Emergency Medicine Journal

SEPTEMBER 27, 2023

Jones SR, Carley S, Harrison M. An introduction to power and sample size estimation. Emerg Med J 2003;20:453–8. doi: 10.1136/emj.20.5.453. Following recent feedback from a reader, the authors have corrected this article.

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Broome Docs

APRIL 30, 2024

Pfizer… pft… not so EPIC SR Hammond J, Fountaine RJ, Yunis C, Fleishaker D, Almas M, Bao W, Wisemandle W, Baniecki ML, Hendrick VM, Kalfov V, Simón-Campos JA, Pypstra R, Rusnak JM. Crit Care Med. 2024 Apr 1;52(4):521-530. doi: 10.1097/CCM.0000000000006176. 0000000000006176. PMID: 38240498.

Poisoning 70

Poisoning Dislocations Operations Ultrasounds 70

PulmCCM

JANUARY 29, 2022

To answer these questions, the on-going EPIC-SR [ Evaluation of Protease Inhibition for COVID-19 in Standard-Risk ] patients is on-going. Thoughts The results of EPIC-SR [i.e., Given that enrollment in EPIC-SR will overlap with the omicron variant, there might concern that this confounds final results.

Hospitals 40

Hospitals Outcomes Wellness Pediatrics 40

SheMD

AUGUST 24, 2023

Turner SR, Artz JD, Darling GE, Donahoe LL, Kidane B, Seely AJE, Valji RH, Plourde M; Canadian Association of Thoracic Surgeons Equity, Diversity and Inclusion Task Force. Emergency medicine in Switzerland: an analysis of physician workforce, gender equality and academics. Swiss Med Wkly. 2022 Oct 8;152:40001. doi: 10.57187/smw.2022.40001.

Leadership 52

Leadership Academics Outcomes Wellness 52

Pediatric Emergency Playbook

MARCH 1, 2018

The crying infant: diagnostic testing and frequency of serious underlying disease. Pediatrics. 2009; 123(3):841-8 Herman M, Le A. The crying infant. Emerg Med Clin North Am. 2007 Nov;25(4):1137-59. The infant with acute, unexplained, excessive crying. Pediatrics. 1991; 88 (3): 450-5. Prentiss KA, Dorfman DH.

Pediatrics 52

Pediatrics Emergency Department 52

Taming the SRU

MARCH 10, 2024

The 6 can’t miss ECG diagnosis for syncope: MNEMONIC: “QT-BRIDE”: Prolonged or shortened QT Brugada or AV Blockade Right heart strain Ischemia/Infarction Delta wave (seen in WPW) Epsilon wave (seen in ARVD) Clinical decision making tools: San Francisco SR: likely to increase admission rates for syncope.

EKG/ECG 86

EKG/ECG Shock Wellness EMS 86

The Skeptics' Guide to EM

SEPTEMBER 12, 2020

My struggle with Burnout My struggle with burnout included the death of my father ( Dr. Ken Milne Sr. ) The moral injury of physicians is being unable to provide high-quality care they want to provide to their patients.

Emergency Department 52

Emergency Department Wellness 52

Resus Review

SEPTEMBER 12, 2015

Tweet MS, Hayes SN, Pitta SR, et al. Tweet MS, Eleid MF, Best PJ, et al. Spontaneous coronary artery dissection: revascularization versus conservative therapy. Circ Cardiovasc Interv 2014;7:777–86. Clinical Features, Management and Prognosis of Spontaneous Coronary Artery Dissection. Circulation 2012;126:579–88.

Shock 52

Shock Outcomes 52

PulmCCM

OCTOBER 23, 2023

However, randomized and observational studies have not shown nirmatrelvir-ritonavir to benefit people of average risk with Covid-19 in the Omicron era: Concurrent to EPIC-HR was the less well-known EPIC-SR (for “standard risk”) trial, which Pfizer stopped quietly before completion when Paxlovid was not found to be reducing hospitalizations (..)

Hospitals 98

Hospitals Emergency Department COPD CDC 98

The Skeptics' Guide to EM

JUNE 27, 2020

A good randomized control trial (RCT) can be more informative than a systematic review (SR) that only includes low quality study (GIGO – garbage in, garbage out). The hierarch is usually described as a pyramid with the lowest form of evidence being expert opinion and the highest level being a systematic review.

