hasson D, Bodilly L, Sveen W, Stalets EL, Dewan M. Community surveillance of respiratory viruses among families in the Utah better identification of germs-longitudinal viral epidemiology (Big-love) study. Clin Infect Dis. 2015;61(8):1217-1224. Do I need proof of the culprit? Hosp Pediatr. 2021;11(1):e1-e5.

Emergency Department 84

Emergency Department Pediatrics Point-of-Care Testing Hospitals 84

EMDocs

MARCH 30, 2024

doi:10.4103/0019-5413.143914 Inaoka T, Ohashi K, El-Khoury GY, Singh H, Berbaum KS. J Spinal Cord Med. 2019;42(4):416-422. doi:10.1080/10790268.2018.1433267 Rajasekaran S, Kanna RM, Shetty AP. Management of thoracolumbar spine trauma: An overview. Indian J Orthop. 2015;49(1):72-82. Jpn J Radiol. 2012;30(8):617-623.

EMS 88

EMS Fractures Emergency Department Dislocations 88

The Skeptics' Guide to EM

FEBRUARY 6, 2021

Background: Chronic marijuana use was recognized by Allen el al in 2004 to cause cyclical vomiting in patients from South Australia. You suspect he has cannabis hyperemesis syndrome and discharge him home with the recommendation to stop smoking as much weed.

Hospitals 40

Hospitals Emergency Department Ultrasounds EMS 40

Dr. Smith's ECG Blog

JUNE 19, 2023

Written by Kaley El-Arab MD, edits by Pendell Meyers and Stephen Smith A 61-year-old male with hypertension and hyperlipidemia presented to the emergency department for chest tightness radiating to the back of his neck that has been intermittent for the past day or two. Here is his triage ECG which was obtained at 20:34 during active pain.

EKG/ECG 52

EKG/ECG Shock Emergency Department 52

Taming the SRU

JULY 24, 2023

2013;75(S1):261-5 Weerakkody Y, Di Muzio B, El-Feky M, et al. Bhatwal AS, Deolekar SR, Karandikar SS. An unusual presentation of gall bladder perforation with hepatic subcapsular collection. Indian J Surg. Gallbladder perforation. Reference article, Radiopaedia.org (Accessed on 11 Jun 2023) [link] Niemeier OW. 1934 Jun;99(6):922-4.

Ultrasounds 68

Ultrasounds Sepsis Radiology Radiology 68

Don't Forget the Bubbles

JANUARY 17, 2024

Zamora IJ, Vu LT, Larimer EL, et al. Managing the Destructive Foreign Body: Water Beads in the Ear (A Case Series) and Literature Review. Annals of Otology, Rhinology & Laryngology , 132 (9), pp.1090-1095. Water-absorbing balls: a “growing” problem. Pediatrics. 2012;130:e1011–e1014 The post Don’t Forget the Orbeez!

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

Taming the SRU

OCTOBER 1, 2023

doi:10.1016/0011-5029(92)90007-c Cheng YJ, Chou SH, Kao EL. 2010.04.030 Brown SGA, Ball EL, Perrin K, et al. Primary and Secondary Spontaneous Pneumothorax: Prevalence, Clinical Features, and In-Hospital Mortality. Can Respir J. 2017;2017:6014967. doi:10.1155/2017/6014967 Light RW. Pleural diseases. 1992;38(5):266-331. Resuscitation.

Fractures 85

Fractures COPD Hospitals Emergency Department 85

EMDocs

AUGUST 12, 2023

El fleksör tendon onarımı sonrası reoperasyonu öngören faktörler. Treasure Island (FL): StatPearls Publishing; February 5, 2023. Çalışkan Uçkun A, Yurdakul FG, Ergani HM, et al. Factors predicting reoperation after hand flexor tendon repair. Ulus Travma Acil Cerrahi Derg. 2020;26(1):115-122. doi:10.14744/tjtes.2019.92590

EMS 68

EMS Fractures Operations Ultrasounds 68

EMDocs

NOVEMBER 4, 2023

doi:10.1007/s13244-016-0503-8 Bruner DI, Ventura EL, Devlin JJ. Cross-sectional imaging of complicated urinary infections affecting the lower tract and male genital organs. Insights Imaging. 2016;7(5):689-711. Scrotal pyocele: Uncommon urologic emergency. J Emerg Trauma Shock. 2012;5(2):206.

EMS 67

EMS Ultrasounds Emergency Department Infectious Diseases 67

Sensible Medicine

SEPTEMBER 29, 2023

Available from: [link] [2] Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PW. References [1] D’Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General Cardiovascular Risk Profile for Use in Primary Care. Circulation. 2008 Feb;117(6):743-53. Resuscitation. 2014;85(5):587-94. [3]

Research 58

Research Hospitals Academics Emergency Department 58

Dr. Smith's ECG Blog

APRIL 2, 2014

There is little ST el evation in inferior leads. Then the patient complained of increasing pain again: There is now profound ST dep ression and STE in aVR , a nd the ST depression extends deeply in V5 and V6. This time, the ST vector is more rightward, toward aVR and also posterior.

