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# האיגוד הישראלי לרפואה דחופה

The Israel Association for Emergency Medicine

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## פוסטים

- [Blog](https://emergencymed.org.il/blog/)
- [Head computed tomography findings in geriatric emergency department patients with delirium, altered mental status, and confusion: A systematic review](https://emergencymed.org.il/head-computed-tomography-findings-in-geriatric-emergency-department-patients-with-delirium-altered-mental-status-and-confusion-a-systematic-review/articles-2/) - Shan W. Liu MD, SD, Sangil Lee MD, MS, Jane M. Hayes MPH, Danya Khoujah MBBS, MEHP, Alexander X. Lo MD, PhD, Michelle Doering MLS, Kerstin de Wit MD … See all authors Abstract Background Delirium, altered mental status (AMS), or confusion among older adults are common presentations to the emergency department (ED). We aimed to report the proportion of older ED patients
- [רפואה דחופה בחזית: דרוש גידול משמעותי בכוח האדם . יו"ר האיגוד ב y-net](https://emergencymed.org.il/רפואה-דחופה-בחזית-דרוש-גידול-משמעותי-ב/articles-2/) - עלייה דרמטית במספר הפניות למרכזים לרפואה דחופה בישראל ללא עלייה הולמת במספר התקנים - והתוצאה היא מצוקה ועומסים בלתי נתפסים. שבוע רפואה דחופה בישראל, הוא הזדמנות להוקיר תודה לאנשים בחוד החנית של הצלת החיים, ולדרוש גיוס כוח אדם איכותי ד"ר צחי סלוצקי|אתמול | 20:17 ליל יום ראשון, 3 לפנות בוקר. שקט שורר ברחבי בית
- [PODCAST: Agitation Deep Dive](https://emergencymed.org.il/podcast-agitation-deep-dive/education-tips/) - 1. The MILDLY agitated patient : verbal de-escalation or PO benzo/antipsychotic 2. The MODERATELY agitated patient : IM benzo/antipsychotic 3. The SEVERELY agitated patient : IM Ketamine 5mg/kg Consider removing the terminology “Agitated Delirium” from your vocabulary, as there is significant racial bias behind this term.
- [PODCAST:  Retropharyngeal Abscess and Top Gun](https://emergencymed.org.il/podcast-retropharyngeal-abscess-and-top-gun/recourse/) - EM Board Bombs · 179. Retropharyngeal Abscess and Top Gun Call Goose and Maverick. We’re diving into the Danger Zone to cover RPAs. These sneaky infections can really cause serious morbidity and mortality. Don’t miss this on the exam! Want to experience the greatest in board studying? Check out our interactive question bank podcast- the
- [PODCAST: Automated Interpretation of Clinical Electroencephalograms Using Artificial Intelligence](https://emergencymed.org.il/podcast-automated-interpretation-of-clinical-electroencephalograms-using-artificial-intelligence/נירולוגיה/) - Interview with Sándor Beniczky, MD, PhD, author of Automated Interpretation of Clinical Electroencephalograms Using Artificial Intelligence. Hosted by Cynthia Armand, MD.
- [PODCAST: No Pirate Zone but Talking ARDS with Dr. Jenny Wilson ACEP Frontline](https://emergencymed.org.il/podcast-no-pirate-zone-but-talking-ards-with-dr-jenny-wilson-acep-frontline/podcast/) - ACEP Frontline · No Pirate Zone but Talking ARDS with Dr. Jenny Wilson In this episode we talk with Dr. Jenny Wilson about ARDS with tips and management within EM.
- [Recommendations for endotracheal tube insertion depths in children](https://emergencymed.org.il/recommendations-for-endotracheal-tube-insertion-depths-in-children/articles-2/) - Chinedu Ulrich Ebenebe1, Kristina Schriever1, Sofia Apostolidou1, Monika Wolf1, Jochen Herrmann2, Dominique Singer1 Philipp Deindl1 Correspondence to Dr Chinedu Ulrich Ebenebe, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; c.ebenebe@uke.de Abstract Background Endotracheal tube (ETT) malposition is frequent in paediatric intubation. The current recommendations for ETT insertion depths are based
- [BIAS IN THE TRAUMA BAY: A MULTICENTER QUALITATIVE STUDY ON TEAM COMMUNICATION](https://emergencymed.org.il/bias-in-the-trauma-bay-a-multicenter-qualitative-study-on-team-communication/recourse/) - Bankhead, Brittany K. MD, MS, FACSBichard, Shannon L. MA, PhDSeltzer, Trent MA, PhDThompson, Lisa A. BAChambers, Barbie MA, PhDDavis, Bayli BS, MAKnowlton, Lisa M. MD, MPH, FACS, FRCSCTatebe, Leah C. MDVella, Michael A. MDDumas, Ryan P. MD, MS, FACS Abstract Background Team communication and bias in and out
- [JAMA: Caring for Patients With Acute Respiratory Distress Syndrome, 2023 Practice Guidelines](https://emergencymed.org.il/jama-caring-for-patients-with-acute-respiratory-distress-syndrome-2023-practice-guidelines/recourse/) - Guideline title ESICM Guidelines on Acute Respiratory Distress Syndrome: Definition, Phenotyping and Respiratory Support Strategies Release date June 16, 2023 Developer European Society of Intensive Care Medicine (ESICM) Target population Adult patients with or at risk for acute respiratory distress syndrome (ARDS) Major recommendations For nonintubated patients with acute hypoxemic respiratory failure not due to
- [NEJM: Prehospital Tranexamic Acid for Severe Trauma](https://emergencymed.org.il/nejm-prehospital-tranexamic-acid-for-severe-trauma/articles-2/) - The PATCH-Trauma Investigators and the ANZICS Clinical Trials Group Abstract BACKGROUND Whether prehospital administration of tranexamic acid increases the likelihood of survival with a favorable functional outcome among patients with major trauma and suspected trauma-induced coagulopathy who are being treated in advanced trauma systems is uncertain. METHODS
- [NEJM: Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest](https://emergencymed.org.il/nejm-mild-hypercapnia-or-normocapnia-after-out-of-hospital-cardiac-arrest/articles-2/) - Glenn Eastwood, Ph.D., Alistair D. Nichol, Ph.D., Carol Hodgson, Ph.D., Rachael L. Parke, Ph.D., Shay McGuinness, M.B., Ch.B., Niklas Nielsen, Ph.D., Stephen Bernard, M.D., Markus B. Skrifvars, Ph.D., Dion Stub, Ph.D., Fabio S. Taccone, Ph.D., John Archer, Ph.D., Demetrios Kutsogiannis, M.D., Abstract BACKGROUND Guidelines recommend normocapnia for adults with coma who are resuscitated after out-of-hospital cardiac arrest. However, mild hypercapnia increases cerebral blood flow and may
- [PODCAST: EM Quick Hits 49 Stroke Management Update, Intussusception, 5 Penetrating Trauma Tips, Skin Foreign Body Hack, CT Radiation Risk, Emergency Fund View Larger Image](https://emergencymed.org.il/podcast-em-quick-hits-49-stroke-management-update-intussusception-5-penetrating-trauma-tips-skin-foreign-body-hack-ct-radiation-risk-emergency-fund-view-larger-image/education-tips/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” " data-title="EM Quick Hit 49 June 2023" data-caption="" aria-label="EM Quick Hit 49 June 2023">View Larger Image Topics in this EM Quick Hits podcast Anand Swaminathan on endovascular therapy for large vessel occlusion ischemic stroke (0:38) Sarah
- [The AHRQ Report on Diagnostic Errors in the Emergency Department: The Wrong Answer to the Wrong Question](https://emergencymed.org.il/the-ahrq-report-on-diagnostic-errors-in-the-emergency-department-the-wrong-answer-to-the-wrong-question/articles-2/) - Gabor D. Kelen,Amy H. Kaji,Kraftin E. Schreyer,Leah B. Colucci,Samuel M. Keim,Sandra M. Schneider,Robert E. Suter,Richard J. Hamilton,Arlene S. Chung,David Foster,Monisha Dilip,Thuy Nguyen,Hamza Ijaz,Wendy W. Sun,Ali S. Raja Mitigating patient harm is paramount for all engaged in medical practice. Accurate identification of root causes of medical errors is
- [Diagnostic Accuracy of Clinical Pathways for Suspected Acute Myocardial Infarction in the Out-of-Hospital Environment](https://emergencymed.org.il/דיוק-אבחון-של-מסלולים-קליניים-עבור-חשד/recourse/) - Abdulrhman Alghamdi PhD a b, Mark Hann PhD c, Edward Carlton MB ChB, PhD d, Jamie G. Cooper MB ChB e f, Eloïse Cook PhD g, Angela Foulkes h, Aloysius N. Siriwardena MBBS, PhD i, John Phillips j, Alexander Thompson PhD c, Steve Bell MSc k, Kim Kirby PhD l, Andy Rosser MSc m, Richard Body MBChB, PhD g n o Study objective Chest pain is one of the most common reasons for emergency ambulance calls. Patients are routinely transported to the hospital to prevent acute myocardial infarction (AMI). We evaluated the diagnostic accuracy of clinical pathways in the out-of-hospital environment. The Troponin-only Manchester Acute Coronary Syndromes decision aid and History, ECG, Age,
- [דיוק אבחון של מסלולים קליניים עבור חשד לאוטם שריר הלב חריף בסביבה מחוץ לבית החולים](https://emergencymed.org.il/דיוק-אבחון-של-מסלולים-קליניים-עבור-חשד/recourse/) - Abdulrhman Alghamdi PhDa b, Mark Hann PhDc, Edward Carlton MB ChB, PhDd, Jamie G. Cooper MB ChBe f, Eloïse Cook PhDg, Angela Foulkesh, Aloysius N. Siriwardena MBBS, PhDi, John Phillipsj, Alexander Thompson PhDc, Steve Bell MSck, Kim Kirby PhDl, Andy Rosser MScm, Richard Body MBChB, PhDg n o מטרת המחקר כאבים בחזה הם אחת הסיבות
- [HEART Score Recalibration Using Higher Sensitivity Troponin T](https://emergencymed.org.il/heart-score-recalibration-using-higher-sensitivity-troponin-t/articles-2/) - Khand, Aleem U.; Backus, Barbra; Campbell, Michael; … Mumma, Bryn E. Study objective We examined the diagnostic performance of a recalibrated History, Electrocardiogram, Age, Risk factors, Troponin (HEART), and Thrombolysis in Myocardial Infarction (TIMI) score in patients with suspected acute cardiac syndrome (ACS). Recalibration of troponin thresholds was performed, including shifting from the 99th percentile
- [PODCAST:  QT Intervals](https://emergencymed.org.il/podcast-qt-intervals/קדם-בית-חולים/) - Jun 12, 2023 ​​Contributor: Travis Barlock MD Educational Pearls The QT interval represents phases 2 and 3 of ventricular plateau and repolarization, respectively. As the QT interval lengthens, more sodium and calcium channels are available and susceptible to action potentials. Prolonged QT interval is more concerning in the setting of bradycardia. This scenario increases the likelihood
- [Autopsy By CT – What Can Post-Mortem CT Teach Us About Trauma Care?](https://emergencymed.org.il/autopsy-by-ct-what-can-post-mortem-ct-teach-us-about-trauma-care-2/articles-2/) - May 24, 2023 / Trauma Written by Vivian Lei Information gathered from post-mortem CT shows that fatal injury patterns in blunt trauma are similar for those who die prior to ED arrival vs. after arrival. The frequent identification of unevacuated pneumothorax and endotracheal tube misplacement suggests that mandatory surgical chest decompression and tube placement confirmation should always
- [PODCAST: Primary Survey - the highlights of June 2023](https://emergencymed.org.il/podcast-primary-survey-the-highlights-of-june-2023/articles-2/) - A summary of some of the best paper we published in the June 2023 issue of the Emergency Medicine Journal. Rick and Sarah talk through topics including home pulse oximetry, out of hospital cardiac arrest, the perils of correctly calculating respiratory rate in the ED and even cross-cultural adaptation of patient communication material. Read the
- [Coronary Artery Calcium Score and Polygenic Risk Score for the Prediction of Coronary Heart Disease Events](https://emergencymed.org.il/coronary-artery-calcium-score-and-polygenic-risk-score-for-the-prediction-of-coronary-heart-disease-events/articles-2/) - Sadiya S. Khan, MD, MSc1,2; Wendy S. Post, MD3; Xiuqing Guo, PhD4; et alJingyi Tan, MA4; Fang Zhu, MSc, MPH5; Daniel Bos, MD, PhD5,6; Bahar Sedaghati-Khayat, MSc7; Jeroen van Rooij, PhD7; Aaron Aday, MD, MS8; Norrina B. Allen, PhD2; Maxime M. Bos, PhD5; André G. Uitterlinden, PhD5,7; Matthew J. Budoff, MD9; Donald M. Lloyd-Jones, MD, ScM1,2; Jonathan D. Mosley, MD, PhD8,10; Jerome I. Rotter, MD4; Philip Greenland, MD1,2,11; Maryam Kavousi, MD, PhD5 Author Affiliations Article Information JAMA. 2023;329(20):1768-1777. doi:10.1001/jama.2023.7575 Key Points Question Does discrimination change when either a coronary artery calcium score or a polygenic
- [Machine learning for diagnosis of myocardial infarction using cardiac troponin concentrations](https://emergencymed.org.il/machine-learning-for-diagnosis-of-myocardial-infarction-using-cardiac-troponin-concentrations/recourse/) - Dimitrios Doudesis, Kuan Ken Lee, Jasper Boeddinghaus, Anda Bularga, Amy V. Ferry, Chris Tuck, Matthew T. H. Lowry, Pedro Lopez-Ayala, Thomas Nestelberger, Luca Koechlin, Miguel O. Bernabeu, Lis Neubeck, Atul Anand, Karen Schulz, Fred S. Apple, William Parsonage, Jaimi H. Greenslade, Louise Cullen, John W. Pickering, Martin P. Than, Alasdair Gray, Christian Mueller, Nicholas L. Mills & CoDE-ACS Investigators Abstract
- [Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with cardiac arrest: a comparative meta-analysis and trial sequential analysis](https://emergencymed.org.il/extracorporeal-cardiopulmonary-resuscitation-versus-conventional-cardiopulmonary-resuscitation-in-adults-with-cardiac-arrest-a-comparative-meta-analysis-and-trial-sequential-analysis/articles-2/) - Low CJW, Ramanathan K, Ling RR, Ho MJC, Chen Y, Lorusso R, MacLaren G, Shekar K, Brodie D. Abstract Background: Although outcomes of patients after cardiac arrest remain poor, studies have suggested that extracorporeal cardiopulmonary resuscitation (ECPR) might improve survival and neurological outcomes. We aimed to investigate any potential benefits of
- [BMJ: Modifiers of the effectiveness of point-of-care troponin testing and determinants of concordance between diagnostic pathway recommendations and disposition in patients with chest pain: a post hoc analysis of a randomised controlled trial](https://emergencymed.org.il/bmj-modifiers-of-the-effectiveness-of-point-of-care-troponin-testing-and-determinants-of-concordance-between-diagnostic-pathway-recommendations-and-disposition-in-patients-with-chest-pain-a-post-hoc/ילדים/) - Viola IL Thulin ,1 Gard Mikael Sæle Myrmel,2 Silje Marie Farestveit Jordalen,1 Ole Christian Lekven ,1,2 Jeyaseelan Krishnapillai,1,2 Ole-Thomas Steiro,2 Richard Body ,3,4 Paul O Collinson ,5 Fred Apple,6 Louise Cullen ,7,8,9 Tone Merete Norekvål,2,10 Torbjørn Wisløff,11,12 Kjell Vikenes ,2,10 Rune Oskar Bjørneklett,1,13 Torbjørn Omland,12,14 Kristin Moberg Aakre Abstract. Introduction While point-of-care (POC) high-sensitivity cardiac troponin
- [PODCAST: Acute Coronary Occlusion](https://emergencymed.org.il/podcast-acute-coronary-occlusion/קדם-בית-חולים/) - In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the February 2026 Emergency Medicine Practice article, Emergency Department Diagnosis and Management of Acute Coronary Occlusion 00:00 - Introduction & Welcome 01:21 - Episode Overview: Acute Coronary Occlusion 02:06 - Why This Topic Matters: Statistics & New Guidelines 03:35 - Nomenclature: ACO vs STEMI/NSTEMI 06:15 - Differential
- [PODCAST: So What: Are C-Collars on the Path of the Dinosaurs - Part 1 of 2](https://emergencymed.org.il/podcast-so-what-are-c-collars-on-the-path-of-the-dinosaurs-part-1-of-2/קדם-בית-חולים/) - In this episode, Dr. Howie Mell sits down with Dr. Ken Milne about recent data and evidence on the use of cervical collars and cervical motion restriction. The question the work to answer is whether it's time for the C-collar to follow backboards and dinosaurs into the relative history of medicine.
- [Which RBBB Patterns Need the Cath Lab?](https://emergencymed.org.il/which-rbbb-patterns-need-the-cath-lab/articles-2/) - Written by Catherine Burger Patients presenting with anginal symptoms and a new right bundle branch block (RBBB) on ECG or RBBB-specific high-risk features should prompt emergent evaluation for reperfusion therapy. Signs of a deadly RBBB This narrative review focuses primarily on the cautious evaluation and treatment of patients with RBBB on ECG. Concerningly, new RBBB
- [JAMA: Measuring the Return on Investment for Clinician-Facing Artificial Intelligence Technologies](https://emergencymed.org.il/jama-measuring-the-return-on-investment-for-clinician-facing-artificial-intelligence-technologies/articles-2/) - Lisa S. Rotenstein, MD, MBA, MSc1,2; Robert M. Wachter, MD1,3; David W. Bates, MD, MSc4,5 Author Affiliations Article Information JAMA Intern Med Published Online: February 23, 2026 doi: 10.1001/jamainternmed.2025.7627 Artificial intelligence (AI) is proliferating, and many clinician-facing AI technologies are being adopted in health care. Examples of these include AI-powered scribes, AI-drafted replies to patients’ electronic health record (EHR) messages, AI electronic medical record summarization, AI
- [Rebelem: MDCalc Wars: GCS Alternatives in the ED: SMS and FOUR Score](https://emergencymed.org.il/rebelem-mdcalc-wars-gcs-alternatives-in-the-ed-sms-and-four-score/education-tips/) - MDCalc Wars: GCS Alternatives in the ED: SMS and FOUR Score Written by Eric Steinberg DO, MEHP REBEL EM Medical Category: Neurology, Trauma brainstem reflexes, coma scale, FOUR Score, full outline of unresponsiveness, gcs, gcs alternatives, glasgow coma scale, level of consciousness, loc, MDCalc, MDCalc Wars, motor score, neuro exam, neuro monitoring, neurological assessment, simplified motor scale, sms score, TBI, trauma evaluation, Traumatic Brain Injury February 23, 2026 🧭 REBEL Rundown 🗝️ Key Points 🤕 Case 🔗
- [JAMA: Type 1 Diabetes A Review](https://emergencymed.org.il/jama-type-1-diabetes-a-review/articles-2/) - LauraM. Jacobsen, MD; Desmond A. Schatz, MD IMPORTANCE Type 1 diabetes is defined by hyperglycemia due to autoimmune destruction of the insulin-producing beta cells in the pancreas, leading to insulin deficiency, and accounts for 5%to 10% of all cases of diabetes. Type 1 diabetes affects approximately 2 million people in the US and 8.4 million
- [PODCAST: Home Where I Wanted to Go After Anaphylaxis](https://emergencymed.org.il/podcast-home-where-i-wanted-to-go-after-anaphylaxis/ילדים/) - Reference: . Timing of repeat epinephrine to inform paediatric anaphylaxis observation periods: a retrospective cohort study. Lancet Child & Adolescent Health. July 2025 Dr. Kammeron Brissett Guest Skeptic: Dr. Kammeron Brissett is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. She completed her pediatrics residency and a chief year at Rainbow Babies and Children’s Hospital in
- [NEJM: Sudden Cardiac Arrest in Athletes](https://emergencymed.org.il/nejm-sudden-cardiac-arrest-in-athletes/articles-2/) - Rachel Lampert 1, Kimberly G Harmon 2 Affiliations Expand PMID: 41534044 DOI: 10.1056/NEJMra2312555 Abstract. The incidence of sudden cardiac arrest in athletes varies according to age, race and ethnic group, sex, sport, and social determinants of health. The common causes of sudden cardiac arrest include cardiomyopathies, electrical disorders, coronary-artery anomalies, and other cardiac structural abnormalities. There has not been an
- [ECG Teaching Cases: Why Does That Bruise Have a Pulse?](https://emergencymed.org.il/ecg-teaching-cases-why-does-that-bruise-have-a-pulse/case-presentation/) - ***Please donate 25 seconds of your time to take our reader engagement survey! We only need about 10 more participants. Thank you to everyone who has taken it already! Here is the link: https://litannenbaum.substack.com/survey/6033390 or just click here *** CODE BLUE OUTPATIENT RADIOLOGY CODE BLUE OUTPATIENT RADIOLOGY “Shannon, what did the hospital voice say? Outpatient what?” you
- [To pack or plug: American Association for the Surgery of Trauma multicenter evaluation of hemorrhage control interventions in pelvic fracture management](https://emergencymed.org.il/to-pack-or-plug-american-association-for-the-surgery-of-trauma-multicenter-evaluation-of-hemorrhage-control-interventions-in-pelvic-fracture-management/articles-2/) - Melike N Harfouche 1, Leslie Sult, Jason D Sciarretta, Samuel R Todd, Christopher F O'Neil, Jonathan P Meizoso, Allison McNickle, Douglas Fraser, Millicent Croman, Joseph J Dubose Collaborators, Affiliations Expand PMID: 41533046 DOI: 10.1097/TA.0000000000004856 Abstract Introduction: Mortality from pelvic ring fractures (PRFs) complicated by hemorrhagic shock remains high, and there are limited high-quality data to guide care. We compared two primary hemorrhage
- [PODCAST: AIrway in Trauma](https://emergencymed.org.il/podcast-airway-in-trauma/קדם-בית-חולים/) - This episode is an absolute cracker! And we can say that as we’ve got outsider help… We have all been involved with patients where securing the airway with a prehospital anaesthetic feels intuitively right; the patient with a severe head injury after a fall from height, the unrestrained driver in a high-speed collision with devastating
- [EMJ Podcast: Solving corridor care, and return of spontaneous circulation : Primary Survey February 2026](https://emergencymed.org.il/emj-podcast-solving-corridor-care-and-return-of-spontaneous-circulation-primary-survey-february-2026/קדם-בית-חולים/) - "Should we be giving blood transfusions to patients with traumatic cardiac arrest?" EMJ editor Prof. Richard Body and associate editor Dr. Sarah Edwards talk through some original research on the value of blood transfusions in this difficult situation. Next is the new UNCORKED study from the Trainee Emergency Research Network (TERN), with some sobering statistics
- [Phenylephrine and Epinephrine Push-Dose Vasopressors](https://emergencymed.org.il/phenylephrine-and-epinephrine-push-dose-vasopressors/education-tips/) - ACEPNOW By Taylor H Cason, PharmD, CPP, BCPS, BCEMP; Michael Gibbs, MD, FACEP, FAAEM | on February 10, 2026 | Case Vignette An unresponsive, unknown male around 50 years old presents to the ED via EMS post-return of spontaneous circulation (ROSC) after being found in pulseless electrical activity (PEA) cardiac arrest. Current vitals include a heart rate of 85
- [Non-IV (PO or IN) Ketamine for Pediatric Sedation?](https://emergencymed.org.il/non-iv-po-or-in-ketamine-for-pediatric-sedation/ילדים/) - Written by Shannon Markus This systematic review suggests that non-injectable ketamine (oral or intranasal) can provide effective and safe pediatric procedural sedation, particularly compared with other oral agents, although the certainty of evidence is low. Sedation without the stick This systematic review assessed noninjectable ketamine (oral and intranasal) for pediatric procedural sedation in the emergency
- [PODCAST: Playing with the Queen of Hearts – AI, Is It Very Smart (for ECG Interpretation)?](https://emergencymed.org.il/podcast-playing-with-the-queen-of-hearts-ai-is-it-very-smart-for-ecg-interpretation/education-tips/) - Date: January 3, 2026 Reference: Shroyer et al. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (Queen of Hearts by PMcardio). Am J Emerg Med. 2025 Nov. Guest Skeptic: Dr. Amal Mattu has been on the faculty at the University of Maryland since 1996. He has developed an academic niche in emergency cardiology
- [ECG Teaching Cases: Another Crashing Patient at Sign Out? Well Flec me…](https://emergencymed.org.il/ecg-teaching-cases-another-crashing-patient-at-sign-out-well-flec-me/articles-2/) - Well Flec me… ECG Teaching Cases Feb 04, 2026 ***This week, my friend, Dr. Bill Boroughf, toxicologist and author of the excellent substack “The Thing About Poison, with Dr. Bill Boroughf” joins me for a case on Flecainide toxicity!*** ***Please take 25 seconds to answer our reader satisfaction survey! Your participation will help me present ECG
- [Left, Right, or Center? Best Location for Paracentesis](https://emergencymed.org.il/left-right-or-center-best-location-for-paracentesis/articles-2/) - Written by Aaron Lacy When using a midline approach to paracentesis, there were no instances of hemorrhage compared to lateral. However, there is fine print to consider before changing your practice… A lateral approach is so mid… While generally safe, hemorrhage from paracentesis can be devastating. This group compared hemorrhage rates between a lateral and midline
- [Derivation and Validation of a Clinical Rule to Detect Bacteremia Versus Contaminants in Positive Pediatric Blood Cultures: A Retrospective Cohort Study](https://emergencymed.org.il/derivation-and-validation-of-a-clinical-rule-to-detect-bacteremia-versus-contaminants-in-positive-pediatric-blood-cultures-a-retrospective-cohort-study/articles-2/) - Jocelyn Gravel, MD, MSca graveljocelyn@hotmail.com ∙ Charlotte Grandjean-Blanchet, MDa ∙ Alino Demean Loghinb ∙ … ∙ Olivia Ostrow, MDc ∙ Émilie Vallières, MD, PhDd ∙ Soha Rached-D’Astous, MD, MSca … Show more Abstract Study objectives Fifty percent of positive blood cultures in the pediatric emergency department (ED) are contaminants. We derived and validated a clinical decision rule discriminating bacteremia from contaminants among children seen in the ED with a positive blood culture. Methods We
- [JAMA: Traumatic Brain Injury and All-Cause and Dementia-Related Mortality in the Framingham Heart Study](https://emergencymed.org.il/jama-traumatic-brain-injury-and-all-cause-and-dementia-related-mortality-in-the-framingham-heart-study/articles-2/) - Rebecca Burton, MA1,2; Shruti Durape, MBBS, MPH1,3,4,5; Eden Price, BA1 et al Author Affiliations Article Information Key Points Question What is the incidence of traumatic brain injury (TBI), and is TBI associated with long-term all-cause and dementia-related mortality? Findings In this cohort study of 10 333 participants in the Framingham Heart Study followed from 1948 to 2022, TBI most often occurred in late life due to
- [JAMA: Age-Adjusted D-Dimer Cutoff Levels to Rule Out Deep Vein Thrombosis](https://emergencymed.org.il/jama-age-adjusted-d-dimer-cutoff-levels-to-rule-out-deep-vein-thrombosis/articles-2/) - Grégoire Le Gal, MD, PhD1,2; Helia Robert-Ebadi, MD3; Venkatesh Thiruganasambandamoorthy, MBBS1,4 et al Author Affiliations Article Information JAMA Published Online: January 5, 2026 2026;335;(5):416-424. doi:10.1001/jama.2025.21561 Key Points Question Does an age-adjusted D-dimer cutoff safely increase the proportion of patients in whom deep vein thrombosis (DVT) can be excluded? Findings In this multinational prospective outcome study including 3205 outpatients presenting to the emergency department with suspected DVT, the age-adjusted D-dimer
- [PODCAST: Meningitis 2.0](https://emergencymed.org.il/podcast-meningitis-2-0/podcast/) - Core EM Modular CME Course Maximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course offers 12 audio-based modules packed with pearls! Information and link below. Patient Presentation & Workup Patient: 36-year-old male, currently shelter-domiciled, presenting with 3 weeks of generalized
- [PODCAST: Fentanyl for Asthma](https://emergencymed.org.il/podcast-fentanyl-for-asthma/קדם-בית-חולים/) - Feb 2, 2026 Contributor: Alec Coston, MD Educational Pearls: BiPAP is often effective in severe asthma, but many patients struggle with mask tolerance due to intense air hunger–driven anxiety, often compounded by hypoxia. Benzodiazepines are commonly used for anxiety, but they can depress respiratory drive, making clinical improvement difficult to interpret (a lower RR may
- [Blunt Cardiac Injury in Thoracic Trauma](https://emergencymed.org.il/blunt-cardiac-injury-in-thoracic-trauma/articles-2/) - מאמר טוב על חבלת לב, בעיקר עונה על שאלת דירוג ועל שאלת מתי הטרופונין שולל (4-6 שעות). שווה להעלות לאתר לדעתי.