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Northwestern EM Blog

APRIL 25, 2022

2020; [link] Konda SR, Howard D, Davidovitch RI, Egol KA. 0b013e31828211f3 Konda SR, Davidovitch RI, Egol KA. Acepnow magazine. The saline load test of the knee redefined: a test to detect traumatic arthrotomies and rule out periarticular wounds not requiring surgical intervention. Journal of orthopaedic trauma. 2013;27(9):491-497.

Soft Tissue Injuries 52

Soft Tissue Injuries Fractures Sepsis Documentation/Coding 52

ACEP Now

JUNE 21, 2023

2004.03.019 Hayden SR, Panacek EA. The effect of emergency medicine residency format on pursuit of fellowship training and an academic career. Acad Emerg Med. Sep 2004;11(9):938-43. doi:10.1197/j.aem.2004.03.019 Procedural competency in emergency medicine: the current range of resident experience. Acad Emerg Med. Jul 1999;6(7):728-35.

EMS 114

EMS Academics Telemedicine Operations 114

PHEM Cast

MARCH 3, 2019

Newton A, Fitton L. Intravenous ketamine for adult procedural sedation in the emergency department: a prospective cohort study. Emerg Med J. 2008 Aug 1;25(8):498–501. Bailard NS. The Emerging Use of Ketamine for Anesthesia and Sedation in Traumatic Brain Injuries. CNS Neuroscience & Therapeutics. 2013; 19: 390–395 Morris C.

Emergency Department 52

Emergency Department Head Injuries Hospitals Pediatrics 52

PHEM Cast

APRIL 21, 2021

Annals of Emergency Medicine 2006; 47(6):548-555 Lewis SR, Butler AR, Parker J, Cook TM, Smith AF. Laryngeal View During Laryngoscopy: A Randomized Trial Comparing Cricoid Pressure, Backward-Upward-Rightward Pressure, and Bimanual Laryngoscopy. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation.

Airway Management 52

Airway Management Resuscitation Hospitals EMS 52

Taming the SRU

JULY 24, 2023

Bhatwal AS, Deolekar SR, Karandikar SS. [link] Suleiman J, Mremi A, Tarmohamed M, Sadiq A, Lodhia J, Concealed gallbladder perforation: a rare case report, Journal of Surgical Case Reports, Volume 2021, Issue 6, June 2021, rjab245, [link] Date RS, Thrumurthy SG, Whiteside S, Umer MA, Pursnani KG, Ward JB, Mughal MM. Int J Surg. Indian J Surg.

Ultrasounds 68

Ultrasounds Sepsis Radiology Radiology 68

Taming the SRU

FEBRUARY 5, 2024

Vickers A, Donnelly JP, Moore JX, Barnum SR, Schein TN, et al. Frederiks, J. A., & Koehler, P. The first lumbar puncture. Journal of the history of the neurosciences, 6(2), 147–153. 2018) Epidemiology of lumbar punctures in hospitalized patients in the United States. PLOS ONE 13(12): e0208622.

Infectious Diseases 86

Infectious Diseases Seizures Ultrasounds Sepsis 86

ACEP Now

NOVEMBER 16, 2023

Hayden SR, Panacek EA. Lubavin BV, Langdorf MI, Blasko BJ. The effect of emergency medicine residency format on pursuit of fellowship training and an academic career. Acad Emerg Med. 2004;11(9):938-43. Procedural competency in emergency medicine: the current range of resident experience. Acad Emerg Med. 1999;6(7):728-35. Beeson et al.

Academics 52

Academics EMS Research Telemedicine 52

The Skeptics' Guide to EM

NOVEMBER 24, 2018

A few months leading up to the presentation my dad, Dr. Ken Milne Sr. [display_podcast] Date: November 24th, 2018 As you may know, I was invited to give a keynote address on burnout at the Australasia College of Emergency Medicine 2018 Annual Scientific Meeting ( #ACEM18 ) in Perth, Australia. This turned out to be a very meta event.

Hospitals 52

Hospitals Emergency Department 52

Pediatric Education

JUNE 18, 2023

17462 Chorney SR, Rizzi MD, Dedhia K. Pediatr Dermatol. 2019;36(1):16-23. doi:10.1111/pde.13725 13725 Aharaz A, Jemec GBE, Hay RJ, Saunte DML Tinea capitis asymptomatic carriers: what is the evidence behind treatment? J Eur Acad Dermatol Venereol. 2021;35(11):2199-2207. doi:10.1111/jdv.17462 Am J Otolaryngol. 2020;41(6):102737.