EKG/ECG 52

EKG/ECG Operations Wellness Outcomes 52

Don't Forget the Bubbles

MAY 10, 2023

2021;40:4-6 El-Shafy IA, Delgado J, Akerman M, Bullaro F, Christopherson NAM, Prince JM. Selected references Diaz-Navarro C, Leon-Castelao E, Hadfield A, Pierce S, Szyld D. Clinical debriefing: TALK© to learn and improve together in healthcare environments. Trends in Anaesthesia and Critical Care. Journal of Surgical Education.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

Sensible Medicine

SEPTEMBER 29, 2023

Available from: [link] [2] Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PW. References [1] D’Agostino RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General Cardiovascular Risk Profile for Use in Primary Care. Circulation. 2008 Feb;117(6):743-53. Resuscitation. 2014;85(5):587-94. [3]

Research 40

Research Hospitals Academics Emergency Department 40

EMDocs

NOVEMBER 18, 2023

2017.12.039 25) Rayan El Sibai, Sari R. Gastrointest Endosc. 2011;73(5):955-962. doi:10.1016/j.gie.2010.12.014 2010.12.014 24) Senter-Zapata M, Khan AS, Subramanian T, et al. Patient and Graft Survival: Biliary Complications after Liver Transplantation. J Am Coll Surg. 2018;226(4):484-494. doi:10.1016/j.jamcollsurg.2017.12.039 Freedman, J.

EMS 67

EMS Ultrasounds Emergency Department Outcomes 67

Mount Sinai EM

APRIL 20, 2024

Right now nationalities included are El Salvador, Haiti, Honduras, Nepal, Nicaragua, and Sudan – DACA: people who were brought to the US as children before 2007 without immigration status can be given work authorization.

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100

ACEP Now

FEBRUARY 11, 2024

Abu Sabaa MA, Elbadry AA, El Malla DA: Ultrasound-guided clavipectoral block for postoperative analgesia of clavicular surgery: A prospective randomized trial. Atalay YO, Mursel E, Ciftci B, et al. Clavipectoral fascia plane block for analgesia after clavicle surgery. Rev Esp Anestesiol Reanim (Engl Ed). 2019;66(10):562–563. Anesth Pain Med.

Ultrasounds 52

Ultrasounds Fractures Emergency Department Hospitals 52

RebelEM

FEBRUARY 5, 2024

PMID: 29452099 Brown SGA, Ball EL, Perrin K, et al. A Systematic Review and Meta-Analysis Comparing Pigtail Catheter and Chest Tube as the Initial Treatment for Pneumothorax. 2018;153(5):1201-1212. Conservative versus Interventional Treatment for Spontaneous Pneumothorax. N Engl J Med. 2020;382(5):405-415.

Outcomes 82

Outcomes Hospitals Research Emergency Department 82

Don't Forget the Bubbles

JULY 17, 2023

Malchau Carlsen EL, et al. Eur J Pediatr. 2023 Jun 19 Switch from intravenous-to-oral antibiotics in neonatal probable and proven early-onset infection: a prospective population-based real-life multicentre cohort study. Arch Dis Child Fetal Neonatal Ed. Plamondon A, et al. JAMA Pediatr.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

ACEP Now

APRIL 4, 2024

Ho VT, Tran K, George EL, et al. Screening for Abdominal Aortic Aneurysm: US Preventive Services Task Force Recommendation Statement. 2019;322:2211-2218. Patients with abdominal aortic aneurysm. Accessed 2/3/24. Most privately insured patients do not receive Federally recommended abdominal aortic aneurysm screening.

Operations 40

Operations Ultrasounds Emergency Department 40

RebelEM

DECEMBER 10, 2023

References Abdulrahman Y, Musthafa S, Hakim SY, Nabir S, Qanbar A, Mahmood I, Siddiqui T, Hussein WA, Ali HH, Afifi I, El-Menyar A, Al-Thani H. Prior high-quality literature clearly supports the superiority of US and this should continue to be our primary modality. World J Surg. 2015 Jan;39(1):172-8. doi: 10.1007/s00268-014-2781-y.

Ultrasounds 40

Ultrasounds Emergency Department Wellness EMS 40

Don't Forget the Bubbles

SEPTEMBER 18, 2023

Community-acquired pneumonia Addo-Yobo E, Anh DD, El-Sayed HF, Fox LM, Fox MP, MacLeod W, et al. Comparison of Centor and McIsaac scores in primary care: a meta-analysis over multiple thresholds. Br J Gen Pract. 2020 Apr;70(693):e245–54. Trop Med Int Health TM IH. 2011 Aug;16(8):995–1006.

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

PEMBlog

DECEMBER 14, 2023

Isaac A, Zhang H, Soon SR, Campbell S, El-Hakim H. Boogaard R, Huijsmans SH, Pijnenburg MW, Tiddens HA, de Jongste JC, Merkus PJ. Tracheomalacia and bronchomalacia in children: incidence and patient characteristics. 2005 Nov;128(5):3391-7. A systematic review of the evidence on spontaneous resolution of laryngomalacia and its symptoms.

Wellness 52

Wellness Pediatrics 52

EB Medicine

MARCH 1, 2019

El-Chami MF, Nicholson W, Helmy T. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S301-S306. Guideline) 22.* Schultz JM, Trunkey DD. Blunt cardiac injury. Crit Care Clin. 2004;20(1):57-70. Review article) 23.* Blunt cardiac trauma. J Emerg Med. 2008;35(2):127-133. Review article) 27.* Bock JS, Benitez RM. Blunt cardiac injury. Cardiol Clin.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

Sensible Medicine

MAY 21, 2023

As it stands, the FDA required limited safety data, and the minimum sample size should have been increased following the signal of preterm births in the phase 2b trial, as was pointed out by Hana El Sahly, M.D., the VRBPAC Chair. This should have been required by the FDA.

Outcomes 87

Outcomes Hospitals Research 87