- [Timing Is Everything—A Repeat CT Protocol for TBI](https://emergencymed.org.il/timing-is-everything-a-repeat-ct-protocol-for-tbi/articles-2/) - Written by Rebecca DiFabio Approaches to repeat CT scans in traumatic brain injuries (TBIs) are highly variable. This study recommends a risk-stratified approach based upon injury severity, patients’ clinical factors, and timing of initial CT. Fickle findings for a common problem Despite TBIs being a major cause of morbidity and mortality, repeat imaging practices remain
- [Repeat Naloxone Doses Increasing—Watch These Patients!](https://emergencymed.org.il/repeat-naloxone-doses-increasing-watch-these-patients/קדם-בית-חולים/) - Written by Jason Lesnick This retrospective analysis found an increased rate of repeat naloxone administration in US EDs from 2016–2022. Needing naloxone to navigate new novel narcotics… This retrospective claims-based cohort study analyzed naloxone use in U.S. EDs and looked for changes in the rate of multiple naloxone administrations over time. Using a retrospective, claims-based
- [PODCAST: Announcing AskEMDI - The Ai Key to Millions of Patient Visits with Dr. Ed](https://emergencymed.org.il/podcast-announcing-askemdi-the-ai-key-to-millions-of-patient-visits-with-dr-ed/podcast/) - ACEP Frontline · Announcing AskEMDI - The Ai Key to Millions of Patient Visits with Dr. Ed Barthell In this episode, we talk about the newly released Ai tool, AskEMDI. This is an early manifestation of the tool that allows researchers and others to data mine millions of ED cases and charts comb emergency specific
- [PODCAST: Prehospital Blood Transfusion](https://emergencymed.org.il/podcast-prehospital-blood-transfusion/קדם-בית-חולים/) - What is prehospital blood transfusion Administration of blood products in the field prior to hospital arrival Aimed at patients in hemorrhagic shock Why this matters Traditional US prehospital resuscitation relied on crystalloid ED and trauma care now prioritize early blood Hemorrhage occurs before hospital arrival Delays to definitive hemorrhage control are common Earlier blood may
- [PODCAST:  Prehospital Care for Patients with Opioid Use Disorder](https://emergencymed.org.il/podcast-prehospital-care-for-patients-with-opioid-use-disorder/קדם-בית-חולים/) - Are you ready for NAEMSP?! In this special edition of the Prehospital Emergency Care podcast, host Greg Muller is joined by Guest Editor Remle Crowe to discuss the journal's latest special issue: "Enhancing Prehospital Care for Patients with Opioid Use Disorder". This episode goes beyond the statistics to explore the deeply human experiences behind the data.
- [2026 Guideline Update: Early Management of Acute Ischemic Stroke](https://emergencymed.org.il/2026-guideline-update-early-management-of-acute-ischemic-stroke/articles-2/) - Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association/American Stroke Association (AHA/ASA) 2026 Guideline for early management of acute ischemic stroke was recently released. This post will first cover the key parts of the guideline that affect ED evaluation and management, followed by the in-depth recommendations. Background Stroke is a significant cause of death and disability worldwide. Ischemic
- [PODCAST: AI בשרות הרפואה מבית הר״י](https://emergencymed.org.il/podcast-ai-בשרות-הרפואה-מבית-הר״י/podcast/)
- [הרצאת CME של חודש ינואר עלתה לאתר](https://emergencymed.org.il/הרצאת-cme-של-חודש-ינואר-עלתה-לאתר/igud/) - הרצאתו שלDr. Lloyd Tannenbaum: High Risk ACS ECGs You Can't Miss עלתה לאתר ואפשר לראות אותה בקישור הבא לחץ כאן לויד טננבאום למד רפואה במכללה הרפואית ג'פרסון בפילדלפיה, פנסילבניה. לאחר מכן התמחה במרכז הרפואי הצבאי ברוק (BAMC) בסן אנטוניו, טקסס. לאחר ההתמחות הוא נשאר כסגל הליבה של ACGME ב-BAMC וסיים את שירותו הפעיל כמנהל תוכנית עמית
- [ECG Pointers: Longer is Always Better… Wait, that’s not right.](https://emergencymed.org.il/ecg-pointers-longer-is-always-better-wait-thats-not-right/קרדיולוגיה/) - Authors: Ava Littlewood-Snodgrass, PharmD (Pharmacy Resident, Geisinger Wyoming Valley) and Lloyd Tannenbaum, MD (EM Attending Physician, APD, Geisinger Wyoming Valley, PA) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations. This week, we feature a post from Dr. Tannenbaum’s ECG Teaching Cases, a free ECG
- [The Case FOR Non-Op Appendicitis Treatment](https://emergencymed.org.il/the-case-for-non-op-appendicitis-treatment/ילדים/) - Written by Shannon Markus Large multicenter trials show that nonoperative antibiotic management of acute uncomplicated appendicitis is a safe, effective, and cost-effective alternative to urgent appendectomy for many adults and children. See Editor’s note at the end for counterpoint. Save a life without the knife The authors critically reviewed the four largest trials comparing nonoperative
- [PODCAST:  Here it Goes Again – Another Clinical Decision Rule for Febrile Infants 61-90 Days](https://emergencymed.org.il/podcast-here-it-goes-again-another-clinical-decision-rule-for-febrile-infants-61-90-days/ילדים/) - Reference: Aronson PL, et al. Prediction Rule to Identify Febrile Infants 61–90 Days at Low Risk for Invasive Bacterial Infections. Pediatrics. September 2025 Date: January 6, 2026 Dr. Jillian Nickerson Guest Skeptic: Dr. Jillian Nickerson is a pediatric emergency medicine attending at Children’s National Hospital and Assistant Professor of Pediatrics and Emergency Medicine at The George Washington University School of Medicine
- [PODCAST: Amiodarone vs. Lidocaine](https://emergencymed.org.il/podcast-amiodarone-vs-lidocaine/קדם-בית-חולים/) - Contributor: Aaron Lessen, MD Educational Pearls: How do amiodarone and lidocaine work on the heart? Amiodarone Blocks potassium channels (Class III effect). Also blocks sodium and calcium channels. Additional noncompetitive beta-blocker effects. Stabilizes cardiac tissue, slows heart rate, and suppresses both atrial and ventricular arrhythmias. Lidocaine Blocks fast sodium channels in ventricular tissue (Class Ib).
- [PODCAST: JEM November 2025 Podcast Summary](https://emergencymed.org.il/podcast-jem-november-2025-podcast-summary/podcast/) - Podcast summary of articles from the November 2025 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include pediatric intussusception, d-dimer in aortic dissection, ketamine for pain control, coronary CTA, immune checkpoint inhibitors, and stellate ganglion blocks. Guest speaker is Dr. Eric Lewis.
- [HiSTORIC Reprise—High-Sensitivity Troponin Here to Stay](https://emergencymed.org.il/historic-reprise-high-sensitivity-troponin-here-to-stay/articles-2/) - Written by Amanda Mathews High-sensitivity cardiac troponin for risk stratification in both low- and intermediate-risk patients reduced length of stay and increased discharges from the ED for patients with suspected acute coronary syndrome. Also, risk of subsequent myocardial infarction or cardiac death at 1 year was lower. High sensitivity is here to stay This was
- [Prehospital Trauma Compendium: Evaluation and Management of Suspected Pelvis Fractures – An NAEMSP Position Statement and Resource Document](https://emergencymed.org.il/prehospital-trauma-compendium-evaluation-and-management-of-suspected-pelvis-fractures-an-naemsp-position-statement-and-resource-document/articles-2/) - John W. Lyng, Joshua G. Corsa, Brad D. Raetzke, Bryan R. Wilson, Andrew McCoy, Steve C. Patterson, Amie Rose, Emily Kraft & Nichole Bosson Abstract Emergency Medical Services (EMS) clinicians may encounter trauma patients with major pelvic fractures from multiple mechanisms of injury. In-hospital evidence that stabilization of pelvic fractures leads to improved
- [PODCAST: Demystifying Non-Invasive Ventilation & HiFlow](https://emergencymed.org.il/podcast-demystifying-non-invasive-ventilation-hiflow/podcast/) - 🚀 High-Flow Nasal Cannula (HFNC) 🗝️ Key Points 💨 NIV = Support without a tube: CPAP, BiPAP, and HFNC improve oxygenation and reduce the work of breathing. 🫁 CPAP = Continuous pressure: Best for hypoxemic patients (e.g., pulmonary edema, OSA). ⚖️ BiPAP = Two pressures (IPAP/EPAP): Great for hypercapnic failure (e.g., COPD, obesity hypoventilation). 🌬️ HFNC = Heated, humidified high flow: Reduces effort, improves comfort, and enhances
- [How to Reverse Antithrombotics in TBI](https://emergencymed.org.il/how-to-reverse-antithrombotics-in-tbi/articles-2/) - Written by Michael Stocker Antithrombotic medication reversal in traumatic brain injury (TBI) is a nuanced topic, requiring assessments of injury severity, appropriate reversal agent and dosing strategy, and potential risks to the patient. Besting bleeding blood-thinned brains We frequently treat TBI in the setting of antithrombotic use; yet, determining when and how to handle reversal
- [PODCAST: Sympathetic Crashing Acute Pulmonary Edema (SCAPE)](https://emergencymed.org.il/podcast-sympathetic-crashing-acute-pulmonary-edema-scape/podcast/) - We discuss the diagnosis and management of SCAPE in the ED. Hosts: Naz Sarpoulaki, MD, MPH Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/SCAPEv2.mp3 Download Leave a Comment Tags: Acute Pulmonary Edema, Critical Care Show Notes Core EM Modular CME CourseMaximize your commute with the new Core EM Modular CME Course, featuring the most essential content distilled from our top-rated podcast episodes. This course
- [Hyperkalemia – Can We Use Succinylcholine for RSI?](https://emergencymed.org.il/hyperkalemia-can-we-use-succinylcholine-for-rsi/articles-2/) - Written by Amanda Mathews This retrospective cohort study found no 24-hour mortality difference when intubating hyperkalemic patients (K > 5.5mmol/L) with succinylcholine versus rocuronium for RSI. Caught between a roc and a hyperkalemic place When conducting rapid sequence intubation (RSI) in the ED, paralytic options include the depolarizing agent succinylcholine and the non-depolarizing agent rocuronium.
- [PODCAST: EM Quick Hits 70 MedMal Cases Upper Back Pain, Traumatic Pneumothorax/Hemothorax Decision Making, Risk Stratification of ICH for Consultation, Post-Circumcision Bleeds, IV Contrast Allergy, Emotional Contagion](https://emergencymed.org.il/podcast-em-quick-hits-70-medmal-cases-upper-back-pain-traumatic-pneumothorax-hemothorax-decision-making-risk-stratification-of-ich-for-consultation-post-circumcision-bleeds-iv-contrast-allergy-e/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per Creative Commons copyright.” Topics in this EM Quick Hits podcast Mike Weinstock on medmal cases: upper back pain (1:29) Andrew Petrosoniak on traumatic pneumothorax and hemothorax decision making (27:55) Justin Morgenstern on brain injury guidelines: risk stratification for neurosurgical consult, imaging and
- [CASE: Cervical Myelopathy](https://emergencymed.org.il/case-cervical-myelopathy/education-tips/) - בסוף הפרסום יש בקשה למשוב A 62-year-old male with a past medical history of osteoarthritis presents to the ED with bilateral lower extremity weakness. He states that for the last few months, he has had an increasingly difficult time climbing stairs. He notes progressively worsening neck pain and stiffness for the past year. This morning, his wife urged him
- [PODCAST:  Hit Me with Your Best Block – 2025 AHS ED Migraine Guidelines](https://emergencymed.org.il/podcast-hit-me-with-your-best-block-2025-ahs-ed-migraine-guidelines/podcast/) - Date: January 5, 2026 Reference: Robblee et al. 2025 guideline update to acute treatment of migraine for adults in the emergency department: The American Headache Society evidence assessment of parenteral pharmacotherapies. Headache 2025 Dec Happy New Year, SGEMers! What better way to start 2026 than with an SGEM Xtra about migraine headaches? We were originally scheduled to record this episode
- [STORM-PE RCT—Thrombectomy for Intermediate-High Risk PE](https://emergencymed.org.il/storm-pe-rct-thrombectomy-for-intermediate-high-risk-pe/articles-2/) - Written by Millie Cossé This RCT of 100 patients with intermediate-high risk PE showed that mechanical thrombectomy plus anticoagulation was superior to anticoagulation alone in reducing RV/LV ratio and earlier normalization of vitals. There’s a STORM brewin’ The authors of the STORM-PE trial randomized 100 hemodynamically stable patients with acute PE and elevated RV/LV diameter
- [CME Dec 2025: Towards a Positive Theory of Choice During Airway Management in Academic Emergency Departments](https://emergencymed.org.il/cme-dec-2025-towards-a-positive-theory-of-choice-during-airway-management-in-academic-emergency-departments/zoom/) - Joseph Offenbacher, MD, is currently the Director of Medical Education in the Emergency Department of the Hadassah University Medical Center- Ein Kerem. He was formerly an Assistant Professor of Emergency Medicine at the New York University (NYU) School of Medicine and an Associate Program Director at the NYU/Bellevue Emergency Medicine Residency Program. He completed the
- [podcast: Cervical Spine Clearance in Adult Blunt Trauma Updates](https://emergencymed.org.il/podcast-cervical-spine-clearance-in-adult-blunt-trauma-updates/קדם-בית-חולים/) - This episode reviews the basics of cervical spine clearance in adult blunt trauma patients including Deciding between clinical decision tools What to do in the intoxicated/obtunded patient What to do after a negative CT in a patient with persistent neck pain and no neurological symptoms References at FOAMcast.org
- [PODCAST: Frontline Author Series - 99 Ways to Die by Dr. Ashely Alker](https://emergencymed.org.il/podcast-frontline-author-series-99-ways-to-die-by-dr-ashely-alker/education-tips/) - ACEP Frontline · Frontline Author Series - 99 Ways to Die by Dr. Ashely Alker In this episode, we talk with emergency physician and author, Dr. Ashely Alker about her new book, 99 Ways to Die and How to Avoid Them.
- [BMJ: Association between location of prehospital intubation, complication rates and time intervals](https://emergencymed.org.il/bmj-association-between-location-of-prehospital-intubation-complication-rates-and-time-intervals/articles-2/) - Alan A Garner1,2, Andrew Scognamiglio3, Anna Lee4 Correspondence to Dr Alan A Garner; alan.garner@sydney.edu.au Abstract Background It has been recommended that prehospital rapid sequence intubation (PH-RSI) be performed in locations that provide 360-degree access to the patient. We aimed to examine the success and complication rate of PH-RSI by location of intubation as well as the effect
- [Can AI Predict Pediatric Sepsis Before It Happens? Critical Care Emergency Medicine Pediatric Emergency Technology](https://emergencymed.org.il/can-ai-predict-pediatric-sepsis-before-it-happens-critical-care-emergency-medicine-pediatric-emergency-technology/articles-2/) - Written by Joshua Belfer Using EHR data from the first 4 hours of ED care, machine learning models accurately predicted which children would develop sepsis within 48 hours—before organ dysfunction was present. Predicting sepsis before the crash Early sepsis recognition remains one of the greatest challenges for pediatric emergency care. In this PECARN-led multicenter study utilizing
- [BMJ: Interventions to reduce imaging in children with upper or lower extremity injuries: a systematic review and meta-analysis](https://emergencymed.org.il/bmj-interventions-to-reduce-imaging-in-children-with-upper-or-lower-extremity-injuries-a-systematic-review-and-meta-analysis/articles-2/) - Scott William Kirkland1, Nick Lesyk1, Erika Herle1, Esther Yang1, Jason Ushko1, Cristina Villa-Roel1, Sandra Campbell2 Lynette D Krebs1, William Sevcik1, Brian H Rowe1 Correspondence to Dr Brian H Rowe; brian.rowe@ualberta.ca Abstract Background Radiation exposure, transition delays and costs associated with unnecessary imaging in children have stimulated research into clinical decision rules and other interventions to reduce imaging in the emergency department (ED). The
- [Prehospital Intubation Without Drugs? That’s Bad Chemistry](https://emergencymed.org.il/prehospital-intubation-without-drugs-thats-bad-chemistry/articles-2/) - Written by Aaron Lacy Similar to prior research on the topic, prehospital endotracheal intubation (ETI) is more successful with both sedative and paralytic than with no medications or sedative alone. Friends don’t let friends intubate without drugs Across the United States, paramedics perform hundreds of thousands of intubations each year. Success on the first attempt is imperative to
- [PODCAST: Under Pressure – To Start Antihypertensives in Hypertensive ED Patients at Discharge](https://emergencymed.org.il/podcast-under-pressure-to-start-antihypertensives-in-hypertensive-ed-patients-at-discharge/podcast/) - Date: December 23, 2025 Reference: Todd et al. Antihypertensive prescription is associated with improved 30-day outcomes for discharged hypertensive emergency department patients. J Am Coll Emerg Physicians Open. 2024 Guest Skeptic: Dr. Mike Pallaci is a Professor of Emergency Medicine at Northeast Ohio Medical University and a Clinical Professor of Emergency Medicine at Ohio University Heritage College of Osteopathic
- [PODCAST: AI and Health—The Year in Review](https://emergencymed.org.il/podcast-ai-and-health-the-year-in-review/podcast/) - Roy Perlis, MD, MSc1; Yulin Hswen, ScD, MPH2 In this episode of JAMA+ AI Conversations, we review the past year in AI and health, and talk about what we hope to see this coming year. We discuss our favorite articles and what they might mean for the future of medicine. This interview is part of a series in which JAMA
- [Early Blood Pressure Rise Signals Worse Stroke Outcomes](https://emergencymed.org.il/early-blood-pressure-rise-signals-worse-stroke-outcomes/articles-2/) - TOPLINE: An increase in systolic blood pressure (sBP) within the first 24 hours after alteplase treatment was associated with worse functional outcomes at 3 months after acute ischaemic stroke. Both higher sBP at baseline and increases in sBP during the first 24 hours were linked to poorer neurologic function. Additionally, higher sBP at baseline independently increased the risk
- [PODCAST: Frailty Frontline: How to identify frailty, and what to do next](https://emergencymed.org.il/podcast-frailty-frontline-how-to-identify-frailty-and-what-to-do-next/ניהול-מלרד/) - GEMCAST · Frailty Frontline: How to identify frailty, and what to do next In this episode of GEMCast, host Dr. Christina Shenvi is joined by Dr. James Van Oppen, emergency physician and frailty expert at the University of Sheffield, to discuss the rising importance of frailty in emergency medicine. Frailty, defined as the loss of
- [CIRCULATION: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care](https://emergencymed.org.il/circulation-2025-american-heart-association-and-american-academy-of-pediatrics-guidelines-for-cardiopulmonary-resuscitation-and-emergency-cardiovascular-care/articles-2/) - Executive Summary: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Marina Del Rios, Jason A Bartos, Ashish R Panchal, Dianne L Atkins, José G Cabañas, Dazhe Cao, Katie N Dainty, Cameron Dezfulian, Aaron J Donoghue, Ian R Drennan, Jonathan Elmer, Karen G Hirsch, Ahamed H Idris, Benny L Joyner, Beena D Kamath-Rayne, Monica E Kleinman, Michael C Kurz, Javier J Lasa, Henry C Lee, Mary E McBride, Tia T Raymond, Jon C
- [EMJ: Association between age and length of stay in the emergency department in a tertiary care hospital: a retrospective observational study](https://emergencymed.org.il/emj-association-between-age-and-length-of-stay-in-the-emergency-department-in-a-tertiary-care-hospital-a-retrospective-observational-study/articles-2/) - Prachur Khandelwal ,1 Yohei Okada ,2,3 Yilin Ning,4 Zhongxun Hu,5 Andrew Fu Wah Ho,2,5 Kenneth Boon Kiat Tan ,5 Marcus Eng Hock Ong 2,5 ABSTRACT. Background Older patients’ attendances at EDs are rising. There are concerns that these individuals have prolonged stays, which have been shown to be associated with adverse clinical outcomes. We assessed
- [JAMA: comparison of Cervical Spine Injury Clinical Prediction Rules for Children After Blunt Trauma](https://emergencymed.org.il/jama-comparison-of-cervical-spine-injury-clinical-prediction-rules-for-children-after-blunt-trauma/articles-2/) - Lois K. Lee, MD, MPH1; Fahd A. Ahmad, MD, MPH2; Lorin R. Browne, DO3 et al Key Points Question Which of 3 prospectively derived clinical cervical spine injury (CSI) prediction rules for radiologic imaging (Pediatric Emergency Care Applied Research Network CSI prediction rule [PECARN CSI rule], National Emergency X-Radiography Utilization Study [NEXUS], Canadian Cervical Spine [c-spine] rule [CCR]) has the best test characteristics? Findings In
- [JAMA: A New H3N2 Influenza Strain Is Raising Concerns About This Flu Season](https://emergencymed.org.il/jama-a-new-h3n2-influenza-strain-is-raising-concerns-about-this-flu-season/articles-2/) - Kate Schweitzer1 Flu season comes around every year, but a new strain is leading many global health experts to worry that this round may be particularly severe. The strain—a version of the influenza A(H3N2) virus—first appeared in surveillance reports in June, 4 months after the 2025-2026 influenza vaccine formulation had already been determined, and has been
- [PODCAST: So What, Frontline Edition - Ketamine vs Etomidate NEJM with Dr. Howie Mell](https://emergencymed.org.il/podcast-so-what-frontline-edition-ketamine-vs-etomidate-nejm-with-dr-howie-mell/podcast/) - ACEP Frontline · So What, Frontline Edition - Ketamine vs Etomidate NEJM with Dr. Howie Mell n this episode, we breakdown the new article and research looking at ketamine and etomidate for intubation. Dr. Mell breaks down the article and what it really means for emergency medicine and airway management. We have this article..."So What"
- [PODCAST: The Wider World of Pre-hospital Care; Roadside to Resus](https://emergencymed.org.il/podcast-the-wider-world-of-pre-hospital-care-roadside-to-resus/קדם-בית-חולים/) - Dec 11, 2025 Welcome to this special edition of Roadside to Resus where we’re diving into some of the progressive and practice-defining developments in pre-hospital emergency care. This episode brings together a superb group of clinicians, educators and leaders who are shaping the future of PHEM across the UK, and we caught up with them
- [PODCAST:  RCEM Learning December 2025](https://emergencymed.org.il/podcast-rcem-learning-december-2025/podcast/) - Merry Christmas! This month for the December 2025 episode of the RCEM Learning Podcast Andy and Dave are talking about higher MAP targets in sepsis and the routine use of antibiotics for max-fax fractures. Rob attempts a festive round up of the most impactful guidelines of the year. We’ll then end with New Online. If
- [Does Time to Vasopressor in Septic Shock Matter?](https://emergencymed.org.il/does-time-to-vasopressor-in-septic-shock-matter/articles-2/) - Written by Caitlin Nicholson In septic shock patients, time from first hypotension to vasopressor initiation showed no association with 90-day mortality or vasopressor-free days. The early vasopressor bird doesn’t always get the worm. This large retrospective cohort study examined whether the timing of vasopressor initiation after the first documented hypotensive episode (SBP ≤100 mmHg) influenced
- [PODCAST: Pediatric Respiratory Emergencies: Beyond Viral Season](https://emergencymed.org.il/podcast-pediatric-respiratory-emergencies-beyond-viral-season/ילדים/) - Written by Anand Swaminathan REBEL Cast, REBEL Core, REBEL EM Medical Category: Pediatrics, Thoracic and Respiratory Asthma, Bronchiolitis, croup, Emergency Medicine, Pediatrics, PEM, REBEL Core Cast, respiratory distress, stridor, wheezing December 4, 2025 📝 Introduction 🔍 Recognizing Respiratory Patterns 🩺 Localizing Sounds for Accurate Diagnosis 💉 Tailoring Treatment for Effective Results 🌬️ Intervening with Severe Asthma 🦓 Navigating the Zebras of Respiratory Cases 📌 Conclusion 📝 Introduction Welcome to
- [Penetrating Trauma Transport—EMS, Police, or Private Vehicle? Emergency Medicine EMS Pediatric Emergency Trauma](https://emergencymed.org.il/penetrating-trauma-transport-ems-police-or-private-vehicle-emergency-medicine-ems-pediatric-emergency-trauma/articles-2/) - Written by Andy Hogan When EMS is not immediately available, transporting adult patients with penetrating injuries in urban settings to trauma centers by police or private vehicle leads to improved survival. Scoop and run for knife or gun? Modern EMS guidelines have shifted from a “scoop and run” approach to emphasize on-scene stabilizing care. Certain
- [PODCAST: papers of the month Aortic Dissection](https://emergencymed.org.il/podcast-papers-of-the-month-aortic-dissection/podcast/) - We've talked about Aortic Dissection before in our Roadside to Resus episode and the huge difficulties in picking out these rare but potentially devastating cases and this month we've got a fantastic paper on the topic! The DAShED study looks at patients presenting with symptoms that could be suggestive of aortic dissection and helps us
- [PODCAST: EM Quick Hits  Pediatric Urinary Retention & Acute Transverse Myelitis, Post-Dural Puncture Headache, Med Mal Cases: Clenched Fist Injury, IV Thrombolysis for Minor Stroke, EM Leadership Spotlight #4](https://emergencymed.org.il/podcast-em-quick-hits-pediatric-urinary-retention-acute-transverse-myelitis-post-dural-puncture-headache-med-mal-cases-clenched-fist-injury-iv-thrombolysis-for-minor-stroke-em-leadership-spot/education-tips/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per Creative Commons copyright.” Topics in this EM Quick Hits podcast Deborah Schonfeld on pediatric urinary retention & acute transverse myelitis (01:27) Jesse McLaren on Occlusion MI Diagnosis (24:44) Matthew McArthur on post-dural puncture headache (31:34) Joseph Yasmeh on Med Mal Cases: clenched fist injury (42:42)
- [PODCAST: EM Quick Hits  Pediatric Urinary Retention & Acute Transverse Myelitis, Post-Dural Puncture Headache, Med Mal Cases: Clenched Fist Injury, IV Thrombolysis for Minor Stroke, EM Leadership Spotlight #4](https://emergencymed.org.il/podcast-em-quick-hits-pediatric-urinary-retention-acute-transverse-myelitis-post-dural-puncture-headache-med-mal-cases-clenched-fist-injury-iv-thrombolysis-for-minor-stroke-em-leadership-spot/education-tips/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per Creative Commons copyright.” Topics in this EM Quick Hits podcast Deborah Schonfeld on pediatric urinary retention & acute transverse myelitis (01:27) Jesse McLaren on Occlusion MI Diagnosis (24:44) Matthew McArthur on post-dural puncture headache (31:34) Joseph Yasmeh on Med Mal Cases: clenched fist injury (42:42)
- [PODCAST: Prehospital Management of Spinal Cord Injuries](https://emergencymed.org.il/podcast-prehospital-management-of-spinal-cord-injuries/קדם-בית-חולים/) - Happy Turkey Day! Join host Dr. Phil Moy as we dive straight into a topic that has "stirred up more conversation than a potluck dinner at an EMS station": the prehospital management of spinal injuries. We are here to highlight the critical manuscript "Prehospital Management of Spinal Cord Injuries, an NAEMSP Comprehensive Review and Analysis of the Literature",
- [PODCAST: Another day for you and me in pain – Chronic Abdominal Pain and ED visits](https://emergencymed.org.il/podcast-another-day-for-you-and-me-in-pain-chronic-abdominal-pain-and-ed-visits/education-tips/) - Date: November 26, 2025 Reference: Ray et al. Emergency Department Visit Frequency Among Adults with Chronic Abdominal Pain: Findings From the 2023 US National Health Interview Survey. AEM November 2025. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine in the UK and an evidence-based medicine advocate. She’s a seasoned knowledge translator with her PaperinaPic infographics. Case: You
- [NEJM: Idiopathic Intracranial Hypertension](https://emergencymed.org.il/nejm-idiopathic-intracranial-hypertension/articles-2/) - Author: Jonathan C. Horton, M.D., Ph.D.Author Info & Affiliations Published October 8, 2025 N Engl J Med 2025;393:1409-1419 DOI: 10.1056/NEJMra2404929 Abstract Idiopathic intracranial hypertension — high cerebrospinal fluid pressure most common in women of reproductive age with obesity — threatens vision. Treatment includes weight loss, medication, and surgery.