Allergic Reactions 40

Allergic Reactions Poisoning Pediatrics Infectious Diseases 40

EMDocs

AUGUST 12, 2023

link] Venkatramani H, Varadharajan V, Bhardwaj P, Vallurupalli A, Sabapathy SR. J Ultrason. 2021;21(87):e306-e317. doi:10.15557/JoU.2021.0052 2021.0052 Bates S. Flexor Tendon Anatomy. April 9, 2013. Accessed June 4, 2023. Flexor tendon injuries. J Clin Orthop Trauma. 2019;10(5):853-861. doi:10.1016/j.jcot.2019.08.005 1981;245(10):1055–1056.

EMS 68

EMS Fractures Operations Ultrasounds 68

Dr. Smith's ECG Blog

SEPTEMBER 17, 2023

The presenting ECG shows SR with narrow QRS complexes. Vital signs unremarkable except borderline hypotension with a systolic BP about 102 mmHg. The following ECG was recorded. Here the image quality is enhanced using the PM Cardio app. What do you think? There is normal R-wave progression in the precordial leads with no evidence of ischemia.

EKG/ECG 86

EKG/ECG COPD Wellness Shock 86

Dr. Smith's ECG Blog

OCTOBER 8, 2023

There is SR. Also maybe hypothermia will unmask or even accentuate BTWI findings? How did the Queen of Heart AI model perform? False positive ECG#4 This ECG was recorded in a patient post ROSC. V1-V3) The QRS may appear very wide, but it is not.

Hyperthermia / Hypothermia 97

Hyperthermia / Hypothermia EKG/ECG Wellness Shock 97

Sensible Medicine

OCTOBER 16, 2023

They then analyzed the two groups—SR vs AF—for a primary endpoint of total mortality. The graph shows the clear results: For patients with SR at baseline, beta-blocker use reduced the risk of death by a whopping 27%. Benefit when in SR. Slowing the rate in AF may not confer the same benefits that it does in SR.

Evidence-Based Practice 106

Evidence-Based Practice Hospitals Wellness Outcomes 106

ACEP Now

MARCH 14, 2024

Scalise P, Prunk SR, Healy D, et al. 169:334-48. Quereshi AZ. Fatal innominate artery hemorrhage in a patient with tetraplegia: case report and literature review. Ann Thorac Cardiovasc Surg. 2013:1960-62. 2005;128: 3906-9.

Operations 52

Operations Pediatrics Airway Management Radiology 52

Resus Review

OCTOBER 9, 2015

Buszman PE, Kiesz SR, Bochenek A, et al. Seung KB, Park DW, Kim YH, et al. Stents versus coronaryartery bypass grafting for left main coronary artery disease. MAIN-COMPARE) N Engl J Med 2008;358:1781–92. Acute and late outcomes of unprotected left main stenting in comparison with surgical revascularization. (Le

Stroke 52

Stroke Outcomes Ultrasounds 52

Dr. Smith's ECG Blog

MAY 8, 2023

. = Here is a visual comparison of the original and modified Sgarbossa Criteria (each has 3 criteria, and only one criterion differs between them: criterion 3 is absolute millimeters in the original, versus proportional in the modified version) Validation in LBBB: Meyers HP. Limkakeng AT. Theiling BJ.

EKG/ECG 52

EKG/ECG Documentation/Coding Outcomes Shock 52

EMDocs

NOVEMBER 18, 2023

24840 28) Savitsky EA, Votey SR, Mebust DP, Schwartz E, Uner AB, McCain S. N Engl J Med. 2007;357(25):2601-2614. doi:10.1056/NEJMra064928 27) Taner T. Liver transplantation: Rejection and tolerance. Liver Transpl. 2017;23(S1):S85-S88. doi:10.1002/lt.24840 Acad Emerg Med. 2000;7(8):898-905. doi:10.1111/j.1553-2712.2000.tb02068.x

EMS 67

EMS Ultrasounds Emergency Department Outcomes 67

Sensible Medicine

OCTOBER 16, 2023

They then analyzed the two groups—SR vs AF—for a primary endpoint of total mortality. The graph shows the clear results: For patients with SR at baseline, beta-blocker use reduced the risk of death by a whopping 27%. Benefit when in SR. Slowing the rate in AF may not confer the same benefits that it does in SR.

Evidence-Based Practice 52

Evidence-Based Practice Hospitals Wellness Outcomes 52

EMDocs

JANUARY 4, 2024

hours, SR 3 hours, XL 5 hours. Can consider in massive overdose, especially of SR or XL formulations. Disposition Following intentional overdose, observe for at least 16 hours post-IR ingestion and 24 hours following SR/XL ingestion. 3,4 Pharmacokinetics: Bupropion has a large volume of distribution and moderate protein binding.