- [NEJM: Idiopathic Intracranial Hypertension](https://emergencymed.org.il/nejm-idiopathic-intracranial-hypertension/articles-2/) - Author: Jonathan C. Horton, M.D., Ph.D.Author Info & Affiliations Published October 8, 2025 N Engl J Med 2025;393:1409-1419 DOI: 10.1056/NEJMra2404929 Abstract Idiopathic intracranial hypertension — high cerebrospinal fluid pressure most common in women of reproductive age with obesity — threatens vision. Treatment includes weight loss, medication, and surgery.
- [In OHCA, Defib Faster and More Survive](https://emergencymed.org.il/in-ohca-defib-faster-and-more-survive/articles-2/) - Written by Jason Lesnick This nationwide database study found that defibrillation within 2 minutes of starting CPR was associated with increased 1-month survival in out-of-hospital cardiac arrest (OHCA) patients. Shock sooner, spark survival These authors asked: Is defibrillation within 2 minutes of starting CPR associated with 1-month survival in patients who suffered atraumatic, shockable OHCA?
- [Evaluating the impact of AI assistance on decision-making in emergency doctors interpreting chest X-rays: a multi-reader multi-case study](https://emergencymed.org.il/evaluating-the-impact-of-ai-assistance-on-decision-making-in-emergency-doctors-interpreting-chest-x-rays-a-multi-reader-multi-case-study/articles-2/) - David Lyell ,1 Michael Dinh,2,3 Mark Gillett,4 Nidhi Abraham,2,3 Emily Rose Symes,3,5 Anindya Pradipta Susanto ,1,6 Bashir Antoine Chakar ,3 Radhika V Seimon ,3 Enrico Coiera,1 Farah Magrabi 1 Abstract Background Artificial intelligence (AI) tools could assist emergency doctors interpreting chest X-rays to inform urgent care. However, the impact of AI assistance on clinical decision-making,
- [Chest Tubes – What You Need to Know](https://emergencymed.org.il/chest-tubes-what-you-need-to-know/trauma/) - Written by Alex Clark Pleural cavity decompression via surgical tube thoracostomy or pleural catheter (pigtail) is a core EM skill. This excellent, high-yield review gets you ready. Totally tubular, dude Indications & Contraindications Indications: Pneumothorax, PTX (spontaneous/traumatic), hemothorax, pleural effusion. Relative contraindications: Overlying cellulitis, coagulopathy (INR >1.5—but do not delay if emergent), or complex anatomy
- [JAMA AI : Software as a Medical Practitioner—Is It Time to License Artificial Intelligence?](https://emergencymed.org.il/jama-ai-software-as-a-medical-practitioner-is-it-time-to-license-artificial-intelligence/articles-2/) - Eric Bressman, MD, MSHP1,2; Carmel Shachar, JD, MPH3; Ariel D. Stern, PhD4 et al Author Affiliations Article Information The Healthy Technology Act of 2025, a bill being considered by Congress, would permit artificial intelligence (AI) systems to prescribe medications without human sign-off. While allowing AI to practice independently may still be a stretch, large language models are already being used to support diagnosis
- [NEJM: Medical Imaging and Pediatric and Adolescent Hematologic Cancer Risk](https://emergencymed.org.il/nejm-medical-imaging-and-pediatric-and-adolescent-hematologic-cancer-risk/articles-2/) - Rebecca Smith-Bindman 1 2 3, Susan A Alber 4, Marilyn L Kwan 5, Priscila Pequeno 6, Wesley E Bolch 7, Erin J A Bowles 8, Robert T Greenlee 9, Natasha K Stout 10 11, Sheila Weinmann 12 13, Lisa M Moy 5, Carly Stewart 1, Melanie Francisco 12, Cameron Kofler 14, James R Duncan 15, Jonathan Ducore 16, Malini Mahendra 3 17, Jason D Pole 6 18 19, Diana L Miglioretti 4 8 20 Affiliations Expand Abstract. Background: Assessing the risk of radiation-induced hematologic cancer from medical imaging in children and adolescents might support informed decisions on the use of imaging.
- [PODCAST: Understanding QTc Prolongation: Causes, Risks, and Management](https://emergencymed.org.il/podcast-understanding-qtc-prolongation-causes-risks-and-management/podcast/) - 📌 Key Points 🫀 Prolonged QTc raises risk of torsades de pointes ⏱️ Correct for heart rate: QTc > 440 ms (men) or > 460 ms (women); > 500 ms = high TdP risk. 💊 Common culprits: Methadone, ondansetron, macrolides, fluoroquinolones, antipsychotics. 🧪 Prevention: Check & replete K, Mg, Ca and avoid QT-prolonging meds when possible. 🚑 If TdP develops: Defibrillate + IV magnesium and stop offending agents. 📝 Introduction
- [Midazolam and Ketamine for Convulsive Status Epilepticus in the Out-of-Hospital Setting](https://emergencymed.org.il/midazolam-and-ketamine-for-convulsive-status-epilepticus-in-the-out-of-hospital-setting-2/articles-2/) - Tony Zitek, MD*; Kenneth A. Scheppke, MD; Peter Antevy, MD; Charles Coyle, EMT-P; Sebastian Garay, EMT-P; Eric Scheppke, DO; David A. Farcy, MD 📌 Key Points Ketamine for Seizure Control: After two midazolam doses, ketamine increased seizure cessation rates significantly in the prehospital setting. Not Yet Standard of Care: Ketamine remains investigational—it wasn’t directly compared to
- [Serious Cardiac Outcomes and Physician Estimation of Risk in Emergency Department Patients With Presyncope Versus Syncope](https://emergencymed.org.il/serious-cardiac-outcomes-and-physician-estimation-of-risk-in-emergency-department-patients-with-presyncope-versus-syncope/articles-2/) - Edward H. Suh, MD*; Dana L. Sacco, MD, MPH; Carolyn Winskill, MS; John DeAngelis, MD; Daniel Nishijima, MD, MAS; Jonathan Schimmel, MD; Alan Storrow, MD; Venkatesh Thiruganasambandamoorthy, MBBS, MSc; Robert E. Weiss, MS; Nancy Wood, MPA, MS; Marc A. Probst, MD, MS ABSTRACT Study objective: Previous research suggests that the short-term incidence of adverse events
- [Association of prehospital optimal blood pressure and peripheral oxygen saturation with hospital outcomes in sports-related and recreation-related traumatic brain injury (SRR-TBI) in Asia](https://emergencymed.org.il/association-of-prehospital-optimal-blood-pressure-and-peripheral-oxygen-saturation-with-hospital-outcomes-in-sports-related-and-recreation-related-traumatic-brain-injury-srr-tbi-in-asia/articles-2/) - Jirayu Chantanakomes ,1 Wasin Pansiritanachot,1 Sattha Riyapan ,1 Sang Do Shin,2 Kyoung Jun Song ,3 Wen-Chu Chiang ,4 Sabariah Faizah Jamaluddin,5 Kentaro Kajino6 ABSTRACT Background While Emergency Medical Services (EMS) guidelines improve outcomes in severe traumatic brain injury (TBI), the effect of optimal blood pressure and oxygenation on sports-related and recreation-related TBI (SRR-TBI) is unclear.
- [PODCAST: Story Time and Tall Tales of Truth with Marv Wayne](https://emergencymed.org.il/podcast-story-time-and-tall-tales-of-truth-with-marv-wayne/education-tips/) - ACEP Frontline · Story Time and Tall Tales of Truth with Marv Wayne In this episode, we talk with EM legend, entrepreneur, and great story teller, Dr. Marvin Wayne, about his adventures through medicine and life. If you are in EM, surgery, interventional radiology, or critical care, you have likely used his "Cook-Wayne" catheter at
- [PODCAST: Nondisabling Stroke Recognition and Management](https://emergencymed.org.il/podcast-nondisabling-stroke-recognition-and-management/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Nondisabling stroke is where Emergency Medicine earns its keep. The threats are quieter, the windows are wider, and the misses—especially in younger and female patients—are more common. In this Part 2 or our 2-part
- [PODCAST: JEM September 2025 Podcast Summary](https://emergencymed.org.il/podcast-jem-september-2025-podcast-summary/education-tips/) - Nov 12, 2025 Podcast summary of articles from the September 2025 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include anticoagulation reversal, suctioning during intubation, push dose epinephrine, chat GPT in toxicology emergencies, IV access in hypotensive patients, and infant head injuries. Guest speaker is Dr. Cory Ohradzansky.
- [PODCAST: Prehospital blood pressure treatment](https://emergencymed.org.il/podcast-prehospital-blood-pressure-treatment/education-tips/) - Episode 51: Managing the (heart) Pump In this episode, Sophie breaks down the chaos behind pressors and blood pressure meds in EMS—what they do, when to use them, and how not to panic when that BP drops or spikes. From norepinephrine (the reliable one) to nitroglycerin (the smooth talker), Sophie introduces the “main characters” of
- [PODCAST: Resuscitation Guidelines 2025; Roadside to Resus](https://emergencymed.org.il/podcast-resuscitation-guidelines-2025-roadside-to-resus/קדם-בית-חולים/) - Nov 10, 2025 Whether you’re just stepping into your first cardiac arrest or you’ve been running them since the days of paddles, this one’s for you. The 2025 resuscitation guidelines have landed after further collaboration between ILCOR, the ERC and the Resuscitation Council UK and in this episode we break down exactly what’s new, what’s
- [JAMA: Metabolic Dysfunction–Associated Steatotic Liver Disease in Adults](https://emergencymed.org.il/jama-metabolic-dysfunction-associated-steatotic-liver-disease-in-adults/articles-2/) - Herbert Tilg, MD1; Salvatore Petta, MD2; Norbert Stefan, MD3,4 et al Author Affiliations Article Information JAMA Published Online: November 10, 2025 doi: 10.1001/jama.2025.19615 Abstract Importance Metabolic dysfunction–associated steatotic liver disease (MASLD) includes a range of liver conditions, progressing from isolated steatosis (characterized by fat accumulation in the liver without inflammation) to metabolic dysfunction–associated steatohepatitis (MASH), which involves fat accumulation and inflammation in the liver. The presence
- [חוסם עורקים PODCAST: Tourniquet Tips](https://emergencymed.org.il/חוסם-עורקים-podcast-tourniquet-tips/education-tips/) - 📌 Key Points ⏰ Highlights 📝 Introduction 📌 Key Points 🩸 Tourniquets save lives and limbs: Apply immediately when you’ve got arterial bleeding. 📍 Placement matters: Position the tourniquet 5–6 cm proximal to the arterial bleed, or if you can’t identify the exact source, place it as high up on the limb as possible. 🔧 Windlass technique: The windlass provides only a small amount of
- [PODCAST: Brain Injury Guidelines (BIG)](https://emergencymed.org.il/podcast-brain-injury-guidelines-big/trauma/) - Oct 27, 2025 Contributor: Aaron Lessen, MD Educational Pearls: Traumatic Brain Injuries are a frequent complaint in the Emergency Department and have increased in recent years. The American Association for Surgery of Trauma (AAST) has created Brain Injury Guidelines (BIG), in an attempt to categorize brain injuries and the level of treatment they require. They
- [PODCAST: Electrical Burns](https://emergencymed.org.il/podcast-electrical-burns/trauma/) - Contributor: Travis Barlock, MD Educational Pearls: Quick Statistics on Electrical Burns: Electrical burns compose roughly 2 to 9% of all burns that come into emergency departments. The majority of patients who receive electrical burns are male, typically aged 20’s to 30’s, accounting for 80 to 90% of all electrical burn victims. The majority of burns
- [Diagnosing Pulmonary Embolism During Pregnancy](https://emergencymed.org.il/diagnosing-pulmonary-embolism-during-pregnancy/articles-2/) - Meriem Hammache 1, Camille Simard 2, Sandrine Hamel 3, Suzie Ouellet 3, Gisèle Jolicoeur 3, Karen Wou 4, Kate Sellen 5, Ramy El-Jalbout 6, Jayson Potts 7, Ghada Bourjeily 8, Maral Koolian 9, Vicky Tagalakis 2, Leslie Skeith 10, Grégoire Le Gal 11, Isabelle Malhamé 12 Affiliations Expand PMID: 40404047 DOI: 10.1016/j.chest.2025.05.014 Free article Abstract Topic importance: Pulmonary embolism (PE) is one of the leading causes of pregnancy-related deaths in high-income countries. Maternal mortality from PE has been attributed to delayed recognition and investigation. The
- [Epinephrine 0.3mg or 0.5mg for Anaphylaxis?](https://emergencymed.org.il/epinephrine-0-3mg-or-0-5mg-for-anaphylaxis/articles-2/) - Written by Clay Smith For anaphylaxis in adults ≥50kg, 0.5mg vs. 0.3mg IM epinephrine is strongly associated with a reduction in escalation of care (repeat epi, epi drip, or intubation). So weird that a dose circa 1918 needs to be reconsidered… Epinephrine auto-injectors come with standard 0.3mg doses (0.15mg for pediatrics). But why 0.3mg? The recommended
- [PODCAST: November 2025; papers of the month](https://emergencymed.org.il/podcast-november-2025-papers-of-the-month/podcast/) - Nov 1, 2025 This month we’ve got four cracking UK-led studies that really speak to how pre-hospital and emergency medicine continue to evolve, not just in the kit and skills we use, but in how we think about the whole patient journey. We’ll start with a paper fromAnaesthesia with Pallavicini et al., exploring pre-hospital central
- [Blood Pressure Effects and Risk of Hypotension due to Intravenous Furosemide in Acute Decompensated Heart Failure](https://emergencymed.org.il/blood-pressure-effects-and-risk-of-hypotension-due-to-intravenous-furosemide-in-acute-decompensated-heart-failure/articles-2/) - Nicholas E Harrison 1, Meghana Bhaskara 1, Kyle Wilson 1, Ankit A Desai 2, Nicholas Montelauro 1, Phillip Levy 3, Peter Pang 1, Robert R Ehrman 3 Affiliations Expand Abstract. Objective: We quantified the magnitude of systolic blood pressure (SBP) adverse effects associated with intravenous furosemide (IVFu), compared to other factors, during treatment for acute decompensated heart failure (ADHF). Methods: Continuous BP monitoring (598.2 person-hours, 91,210 observations) before and after IVFu
- [Norepinephrine vs. Epinephrine for Post-Arrest Shock](https://emergencymed.org.il/norepinephrine-vs-epinephrine-for-post-arrest-shock/articles-2/) - Written by Catherine Burger This meta-analysis shows decreased episodes of repeat cardiac arrest when post-arrest shock was treated with norepinephrine vs. epinephrine, but there were no differences in survival or discharge with good neurological outcome. Norepinephrine edges out epi in post-arrest shock This systematic review and meta-analysis compared the efficacy of epinephrine (EPI) and norepinephrine
- [PODCAST: Prevalence of violence against health care workers among agitated patients in an urban emergency department](https://emergencymed.org.il/podcast-prevalence-of-violence-against-health-care-workers-among-agitated-patients-in-an-urban-emergency-department/education-tips/) - Date: October 30, 2025 Reference: Boes et al. Prevalence of violence against health care workers among agitated patients in an urban emergency department. October 2025 AEM Guest Skeptic: Dr. Suchismita Datta. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. Case: It’s 7:34 pm. You just
- [JAMA: Effectiveness and Cost-Effectiveness of Automated External Defibrillators in Private Homes A Report From the Cardiac Arrest Registry to Enhance Survival](https://emergencymed.org.il/jama-effectiveness-and-cost-effectiveness-of-automated-external-defibrillators-in-private-homes-a-report-from-the-cardiac-arrest-registry-to-enhance-survival/articles-2/) - Lars W. Andersen, MD, MPH, PhD, DMSc1,2,3; Mathias J. Holmberg, MD, MPH, PhD3; Eline Krijkamp, PhD4 et al JAMA Intern Med Published Online: October 25, 2025 doi: 10.1001/jamainternmed.2025.6123 related icon Related Articlesfigure icon Figuresattach icon Supplemental Content Key Points Question Are automated external defibrillations (AEDs) in private homes effective and cost-effective? Findings In this cohort study including 582 536 patients, survival was better with AED application compared with no AED application in
- [JAMA: Perspectives on Point-of-Care Ultrasonography Credentialing and Privileging](https://emergencymed.org.il/jama-perspectives-on-point-of-care-ultrasonography-credentialing-and-privileging/articles-2/) - Stephanie M. Conner, MD1; James E. Anstey, MD2; Meghan K. Thomas, MD, MS, MPH3 et al JAMA Netw Open Published Online: October 22, 2025 2025;8;(10):e2538759. doi:10.1001/jamanetworkopen.2025.38759 Key Points Question What factors play a role in point-of-care ultrasonography (POCUS) privileging and credentialing policy implementation at health care institutions across the US? Findings In this qualitative study, 20 POCUS leaders reported that successful POCUS policy implementation was driven by institutional and
- [PODCAST: pseudomonas antibiotics](https://emergencymed.org.il/podcast-pseudomonas-antibiotics/podcast/)
- [PODCAST: Oral vs Temporal Thermometers](https://emergencymed.org.il/podcast-oral-vs-temporal-thermometers/education-tips/) - Contributor: Taylor Lynch, MD Educational Pearls: A recent study published in a pediatric journal in April 2025 compared temporal and oral thermometers Paired temperature measurements (temporal and oral temperature within 30 minutes) were obtained from 1,412 pediatric patients 26% of patients had statistically different temporal and oral temperatures The temporal reading was always lower than
- [Can EMS Use PECARN Peds C-Spine Rule Prehospital?](https://emergencymed.org.il/can-ems-use-pecarn-peds-c-spine-rule-prehospital/קדם-בית-חולים/) - Written by Joshua Belfer The PECARN cervical spine injury prediction rule performed well when applied by EMS clinicians, with high sensitivity and negative predictive value, suggesting it may help reduce unnecessary spinal motion restriction in children after blunt trauma. PECARN to go: Can EMS call the (c‑spine) shots? We rely on clinical prediction rules in
- [How Many Intubations Before You’re Competent?](https://emergencymed.org.il/how-many-intubations-before-youre-competent/education-tips/) - Written by Jason Lesnick This secondary analysis found that intubation success correlated with experience, and competency likely is achieved between 35–50 intubations. The ACGME was… right? These authors determined if experience was associated with intubation success and, if so, how many intubations were needed to achieve competency. This study was a secondary analysis of 2,839
- [PODCAST:Smooth Muscle Relaxator – But does Magnesium Work for Renal Colic?](https://emergencymed.org.il/podcastsmooth-muscle-relaxator-but-does-magnesium-work-for-renal-colic/podcast/) - Date: October 10, 2025 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department. Case: A 37-year-old man presents to the emergency department (ED) with severe right-sided flank pain. The pain
- [Risk of complications using a sedation protocol for aeromedical retrieval of acutely unwell mental health patients: a retrospective cohort study in Outback Australia](https://emergencymed.org.il/risk-of-complications-using-a-sedation-protocol-for-aeromedical-retrieval-of-acutely-unwell-mental-health-patients-a-retrospective-cohort-study-in-outback-australia/articles-2/) - Jack Lewis , Angus Perks ,Peter Brendt ,Emma Webster ,Georgina M Luscombe Abstract Background Aeromedical transfer of acutely unwell mental health (AMH) patients presents potential risks to patient, staff and aircraft. Pharmacological options to reduce risk can impair consciousness, risking airway compromise and management challenges in-flight. Pre-emptive intubation carries associated patient risks
- [PODCAST: Airway — The First Frontier (Part 1&2)](https://emergencymed.org.il/podcast-airway-the-first-frontier-part-12/education-tips/) - Episode 45: Airway — The First Frontier (Part 1) Episode 46: Airway — The First Frontier (Part 2) Episode notes They taught us how to line up the landmarks and pass a tube, but they didn’t tell us how humbling a bad view can feel at 3 a.m., or how much the little things like positioning, BVM
- [Prehospital Trauma Compendium: Tranexamic Acid in Trauma – A Joint Position Statement and Resource Document of NAEMSP, ACEP, and ACSCOT](https://emergencymed.org.il/prehospital-trauma-compendium-tranexamic-acid-in-trauma-a-joint-position-statement-and-resource-document-of-naemsp-acep-and-acscot/education-tips/) - ABSTRACT Prehospital use of tranexamic acid (TXA) has grown substantially over the past decade despite contradictory evidence supporting its widespread use. Since the previous guidance document on The prehospital use of TXA for injured patients was published by the National Association of Emergency Medical
- [חופשה לחגים עד 15.10](https://emergencymed.org.il/חופשה/articles-2/) - חברים יקרים יצאתי לחופשה בחו"ל עד לאחר סוכות. בתקופת החופש לא יהיו עדכונים באתר. אשוב לאחר החג שלכם ערן
- [PODCAST: Crashing Asthmatic: ED Management That Saves Lives](https://emergencymed.org.il/podcast-crashing-asthmatic-ed-management-that-saves-lives/קדם-בית-חולים/) - When wheezing goes silent, things get real. Let's do a rapid-fire breakdown of how to manage life-threatening asthma in the ED — with pearls that might just save a life. Vent settings, epi hacks, ketamine tricks, and more in under 15 minutes.
- [JAMA: Screening and Risk Algorithms for Detecting Pediatric Suicide Risk in the Emergency Department](https://emergencymed.org.il/jama-screening-and-risk-algorithms-for-detecting-pediatric-suicide-risk-in-the-emergency-department/articles-2/) - Robert H. Aseltine Jr, PhD1,2; Shane J. Sacco, PhD2,3; Steven Rogers, MD2,4,5 et al Key Points Question How does the performance of in-person screening compare with risk algorithms in identifying youths at risk of suicide? Findings In this cohort study of 19 653 youths, a risk algorithm using patients’ clinical data significantly outperformed universal screening instruments in identifying pediatric patients in the emergency department at risk
- [PODCAST: Penicillin Allergy?](https://emergencymed.org.il/podcast-penicillin-allergy/מתמחים/) - s that penicillin or amoxicillin allergy real? Probably not. In this episode, we explore how to assess risk, talk to parents, and refer for delabeling. You’ll also learn what happens in the allergy clinic, why the label matters, and how to be a better antimicrobial steward. Learning Objectives Describe the mechanisms and clinical manifestations of
- [PODCAST: Symptomatic Bradycardia and Procedural Sedation and Analgesia](https://emergencymed.org.il/podcast-symptomatic-bradycardia-and-procedural-sedation-and-analgesia/סדציה/) - ACEP Critical Decisions in Emergency Medicine · August 2025: Symptomatic Bradycardia and Procedural Sedation and Analgesia
- [What’s the Ideal Intranasal Midazolam Dose for Peds Sedation?](https://emergencymed.org.il/whats-the-ideal-intranasal-midazolam-dose-for-peds-sedation/articles-2/) - Written by Vivian Lei Sniffing out the sweet spot for IN midazolam. Intranasal (IN) midazolam is a popular choice for pediatric procedural sedation in the ED, but dosing practices have historically varied widely. This prospective, double-blind, adaptive selection, randomized clinical trial enrolled 101 children (6 months to 7 years) undergoing laceration repair
- [CIRCULATION: 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines](https://emergencymed.org.il/circulation-2025-aha-acc-aanp-aapa-abc-accp-acpm-ags-ama-aspc-nma-pcna-sgim-guideline-for-the-prevention-detection-evaluation-and-management-of-high-blood-pressure-in-adults-a-report-of-the-americ/articles-2/) - Writing Committee Members*; Daniel W Jones, Keith C Ferdinand, Sandra J Taler, Heather M Johnson 1, Daichi Shimbo 1, Marwah Abdalla 2, M Martine Altieri 3, Nisha Bansal, Natalie A Bello, Adam P Bress 4, Jocelyn Carter 5, Jordana B Cohen, Karen J Collins, Yvonne Commodore-Mensah 6, Leslie L Davis, Brent Egan 7, Sadiya S Khan, Donald M Lloyd-Jones, Bernadette Mazurek Melnyk 8, Eva A Mistry, Modele O Ogunniyi 9, Stacey L Schott 10, Sidney C Smith Jr, Amy W Talbot, Wanpen Vongpatanasin, Karol E Watson 11, Paul K Whelton, Jeff D Williamson 12 Abstract.
- [JAMA: Artificial Intelligence–Enhanced Electrocardiography for Complete Heart Block Risk Stratification](https://emergencymed.org.il/jama-artificial-intelligence-enhanced-electrocardiography-for-complete-heart-block-risk-stratification/articles-2/) - Arunashis Sau, PhD1,2; Henry Zhang, BSc1; Joseph Barker, MRes1 et alJAMA Cardiol Published Online: August 20, 2025 doi: 10.1001/jamacardio.2025.2522 related icon Related Articlesfigure icon Figuresattach icon Supplemental Content Key Points Question Can artificial intelligence–enhanced electrocardiography (AI-ECG) be used to identify individuals with risk of incident complete heart block (CHB)? Findings This cohort study demonstrated that an AI-ECG risk model can predict the risk of incident CHB and is superior to traditional,
- [שנה טובה ומבורכת לכל ציוותי ררפואה דחופה Happy New Year to Emergency Medical Teams](https://emergencymed.org.il/שנה-טובה-ומבורכת-לכל-ציוותי-ררפואה-דחו/articles-2/) - To our incredible emergency medical teams, As the New Year approaches, we want to extend our deepest gratitude for your unwavering dedication, courage, and compassion. You are the first responders, the frontline heroes who rush in when others run out. You face challenges with strength and professionalism, saving lives and bringing comfort in the most
- [JAMA: Acupuncture for Chronic Low Back Pain in Older Adults A Randomized Clinical Trial](https://emergencymed.org.il/jama-acupuncture-for-chronic-low-back-pain-in-older-adults-a-randomized-clinical-trial/articles-2/) - Lynn L. DeBar, PhD, MPH1; Robert D. Wellman, MS2; Morgan Justice, PhD2 et al Key Points Question Is acupuncture needling (both a standard acupuncture course and additional maintenance sessions) an effective treatment for older adults with chronic low back pain (CLBP)? Findings In this randomized clinical trial that included 800 older adults with CLBP, acupuncture needling (both a standard course and additional maintenance sessions)
- [PODCAST: Acute Heart Failure Risk Stratification and Disposition](https://emergencymed.org.il/podcast-acute-heart-failure-risk-stratification-and-disposition/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” We’d like to think that we’re getting better at identifying acute heart failure and making good disposition decisions. But the facts are, ED physicians are only about 80% accurate diagnosing acute heart failure, and
- [PODCAST: Etomidate vs. Ketamine for Rapid Sequence Intubation](https://emergencymed.org.il/podcast-etomidate-vs-ketamine-for-rapid-sequence-intubation/education-tips/) - Dec 23, 2024 Contributor: Ricky Dhaliwal MD Educational Pearls: Etomidate was previously the drug of choice for rapid sequence intubation (RSI) However, it carries a risk of adrenal insufficiency as an adverse effect through inhibition of mitochondrial 11-β-hydroxylase activity A recent meta-analysis analyzing etomidate as an induction agent showed the following: 11 randomized-controlled trials with
- [PODCAST: Combo Rescue Inhalers - New Guidelines](https://emergencymed.org.il/podcast-combo-rescue-inhalers-new-guidelines/podcast/) - Apr 30, 2025 Contributor: Aaron Lessen, MD Educational Pearls: What is a Rescue Inhaler? A rescue inhaler is a medication for people with asthma to quickly reverse the symptoms of an asthma attack. Historically albuterol (Short Acting Beta Agonist (SABA)) monotherapy has been the mainstay rescue inhaler. This is because albuterol works fast and is
- [PODCAST: Fever Management](https://emergencymed.org.il/podcast-fever-management/education-tips/) - Aug 22, 2025 Contributor: Aaron Lessen, MD Educational Pearls: Recorded March 2025 What is the best treatment for a fever? Tylenol? Ibuprofen? Combined? Alternating the two? The journal Pediatrics aimed to answer this question with a meta-analysis of 31 randomized controlled trials including 5,009 febrile children. Results showed that both combined and alternating acetaminophen/ibuprofen regimens
- [PODCAST:  Massive Hemorrhage Protocol 2.0 with Petro](https://emergencymed.org.il/podcast-massive-hemorrhage-protocol-2-0-with-petro/trauma/) - You are here: Home / EMCrit / EMCrit 407 – Massive Hemorrhage Protocol 2.0 with Petro EMCrit 407 – Massive Hemorrhage Protocol 2.0 with Petro August 30, 2025 by Scott Weingart, MD FCCM 5 Comments In this episode we go back to the treatment of massive hemorrhage, not just trauma, but also OB with post-partum hemorrhage and GI bleeds. We touch on massive
- [Shortness of Breath After Heart Surgery](https://emergencymed.org.il/shortness-of-breath-after-heart-surgery/articles-2/) - Savannah Pocquette, DO ∙ Katelyn Levy, MD ∙ Jeffrey Gardecki, DO Keywords complex pericardial effusion cardiac tamponade focused cardiac ultrasonography 1 Patient Presentation A 56-year-old man with a history of aortic root aneurysm 3 weeks after surgery from an aortic root replacement with a mechanical valve-conduit presented to the emergency department with exertional dyspnea. He reported a week of progressive worsening of symptoms. He was
- [A Model for Developing Subspecialty Clinical  Practice Guidelines: The Geriatric Emergency  Department Guidelines 2.0](https://emergencymed.org.il/a-model-for-developing-subspecialty-clinical-practice-guidelines-the-geriatric-emergency-department-guidelines-2-0/articles-2/) - Satheesh Gunaga DO1,2,3 , Christopher R. Carpenter MD, MSc4 aura Kennedy MD, MPH5,6 Lauren T. Southerland MD, MPH7 Alexander X. Lo MD, PhD8 Sangil Lee MD, MS9 , Kirby Swan DO1,3 , Fabrice Mowbray PhD, RN10, Rachel M. Skains MD, MSPH11, Teresita M. Hogan MD12, Martin F. Casey MD, MPH13, Kei Ouchi MD, MPH6,14, Naomi
- [PODCAST: Meningitis Retention Syndrome](https://emergencymed.org.il/podcast-meningitis-retention-syndrome/education-tips/) - Sep 8, 2025 Contributor: Travis Barlock MD Educational Pearls: Meningitis retention syndrome is a relatively novel and rare clinical condition Aseptic meningitis + acute urinary retention One study reports an incidence of about 8% in patients with acute aseptic meningitis Clinical presentation Typical meningeal symptoms including fever, stiff neck, and headache Urinary retention occurs about
- [PODCAST: The Warrior – Pharmacological Interventions for the Acute Treatment of Hyperkalemia](https://emergencymed.org.il/podcast-the-warrior-pharmacological-interventions-for-the-acute-treatment-of-hyperkalemia/podcast/) - Reference: Jessen et al. Pharmacological interventions for the acute treatment of hyperkalaemia: A systematic review and meta-analysis. Resuscitation 2025 Date: August 6, 2025 Guest Skeptic: William Toon is a paramedic who, this past May achieved over 50 years of continuous EMS certification. His professional path has taken him from front-line paramedic to national presenter, expert witness, flight medic, EMS program
- [PODCAST: Awake NasoTracheal Intubation (AFOI) – When to Pick Your Patient’s Nose!](https://emergencymed.org.il/podcast-awake-nasotracheal-intubation-afoi-when-to-pick-your-patients-nose/articles-2/) - This episode delivers a deep dive into awake nasotracheal intubation / nasal intubation with a bronchoscope. We cover when to choose the nasal route, how to prepare the patient and equipment, and how to avoid common pitfalls. We break down nostril selection, airway preparation, tube and scope choice, pharmacologic adjuncts, topical anesthesia techniques, and operator
- [Effectiveness of Point-of-Care High-Sensitivity Troponin Testing in the Emergency Department: A Randomized Controlled Trial](https://emergencymed.org.il/effectiveness-of-point-of-care-high-sensitivity-troponin-testing-in-the-emergency-department-a-randomized-controlled-trial/articles-2/) - Viola I. L. Thulin, MD; Silje M. F. Jordalen, MD; Gard M. S. Myrmel, MD; Ole Christian Lekven, MD; Jeyaseelan Krishnapillai, MD; Ole Thomas Steiro, MD, PhD; Richard Body, MD, PhD; Paul Collinson, MD; Fred S. Apple, PhD; Louise Cullen, MD, PhD; Tone M. Norekvål, PhD; Torbjørn Wisløff, MSc, PhD; Kjell Vikenes, MD, PhD; Rune
- [C-Collars and Backboards Do More Harm than Good? Critical Care Emergency Medicine Pediatric Emergency Trauma](https://emergencymed.org.il/c-collars-and-backboards-do-more-harm-than-good-critical-care-emergency-medicine-pediatric-emergency-trauma/articles-2/) - September 8, 2025 The National Association of EMS Physicians (NAEMSP)’s comprehensive review of spinal motion restriction in prehospital management of trauma concluded that cervical collars and backboards are likely more likely to harm patients than to prevent delayed neurological injury (DNI). Step on a crack, break EMS dogma’s back C-collars and backboard use to prevent
- [Queen of Hearts – AI vs. Doctor in STEMI/OMI Accuracy](https://emergencymed.org.il/queen-of-hearts-ai-vs-doctor-in-stemi-omi-accuracy/articles-2/) - Written by Ketan Patel The Queen of Hearts AI (QoH AI) model beat both emergency physicians (EPs) and cardiologists at deciding who needs immediate catheterization for certain STEMI-equivalents and STEMI-mimics—88.9% accuracy vs. ~66%—promising fewer missed occlusion myocardial infarctions (OMIs) and fewer unnecessary activations. ECG Poker: Can you beat the Queen of Hearts? The ever-expanding role
- [PODCAST: ARIA - Alzheimer's Treatments and Risk in the ED with Dr. Christina Shenvi](https://emergencymed.org.il/podcast-aria-alzheimers-treatments-and-risk-in-the-ed-with-dr-christina-shenvi/podcast/) - ACEP Frontline · ARIA - Alzheimer's Treatments and Risk in the ED with Dr. Christina Shenvi In this episode, we talk with Dr. Christina Shenvi about ARIA, a finding associated with an early stage Alzheimer's infusion that can impact stroke and VTE care. The MRI of choice per neuroradiology are the T2 weighted and flare
- [PODCAST: Cardiac Arrest in Pregnancy](https://emergencymed.org.il/podcast-cardiac-arrest-in-pregnancy/קדם-בית-חולים/) - Jul 7, 2025 In this episode, we take a deep dive into an SAQ on Cardiac Arrest in Pregnancy. This is an important area of study for the Fellowship Written SAQ where the modifiers for bread and butter Resuscitation medicine is tested. Our modifier for this episode is Pregnancy. Whether you're preparing for your exams
- [STEMI Criteria Alone Miss LAD Occlusions – How to Spot OMI](https://emergencymed.org.il/stemi-criteria-alone-miss-lad-occlusions-how-to-spot-omi/articles-2/) - Reliance on STEMI criteria alone misses a substantial proportion of LAD occlusions, while expert and AI ECG interpretation achieved earlier and more accurate detection, with 100% sensitivity for LAD occlusion MI in this study. Oh, my! AI caught an OMI! This study evaluated the diagnostic accuracy of guideline-based STEMI ECG criteria vs. blinded expert interpretation
- [Resuscitation: Beyond STEMI: High-risk ECG patterns as predictors of occlusive myocardial infarction in out-of-hospital cardiac arrest patients](https://emergencymed.org.il/resuscitation-beyond-stemi-high-risk-ecg-patterns-as-predictors-of-occlusive-myocardial-infarction-in-out-of-hospital-cardiac-arrest-patients/articles-2/) - Claudio Silwanis 1, Julian Maier 2, Johannes Eder 1, Max Groche 1, Alexander Nahler 1, Alexander Fellner 1, Hermann Blessberger 3, Jörg Kellermair 3, Clemens Steinwender 3, Thomas Lambert 1 Affiliations Expand PMID: 40783097 DOI: 10.1016/j.resuscitation.2025.110763 Abstract. Background/aim: Immediate coronary angiography (CAG) is recommended for patients with ST-elevation myocardial infarction (STEMI) after out-of-hospital cardiac arrest (OHCA). However, some occlusive myocardial infarctions (OMI) do not meet STEMI criteria. This study investigated whether additional ECG patterns beyond STEMI could more
- [PODCAST: The Limping Child](https://emergencymed.org.il/podcast-the-limping-child/trauma/) - Limping is a common complaint in pediatric emergency care, but the differential is broad and the stakes are high. In this episode, we walk through a detailed, age-based approach to the evaluation of the limping child. You’ll learn how to integrate the Kocher criteria, when imaging and labs are truly necessary, and how to avoid
- [PODCAST: Hepatic Encephalopathy](https://emergencymed.org.il/podcast-hepatic-encephalopathy/podcast/) - Contributor: Alec Coston, MD Educational Pearls: Hepatic encephalopathy (HE) is defined as a disruption in brain function that results from impaired liver function or portosystemic shunting. Manifests as various neurologic and psychiatric symptoms such as confusion, inattention, and cognitive dysfunction Although ammonia levels have historically been recognized as important criteria for HE, the diagnosis is
- [JAMA: Out-of-Hospital Cardiac Arrest in US Airports](https://emergencymed.org.il/jama-out-of-hospital-cardiac-arrest-in-us-airports/articles-2/) - Aditya C. Shekhar, MBE1; Joshua Kimbrell, BA2; Timothy Friedmann, MD1,3 et al JAMA Netw Open Published Online: August 29, 2025 2025;8;(8):e2529754. doi:10.1001/jamanetworkopen.2025.29754 Key Points Question How are out-of-hospital cardiac arrest (OHCA) cases at US airports different from OHCA cases at other public venues? Findings This cross-sectional study used a nationwide database of emergency medical services (EMS) activations in the US to compare OHCA in airports with nonairport nonresidential settings.
- [EM Pharmacotherapy Literature of 2024](https://emergencymed.org.il/em-pharmacotherapy-literature-of-2024/articles-2/) - EM Pharmacotherapy Literature of 2024 August 28, 2025 Written by Amanda Mathews This article reviewed major ED pharmacotherapy studies from 2024, including topics such as anticoagulation reversal, seizure prophylaxis in TBI, and thrombolysis in ischemic stroke. Update your pharmacopia There are a lot of great studies highlighted in this article. Here are a few big
- [Can POCUS Improve Rhythm Identification and Outcomes in Out-of-Hospital Cardiac Arrests?](https://emergencymed.org.il/can-pocus-improve-rhythm-identification-and-outcomes-in-out-of-hospital-cardiac-arrests/articles-2/) - Michael E. Billington, MD, reviewing Gaspari R et al. Ann Emerg Med 2025 Jun 30 Point-of-care ultrasound early in cardiac arrest detected previously unidentified shockable rhythms, but outcomes didn't improve. Electrocardiograms (ECGs) are used in every step of cardiac arrest resuscitation algorithms. However, during resuscitation, ECG artifacts or misinterpretations can lead to inaccurate rhythm identification and incorrect management paths.
- [BMJ: Improving Care with the First measurement of high-sensitivity troponin T (ICare-FirsT) to enable early rule out and reduce length of stay: a diagnostic and observational study](https://emergencymed.org.il/bmj-improving-care-with-the-first-measurement-of-high-sensitivity-troponin-t-icare-first-to-enable-early-rule-out-and-reduce-length-of-stay-a-diagnostic-and-observational-study/articles-2/) - John W Pickering ,1,2 Laura Joyce ,2,3 Gerard Devlin,4 Chris Pemberton,1 Richard Troughton,1 A Mark Richards,1 Martin P Than 1, Abstract Background Pathways incorporating clinical risk assessment, ECG and serial troponin measurements for the assessment of patients with possible myocardial infarction (MI) in the ED are standard practice. Incorporating a single troponin test to
- [PODCAST: Airway Management in TBI or Ischemia](https://emergencymed.org.il/podcast-airway-management-in-tbi-or-ischemia/articles-2/) - ​ Try Alex (chatbot in right lower corner of the website) Evidence-based, fully-referenced answers ​Airway Management in TBI or Ischemia​ Published on September 1, 2025 Written by Vivian Lei This is a concise, evidence-based approach to intubating patients with acute brain injury while minimizing secondary brain injury and preserving cerebral perfusion. Mindful Intubation Emergency airway management
- [PODCAST: Beta Blocker Overdose: There's only one real antidote](https://emergencymed.org.il/podcast-beta-blocker-overdose-theres-only-one-real-antidote/podcast/) - This is not your grandma's insulin. You need to know how to treat beta blocker overdose- flawlessly. Let's talk first-line antidotes, and life-saving interventions. Want to experience the greatest in board studying? ⁠Check out our interactive question bank podcast- the FIRST of its kind here⁠ Cite this podcast as: Briggs, Blake, Husain, Iltifat. 265. Beta Blocker
- [ACEP: Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Mild Traumatic Brain Injury](https://emergencymed.org.il/acep-clinical-policy-critical-issues-in-the-management-of-adult-patients-presenting-to-the-emergency-department-with-mild-traumatic-brain-injury/articles-2/) - Approved by ACEP Board of Directors, February 1, 2023 Clinical Policy Endorsed by the Emergency Nurses Association (April 5, 2023) American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Mild Traumatic Brain Injury, Jonathan H Valente, John D Anderson, William F Paolo, Kelly Sarmiento, Christian A Tomaszewski, Jason S Haukoos, Deborah B Diercks; Members of the American College of Emergency Physicians
- [INJURY: The utility of a second head CT scan after a negative initial CT scan in head trauma patients on new direct oral anticoagulants (DOACs)](https://emergencymed.org.il/injury-the-utility-of-a-second-head-ct-scan-after-a-negative-initial-ct-scan-in-head-trauma-patients-on-new-direct-oral-anticoagulants-doacs/articles-2/) - Maha Mourad 1, Ayla Senay 2, Bilal Kharbutli 3 Affiliations Expand Abstract Background: New direct oral anticoagulants (DOACs) are commonly used in the management of atrial fibrillation and VTE. Currently, there is no strong evidence to support the current practice of routinely repeating computed tomography (CT) head in anticoagulated patients within 24 hours after their first negative CT
- [How Does Cryoprecipitate Fit into Trauma Resuscitation?](https://emergencymed.org.il/how-does-cryoprecipitate-fit-into-trauma-resuscitation/trauma/) - Written by Millie Cossé If you have access to the common massive transfusion protocol (MTP) cooler construct of 6:6:1 PRBCs:FFP:platelets, cryoprecipitate should be used at about the start of the second cooler. When do you need to call for cryo? This observational study of 2,117 level-one trauma patients receiving emergency release blood evaluated transfusion ratios
- [Resuscitation: Incidence and outcomes of out-of-hospital cardiac arrest from initial asystole: a systematic review and meta-analysis](https://emergencymed.org.il/resuscitation-incidence-and-outcomes-of-out-of-hospital-cardiac-arrest-from-initial-asystole-a-systematic-review-and-meta-analysis/articles-2/) - Dhiraj Bhatia Dwivedi 1, Jocasta Ball 2, Karen Smith 3, Ziad Nehme 4 Affiliations Expand Abstract Aim: To examine global variation in the incidence and outcomes of Emergency Medical Services (EMS) attended and treated out-of-hospital cardiac arrest (OHCA) from initial asystole. Data sources: We systematically reviewed electronic databases for studies between 1990 and August 2024 reporting EMS-attended or treated
- [JAMA: APOE ε4 and Risk of Intracranial Hemorrhage in Patients With Atrial Fibrillation Taking Apixaban](https://emergencymed.org.il/jama-apoe-ε4-and-risk-of-intracranial-hemorrhage-in-patients-with-atrial-fibrillation-taking-apixaban/articles-2/) - Santiago Clocchiatti-Tuozzo, MD, MHS1,2,3; Cyprien A. Rivier, MD, MS1,2; Daniela Renedo, MD4 et al Key Points Question Does the APOE ε4 allele increase the risk of intracranial hemorrhage among patients with atrial fibrillation who are treated with apixaban? Findings In this cohort study that evaluated 2038 patients who had atrial fibrillation on apixaban and no history of stroke, carriers vs noncarriers of 1 or 2 APOE epsilon ε4 alleles
- [JAMA: Hepatitis C Screening in Emergency Departments The DETECT Hep C Randomized Clinical Trial](https://emergencymed.org.il/jama-hepatitis-c-screening-in-emergency-departments-the-detect-hep-c-randomized-clinical-trial/articles-2/) - Jason Haukoos, MD, MSc1,2,3,4; Richard E. Rothman, MD, PhD5; James W. Galbraith, MD6 et al Key Points Question What is the most effective way to screen patients for hepatitis C virus (HCV) infection in emergency departments (EDs)? Findings This multicenter randomized clinical trial included 147 498 ED patient visits. Of these, 73 847 underwent nontargeted screening, resulting in 9867 tested for HCV and 154 new diagnoses, whereas
- [ECG Analysis – AI vs. Emergency Doc?](https://emergencymed.org.il/ecg-analysis-ai-vs-emergency-doc/articles-2/) - Written by Catherine Burger Comparing the accuracy of ECG interpretation between Emergency Medicine Providers (EMP) and 3 separate AI models, EMPs narrowly took the lead. Who does it better… humans or AI? This study involved 30 practitioners certified by the Turkish Minister of Health, each with 5–10 years of experience vs. 3 separate AI models:
- [PODCAST: Dilutional Hyponatremia](https://emergencymed.org.il/podcast-dilutional-hyponatremia/מתמחים/) - Jul 28, 2025 Contributor: Taylor Lynch, MD Educational Pearls: Dilutional Hyponatremia: Occurs when there is an excess of free water relative to sodium in the body. Causes a falsely low sodium concentration without a true change in total body sodium. Commonly seen in DKA: Hyperglycemia raises plasma osmolality. Water shifts from the intracellular to extracellular
- [TRAUMA: Traumatic pneumothorax and hemothorax: What you need to know](https://emergencymed.org.il/trauma-traumatic-pneumothorax-and-hemothorax-what-you-need-to-know/articles-2/) - Jacqueline J Blank 1, Marc A de Moya Affiliations Expand Abstract Abstract: Thoracic trauma occurs in approximately 25% of all traumas, and one third of these patients will present with a pneumothorax, hemothorax, or a combination of the two. Hemodynamically abnormal patients require expeditious tube thoracostomy drainage, while the decision to intervene on
- [Rising and Falling hs-Tn Means Badness](https://emergencymed.org.il/rising-and-falling-hs-tn-means-badness/articles-2/) - August 12, 2025 Written by Rebecca DiFabio and Ketan Patel Both rising and falling patterns in serial high-sensitivity cardiac troponin (hs-cTn) measurement were associated with significantly higher risk of 30-day MACE. Risers, fallers, and the flatliners – sorting the chest pain crowd Chest pain is one of the most common ED complaints, and risk
- [EMJ: High whole blood to total transfusion volume ratio and survival outcomes in patients with trauma requiring massive transfusions](https://emergencymed.org.il/emj-high-whole-blood-to-total-transfusion-volume-ratio-and-survival-outcomes-in-patients-with-trauma-requiring-massive-transfusions/articles-2/) - Chi Peng,1 Ronghui Zhu,2 Fan Yang,3 Yibin Guo,2 Lei Li,1 Zhichao Jin,2 Cheng Wu,2 Shuogui Xu Abstract Objective Whole blood (WB) resuscitation has been reported to improve haemostasis and reduce mortality in trauma patients with severe haemorrhage. However, the ideal ratio of WB to total transfusion volume (TTV) and whether a high WB to TTV ratio
- [Rock the Blocks – Serratus Anterior Plane Blocks for Acute Pain with US](https://emergencymed.org.il/rock-the-blocks-serratus-anterior-plane-blocks-for-acute-pain-with-us/articles-2/) - Written by Jonathan Brewer The serratus anterior plane block (SAPB) is an effective alternative for managing acute chest wall pain in the ED. Block the pain This clinical review utilized 14 articles (81 patients) to evaluate the utility of SAPB for analgesia. There were a variety of indications, including rib fractures, tube thoracostomy, acute zoster
- [CPR Update – Got ROSC…Now What?](https://emergencymed.org.il/cpr-update-got-roscnow-what/articles-2/) - Written by Jason Lesnick For patients with return of spontaneous circulation (ROSC) in the ED, a massively oversimplified summary is target normal: BP, O2, CO2, and temperature. Congrats, you got ROSC! Now what? There is a large pool of research concerning ways to manage these extremely sick patients who are at risk for re-arrest and
- [PODCAST: July 2025: Cardiovascular Disorders in the EDOU and Ectopic Pregnancy Presentations](https://emergencymed.org.il/podcast-july-2025-cardiovascular-disorders-in-the-edou-and-ectopic-pregnancy-presentations/education-tips/) - ACEP Critical Decisions in Emergency Medicine · July 2025: Cardiovascular Disorders in the EDOU and Ectopic Pregnancy Presentations In the July 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss cardiovascular disorders in the emergency department observation unit and ectopic pregnancy presentations. As always, you’ll also hear about the
- [PODCAST: JEM June 2025 Podcast Summary](https://emergencymed.org.il/podcast-jem-june-2025-podcast-summary/education-tips/) - Aug 6, 2025 Podcast summary of articles from the June 2025 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include Artificial Intelligence in X ray interpretation, metoclopramide, antipsychotics, stroke treatment, carbon monoxide toxicity, and organophosphate toxicity. Guest speaker is Dr. John Bennison.