Seizures 65

Seizures EKG/ECG Poisoning Shock 65

EMDocs

FEBRUARY 12, 2024

5) Malinoski DJ, Todd SR, Slone S, Mullins RJ, Schreiber MA. Comparing Central Venous Blood Gas to Arterial Blood Gas and Determining Its Utility in Critically Ill Patients: Narrative Review. Anesth Analg. 2021 Aug 1;133(2):374-378. doi: 10.1213/ANE.0000000000005501. 0000000000005501. PMID: 33780397. (5) 2005 Nov;140(11):1122-5.

Emergency Department 93

Emergency Department Resuscitation COPD Shock 93

Broome Docs

MARCH 28, 2024

Yerke JR, Mireles-Cabodevila E, Chen AY, Bass SN, Reddy AJ, Bauer SR, Kokoczka L, Dugar S, Moghekar A. PMID: 37805062 Bottom line: In this before and after cohort, the change to a smaller BVM was associated with lower rates of ROSC. Peripheral pressors: not only safe, but beneficial? 2023 Aug 21:S0012-3692(23)05350-3. doi: 10.1016/j.chest.2023.08.019.

PPE 109

PPE Ultrasounds Resuscitation Administration 109

Taming the SRU

MAY 3, 2023

Konstam MA, Cohen SR, Salem DN, et al. Effects of alterations in pulmonary vascular resistance on right ventricular function. The Journal of thoracic and cardiovascular surgery. 1967;54(6):886-894. Comparison of left and right ventricular end-systolic pressure-volume relations in congestive heart failure. Elsevier; 1985.

Wellness 52

Wellness Hospitals Shock Outcomes 52

Pediatric Emergency Playbook

AUGUST 1, 2016

References Allen CH, Etzwiler LS, Miller MK, Maher G, Mace S, Hostetler MA, Smith SR, Reinhardt N, Hahn B, Harb G; INcreased Flow Utilizing Subcutaneously-Enabled Pediatric Rehydration Study Collaborative Research Group. Recombinant human hyaluronidase-enabled subcutaneous pediatric rehydration.

Allergic Reactions 52

Allergic Reactions Dehydration Pediatrics Administration 52

EMDocs

MARCH 6, 2024

Smith SR, Murray D, Pockney PG, et al. Sullivan LM, Massaro JM, D’Agostino RB, Sr. Rech MA, Gottlieb M. Prothrombin Complex Concentrate Should Be Used to Reverse Factor Xa Inhibitors in the Setting of Life-Threatening Bleeding. Ann Emerg Med. 2023 Sep;82(3):362-363. Dis Colon Rectum. 2018;61(1):99–106. 2017;2(9): 635–43.

Blood Transfusions 83

Blood Transfusions Outcomes Resuscitation Hospitals 83

ALiEM

OCTOBER 4, 2023

Hulse EJ, Haslam JD, Emmett SR, Woolley T. What do we currently know about Novichoks? The state of the art. Arch Toxicol. 2023 Mar;97(3):651-661. doi: 10.1007/s00204-022-03437-5. Epub 2022 Dec 30. PMID: 36583745. Organophosphorus nerve agent poisoning: managing the poisoned patient. Br J Anaesth. 2019 Oct;123(4):457-463. doi: 10.1016/j.bja.2019.04.061.

Poisoning 78

Poisoning Seizures Hospitals 78

Dr. Smith's ECG Blog

JANUARY 9, 2024

Cardioversion will address the rhythm problem immediately, also if the chest discomfort subsides when SR is restored, ischemia from ACS becomes much less likely. After atrial rhythm/SR was restored the patient slowly improved. Ischemia from ACS causing the chest discomfort, with VT another consequence (or coincidence)?

EKG/ECG 88

EKG/ECG Stroke Hospitals Documentation/Coding 88

RebelEM

NOVEMBER 30, 2023

PMID: 37597449 Rai A , Dassum SR , Ahmad YR , Ansari S , Kitch BT , Filbin M , Rhee C. Guideline-based and restricted fluid resuscitation strategy in sepsis patients with heart failure: A systematic review and meta-analysis [published online ahead of print, 2023 Aug 9]. Am J Emerg Med. 2023;73:34-39.

Sepsis 104

Sepsis Fluid Resuscitation Resuscitation Administration 104