- [PODCAST: ACEP Thoracic Aortic Dissection Clinical Policy Update](https://emergencymed.org.il/podcast-acep-thoracic-aortic-dissection-clinical-policy-update/podcast/) - n this episode, we review a new clinical policy from the American College of Emergency Physicians (ACEP) on the use of risk stratification tools and D-dimer to exclude non-traumatic thoracic aortic dissection. Shownotes: FOAMcast.org Direct download: ACEP_TAD.mp3 Category: -- posted at: 2:40pm EDT
- [PODCAST: Acute toxicity of heavy metals](https://emergencymed.org.il/podcast-acute-toxicity-of-heavy-metals/podcast/) - Aug 4, 2025 Contributor: Megan Hurley MD Educational Pearls: Acute toxicity of heavy metals: Gastrointestinal upset is the most common presentation Chronic toxicity of heavy metals: Symptoms depend on the metal ingested Increased risk of cancer Altered mentation Developmental delays (in children) Kidney failure Four heavy metals that are tested for in a general panel
- [PODCAST: Massive Hemorrhage Protocols 2.0 – Update on the 7 TsMassive Hemorrhage Protocols 2.0 – Update on the 7 Ts](https://emergencymed.org.il/podcast-massive-hemorrhage-protocols-2-0-update-on-the-7-tsmassive-hemorrhage-protocols-2-0-update-on-the-7-ts/קדם-בית-חולים/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Massive hemorrhage is one of the most time-critical, high-stakes scenarios in Emergency Medicine. Every minute matters. Every decision counts. But more blood is not always better—what saves lives is systematic, team-based, goal-directed care. In this
- [Emergency medicine updates: Cardiopulmonary resuscitation](https://emergencymed.org.il/emergency-medicine-updates-cardiopulmonary-resuscitation/articles-2/) - Brit Long 1, Michael Gottlieb 2 Affiliations Expand Abstract Introduction: Cardiac arrest is the loss of functional cardiac activity; emergency clinicians are integral in the management of this condition. Objective: This paper evaluates key evidence-based updates concerning cardiopulmonary resuscitation (CPR). Discussion: Cardiac arrest includes shockable rhythms (i.e., pulseless ventricular tachycardia and ventricular fibrillation) and non-shockable rhythms (i.e., asystole and pulseless electrical
- [PODCAST: Pediatric Critical Access and Resuscitation with Dr. Patrick Joynt](https://emergencymed.org.il/podcast-pediatric-critical-access-and-resuscitation-with-dr-patrick-joynt/education-tips/) - ACEP Frontline · Pediatric Critical Access and Resuscitation with Dr. Patrick Joynt In this episode, we get some expert tips on pediatric resuscitation and access considerations. This is part of the 3rd Annual Emergency Medicine - High Risk, Don't Miss conference from Colorado ACEP. This episode features PEM physician, Dr. Patrick Joynt.
- [PODCAST: JEM May 2025 Podcast Summary](https://emergencymed.org.il/podcast-jem-may-2025-podcast-summary/podcast/) - Jul 30, 2025 Podcast summary of articles from the May 2025 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include HEART score for chest pain, narcotic overdose, airway quality, ED imaging studies, POCUS for soft tissue abscess, and hyperosmolar hyperglycemic state. Guest speaker is Dr. John Bennison.
- [JAMA: iginal Investigation Health Informatics AI-Driven Injury Reporting in Pediatric Emergency Departments](https://emergencymed.org.il/jama-iginal-investigation-health-informatics-ai-driven-injury-reporting-in-pediatric-emergency-departments/articles-2/) - Devin Singh, BMSc, MBBS, MSc1,2,5; Alper Celik, PhD3; Evangeline W. J. Zhang, HBSc, MS1; et al Key Points Question Can natural language processing (NLP) models automate detecting injury cases in emergency department patient medical records to improve the efficiency of injury reporting and surveillance programs? Findings In this prognostic study of 217 173 emergency department visits at The Hospital for Sick Children, NLP models identified 90% of
- [GSW – Bowel to Bone – Do Antibiotics Help?](https://emergencymed.org.il/gsw-bowel-to-bone-do-antibiotics-help/articles-2/) - Written by Millie Cossé Duration of prophylactic antibiotic therapy was not found to be associated with likelihood of developing a fracture-related infection after GSW associated with bowel injury in this small retrospective study. Bowel to bone – leave it alone? If a bullet travels through bowel and strikes bone, causing a fracture, it’s probably going
- [In Trauma Transport, Rotor Wins (With a Time Limit!)](https://emergencymed.org.il/in-trauma-transport-rotor-wins-with-a-time-limit/education-tips/) - Written by Joshua Belfer Helicopter transport improves survival in trauma patients who meet triage criteria, but only if it saves at least 13–17 minutes over ground transport. Time is tissue, but what happens when it comes to transport? Air medical transport (AMT) is often used to expedite care for severely injured patients, but until now,
- [PODCAST: Angioedema](https://emergencymed.org.il/podcast-angioedema/podcast/) - Definition & Pathophysiology Angioedema = localized swelling of mucous membranes and subcutaneous tissues due to increased vascular permeability. Triggers increased vascular permeability → fluid shifts into tissues. Etiologies Histamine-mediated (anaphylaxis) Associated with urticaria/hives, pruritus, and redness. Triggered by allergens (foods, insect stings, medications). Rapid onset (minutes to hours). Bradykinin-mediated Hereditary angioedema (HAE): C1 esterase inhibitor
- [Emergency Department Preparedness in a Mega Mass Casualty Incident While Under Missile Fire: Lessons Learned from Israel on October 7, 2023”](https://emergencymed.org.il/emergency-department-preparedness-in-a-mega-mass-casualty-incident-while-under-missile-fire-lessons-learned-from-israel-on-october-7-2023/recourse/) - מאמר שייפורסם החודש ב journal of emergency medicine נכתב ע״י החברים באיגוד על המצב והתגובות של מערכת הבריאות ב 7.10.2023 Baruch Berzon, MD1,2,# ∙ Debra West, MBBS3,# ∙ Eliana Jacobs4 ∙ Maximilian Nerlander, MBBS5,6 ∙ Shaden Salameh, MD, MHA7,8 Shaden.md@gmail.com ∙ Eran Talor, MD9 ∙ Tzachi Slutsky, MD10 ∙ Jonathan Rieck, MD11 ∙ Evan Avraham Alpert, MD4,8 Abstract Introduction On October 7, 2023, approximately 2,500 Hamas terrorists infiltrated southern Israel from Gaza. Over 1,200 people were killed and 1600 were injured in the largest mass casualty incident (MCI) in
- [PODCAST: EMSAC 2024](https://emergencymed.org.il/podcast-emsac-2024/קדם-בית-חולים/) - Jul 26, 2025 Contributors: Col. (Dr.) Stacy Shackelford Dr. Sean Keenan Paramedic Alan Moreland Dr. Chris Tems Kara Napolitano From military-inspired trauma protocols to behavioral health alternatives and cardiac resuscitation, EMS is evolving fast. Our Medical Minutes from EMSAC highlight the growing need for prehospital providers to think critically, act quickly, and adapt to new
- [NEJM: Intravenous Tenecteplase before Thrombectomy in Stroke](https://emergencymed.org.il/nejm-intravenous-tenecteplase-before-thrombectomy-in-stroke/articles-2/) - Z. Qiu,1,2 F. Li,1 H. Sang,3 G. Yuan,4 D. Xie,1 K. Zhou,1 M. Li,1 Z. Meng,1 Z. Kong,5 Z. Ruan,6 C. Li,7 G. Yang,8 J. Wu,4 C. Long,4 B. Yang,5 H. Hu,8 Y. Li,9 J. Luo,10 Z. Shi,11 X. Huang,12 S. Jiang,13 T. Yi,14 G. Zeng,15 J. Liu,16 X. Luo,17 S. Liu,18 M. Chang,19 Youlin
- [How Fast to Rewarm Hypothermic Patients?](https://emergencymed.org.il/how-fast-to-rewarm-hypothermic-patients/articles-2/) - Written by Clay Smith A faster early rewarming rate of 3º per hour, when going from very cold to 33ºC, was associated with improved 28-day survival and favorable neurological outcome. It’s getting hot in here… This was a secondary analysis of prospectively collected data (ICE-CRASH study) from 36 Japanese hospitals and included 395 patients with accidental hypothermia (<32ºC).
- [PODCAST: They're Takin' our Jobs](https://emergencymed.org.il/13869/ניהול-מלרד/) - ACEP Frontline · 'They're Takin' our Jobs' - AI in EM with Dr. Henry Pitzele and Atul Srivastava Artificial intelligence is everywhere, with the opportunities and applications in medicine growing daily. In this session, Dr. Henry Pitzele and Atul Srivastava talk about some of the programs and how they can improve care in EM. We
- [PODCAST: Acute Agitation](https://emergencymed.org.il/podcast-acute-agitation-2/education-tips/) - We’re back with another episode of Push Dose Pearls with ED Clinical Pharacist, Haley Burhans! In this episode, we break down the essentials of managing agitation in the ED—starting with why you should avoid diphenhydramine in the elderly and benzodiazepines in the 3 D’s: drunk, delirium, and dementia. We discuss how to quickly assess the
- [PODCAST: Pediatric Status Epilepticus](https://emergencymed.org.il/13863/articles-2/) - In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the July 2025 Emergency Medicine Practice article, Emergency Department Management of Status Epilepticus in Pediatric Patients Introduction Welcome and brief overview of the episode Promotion of EB Medicine’s $1 for 7-day trial offer Why Pediatric Status Epilepticus Matters Seizures make up ~1% of ED visits and ~3%
- [JAMA:Older Adults Are Spending Too Long in the ED—Here’s Why and What Could Help](https://emergencymed.org.il/jamaolder-adults-are-spending-too-long-in-the-ed-heres-why-and-what-could-help/articles-2/) - Virginia Hunt1 With beeping monitors, hurried footsteps, and bright lights all teeming with urgency, emergency departments (EDs) can be overwhelming for anyone. But for older adults, every hour spent in an ED can increase the risk of immobility and delirium. “Precipitants of delirium in older adults are disruptions in sleep, immobility, and change of environment,” said Maura Kennedy, MD,
- [JAMA: Emergency Department Use Prior to Cancer Diagnosis and Mortality](https://emergencymed.org.il/jama-emergency-department-use-prior-to-cancer-diagnosis-and-mortality/articles-2/) - Keerat Grewal, MD, MSc1,2,3,4; Andrew Calzavara, MSc3; Shelley L. McLeod, PhD1,5; et al Key Points Question What is the risk of mortality among patients with and without emergency department (ED) use in the 90 days prior to cancer diagnosis? Findings In this cohort study of 410 120 patients with a cancer diagnosis, patients with ED use prior to diagnosis had statistically significantly higher risk of mortality compared
- [JAMA: Sequelae and Care After Firearm Injury](https://emergencymed.org.il/jama-sequelae-and-care-after-firearm-injury/articles-2/) - Bethany L. Strong, MD, MS1; Margaret H. Lauerman, MD1; Thomas M. Scalea, MD1 Firearm injury is caused by a weapon that uses a powder charge (handguns, rifles, and shotguns) and creates a wound or injury. According to the US Centers for Disease Control and Prevention (CDC), more than 48 000 firearm-related deaths occurred in the US in 2022. Firearm-related injuries are estimated to affect 120 000 individuals
- [PODCAST: Oxygen Administration in Trauma Patients](https://emergencymed.org.il/podcast-oxygen-administration-in-trauma-patients/קדם-בית-חולים/) - Jul 14, 2025 Contributor: Aaron Lessen, MD Educational Pearls: Many trauma patients are placed on oxygen via non-rebreather A large, multicenter, controlled trial evaluated the outcomes of oxygen administration in trauma patients Patients were randomized to two groups 1. 8-hour restrictive oxygen strategy: only receiving oxygen when the patient’s saturation dropped below 94% 2. 8-hour
- [PODCAST: Airway to Heaven- A Primer on Mechanical Ventilation for Emergency Providers](https://emergencymed.org.il/podcast-airway-to-heaven-a-primer-on-mechanical-ventilation-for-emergency-providers/podcast/) - Saturday Jul 05, 2025 Dr. Harish Kinni, a triple-board-certified emergency medicine and critical care physician and assistant professor at the Mayo Clinic, provides an overview of the fundamentals of ventilator care for emergency department professionals. We will review key modes that we should know, the variables to set, how to adjust them for your patient’s
- [Prehospital Adenosine for SVT – 6 or 12 mg?](https://emergencymed.org.il/prehospital-adenosine-for-svt-6-or-12-mg/articles-2/) - Written by Nickolas Srica An initial dose of 12 mg of adenosine for suspected paroxysmal supraventricular tachycardia (PSVT) was associated with increased prehospital improvement, reduced rates of hospital admission, and less re-dosing compared to 6 mg, while complications remained rare and similar across both groups. Pause before starting with 6 mg… This was a retrospective observational
- [Ketamine Monosedation in Pediatrics – A Safe Choice](https://emergencymed.org.il/ketamine-monosedation-in-pediatrics-a-safe-choice/articles-2/) - Written by Alexander Sheehan and Ketan Patel This study shows that ketamine alone is a safe choice for pediatric sedation in the ED, with serious adverse events (AE) occurring rarely, primarily in older children or when opioids are coadministered. No tube, no trouble – 12,000 kids later, ketamine still crushes it Procedural sedation is common
- [JAMA: Intraosseous vs Intravenous Access for Epinephrine in Pediatric Out-of-Hospital Cardiac Arrest](https://emergencymed.org.il/jama-intraosseous-vs-intravenous-access-for-epinephrine-in-pediatric-out-of-hospital-cardiac-arrest/articles-2/) - Masashi Okubo, MD, MS1; Sho Komukai, PhD2; Junichi Izawa, MD, DrPH3,4; et al Author Affiliations Article Information Cite Permissions Metrics Comments JAMA Netw Open Published Online: June 25, 2025 2025;8;(6):e2517291. doi:10.1001/jamanetworkopen.2025.17291 related icon Related Articlesfigure icon Figuresattach icon Supplemental Content Key PointsQuestion Is an intraosseous vs intravenous route for epinephrine administration associated with a difference in survival to hospital discharge among pediatric patients with out-of-hospital cardiac arrest? Findings In this cohort study of 739
- [PODCAST: Ketamine & Midazolam for Prehospital Seizure Management](https://emergencymed.org.il/podcast-ketamine-midazolam-for-prehospital-seizure-management/קדם-בית-חולים/) - Jul 7, 2025 Contributor: Aaron Lessen, MD Educational Pearls: Prehospital seizures are typically managed with intramuscular midazolam (Versed) Seizures theoretically involve the NMDA pathway, and ketamine is a potent NMDA antagonist A recent retrospective cohort study analyzed a Florida EMS protocol that uses ketamine in seizures refractory to midazolam One group received two doses of
- [PODCAST: Penetrating Neck Injuries children](https://emergencymed.org.il/podcast-penetrating-neck-injuries-children/קדם-בית-חולים/) - Penetrating neck injuries in children are rare—but when they happen, the stakes are high. In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, we explore the clinical pearls behind “no-zone” management, how to distinguish hard and soft signs, when to image versus operate, and why airway always comes first. Get ready for a focused,
- [PODCAST :Push Dose Pearls- Hypoglycemia](https://emergencymed.org.il/podcast-push-dose-pearls-hypoglycemia/קדם-בית-חולים/) - Hypoglycemia can be subtle—or dangerously obvious—and knowing when and how to treat it is critical. In her first episode as our new Push Dose Pearls expert, Emergency Medicine Clinical Pharmacist, Haley Burhans, joins us to break it down. We discuss glucose thresholds by age, when to draw critical labs, and how to choose the right
- [PODCAST: Light Em Up Up Up (CT) or Not for Pediatric Blunt Abdominal Trauma?](https://emergencymed.org.il/podcast-light-em-up-up-up-ct-or-not-for-pediatric-blunt-abdominal-trauma/trauma/) - Reference: Arnold CG, et al. Performance of individual criteria of the Pediatric Emergency Care Applied Research Network (PECARN) intraabdominal injury prediction rule. Acad Emerg Med. Jan 2025 Date: May 7, 2025 Dr. Sandi Angus Guest Skeptic : Dr. Sandi Angus is a Paediatric and Adult Emergency Medicine Registrar in the Shrewsbury and Telford Hospital NHS Trust. She is passionate about
- [INJURY: Shock index identifies compensated shock in the 'Normotensive' trauma patient](https://emergencymed.org.il/injury-shock-index-identifies-compensated-shock-in-the-normotensive-trauma-patient/articles-2/) - Theodore M Lin 1, Ali M Memon 2, Emily A Reeson 3, Grace C Tolan 4, Trevor M Low 5, Kristina M Kupanoff 6, Dih-Dih Huang 7, Michael D Jones 8, Brian R Czarkowski 9, Hahn Soe-Lin 10, James N Bogert 11, Jordan A Weinberg 12 Affiliations Expand Abstract Introduction: Hemorrhagic shock is a life-threatening condition that requires rapid identification for timely intervention. Although shock is easily discernible in the hypotensive patient, compensated shock in the "normotensive" patient is not.
- [Is Intranasal Ketamine as Good as IV? Emergency Medicine Pain/Sedation/Procedure Pharmacy/Pharmacology](https://emergencymed.org.il/is-intranasal-ketamine-as-good-as-iv-emergency-medicine-pain-sedation-procedure-pharmacy-pharmacology/articles-2/) - July 3, 2025 Written by Shannon Markus In ED patients with bone fractures, intranasal ketamine provided pain relief comparable to IV ketamine and morphine, with no significant differences in efficacy or adverse effects across groups. Smells like effective analgesia… This single-center, double-blind, randomized controlled trial evaluated the efficacy of intranasal ketamine (1 mg/kg) compared to
- [NEJM: As-Needed Albuterol–Budesonide  in Mild Asthma](https://emergencymed.org.il/nejm-as-needed-albuterol-budesonide-in-mild-asthma/articles-2/) - C. LaForce,1 F. Albers,2 A. Danilewicz,3 A. Jeynes‑Ellis,3 M. Kraft,4 R.A. Panettieri, Jr.,5 R. Rees,3 S. Bardsley,6 L. Dunsire,6 T. Harrison,7 O. Sobande,8 R. Surujbally,6 F. Trudo,9 C. Cappelletti,10 A. Papi,11 R. Beasley,12 B.E. Chipps,13 E. Israel,14,15 H. Pandya,6 M. Clancy,16 and L.B. Bacharier,17 for the BATURA Investigators* Abstract
- [PODCAST: Massive Transfusion Protocol in the ED](https://emergencymed.org.il/podcast-massive-transfusion-protocol-in-the-ed/קדם-בית-חולים/) - If you’ve seen Fast & Furious, you already get the vibe—speed saves lives. In this episode, we break down the Massive Transfusion Protocol (MTP): when to activate it, how to do it right, and ratios. We also hit key points on TXA, resuscitation strategy, and common mistakes in trauma care.
- [PODCAST: Antihypertensives and Emergency Room Considerations](https://emergencymed.org.il/podcast-antihypertensives-and-emergency-room-considerations/podcast/) - Contributor: Alec Coston, MD Educational Pearls: For patients presenting to the emergency room with hypertension, clinicians should determine if it is isolated and uncomplicated, or involves comorbidities with more complex underlying pathophysiology. For uncomplicated and isolated hypertension, first-line treatment is thiazide diuretics. How do thiazide diuretics work to treat hypertension? Thiazide diuretics work by blocking
- [What’s the Long-Term Stroke Risk in TIA Patients?](https://emergencymed.org.il/whats-the-long-term-stroke-risk-in-tia-patients/articles-2/) - Written by Alexander Sheehan and Ketan Patel Patients with transient ischemic attack (TIA) or minor stroke remain at high risk of subsequent stroke for up to 10 years, emphasizing the need for sustained secondary prevention beyond the initial acute period. TIA – the warning shot that keeps on reloading While most literature has focused on
- [BMJ: Streaming and redirection of lower acuity adult patients attending the ED: patient and staff experience](https://emergencymed.org.il/bmj-streaming-and-redirection-of-lower-acuity-adult-patients-attending-the-ed-patient-and-staff-experience/articles-2/) - Emily Louise Phillpotts Sarah Voss ,1 Jessica Coggins ,1 Laura Goodwin ,1 ,1 Edward Carlton,2 Rebecca Hoskins,1 Cathy Liddiard,1 Karen Butler,3 Laura Wilkinson,2 Grace Blows,4 Lisa Evans,4 Rebecca Macfarlane,4 Jonathan Benger Correspondence to Emily Louise Phillpotts; emily.phillpotts@uwe.ac.uk Abstract Background Streaming and redirection in the ED involves the assessment, triage
- [JAMA: Termination of Resuscitation Rules for In-Hospital Cardiac Arrest](https://emergencymed.org.il/jama-termination-of-resuscitation-rules-for-in-hospital-cardiac-arrest/קרדיולוגיה/) - Mathias J Holmberg 1 2, Asger Granfeldt 1 2, Ari Moskowitz 3, Kasper G Lauridsen 1 4 5, Daniel Bergum 6, Christian F Christiansen 1 7, Jerry P Nolan 8 9, Lars W Andersen 1 2 10 Affiliations Expand Abstract Importance: There are no validated decision rules for terminating resuscitation during in-hospital cardiac arrest. Decision rules may guide termination and prevent inappropriate early termination of resuscitation. Objective: To develop and validate termination of resuscitation rules
- [PODCAST: Right Heart Failure and Pulmonary Hypertension for the EM Doc](https://emergencymed.org.il/podcast-right-heart-failure-and-pulmonary-hypertension-for-the-em-doc/podcast/) - ACEP Frontline · Right Heart Failure and Pulmonary Hypertension for the EM Doc with Dr. Marianne Wallis - CoACEP In this episode from Colorado ACEP, we learn about the EM approach to right heart failure and pulmonary hypertension. cardiacheart failurehypertensioncardiologyemergencyphysiciandoctoracepcolorado
- [Best Practices in Managing an Emergency Department Under Ballistic Missile Attack. Zoom meeting](https://emergencymed.org.il/best-practices-in-managing-an-emergency-department-under-ballistic-missile-attack/zoom/) - International Zoom meeting of the Israeli Medical Association on working in the emergency department under missile barrages שד
- [PODCAST:  June 2025 Annals of Emergency Medicine](https://emergencymed.org.il/podcast-june-2025-annals-of-emergency-medicine/education-tips/) - Annals of Emergency Medicine · Annals June 2025 In the June 2025 Annals podcast, Ryan and Rory discuss attrition rates for ED clinicians, web-based POCUS training, the risk of delayed respiratory failure in opioid overdoses and much more.
- [“Falls” Decision Rule – Reducing Head CT in Elderly Emergency Medicine Imaging Trauma](https://emergencymed.org.il/falls-decision-rule-reducing-head-ct-in-elderly-emergency-medicine-imaging-trauma/articles-2/) - Written by Amanda Matthews This external validation of the Falls decision-making tool for older adult patients with head trauma had high sensitivity and negative predictive value while reducing unnecessary CT scans by almost 32%. Does the “Falls” rule fall short? This study sought to externally validate the “Falls” decision rule for older adults with ground-level
- [OPTPRESS – High MAP Goal in Older Patients with Septic Shock](https://emergencymed.org.il/optpress-high-map-goal-in-older-patients-with-septic-shock/articles-2/) - June 19, 2025 Written by Catherine Burger This randomized control trial of older ICU patients with septic shock in Japan showed higher mortality and more frequent adverse events in patients randomized to a high MAP goal (80-85 mmHg) compared to usual care (65-70 mmHg). Hypertension is bad for you…even when you have septic shock Authors
- [BMJ: Acute coronary syndrome rule-out strategies in the emergency department: an observational evaluation of clinical effectiveness and current UK practice](https://emergencymed.org.il/bmj-acute-coronary-syndrome-rule-out-strategies-in-the-emergency-department-an-observational-evaluation-of-clinical-effectiveness-and-current-uk-practice/articles-2/) - The Trainee Emergency Research Network (TERN) Correspondence to tern@rcem.ac.uk; fraser.birse@nbt.nhs.uk Abstract Background Numerous strategies have been developed to rapidly rule-out acute coronary syndrome (ACS) using high-sensitivity troponin. We aimed to establish their performance in terms of emergency care length of stay (LOS) in real-world practice. Methods A multicentre observational cohort study in
- [Resuscitation: Oxygen and carbon dioxide targets after cardiac arrest: an updated systematic review](https://emergencymed.org.il/resuscitation-oxygen-and-carbon-dioxide-targets-after-cardiac-arrest-an-updated-systematic-review/articles-2/) - athias J. Holmberg a,*, Takanari Ikeyamab,c , Rakesh Gargd , Ian R. Drennane,f,g,h , Eric J. Lavonasi,j , Janet E. Brayk,l , Theresa M. Olasveengenm,n , Katherine M. Bergo,p , on behalf of the International Liaison Committee on Resuscitation Basic Life Support and Advanced Life Support Task Forces, Abstract
- [PODCAST: HEART Score](https://emergencymed.org.il/podcast-heart-score/podcast/) - Jun 23, 2025 Contributor: Taylor Lynch, MD Educational Pearls: How do we risk-stratify chest-pain patients? One option is the HEART score This score predicts a patient’s 6-week risk of a major adverse cardiac event. Ex. Cath procedure, CABG, PCI, death H stands for History Ask 1) Was the patient diaphoretic? 2) Did they have nausea
- [PODCAST: EM Quick Hits 65 Occipital Nerve Block, PoCUS in Pulmonary Embolism, Myelopathy, Team Resuscitation, Incidental Neutropenia, Peer Programs](https://emergencymed.org.il/podcast-em-quick-hits-65-occipital-nerve-block-pocus-in-pulmonary-embolism-myelopathy-team-resuscitation-incidental-neutropenia-peer-programs/articles-2/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Topics in this EM Quick Hits podcast Matthew MacArthur on the role of occipital nerve block for the treatment of headache (1:32) Ian Chernoff on the role of POCUS in patients with pulmonary embolism (10:25) Hans Rosenberg on identification
- [PODCAST:  RCEM Learning June 2025](https://emergencymed.org.il/podcast-rcem-learning-june-2025/podcast/) - Jun 12, 2025 Happy June! This month for the June 2025 episode of the RCEM Learning Podcast Rob covers for Andy and discussed two HALO-heavy papers with Dave - looking at the London HEMS pre-hospital thoracotomy paper and a systematic review looking at resuscitative hysterotomy. Becky and Chris go on the first of a two
- [JAMA: Outcomes of Endovascular Treatment in Patients With Vertebrobasilar Artery Occlusion Beyond 24 Hours](https://emergencymed.org.il/jama-outcomes-of-endovascular-treatment-in-patients-with-vertebrobasilar-artery-occlusion-beyond-24-hours/articles-2/) - Key Points Question What are the outcomes among patients undergoing endovascular thrombectomy for vertebrobasilar artery occlusion beyond 24 hours from the patient’s last known well time? Findings In this cohort study of 202 patients with vertebrobasilar artery occlusion treated beyond 24 hours after last known well time, endovascular thrombectomy with best medical treatment was associated with a
- [PODCAST: EMCrit Wee – Ketamine for Early Status Epilepticus Debate with First10EM](https://emergencymed.org.il/podcast-emcrit-wee-ketamine-for-early-status-epilepticus-debate-with-first10em/קדם-בית-חולים/) - You are here: Home / EMCrit / EMCrit Wee – Ketamine for Early Status Epilepticus Debate with First10EM Recently I included a paper on ketamine for early status epilepticus treatment in the RACC-Lit review. Justin Morgenstern of First10EM disagreed with my conclusions in his research roundup for April 2025. So, I brought him on the podcast for a fun debate on
- [Trauma Intubation Location and Mortality – ER or OR?](https://emergencymed.org.il/trauma-intubation-location-and-mortality-er-or-or/articles-2/) - Written by Samuel Rouleau A retrospective study found that trauma patients who were intubated in the ED had no difference in mortality compared to those intubated in the OR on propensity-matched analysis. TraumaRama → resuscitate then intubate! A prior study found higher mortality for trauma patients needing hemorrhage control surgery when intubated in the ED
- [AHA: Association of Cannabis Use With Cardiovascular Outcomes Among US Adults](https://emergencymed.org.il/aha-association-of-cannabis-use-with-cardiovascular-outcomes-among-us-adults/articles-2/) - Abra M Jeffers 1 2 3 4, Stanton Glantz 5, Amy L Byers 6 7 8, Salomeh Keyhani 1 9 10 Affiliations Expand Abstract Background: We examined the association between cannabis use and cardiovascular outcomes among the general population, among never-tobacco smokers, and among younger individuals. Methods and results: This is a population-based, cross-sectional study of 2016 to 2020 data from the Behavioral Risk Factor Surveillance Survey from 27 American
- [Injury: Finger Thoracostomy BEFORE Tension Develops?](https://emergencymed.org.il/injury-finger-thoracostomy-before-tension-develops/articles-2/) - June 9, 2025 Written by Michael Stocker Performing emergency finger thoracostomy (EFT) improved oxygen saturation in patients presenting to helicopter emergency medical services (HEMS) with blunt chest trauma requiring intubation and suspected compensated obstructive shock. Cut the tension before it develops? Prehospital EFT is a proven intervention to address tension pneumothorax (PTX). Could there
- [PODCAST: Frank's Sign - A Marker for Coronary Artery Disease](https://emergencymed.org.il/podcast-franks-sign-a-marker-for-coronary-artery-disease/קדם-בית-חולים/) - Jun 9, 2025 Contributor: Travis Barlock MD Educational Pearls Frank’s sign is a curious physical exam finding first described in the literature in 1973 Bilateral earlobe creases are recognized as a marker of coronary artery disease and cerebrovascular disease Some studies have found an increase in all-cause mortality in patients with bilateral diagonal earlobe creases
- [JAMA: Acute Blood Pressure Lowering and Risk of Ischemic Lesions on MRI After Intracerebral Hemorrhage](https://emergencymed.org.il/jama-acute-blood-pressure-lowering-and-risk-of-ischemic-lesions-on-mri-after-intracerebral-hemorrhage/articles-2/) - KenS.Butcher, MD,PhD;BrianBuck,MD,PhD;DarDowlatshahi,MD;LauraC.Gioia,MD,MSc;MaheshKate,MD,MSc; AnaC.Klahr, PhD;AshwinSivasubramaniam,MBBS;AshfaqShuaib,MBBS;AlanWilman,PhD;VijayK.Sharma,MD; Georgios Tsivgoulis, MD, PhD; Christos Krogias, MD; Ashkan Shoamanesh,MD Key Points Question Does acute blood pressure (BP) reduction increase the incidence of subacute ischemic lesions in spontaneous intracerebral hemorrhage (ICH)? Findings The frequency of ischemic lesions detected with diffusion-weighted magnetic resonance imaging at 48 hours did not increase in patients with ICH randomized
- [Does Ketamine Cause Peri-Intubation Hypotension?](https://emergencymed.org.il/does-ketamine-cause-peri-intubation-hypotension/articles-2/) - June 10, 2025 Written by Aaron Lacy This meta-analysis did not find a difference in peri-intubation hypotension with ketamine vs. other induction agents, even after removing studies at high risk for bias and analyzing subgroups. Ketamine vs. all… again… and again Peri-intubation hypotension is lumped into the list of major adverse events that occur during rapid
- [JAMA: An Educational Video Game in Trauma Triage at Nontrauma Centers A Secondary Analysis of a Randomized Clinical Trial](https://emergencymed.org.il/jama-an-educational-video-game-in-trauma-triage-at-nontrauma-centers-a-secondary-analysis-of-a-randomized-clinical-trial/articles-2/) - Deepika Mohan, MD, MPH1,2; Baruch Fischhoff, PhD3; Victor Talisa, PhD2; et alJonathan Elmer, MD, MS2,4,5; Douglas B. White, MD, MAS2; Derek C. Angus, MD, MPH2; Andrew Peitzman, MD1; Brad Bendesky, MD6; Allyson Cook Chapman, MD7; Raquel M. Forsythe, MD1; Frank X. Guyette, MD, MPH4; Allyson M. Hynes, MD8,9; Jonathan J. Oskvarek, MD, MBA10,11; Scott D. Weingart, MD12; Michael Weinstock, MD13,14; Chung-Chou H. Chang, PhD2 Author Affiliations Article Information JAMA Netw Open. 2025;8(6):e2513375. doi:10.1001/jamanetworkopen.2025.13375 Key Points Question How are behavioral interventions targeting physician performance associated with clinical decision-making? Findings In this process evaluation of a randomized clinical trial, exposure to an educational trauma triage video game was
- [What is the Utility of Point-of-Care Ultrasound for Diagnosis of Soft Tissue Abscess vs. Cellulitis?](https://emergencymed.org.il/what-is-the-utility-of-point-of-care-ultrasound-for-diagnosis-of-soft-tissue-abscess-vs-cellulitis/articles-2/) - Kristine Jeffers 1, Samuel M Keim 2, Brit Long 1, Michael Gottlieb 3, Srikar R Adhikari 2 Affiliations Expand Abstract Background: Skin and soft tissue infections (SSTIs) including cellulitis and abscess are common conditions managed in the emergency department, but differentiating these on history and physical examination alone can be challenging. Point-of-care ultrasound (POCUS) has been proposed as a
- [(D)on’t you want to (V)erify (T)hrombosis?](https://emergencymed.org.il/dont-you-want-to-verify-thrombosis/articles-2/) - Written by Megan Hilbert Proximal compression ultrasound (PUL) in the ED and risk stratification (via Well’s score) can result in appropriate evaluation and management decisions for patients presenting with concern for DVT. While my title may be tortured, this algorithm is not This was an observational cohort study with convenience sampling at a community hospital
- [PODCAST: Your Mission, Should You Choose to Accept It – To Be an EM Doc](https://emergencymed.org.il/podcast-your-mission-should-you-choose-to-accept-it-to-be-an-em-doc/ניהול-מלרד/) - Date: June 2, 2025 Dr. Andrew Tagg Guest Skeptic: Dr. Andrew (Andy) Tagg is an Emergency Physician with a special interest in education and lifelong learning. He is the co-founder and website lead of Don’t Forget the Bubbles. This is another SGEM Xtra that talks about what we can learn about being physicians from certain pop culture (TV and
- [BMJ: Factors affecting diagnostic imaging decision-making in the emergency department during day and night shifts](https://emergencymed.org.il/bmj-factors-affecting-diagnostic-imaging-decision-making-in-the-emergency-department-during-day-and-night-shifts/articles-2/) - obert Peter Klein1, Gary Velan1,2, Husna Razee3, Andrew Coggins4, Kevin Lai4, Amith Shetty5,6, Noel Young7, Michelle Moscova2,8 Correspondence to Dr Michelle Moscova; m.moscova@unsw.edu.au Abstract. Background Medical imaging use has increased progressively, prompting discussions about its clinical impact. Interventions to reduce low-value imaging have had varying success, as they generally do not consider the influence of the clinical environment on decision-making. Factors affecting imaging
- [PODCAST: Withdrawal warriors battle with barbs! Phenobarbital as a treatment for alcohol withdrawal](https://emergencymed.org.il/podcast-withdrawal-warriors-battle-with-barbs-phenobarbital-as-a-treatment-for-alcohol-withdrawal/podcast/) - Is it possible that the cutting edge therapy for alcohol withdrawal care is one of the older tools in our bag? Possibly! In this chapter, one of the rising stars, Dr. Brandy Hernandez, Emergency Pharmacist, discusses the case for phenobarbital for helping patients for with their acute alcohol withdrawal symptoms. Find out when it may
- [PODCAST: Hantavirus- Desert Killer you can't miss](https://emergencymed.org.il/podcast-hantavirus-desert-killer-you-cant-miss/podcast/) - This place is stunning—and deadly. Filmed live at Great Sand Dunes NP, home to one of the most lethal infections you’ve never heard of: Hantavirus Pulmonary Syndrome. This episode breaks down Hantavirus Pulmonary Syndrome: signs, exposure risks, and what every EM doc must know. Know the early signs. Know when to worry. Because you don’t need
- [PODCAST: Ten Lessons They Don’t Teach in Medical School (But Should)](https://emergencymed.org.il/podcast-ten-lessons-they-dont-teach-in-medical-school-but-should/education-tips/) - Date: May 14, 2025 Dr. Ross Prager Guest Skeptic: Dr. Ross Prager is an Intensivist at the London Health Sciences Centre and an adjunct professor at Western University. His expertise in critical care medicine is complemented by his research interests in critical care ultrasound and evidence-based knowledge translation. This is an SGEM Xtra episode. The inspiration was a
- [PODCAST: Aspiration Pneumonia in the ED: Diagnosis & Management](https://emergencymed.org.il/podcast-aspiration-pneumonia-in-the-ed-diagnosis-management/podcast/) - Learn how to diagnose and manage aspiration pneumonia in the ED with a twist. There's a board test answer and a "real life" answer for this one...Let's talk risk factors, key imaging findings, antibiotic choices, and when to worry. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the
- [PODCAST: Intranasal Fentanyl](https://emergencymed.org.il/podcast-intranasal-fentanyl/קדם-בית-חולים/) - May 26, 2025 Contributor: Aaron Lessen, MD Educational Pearls: How do we take care of kids in severe pain? There are many non-pharmacologic options for pain (i.e. ice, elevation) as well as more conventional medication options (i.e. acetaminophen, NSAIDS) but in severe pain stronger medications might be indicated. These stronger medications include options such as
- [PODCAST: The Evolution and Emergence of TBI Biomarkers with Dr. Chris Davlantes](https://emergencymed.org.il/podcast-the-evolution-and-emergence-of-tbi-biomarkers-with-dr-chris-davlantes/education-tips/) - ACEP Frontline · The Evolution and Emergence of TBI Biomarkers with Dr. Chris Davlantes In this episode, we talk with Dr. Chris Davlantes about the evolution of blood tests to detect and risk stratify traumatic brain injuries. Over the last few years, we have seen tests emerge, but now have access to POC technology that
- [JAMA: Emergency Department Boarding, Inpatient Census, and Interhospital Transfer Acceptances](https://emergencymed.org.il/jama-emergency-department-boarding-inpatient-census-and-interhospital-transfer-acceptances/articles-2/) - Margaret Greenwood-Ericksen, MD1; Neil Kamdar, MA2,3,4; Kjirsten Swenson, MD1; et alPeter Pruitt, MD5; Marta L. McCrum, MD6; Gabriel Paul, MD1; Larissa Myaskovsky, PhD7; Keith E. Kocher, MD8; Kori S. Zachrison, MD9,10 Author Affiliations Article Information JAMA Netw Open. 2025;8(5):e2512299. doi:10.1001/jamanetworkopen.2025.12299 editorial comment icon Editorial Comment Key Points Question Are emergency department (ED) boarding and inpatient census associated with interhospital transfer (IHT) acceptances? Findings This cross-sectional study of 26 020 IHT requests found that the severity of ED boarding and inpatient census were associated with declining IHT
- [BME: Recognising and managing functional neurological disorder in the acute healthcare setting](https://emergencymed.org.il/bme-recognising-and-managing-functional-neurological-disorder-in-the-acute-healthcare-setting/articles-2/) - Andre Galenchik-Chan1 Thomas Ren1. David Cohen2. Carine W Maurer3 Correspondence to Dr Carine W Maurer; carine.maurer@stonybrookmedicine.edu Abstract Functional neurological disorder (FND) is a complex and heterogenous condition characterised by abnormal neurological symptoms that are linked to structural and functional alterations in widely distributed brain networks. For many patients with FND, the emergency department (ED) is
- [C-Spine Clearance in Kids – What You Need to Know](https://emergencymed.org.il/c-spine-clearance-in-kids-what-you-need-to-know/קדם-בית-חולים/) - Written by Vivian Lei These are the top 10 things to know about safely clearing the pediatric cervical spine after trauma while minimizing unnecessary imaging and immobilization. A pain in the neck – pediatric c-spine clearance We’ve covered pediatric c-spine clearance before. C-spine injuries occur in
- [PODCAST: Blue Bloating and Pink Puffing with the COPD Decision Tool - Dr. Peter](https://emergencymed.org.il/podcast-blue-bloating-and-pink-puffing-with-the-copd-decision-tool-dr-peter/podcast/) - ACEP Frontline · Blue Bloating and Pink Puffing with the COPD Decision Tool - Dr. Peter DeBlieux In this episode, we talk with Dr. Peter DeBlieux about the management of COPD and a tool to help EM docs get the patients where they need to be.
- [What’s the Best Migraine Cocktail?](https://emergencymed.org.il/whats-the-best-migraine-cocktail/articles-2/) - Written by Amanda Mathews There was no clear choice for single-agent pain control, but chlorpromazine IV/IM was among the most effective for pain relief at two hours, and IV/IM ketorolac was among the worst. Figuring out a migraine cocktail is a headache Researchers identified 64 trials to include in this Bayesian network meta-analysis. The four
- [PODCAST:  Cuts like a Knife or Antibiotics for Pediatric Appendicitis](https://emergencymed.org.il/podcast-cuts-like-a-knife-or-antibiotics-for-pediatric-appendicitis/ילדים/) - Reference: St Peter, et al. Appendicectomy versus antibiotics for acute uncomplicated appendicitis in children: an open-label, international, multicentre, randomized noni-inferiority trial. The Lancet. Jan 2025 Date: March 19, 2025 Dr. Camille Wu Guest Skeptic: Dr. Camille Wu is a paediatric surgeon based at Sydney Children’s Hospital where she is the Head of Department. She is also on the
- [Resuscitation:  Associations with resolution of ST-segment elevation myocardial infarction criteria on out-of-hospital 12-lead electrocardiograms following resuscitation from cardiac arrest](https://emergencymed.org.il/resuscitation-associations-with-resolution-of-st-segment-elevation-myocardial-infarction-criteria-on-out-of-hospital-12-lead-electrocardiograms-following-resuscitation-from-cardiac-arrest/articles-2/) - Christopher J Naas1, Hadi O Saleh2, Thomas W Engel 2nd3, David D Gutterman4, Aniko Szabo5, Thomas Grawey6, Benjamin W Weston7, Christopher E Monti8, John E Baker9, Jacob Labinski10, Lujia Tang11, Jamie Jasti12, Jason A Bartos13, Rajat Kalra14, Demetris Yannopoulos15, M Riccardo Colella16, Tom P Aufderheide17 ABSTRACT Introduction: A previous study found that following out-of-hospital cardiac arrest (OHCA), 67% of out-of-hospital 12-lead electrocardiograms (ECGs) diagnostic for ST-segment elevation myocardial infarction (STEMI)
- [PODCAST: Annals Podcast April 2025](https://emergencymed.org.il/podcast-annals-podcast-april-2025/podcast/) - Annals of Emergency Medicine · Annals Podcast April 2025 In the April edition of the Annals of Emergency Medicine podcast, Rory and Ryan discuss ketamine for prehospital seizures, firearm injuries in the ED, and the best therapies for headaches.
- [PODCAST: Parkinson's, Myasthenia Gravis, and MS in the ED](https://emergencymed.org.il/podcast-parkinsons-myasthenia-gravis-and-ms-in-the-ed/podcast/) - In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the May 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Complications of Chronic Neurologic Disease: Parkinson Disease, Myasthenia Gravis, and Multiple Sclerosis Parkinson’s Disease Importance of maintaining medication schedule for Parkinson’s patients Strategies for ensuring patients receive their medications promptly Overview of Carbidopa Levodopa’s
- [PODCAST: Strategies for Keeping Trauma at Bay with Rob Orman, MD](https://emergencymed.org.il/podcast-strategies-for-keeping-trauma-at-bay-with-rob-orman-md/trauma/) - In this episode, Sam Ashoo, MD interviews Rob Orman, MD about ways to manage the trauma inflicted by the ER. Discussing Trauma in Emergency Medicine Personal Experiences with Trauma The Impact of Suppression Defining Trauma and Its Effects Integration vs. Disintegration Debriefing and Coping Mechanisms The Driveway Debrief Nurse and Physician Dynamics Reflective Solitude vs.
- [כלי מציאות מדומה יעילים יותר להכשרת צוותי חירום לאר"ן.  Exploring the role of virtual reality in preparing emergency responders for mass casualty incidents](https://emergencymed.org.il/כלי-מציאות-מדומה-יעילים-יותר-להכשרת-צו/articles-2/) - במחקר נמצא כי בהשוואה להכשרה מסורתית, הדרכה באמצעות מציאות מדומה מפחיתה עומס מנטלי ותסכול ומשפרת את דיוק הדיווח בקרב צוותי רפואת חירום. חקר שבחן את השימוש בכלים של מציאות מדומה להכשרת צוותי חירום לאירועים רבי נפגעים מצא כי היא יעילה יותר מהדרכות מסורתיות. במחקר, שנערך על ידי ד"ר אלנה לוחמנובה מהמחלקה לרפואת חירום, אבחון ובריאות
- [ACEP: A Critical Issue in the Management of Adult Patients Presenting to the Emergency Department With Acute Carbon Monoxide Poisoning: Approved by the ACEP Board of Directors January 22, 2025](https://emergencymed.org.il/acep-a-critical-issue-in-the-management-of-adult-patients-presenting-to-the-emergency-department-with-acute-carbon-monoxide-poisoning-approved-by-the-acep-board-of-directors-january-22-2025/articles-2/) - From the American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Carbon Monoxide Poisoning: Richard D. Shih, MD (Writing Committee Chair) Christian A. Tomaszewski, MD, MS, MBA Amy Kaji, MD, MPH, PhD (Methodologist) Deborah B. Diercks, MD, MSc (Committee Chair) ABSTRACT This clinical policy from the American College of Emergency Physicians addresses a
- [PODCAST: Break on Through to the Other Side – Management of Clinical Scaphoid Fractures](https://emergencymed.org.il/podcast-break-on-through-to-the-other-side-management-of-clinical-scaphoid-fractures/trauma/) - Reference: Cohen et al; SUSPECT study group. Can we avoid casting for suspected scaphoid fractures? A multicenter randomized controlled trial. J Orthop Traumatol. 2025 Date: May 1, 2025 Guest Skeptic: Dr. Matt Schmitz is an orthopedic surgeon specializing in Adolescent Sports Medicine and Young Adult Hip Preservation. He practices at the Rady Children’s Hospital in San Diego and is
- [PODCAST: Adult Asthma Management Strategies For Improved Prognosis – A Stepwise Approach](https://emergencymed.org.il/podcast-adult-asthma-management-strategies-for-improved-prognosis-a-stepwise-approach/קדם-בית-חולים/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Welcome to Part 1 of our two-part podcast series on Adult Asthma Exacerbations. Given this past summers’ increase in the number and size of forest fires leading to increased asthma presentations to the ED,
- [Do Sepsis Mandates Lead to Overtreatment and Harm?](https://emergencymed.org.il/do-sepsis-mandates-lead-to-overtreatment-and-harm/articles-2/) - Written by Jason Lesnick This retrospective study found 1 in 3 patients who received broad spectrum antibiotics in the ED likely did not have a bacterial infection and one in six had antibiotic-related complications. The retrospectoscope strikes again! Sepsis metrics place an immense amount of pressure on emergency physicians to give broad spectrum antibiotics rapidly
- [How to Intubate in 2025 – The Best Current Evidence](https://emergencymed.org.il/how-to-intubate-in-2025-the-best-current-evidence/articles-2/) - Written by Aaron Lacy 40% of patients undergoing endotracheal intubation (ETI) have a major adverse event. This article gets you up to speed on what tools, techniques, drugs, and interventions give your patient the best shot at a successful intubation without adverse events. Intubate like its 2025 Avoiding Hypoxia Unless contraindication, preoxygenation with a dedicated non-invasive
- [PODCAST: Psychedelics and Risk of Schizophrenia](https://emergencymed.org.il/podcast-psychedelics-and-risk-of-schizophrenia/podcast/) - May 12, 2025 Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Psychedelics are being studied for their therapeutic effects in mental illnesses, including major depressive disorder, post-traumatic stress disorder, anxiety, and many others Classic psychedelics include compounds like psilocybin, LSD, and ayahuasca MDMA and ketamine are often included in psychedelic research, but have a different mechanism of
- [Diagnostic yield of 24 to 48-hour ambulatory cardiac monitoring in discharged emergency department patients](https://emergencymed.org.il/diagnostic-yield-of-24-to-48-hour-ambulatory-cardiac-monitoring-in-discharged-emergency-department-patients/articles-2/) - James L Homme 1, Lincoln A Kranz 2, Madison House 3, Jacob R Greenmyer 4 Abstract. Objective: To evaluate the diagnostic yield of Holter monitoring at Emergency Department (ED) discharge. Methods: A retrospective chart review was performed of all patients discharged from the Mayo Clinic Emergency Department with a 3- or 12‑lead, 24- or 48-h Holter monitor from January 2, 2017 through
- [PODCAST: A Guide to Skillful Death Communication with Alex Jabr, PhD](https://emergencymed.org.il/podcast-a-guide-to-skillful-death-communication-with-alex-jabr-phd/ניהול-מלרד/) - Delivering the news of death is one of the hardest yet most overlooked skills in emergency medicine. Many learn by watching others or through trial and error rather than structured training (or just make it up as they go). This lack of preparation can lead to discomfort, stress, avoidance, and even systemic failures in how
- [BMJ: Removing systolic blood pressure from the National Early Warning Score (NEWS) for mortality prediction: an observational study](https://emergencymed.org.il/bmj-removing-systolic-blood-pressure-from-the-national-early-warning-score-news-for-mortality-prediction-an-observational-study/articles-2/) - Arian Zaboli ,1 Francesco Brigo,1 Gloria Brigiari,2 Serena Sibilio,3 Marta Parodi,4 Norbert Pfeifer,5 Gianni Turcato 4,6 Abstract Background Vital signs in triage are essential for effective risk stratification in the emergency department (ED). They are also increasingly used to calculate an early warning score at the time of presentation. However, obtaining a blood pressure is
- [Identifying and profiling prearrival characteristics of avoidable emergency department visits transported by paramedics: a cohort study using linked prehospital and hospital data](https://emergencymed.org.il/identifying-and-profiling-prearrival-characteristics-of-avoidable-emergency-department-visits-transported-by-paramedics-a-cohort-study-using-linked-prehospital-and-hospital-data/articles-2/) - Ryan Peter Strum1,2, Andrew Costa1,2. Brent McLeod3, Shawn E Mondoux4,5 Correspondence to Dr Ryan Peter Strum; strumr@mcmaster.ca Abstract Background Increasing demand and crowding in emergency departments (EDs) remain persistent challenges for healthcare systems worldwide. A portion of these visits is avoidable, indicating they could have been effectively managed in non-ED care settings. There has been increased attention
- [Prophylactic Antibiotics for Epistaxis?](https://emergencymed.org.il/prophylactic-antibiotics-for-epistaxis/articles-2/) - Written by Kathryn Sulkowski and Ketan Patel Patients with anterior nasal packing experience an exceptionally low risk of clinically significant infection (CSI), making the use of prophylactic antibiotics largely unnecessary. Antibiotics for epistaxis? Let’s not make a mountain out of a nosehill Epistaxis is a common issue encountered in the ED, and conservative measures often
- [ניתוח או גיבוס לשבר מרפק בילדים - האם הפרקטיקה עומדת להשתנות?](https://emergencymed.org.il/ניתוח-או-גיבוס-לשבר-מרפק-בילדים-האם-הפ/articles-2/) - Casting vs Surgical Treatment of Children With Medial Epicondyle Fractures A Randomized Clinical Trial מחקר חדש בחן מהו הטיפול האופטימלי לשברי מרפק מסוג אפיקונדיל מדיאלי אצל ילדים - קיבוע ניתוחי לאיחוי השבר וליציבות מירבית של המרפק או גיבוס בלבד שבו שיעור אי האיחוי גבוה יותר? לא נמצא יתרון לניתוח שברים של הבליטה המדיאלית
- [Andexanet vs. PCC for DOAC Reversal](https://emergencymed.org.il/andexanet-vs-pcc-for-doac-reversal/articles-2/) - Written by Megan Hilbert For direct oral anticoagulant related intracranial hemorrhage (ICH), andexanet was more likely than prothrombin complex concentrate (PCC) to prevent worsening of hemorrhage but was associated with more thrombotic events (TE). The tightrope that is reversal of anticoagulation This retrospective observational study evaluated the primary hemostatic efficacy of andexanet versus PCC and
- [PODCAST:  RCEM Learning May 2025](https://emergencymed.org.il/podcast-rcem-learning-may-2025/podcast/) - May 7, 2025 Happy May! This month for the May 2025 episode of the RCEM Learning Podcast Rob covers for Andy and Dave and discusses a systematic review and meta-analysis looking at the safety of different rate control methods in treating AF with rapid ventricular response. Becky and Chris go on a very deep dive
- [כנס רפואה דחופה תוכנית מדעית](https://emergencymed.org.il/כנס-רפואה-דחופה-תוכנית-מדעית/articles-2/) - התוכנית המדעית של כנס האיגוד לרפואה דחופה עלתה לאוויר לצפיה לחץ כאן
- [PODCAST:  Code Brown, When the runs run the room! - Management of Acute Diarrheal Emergencies 10 hours ago](https://emergencymed.org.il/podcast-code-brown-when-the-runs-run-the-room-management-of-acute-diarrheal-emergencies-10-hours-ago/podcast/) - Diarrhea is one of the more common concerns in emergency medicine worldwide and in the United States, yet we often do not spend enough time understanding the breadth of causes and considerations for this syndrome. Do you know which patients benefit from Zinc? Would you like to review HUS? Can you mixup Oral Rehydration Solution
- [EM Connect group](https://emergencymed.org.il/em-connect-group/מתמחים/) - בהמשך לשיתוף הפעולה בין קהילת האיגוד הישראלי לרפואה דחופה לבין יוזמת MiluEM פרוייקט התנדבות ועיבוי המערך הישראלי באנשי רפואה דחופה מרחבי העולם וגם בהמשך ישיר למסקנות המושב בנושא הרחבת שיתוף הפעולה במליאת הכנס השנתי ב-2024: נרגשים להשיק את מיזם EM Connect: קהילת וואטסאפ שמחברת אנשי מקצוע מתחום רפואה הדחופה ומכל העולם. מטרת הפלטפורמה היא לייצר
- [JAMA: Aspirin Continuation or Discontinuation in Surgically Treated Chronic Subdural Hematoma](https://emergencymed.org.il/jama-aspirin-continuation-or-discontinuation-in-surgically-treated-chronic-subdural-hematoma/articles-2/) - A Randomized Clinical Trial Maria Kamenova, MD1,2; Lea Pacan, BMed2; Christian Mueller, MD2,3; et alMichael Coslovsky, PhD4; Katharina Lutz, MD5; Serge Marbacher, MD6; Manuel Moser, MD7; Anne-Katrin Hickmann, MD8; Christian Zweifel, MD9; Raphael Guzman, MD1,2; Luigi Mariani, MD1,2; Jehuda Soleman, MD1,2; for the SECA Investigators Author Affiliations Article Information JAMA Neurol. Published online April 27, 2025. doi:10.1001/jamaneurol.2025.0850 Key Points Question Does discontinuation of low-dose acetylsalicylic acid (ASA) during the perioperative phase of surgical treatment of chronic subdural hematoma (cSDH) reduce recurrence rates?
- [PODCAST: Did You Ever Have To Make Up Your Mind – Midazolam or Ketamine for Acute Agitation in the Pre-Hospital Setting](https://emergencymed.org.il/podcast-did-you-ever-have-to-make-up-your-mind-midazolam-or-ketamine-for-acute-agitation-in-the-pre-hospital-setting/podcast/) - Reference: Muldowney et al. A Comparison of Ketamine to Midazolam for the Management of Acute Behavioral Disturbance in the Out-of-Hospital Setting. Ann Emerg Med. 2025 Date: April 24, 2025 Guest Skeptic: Dr. Howie Mell received his Medical Doctorate (MD) from the University of Illinois at Chicago, College of Medicine at Rockford. Prior to that, he received a Master of
- [JAMA: Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury](https://emergencymed.org.il/jama-clinical-outcomes-of-hypertonic-saline-vs-mannitol-treatment-among-children-with-traumatic-brain-injury/articles-2/) - Shu-Ling Chong 1 2, Yanan Zhu 3, Quan Wang 4, Paula Caporal 5, Juan D Roa 6, Freddy Israel Pantoja Chamorro 7, Thelma Elvira Teran Miranda 8, Hongxing Dang 9, Chin Seng Gan 10, Qalab Abbas 11, Ivan J Ardila 12, Mohannad Ahmad Antar 13, Jesús A Domínguez-Rojas 14, María Miñambres Rodríguez 15, Natalia Zita Watzlawik 16, Natalia Elizabeth Gómez Arriola 17, Adriana Yock-Corrales 18, Rubén Eduardo Lasso-Palomino 19, Ming Mei Xiu 20, Jacqueline S M Ong 21, Hiroshi Kurosawa 22, Gabriela Aparicio 23, Chunfeng Liu 24, Rujipat Samransamruajkit 25, Juan C Jaramillo-Bustamante 26 27, Nattachai Anantasit 28, Yek Kee Chor 29, Deborah M Turina 30, Pei Chuen Lee 31, Marisol Fonseca Flores 32, Francisco Javier Pilar
- [PODCAST: Parvovirus B19 (Fifth Disease)](https://emergencymed.org.il/podcast-parvovirus-b19-fifth-disease/ילדים/) - In this episode, we tackle the clinical mischief of Parvovirus B19, a common viral infection with a surprisingly wide range of manifestations—from the classic “slapped cheek” rash of erythema infectiosum to aplastic crises in children with hemolytic anemias and fetal hydrops in pregnant contacts. We’ll break down the virology, epidemiology, clinical presentation, and complications of Parvovirus
- [PODCASTP: penicillin Allergies](https://emergencymed.org.il/podcastp-penicillin-allergies/podcast/) - Contributor: Geoff Hogan MD Educational Pearls: Penicillin allergies are relatively uncommon despite their frequent reports 10% of the population reports a penicillin allergy but only 5% of these cases are clinically significant 90-95% of patients may tolerate a rechallenge after appropriate allergy evaluation Penicillin Allergy Decision Rule (PEN-FAST) on MD Calc Useful tool to assess
- [Diagnostic accuracy of point-of-care ultrasound of the posterior fatpad in elbow fractures](https://emergencymed.org.il/diagnostic-accuracy-of-point-of-care-ultrasound-of-the-posterior-fatpad-in-elbow-fractures/articles-2/) - Matthieu Robitaille 1, Marcel Émond 2 3, Mukul Sharma 4, Ariane Mackey 2 1, Pierre-Gilles Blanchard 2 3, Marie-Joe Nemnom 5, Marco L A Sivilotti 6, Ian G Stiell 7 5, Grant Stotts 8, Jacques Lee 9 10, Andrew Worster 11, Judy Morris 12, Ka Wai Cheung 13, Albert Y Jin 14, Demetrios J Sahlas 4, Heather E Murray 6, Steve Verreault 2 1, Marie-Christine Camden 2 1, Samuel Yip 15, Philip Teal 15, David J Gladstone 16, Mark I Boulos 16, Nicolas Chagnon 17, Elizabeth Shouldice 18, Clare Atzema 10, Tarik Slaoui 12, Jeanne Teitlebaum 12, George A Wells 5, Jeffrey J Perry 19 20 Affiliations Expand Abstract Background: Diffusion
- [Canadian TIA Score + MRI Predicts 90-day Stroke](https://emergencymed.org.il/canadian-tia-score-mri-predicts-90-day-stroke/articles-2/) - Written by Alexander Turner and Ketan Patel In this substudy of the Canadian TIA Score cohort, using the score plus MRI better predicted subsequent 90-day stroke, particularly in the medium-risk group. CT misses it, MRI gets it – finding the stroke before it strikes back The Canadian TIA Score does a good job of risk stratifying TIA patients into low, medium, and
- [Influenza Pneumonia? Start Antivirals Early](https://emergencymed.org.il/influenza-pneumonia-start-antivirals-early/articles-2/) - Written by Caitlin Nicholson Delayed initiation of antiviral therapy in adults hospitalized with influenza-associated pneumonia was associated with higher 30-day mortality and severe outcomes. Considering antiviral treatment? Don’t delay! This large retrospective cohort study evaluated the association between timing of antiviral therapy initiation and 30-day mortality in 26,233 adults hospitalized with influenza-associated pneumonia across seven
- [How Long Should We Observe After Opiate Overdose?](https://emergencymed.org.il/how-long-should-we-observe-after-opiate-overdose/articles-2/) - Written by Doug Wallace With notable exclusion criteria, the incidence of intubation in opiate overdose patients after 4 hours was rare in this study: 9/1591 (0.6%). A little obs never hurt anyone Opiate overdose deaths continue to rise. These patients frequently present to the ED. Recommendations for the duration of ED observation have largely not
- [RESUSCITATION: A retrospective 'target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation](https://emergencymed.org.il/resuscitation-a-retrospective-target-trial-emulation-comparing-amiodarone-and-lidocaine-for-adult-out-of-hospital-cardiac-arrest-resuscitation/articles-2/) - Tanner Smida 1, Remle Crowe 2, Bradley S Price 3, James Scheidler 4, P S Martin 4, Michael Shukis 4, James Bardes 4 Affiliations Expand Abstract Objective: The administration of amiodarone or lidocaine is recommended during the resuscitation of out-of-hospital cardiac arrest (OHCA) patients presenting with defibrillation-refractory or recurrent ventricular fibrillation or ventricular tachycardia. Our objective was to use 'target trial emulation' methodology to compare the outcomes of patients
- [PODCAST:  RCEM Learning April 2025](https://emergencymed.org.il/podcast-rcem-learning-april-2025/podcast/) - April 20250 Apr 8, 2025 Happy April! This month for the April 2025 episode of the RCEM Learning Podcast we have Andy and Dave talking about the use of beta-blockers in sepsis. Becky and Chris talking about mortality reviews in the ED. In a similarly patient-safety aligned topic I speak to Maegan Ladell talking about
- [JAMA: Epinephrine vs Norepinephrine as Initial Treatment in Children With Septic Shock](https://emergencymed.org.il/jama-epinephrine-vs-norepinephrine-as-initial-treatment-in-children-with-septic-shock/articles-2/) - Epinephrine vs Norepinephrine as Initial Treatment in Children With Septic Shock Matthew A. Eisenberg, MD, MPH1,2,3; Nathan Georgette, MD1,2,3; Alexandra H. Baker, MD1,2,3; et alGregory P. Priebe, MD4,5,6; Michael C. Monuteaux, ScD1,2,3 Author Affiliations Article Information JAMA Netw Open. 2025;8(4):e254720. doi:10.1001/jamanetworkopen.2025.4720 editorial comment icon Editorial Comment Key Points Question Is there an association between the first vasoactive agent administered and outcomes in children with septic shock without known cardiac
- [Chest:  Bringing PERT to Pediatrics: Initial Experience and Outcomes of a Pediatric Multidisciplinary Pulmonary Embolism Response Team (PERT)](https://emergencymed.org.il/chest-bringing-pert-to-pediatrics-initial-experience-and-outcomes-of-a-pediatric-multidisciplinary-pulmonary-embolism-response-team-pert/articles-2/) - Mary P Dang 1, Anna Cheng 2, Jessica Garcia 1, Ying Lee 1, Mihir Parikh 3, Ali B V McMichael 4, Brian L Han 5, Sheena Pimpalwar 5, Elliot S Rinzler 5, Olivia L Hoffman 6, Sirine A Baltagi 7, Cindy Bowens 6, Abhay A Divekar 8, A Paige Davis Volk 6, Craig J Huang 9, Surendranath R Veeram Reddy 8, Yousef Arar 8, Ayesha Zia 10 Affiliations Expand Abstract Background: Multidisciplinary pulmonary embolism response teams (PERTs) streamline care of adults with life-threatening pulmonary embolism (PE).
- [PODCAST: So Sweet...Type 1 Diabetes Screening in the ED with Dr. James Paxton](https://emergencymed.org.il/podcast-so-sweet-type-1-diabetes-screening-in-the-ed-with-dr-james-paxton/podcast/) - ACEP Frontline · So Sweet...Type 1 Diabetes Screening in the ED with Dr. James Paxton Emergency medicine has been the safety net for the medical system for years, but is the only access point for many across this country. We are also seeing rising incidence of diabetes in all ages. As a result, emergency medicine
- [JAMA Editorial: Transient Ischemic Attack—Not So Transient After All!](https://emergencymed.org.il/jama-editorial-transient-ischemic-attack-not-so-transient-after-all/articles-2/) - Eric E. Smith, MD, MPH1; Babak B. Navi, MD, MS2,3 Author Affiliations Article Information JAMA Neurol. 2025;82(4):321-322. doi:10.1001/jamaneurol.2024.5090 According to conventional thinking, transient ischemic attacks (TIAs) are supposed to resolve without permanent injury to the brain. However, this conventional view may be too rosy. A study1 in this issue of JAMA Neurology suggests that TIAs are
- [How do You Manage Pain in Patients with Opioid Use Disorder? Emergency Medicine Pain/Sedation/Procedure Psychiatry | Substance Use](https://emergencymed.org.il/how-do-you-manage-pain-in-patients-with-opioid-use-disorder-emergency-medicine-pain-sedation-procedure-psychiatry-substance-use/articles-2/) - Written by Millie Cossé Management of acute pain in patients with opioid use disorder is tricky and likely requires a multi-modal approach. Evidence to support a single best strategy is lacking. Take the edge off This systematic review of 115 studies seeks to summarize the known risks and benefits of various interventions for managing acute
- [New Sudbury Vertigo Risk Score Derivation Emergency Medicine ENT/Face Neurology](https://emergencymed.org.il/new-sudbury-vertigo-risk-score-derivation-emergency-medicine-ent-face-neurology/articles-2/) - Written by Shannon Markus The Sudbury Vertigo Risk Score helps identify patients with vertigo who are at risk for stroke. It has remarkable sensitivity for serious neurologic pathology but has yet to be validated. A new spin on vertigo risk Vertigo is a common ED complaint, though only 2-5% of cases stem from serious conditions
- [VIDEO POST: Scorpion stings: Live from Death Valley](https://emergencymed.org.il/scorpion-stings-live/קדם-בית-חולים/) - Scorpion stings: Live from Death ValleyExplore the dangers of scorpion envenomation in this thrilling LIVE-recorded episode from Death Valley, CA. This is an episode you’ll want to watch- the video shots of Death Vally are INCREDIBLE. Check us out on Youtube, Instagram, or TikTok. Learn key emergency medicine pearls and treatment strategies for your next
- [PODCAST: Geriatric Emergency Medicine](https://emergencymed.org.il/podcast-geriatric-emergency-medicine/education-tips/) - Hosts: Ula Hwang, MD Brian Gilberti, MD Key Topics Discussed Importance and impact of geriatric emergency departments. Optimizing care strategies for geriatric patients in ED settings. Practical approaches for non-geriatric-specific EDs. Challenges in Geriatric Emergency Care Geriatric patients often present with: Multiple chronic conditions Polypharmacy Functional decline (mobility issues, cognitive impairments, social isolation) Adapting Clinical
- [PODCAST: Key clinical considerations when managing heart transplant patients due to their unique pathophysiology](https://emergencymed.org.il/podcast-key-clinical-considerations-when-managing-heart-transplant-patients-due-to-their-unique-pathophysiology/education-tips/) - Contributor: Travis Barlock, MD Educational Pearls: Key clinical considerations when managing heart transplant patients due to their unique pathophysiology 1. Arrhythmias A transplanted heart is denervated, meaning it lacks autonomic nervous system innervation The lack of vagal tone results in an increased resting heart rate Adenosine can be used since it primarily slows conduction through
- [PODCAST: Differential Cause of Right Heart Failure with Dr. Kristen Nordenholz - CoACEP](https://emergencymed.org.il/podcast-differential-cause-of-right-heart-failure-with-dr-kristen-nordenholz-coacep/podcast/) - ACEP Frontline · Differential Cause of Right Heart Failure with Dr. Kristen Nordenholz - CoACEP In this episode, Dr. Kristen Nordenholz breaks down some of the causes and differential for right heart failure in EM. This ties in with the prior podcast from CoACEP with Dr. Tems talking about the indications for ECMO.
- [PODCAST: Pediatric Febrile Seizures](https://emergencymed.org.il/podcast-pediatric-febrile-seizures/ילדים/) - Contributor: Taylor Lynch, MD Educational Pearls: Pediatric febrile seizures are defined as seizures that occur between the ages of six months to five years in the presence of a fever greater than or equal to 38.0 ºC (100.4 ºF). It is the most common pediatric convulsive disorder, with an incidence between 2-5% What are the
- [Auto-Transfusion Tourniquet (A-TT) Reanimation of Cardiac Arrest Patients-A Retrospective Chart Review](https://emergencymed.org.il/auto-transfusion-tourniquet-a-tt-reanimation-of-cardiac-arrest-patients-a-retrospective-chart-review/articles-2/) - Martin Pallares Perez1, David H Tang2 and Noam Gavriely3,4* 1Facultad de Medicina, Centro de Estudios Universitarios Xochicalco Campus Ensenada, San Francisco 1139, Fraccionamiento Misión, CP 22830, Ensenada, B.C., México 2Jerry L Pettis Memorial Va Medical Center, Loma Linda, CA USA 3Department of Physiology and Biophysics, Technion, Israel Institute of Technology, Haifa, Israel (retired) 4OHK Medical
- [Appendectomy or Antibiotics for Appendicitis in Children? Emergency Medicine](https://emergencymed.org.il/appendectomy-or-antibiotics-for-appendicitis-in-children-emergency-medicine/articles-2/) - Written by Vivian Lei Antibiotic treatment for acute uncomplicated appendicitis in children has a significantly higher failure rate (34% vs. 7%) compared to appendectomy, but this is limited by differing definitions of failure and the chosen non-inferiority margin. Antibiotics buy time, but surgery seals the deal This is a large, international, multicenter, randomized, non-inferiority trial
- [PODCAST: March 2025 Annals of Emergency Medicine](https://emergencymed.org.il/podcast-march-2025-annals-of-emergency-medicine/podcast/) - Annals of Emergency Medicine · March 2025 In the March issue of the Annals of Emergency Medicine podcast, Rory and Ryan discuss cephalosporins for outpatient pyelonephritis, ED-initiated buprenorphine programs, cervical cancer screening in the ED and much more. Emergency medicine
- [VIDEO: Ankle Sprains](https://emergencymed.org.il/video-ankle-sprains/קדם-בית-חולים/) - Introduction:– Ankle sprains are among the most common injuries, affecting both athletes and everyday pedestrians.– The streets of New York City illustrate how treacherous surfaces can lead to ankle injuries.– The ankle is the most commonly injured joint in sports; jogging is a frequent cause.Anatomy of the Ankle:– The ankle joint, or mortise, is formed
- [PODCAST: Smoke Inhalation Injury](https://emergencymed.org.il/podcast-smoke-inhalation-injury/קדם-בית-חולים/) - Table of Contents 00:37 – Overview of Smoke Inhalation Injury 00:55 – Three Key Pathophysiologic Processes 01:41 – Physical Exam Findings to Watch For 02:12 – Airway Management and Early Intervention 03:23 – Carbon Monoxide Toxicity 04:24 – Workup and Initial Treatment of CO Poisoning 06:14 – Cyanide Toxicity 07:19 – Treatment Options for Cyanide Poisoning 09:12 – Take-Home Points and Clinical Pearls Physiological
- [PODCAST : summary EM clerkship  CNS, Cardiopulmonary, Renal Diagnosis:](https://emergencymed.org.il/podcast-summary-em-clerkship-cns-cardiopulmonary-renal-diagnosis/podcast/) - Phase One: CNS Ataxia, Slurred Speech, Confusion, N/V, Seizures Phase Two: Cardiopulmonary CHF, Cardiogenic Shock/Hypotension, Pulmonary Edema, ARDS Phase Three: Renal Flank pain, Hematuria, Oliguria, Renal Failure Diagnosis: HIGH INDEX OF SUSPICION Ethylene Glycol Serum Level Elevated Osmolar Gap Serial Anion Gap Measurements Treatment: Fomepizole or Ethanol to prevent breakdown to toxic glycolic acid/oxalic acid
- [PODCAST: SGEM Xtra Zombie Idea - ED Crowding is Due to Non-Urgent Patients](https://emergencymed.org.il/podcast-sgem-xtra-zombie-idea-ed-crowding-is-due-to-non-urgent-patients/education-tips/) - Date: April 1, 2025 This is another SGEM Xtra. I was asked to give a public lecture for the Gateway Centre of Excellence in Rural Health. The topic was the zombie idea that emergency department crowding is due to non-urgent patients. You can click on this LINK and get a PDF copy of my slides. The YouTube video of
- [PODCAST: Your First Leadership Role? Start With These 8 Principles](https://emergencymed.org.il/podcast-your-first-leadership-role-start-with-these-8-principles/education-tips/) - Leadership impacts everyone, whether steering an entire organization or navigating team dynamics. It’s an essential skill, yet it often feels elusive, even for experienced professionals. While every leadership challenge is unique, the core principles remain universal. This episode breaks down eight critical leadership principles drawn from years of experience, hard lessons, conversations with seasoned experts,
- [Resuscitation: Femoral artery Doppler ultrasound is more accurate than manual palpation for pulse detection in cardiac arrest + PODCAST](https://emergencymed.org.il/resuscitation-femoral-artery-doppler-ultrasound-is-more-accurate-than-manual-palpation-for-pulse-detection-in-cardiac-arrest-podcast/articles-2/) - Contributor: Aaron Lessen, MD Educational Pearls: Point-of-care ultrasound (POCUS) is used to assess cardiac activity during cardiac arrest and can identify potential reversible causes such as pericardial tamponade Ultrasound could be beneficial in another way during cardiac arrest as well: pulse checks Manual palpation for detecting pulses is imperfect, with false positives and negatives Doppler
- [JAMA: Cardiac Arrest During Long-Distance Running Races](https://emergencymed.org.il/jama-cardiac-arrest-during-long-distance-running-races/קדם-בית-חולים/) - Jonathan H. Kim, MD, MSc1; Austin J. Rim, MD1; James T. Miller, MS1; et al Key Points Question What is the contemporary incidence of cardiac arrest and death among marathon and half-marathon runners in the US? Findings In this case series and cohort study from the Race Associated Cardiac Event Registry, the incidence of cardiac arrest during marathons and half-marathons has remained relatively stable since 2010,
- [EPIC RCT – POCUS IV Wins in Pediatrics](https://emergencymed.org.il/epic-rct-pocus-iv-wins-in-pediatrics/articles-2/) - Written by Megan Hilbert Regardless of anticipated difficulty of placement of peripheral intravenous catheter (PIVC) in a pediatric patient, ultrasound-guided insertion results in improved success. An EPIC win for DIVAs PIVC has a less than 50% initial success rate on first attempt in pediatric patients. This results in increased pain and anxiety. In patients with
- [Effect of change of high-sensitivity troponin I assay on emergency department diagnosis and disposition of patients with possible acute coronary syndrome](https://emergencymed.org.il/effect-of-change-of-high-sensitivity-troponin-i-assay-on-emergency-department-diagnosis-and-disposition-of-patients-with-possible-acute-coronary-syndrome/articles-2/) - John W Pickering PhD, Scott Kelland MBChB, Otis Williams BMedSci(Hons), Jamin Kim MBChB, Sally Aldous MD, Laura R Joyce MBChB, Martin P Than MBBS Abstract Objective Changing cardiac troponin (cTn) assays may affect a hospital's admission and myocardial infarction rates. The effect of changing from a contemporary to high-sensitivity (hs) cTnI assay has been well described, but the real-life
- [Blood culture collection and administration of intravenous ceftriaxone by paramedics in patients with suspected sepsis (the pass trial)](https://emergencymed.org.il/blood-culture-collection-and-administration-of-intravenous-ceftriaxone-by-paramedics-in-patients-with-suspected-sepsis-the-pass-trial/articles-2/) - Daniel Cudini BEx Sci, BEmergHlth (Paramedic), Grad Dip EmergHlth (ICP), MACPara, Karen Smith BSc(Hons), Grad Cert Exec BA, Grad Dip Epi and Biostats, PhD, OAM … See all authors Abstract Objective To evaluate the feasibility of pre-hospital blood culture (BC) collection and intravenous (IV) antibiotic administration in patients with suspected sepsis. Methods In
- [PODCAST: JEM February 2025 Podcast Summary](https://emergencymed.org.il/podcast-jem-february-2025-podcast-summary/cme/) - Podcast summary of articles from the February 2025 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include ECPR, supraglottic airway devices, environmental factors in out of hospital cardiac arrest, pediatric admissions, Bechet's disease, and auricular hematomas. Guest speaker is Dr. John Bennison.
- [JAMA: Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults](https://emergencymed.org.il/jama-out-of-hospital-cardiac-arrest-in-apparently-healthy-young-adults/articles-2/) - Zian H. Tseng, MD, MAS1; Kosuke Nakasuka, MD, PhD1 Abstract Importance Out-of-hospital cardiac arrest incidence in apparently healthy adults younger than 40 years ranges from 4 to 14 per 100 000 person-years worldwide. Of an estimated 350 000 to 450 000 total annual out-of-hospital cardiac arrests in the US, approximately 10% survive. Observations Among young adults who have had cardiac arrest outside of a
- [PODCAST: Is 4 Better Than 3 - The New ACGME EM Program Recommendations](https://emergencymed.org.il/podcast-is-4-better-than-3-the-new-acgme-em-program-recommendations/education-tips/) - ACEP Frontline · Is 4 Better Than 3 - The New ACGME EM Program Recommendations he new ACGME recommendations for EM program length as well as other adjustment to the EM specialty curriculum have caused quite the stir. We talk with the past-chair, chair, and incoming chair of the EM Review Committee about the changes,
- [A Critical Issue in the Management of Adult Patients Presenting to the Emergency Department With Acute Carbon Monoxide Poisoning](https://emergencymed.org.il/a-critical-issue-in-the-management-of-adult-patients-presenting-to-the-emergency-department-with-acute-carbon-monoxide-poisoning/articles-2/) - Approved by the ACEP Board of Directors January 22, 2025 American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Carbon Monoxide Poisoning ∙ Richard D. Shih, MD ∙ Christian A. Tomaszewski, MD, MS, MBA∙ … ∙ John T. Finnell, MD ∙ Travis Schulz, MLS, AHIP ∙ Kaeli Vandertulip, MSLS, MBA, AHIP… Show more Abstract This clinical policy from the American College of Emergency Physicians addresses a key issue in
- [Midazolam and Ketamine for Convulsive Status Epilepticus in the Out-of-Hospital Setting](https://emergencymed.org.il/midazolam-and-ketamine-for-convulsive-status-epilepticus-in-the-out-of-hospital-setting/articles-2/) - Tony Zitek, MDa,b zitek10@gmail.com ∙ Kenneth A. Scheppke, MDc ∙ Peter Antevy, MDc∙ … ∙ Sebastian Garay, EMT-Pc ∙ Eric Scheppke, DOc ∙ David A. Farcy, MDa,b,c… Show more Abstract Study objective To determine if ketamine, when added to midazolam for the treatment of out-of-hospital seizures, is associated with an increase in the rate of cessation of convulsions prior to hospital arrival. Methods We performed a retrospective cohort study of out-of-hospital patients with an active convulsive seizure being
- [Would You Recognize Occlusion Myocardial Infarction on EKG?](https://emergencymed.org.il/would-you-recognize-occlusion-myocardial-infarction-on-ekg/articles-2/) - Written by Millie Cossé Approximately half of patients with high-risk occlusion myocardial infarction (OMI) do not meet STEMI criteria, making it extremely important that EM physicians recognize high-risk OMI patterns on EKG. There’s so much more than STEMI/NSTEMI This narrative review article describes high-risk EKG patterns suggestive of OMI (see image below). There is a
- [ETT in PHARYNX for ‘Can’t Intubate, Can’t Oxygenate’?](https://emergencymed.org.il/ett-in-pharynx-for-cant-intubate-cant-oxygenate/articles-2/) - Written by Aaron Lacy Patients with potentially difficult airways were oxygenated and ventilated in the operating room via an endotracheal tube in the pharynx, which could be applied to a ‘can’t intubate, can’t oxygenate (CICO)’ scenario. TTIP for CICO? The CICO scenario is a shared nightmare for those who manage airways. In this situation, the airway
- [Trends in Firearm Injuries Treated in Emergency Departments by Individual- and County-Level Characteristics, 2019 to 2023](https://emergencymed.org.il/trends-in-firearm-injuries-treated-in-emergency-departments-by-individual-and-county-level-characteristics-2019-to-2023/articles-2/) - Marissa L. Zwald, PhD, MPHa ipv5@cdc.gov ∙ Kristin M. Holland, PhD, MPHa ∙ Steven A. Sumner, MDa∙ … ∙ Anika Wallace, MPHa ∙ Norah W. Friar, MPHa ∙ Thomas R. Simon, PhDa… Show more Abstract. Study objective To understand trends in nonfatal firearm injuries by examining rates of firearm injury emergency department (ED) visits stratified by individual- and county-level characteristics. Methods Data from participating EDs within 10 jurisdictions in the United States funded through the Centers for Disease Control
- [הרצאת  CME  מרץ- ד״ר אבי עירוני:שימוש באקמו במחלקה לרפואה דחופה](https://emergencymed.org.il/הרצאת-cme-מרץ-ד״ר-אבי-עירונישימוש-באקמו-ב/zoom/) - הרצאת CME של חודש מרץ עלתה לאתר שימוש באקמו במחלקה לרפואה דחופה
- [PODCAST: RECM March 2025](https://emergencymed.org.il/podcast-recm-march-2025/podcast/) - Happy March! This month for the March 2025 episode of the RCEM Learning Podcast starts with an update from Rob. We have Andy and Dave talking about oxygen targets in trauma in the TRAUMOX2 RCT. Becky and Chris talk about a BOAST orthopaedic guideline for the management of lateral patella dislocation. We interview Raine Astin-Chamberlain
- [Reducing time delays and enhancing reperfusion eligibility related to stroke suspicion by the Emergency Medical Dispatch Centre: a registry-based observational study](https://emergencymed.org.il/reducing-time-delays-and-enhancing-reperfusion-eligibility-related-to-stroke-suspicion-by-the-emergency-medical-dispatch-centre-a-registry-based-observational-study/articles-2/) - Nedim Leto ,1,2,3 Elisabeth Farbu,1,4 Paul Barach,5,6 Michael Busch,2,7 Helene Lund,8 Conrad Arnfinn Bjørshol ,1,2 Martin Kurz,1,4 Annette Fromm,3 Øyvind Østerås,9 Linn Therese Hagen,10 Thomas Werner Lindner2 Abstract Background and aims Research on the importance of the Emergency Medical Dispatch Centre (EMDC) role in reducing the
- [PODCAST:  Shock Types in 15 minutes](https://emergencymed.org.il/podcast-shock-types-in-15-minutes-2/podcast/) - We’re starting off the year strong with a quick review of the 4 major types of shock and your approach to each one. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake; Husain, Iltifat. 245. Shock
- [PODCAST Clean kill: when intubation kills your pt](https://emergencymed.org.il/podcast-clean-kill-when-intubation-kills-your-pt-2/education-tips/) - You intubate... and then your patient codes. What did you do wrong? When is "ABC" the wrong order? Let's dive into this nuanced topic in critical care. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake.
- [PODCAST: High blood pressure: will your head explode?](https://emergencymed.org.il/podcast-high-blood-pressure-will-your-head-explode/podcast/) -  How do you treat asymptomatic hypertension in the ED? When is it urgent? Emergent? We break down what you need to know, myths, and what really matters. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs,
- [PODCAST: High-Yield Pearls Blitz](https://emergencymed.org.il/podcast-high-yield-pearls-blitz-2/podcast/) - Boost your EM knowledge with high-yield, rapid pearls! In this episode, we cover life-saving tips for thyroid storm, beta-blocker overdose, heat stroke, SAH, and Ludwig’s— all in under 10 minutes. Perfect for EM boards or quick clinical refresher. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST
- [PODCAST: Grand Rounds - Dr. Alexander Ginsburg - Integrating Palliative Care in the ED](https://emergencymed.org.il/podcast-grand-rounds-dr-alexander-ginsburg-integrating-palliative-care-in-the-ed/education-tips/) - In this Grand Rounds chapter, Dr. Alex Ginsburg, board certified in both emergency medicine and palliative care, and physician leader practicing in both specialties at Mayo Clinic in Rochester, Minnesota discusses a pragmatic way to incorporate palliative care into a busy and complicated emergency medicine practice. Beginning with why this is important and highlighting the
- [Does Single Dose Epinephrine Improve Outcomes for Patients with Out-of-Hospital Cardiac Arrest and Bystander CPR or a Shockable Rhythm?](https://emergencymed.org.il/does-single-dose-epinephrine-improve-outcomes-for-patients-with-out-of-hospital-cardiac-arrest-and-bystander-cpr-or-a-shockable-rhythm/articles-2/) - Tyler S George 1, Nicklaus P Ashburn 1, Anna C Snavely 1 2, Bryan P Beaver 3, Michael A Chado 4, Harris Cannon 1, Casey G Costa 5, James E Winslow 1, R Darrell Nelson 1, Jason P Stopyra 1, Simon A Mahler 1 6 7 Affiliations Expand Background: A single dose epinephrine protocol (SDEP) for out-of-hospital cardiac arrest (OHCA) achieves similar survival to hospital discharge (SHD) rates as a multidose epinephrine protocol (MDEP). However, it is unknown if a SDEP
- [PODCAST: EM Quick Hits 63 S-TEC and HUS, IM Epinephrine in OHCA, Dengue, Geriatric Trauma Imaging, TTP](https://emergencymed.org.il/podcast-em-quick-hits-63-s-tec-and-hus-im-epinephrine-in-ohca-dengue-geriatric-trauma-imaging-ttp/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Topics in this EM Quick Hits podcast Stephen Freedman on pediatric bloody diarrhea, S-TEC and hemolytic uremic syndrome (1:06) Justin Morgenstern on the evidence for IM epinephrine in out of hospital cardiac arrest (27:04) Matthew McArther on recognition and
- [Midazolam Misses the Mark? Procedural Anxiety in Kids Emergency Medicine Pain/Sedation/Procedure Pediatric Emergency Pharmacy/Pharmacology](https://emergencymed.org.il/midazolam-misses-the-mark-procedural-anxiety-in-kids-emergency-medicine-pain-sedation-procedure-pediatric-emergency-pharmacy-pharmacology/articles-2/) - Written by Joshua Belfer In a cohort of 102 children receiving intranasal midazolam in the ED for a laceration repair, nearly half exhibited extreme procedural anxiety. IN midazolam isn’t a silver bullet for procedural anxiety This cross-sectional study examined the incidence of extreme procedural anxiety despite intranasal midazolam (INM) administration in children undergoing laceration repair
- [המרכז הרפואי שיבא מציג פרויקט מהפכני: חדר מיון מבוסס AI](https://emergencymed.org.il/המרכז-הרפואי-שיבא-מציג-פרויקט-מהפכני-ח/blog/) - הבינה המלאכותית נכנסת אל שלב הטריאז׳ ב”שיבא”: המערכת מבצעת מיפוי ואיסוף נתונים רפואיים של המטופל, מבצעת ניתוח ראשוני ומציגה בפני הרופא סיכום מקיף הכולל פיענוחים ואבחנות מבוססות AI רוע החדשנות ARC במרכז הרפואי שיבא בתל השומר חושפת לראשונה את פרויקט K – חדר מיון מבוסס בינה מלאכותית (AI), אשר עשוי לחולל שינוי מהותי באופן שבו
- [רפואה דחופה הוכרה  כמקצוע בסיס להתמחות ברפואה פלאטבית](https://emergencymed.org.il/רפואה-דחופה-הוכרה-כמקצוע-בסיס-להתמחות/articles-2/) - היום אושר ע"י הוועד הפועל של המועצה המדעית בהר"י שהמקצוע שלנו רפואה דחופה יכול להיות מקצוע בסיס להתמחות על ברפואה פלאטיבית.
- [סיכום ישיבת ועד האיגוד](https://emergencymed.org.il/סיכום-ישיבת-ועד-האיגוד/articles-2/) - הוועד נפגש בזום ב 23.9.21 נכחו פרופ' דרשר, ד"ר טל-אור, ד"ר הדר, וד"ר שאדן. להלן עקרי הדברים: כנס רפואה דחופה הכניס כ 40000 שקלים לקופת האיגוד גרף שמראה את ההכנסות מהכנסים האחרונים מצורף בהמשך. קורס למתמחים ברפואה דחופה מתחיל בקרוב. אנחנו מבקשים שכל המשתתפים בקורס ישלמו את עלות הקורס (3000 שקל למשתתף) לפני תחילת הקורס
- [סקר שחיקה שעושה האירגון הארופאי לרפואה דחופה](https://emergencymed.org.il/סקר-שחיקה-שעושה-האירגון-הארופאי-לרפוא/ניהול-מלרד/) - The pandemic has put a lot of stress on the emergency medical services, and above all the personnel that is working in them. The EM-day is proposing a short survey with the aim to evaluate the dimension of the stress and fatigue of the EM personnel during the pandemics. The results of this investigation will
- [PODCAST: Procalcitonin in the ED and Beyond with Dr. James Neuenschwander](https://emergencymed.org.il/podcast-procalcitonin-in-the-ed-and-beyond-with-dr-james-neuenschwander/recourse/) - ACEP Frontline · Procalcitonin in the ED and Beyond with Dr. James Neuenschwander Today we're joined by repeat guest Dr. James Neuenshwander, Attending Physician and Research Director for Genesis Healthcare System and Adjunct Associate Professor at The Ohio State University Medical Center. We usually discuss topics around potassium and things of that nature with Dr.
- [Physicians in Ukraine: Caring for Patients in the Middle of a War](https://emergencymed.org.il/physicians-in-ukraine-caring-for-patients-in-the-middle-of-a-war/articles-2/) - Rita Rubin, MA Article Information JAMA. Published online March 16, 2022. doi:10.1001/jama.2022.4680 Roman Kizyma, MD, director of pediatric oncology at the Western Ukrainian Specialized Children’s Medical Center in Lviv, Ukraine, has spent most of his waking hours since Russia invaded his country dealing with challenges his medical training never prepared him for: transferring children who’ve just had a bone marrow
- [מצגת הועדה לבחינת עבודת הרופאות והרופאים ברפואה דחופה בישראל](https://emergencymed.org.il/מצגת-הועדה-לבחינת-עבודת-הרופאות-והרופ/articles-2/) - המצגת מהדיון עלתה לאתר בכתובת למצגת לחץ כאן לPDF הצגת עיקרי העבודה של הוועדה לקיצור תוכנית המתמחות במלרד סופי[19540]
- [פודקאסט זה מובא במיוחד בשבוע לפני הבחירות שימו לב לכותרת : MI Risk during Elections](https://emergencymed.org.il/פודקאסט-זה-מובא-במיוחד-בשבוע-לפני-הבחי/articles-2/) - Oct 3, 2022 Contributor: Aaron Lessen, MD Educational Pearls: 2020 retrospective study with dat from two California hospitals compared rates of cardiovascular admissions in a five day period two weeks before and the five days after the presidential election Hospitalization rate for acute cardiovascular disease increased by 17% and rate of acute myocardial infarction increased
- [ACEP:   Clinical Alert: Ebola](https://emergencymed.org.il/acep-clinical-alert-ebola/articles-2/) - October 13, 2022 With the recently confirmed outbreak of Ebola Virus Disease (EVD) in Uganda, the Centers for Disease Control are asking emergency physicians to consider the virus in presenting patients who are residents or travelers with relevant exposure. This week, the CDC and the Department of Homeland Security began routing travelers from Uganda into five United
- [PODCAST: Strategies for Shift Endurance](https://emergencymed.org.il/podcast-strategies-for-shift-endurance/articles-2/) - Nov 21, 2022 It’s a tough time to practice medicine right now, which makes paying attention to self care even more important. In this episode we break down three specific strategies for: improving mental and physical performance, sustaining shift endurance, and building a scaffolding for joy at work. Interested in one-on-one coaching? Learn more at roborman.com
- [תגובת בקולג' האמריקאי לרפואה דחופה, למדדי איכות לטיפול בספסיס](https://emergencymed.org.il/תגובת-ה-acep-למדדי-איכות-לטיפול-בספסיס/articles-2/) - מכתב חשוב של ACE P בנושא מדדי איכות לטיפול בספסיס והלם ספטי. חשוב מאוד לקרוא. הם מטילים ספק ברוב הקריטריונים מבחינת יעילות קלינית, כולל 30 מ"ל לק"ג הרצה, אנטיביוטיקה בחולים שאינם בהלם, מדידות לקטט חוזרות. הם מדגישים את הקושי להגדיר את זמן אפס לחישוב זמני עמידה במדדי האיכות. לא להיות ניהיליסט כמובן, וצריך
- [מכתבה של ד"ר דברה בסט לחברי האיגוד](https://emergencymed.org.il/מכתבה-של-דר-דברה-בסט-לחברי-האיגוד/articles-2/) - לחברי האיגוד הישראלי לרפואה דחופה שלום אני כותבת לכם בשילוב של אכזבה וגאווה. עד היום הקדשתי את החיים המקצועיים שלי לקידום הרפואה הדחופה בישראל גם לטובת עמיתיי הרופאים שעושים את העבודה המאתגרת שלנו יום יום לעתים בתנאים בלתי אפשריים, אבל בעיקר בגלל אמונה עמוקה ששינוי בשיטה בה אנחנו עובדים ייטיב עם החולים ועם הפצועים בישראל
- [Special Issue "Clinical Advances in Pediatric Emergency Medicine"](https://emergencymed.org.il/special-issue-clinical-advances-in-pediatric-emergency-medicine/articles-2/) - Print Special Issue Flyer Special Issue Editors Special Issue Information Keywords Published Papers A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Emergency Medicine". Deadline for manuscript submissions: 20 July 2023 | Viewed by 167 Share This Special Issue Special Issue
- [Verbal And Physical Violence In An Urban ED Setting](https://emergencymed.org.il/verbal-and-physical-violence-in-an-urban-ed-setting/articles-2/) - March 6, 2023 / Ethics, Health Policy, Wellness Written by Doug Wallace Violence directed at healthcare workers (HCWs) is common in the ED setting. Studies have demonstrated workplace violence is underreported and can have long term effects on HCWs. Why does this matter? Most violence in the workplace is perpetrated by patients against HCWs. One targeted ED study found
- [Diagnostic Error In EM – Pushback On The AHRQ](https://emergencymed.org.il/diagnostic-error-in-em-pushback-on-the-ahrq/articles-2/) - March 8, 2023 / Ethics, Health Policy Written by Rebecca White Diagnostic errors in the ED occur at rates similar to those in other clinical settings. Not all errors have human causes, and not all are inevitable – this article suggests systems-level opportunities for improvement. Why does this matter? A recent review published ED diagnostic error rates. While
- [Can ChatGPT Write Journal Articles?](https://emergencymed.org.il/can-chatgpt-write-journal-articles/articles-2/) - April 17, 2023 / Ethics, Technology Written by Gabby Leonard ChatGPT is an artificial intelligence software that is being explored for scientific writing. While there is great potential for utilizing this in the medical field, it should not be used in isolation and requires human oversight for both concept proof and personalization. Why does this matter? Scientists are
- [על רקע המשבר במערכת: משרד הבריאות מקים ועדה לבחינת העבודה בחדרי מיון הוועדה תעסוק בין היתר בדרכים לצמצום שחיקה ומניעת נטישה של רופאים מומחים, כשברקע סקר של המשרד שמצביע כי עובדי המחלקות לרפואה דחופה הם השחוקים ביותר במערכת. בראש הוועדה יעמוד ד"ר ספי מנדלוביץ, משנה למנכ"ל המשרד](https://emergencymed.org.il/על-רקע-המשבר-במערכת-משרד-הבריאות-מקים-ו/ניהול-מלרד/) - הוועדה תעסוק בין היתר בדרכים לצמצום שחיקה ומניעת נטישה של רופאים מומחים, כשברקע סקר של המשרד שמצביע כי עובדי המחלקות לרפואה דחופה הם השחוקים ביותר במערכת. בראש הוועדה יעמוד ד"ר ספי מנדלוביץ, משנה למנכ"ל המשרד לכתבה המלאה
- [וובנרים ללא תשלום](https://emergencymed.org.il/וובנרים-ללא-תשלום/articles-2/) - מצאתי מקום שמפרסם וובנרים ללא תשלום יש מספר לא מבוטל של וובנרים כאלה אני מעמיד לשאלה את הנושא. במידה ויהיה רוב אמשיך לפרסם [wpforms id="10111"]
- [Author Series - Urban Emergency Medicine by Dr. Mark Curato - ACEP23](https://emergencymed.org.il/author-series-urban-emergency-medicine-by-dr-mark-curato-acep23/education-tips/) - ACEP Frontline · Author Series - Urban Emergency Medicine by Dr. Mark Curato - ACEP23 In this episode, we talk with Dr. Mark Curato about his new textbook, Urban Emergency Medicine, which focuses on the care and challenges of emergency medicine in the urban environment. www.amazon.com/Urban-Emergency-M…ato/dp/1009181564
- [הרופאים מחו"ל שהתגייסו בבתי החולים במלחמה: "תנו לי אפילו לשטוף רצפה"](https://emergencymed.org.il/הרופאים-מחול-שהתגייסו-בבתי-החולים-במל/articles-2/) - הם עזבו עבודה נוחה וחיי משפחה מסודרים בחו"ל ובאו לתת הכול בימי המלחמה. עשרות רופאים בכירים לרפואה דחופה מרחבי העולם מתנדבים בארץ ועוזרים לצוותים הרפואיים במחלקות לרפואה דחופה. הדבר הוביל להיווסדה של יוזמה חדשה שמטפחת את הקשר בין רופאים יהודים ברחבי העולם עם צוותי הרפואה הדחופה בארץ: "בשבילי כרופא, לטפל בחיילים זה היה הדבר הכי
- [מחקר: תהליכי קבלת ההחלטות הרפואיות במלר"ד](https://emergencymed.org.il/מחקר-תהליכי-קבלת-ההחלטות-הרפואיות-במל/articles-2/) - שלום רב, במסגרת מחקר בביה"ס לבריאות הציבור, בפקולטה לרפואה באוניברסיטה העברית, אנחנו בוחנים את תהליכי קבלת ההחלטות הרפואיות במלר"ד. כחלק מן המחקר אנו מעבירים שאלון "דלפי" בקרב רופאים העובדים במלר"ד, זאת כדי להגיע להסכמות רחבות ככל הניתן על הגורמים הלא-קליניים המשפיעים על קבלת ההחלטות במלר"ד. אנחנו פונים אליכם כמי שמבינים לעומק את העבודה והדינמיקה הייחודית
- [דבר יו״ר האיגוד לשנה החדשה](https://emergencymed.org.il/דבר-יו״ר-האיגוד-לשנה-החדשה/articles-2/) - חברים יקרים , ביממה מורכבת וקשה זו מבקש לחזק את קהילת האיגוד הישראלי לרפואה דחופה שעומדת דרוכה ומוכנה בחזית מערכת הבריאות הישראלית. וקצת אסקפיזם.. מבקש לעדכנכם בפרטי הסכם הרופאים שנחתם והבשורה המשמעותית למחלקות לרפואה דחופה. ראו מצ"ב: 1.⁠ ⁠ביטול חובת 5 שעות ליבה ומעבר לשעון גמיש אמיתי של 36 שעות שבועיות עפ"י החלטת מנהל מלר"ד.
- ["אין מקום לטעויות": כך מכשירים רופאים מכל העולם להציל חיים](https://emergencymed.org.il/אין-מקום-לטעויות-כך-מכשירים-רופאים-מכ/recourse/) - תכנית חדשנית שיזם ד"ר אחמד נעמה, מנהל המחלקה לרפואה דחופה בהדסה עין כרם, בשיתוף מומחים מהדסה ומהעולם, מציעה הכשרה מעשית בתחום לרופאים ממדינות שונות וזוכה להתעניינות נרחבת. הקורס, שהתקיים לאחרונה בפראג, נועד לשפר מיומנויות קריטיות בהצלת חיים ושיכוך כאב – והצליח לזכות בהכרה בינלאומית מרשימה Source: "אין מקום לטעויות": כך מכשירים רופאים מכל העולם להציל
- [TRAUMA: THE PROCEDURES COURSE 24-25/6](https://emergencymed.org.il/trauma-the-procedures-course-24-25-6/education-tips/)
- [Antivirals or Symptom Relief for Non-Severe Influenza?](https://emergencymed.org.il/antivirals-or-symptom-relief-for-non-severe-influenza/blog/) - Written by Megan Hilbert For treatment of non-severe influenza, there has not been an identified antiviral medication that should be used for treatment instead of simple symptomatic management. It’s flu season and I’m flying through treatment options In January we covered early oseltamivir for severe influenza cases admitted to the hospital, but now we are widening
- [PE Guidelines Say LMWH…Why So Much UFH?](https://emergencymed.org.il/pe-guidelines-say-lmwhwhy-so-much-ufh/blog/) - Written by Bo Stubblefield Guidelines recommended low molecular weight heparin (LMWH) for most patients with acute pulmonary embolism (PE), but we often choose unfractionated heparin (UFH). Here’s why… “In a dark place we find ourselves, and a little more knowledge lights our way…” A recent study of nearly 300,000 patients hospitalized with acute PE between 2011-2020 found
- [PODCAST: You Take My Breath Away – D-dimer for Ruling out PE in High-Risk Patients](https://emergencymed.org.il/podcast-you-take-my-breath-away-d-dimer-for-ruling-out-pe-in-high-risk-patients/pocus/) - Podcast: Play in new window | Download Reference: Bannelier et al. Failure rate of D-dimer testing in patients with high clinical probability of pulmonary embolism: Ancillary analysis of three European studies. AEM Feb 2025 Date: February 27, 2025 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She
- [PODCAST: Is ECMO the Future of em Resuscitation with Dr. Chris Tems – CoACEP](https://emergencymed.org.il/podcast-is-ecmo-the-future-of-em-resuscitation-with-dr-chris-tems-coacep/case-podcast/) - In this episode, we drop in on the Colorado ACEP Leadership Symposium with a talk by Dr. Chris Tems as he poses the question on whether ECMO is the future of EM cardiac arrest resuscitation.
- [מהפך בדיני רשלנות רפואית בארה"ב: משקל רב יותר לקווים מנחים](https://emergencymed.org.il/מהפך-בדיני-רשלנות-רפואית-בארהב-משקל-ר/articles-2/) - המכון המשפטי האמריקאי אישר לאחרונה כללים חדשים ליישוב תביעות רשלנות רפואית: מסטנדרט של "פרקטיקה מקובלת" לסטנדרט של "טיפול סביר" ורפואה מבוססת ראיות מהפך משמעותי בדיני הרשלנות הרפואית בארה"ב עם אימוץ סטנדרט משפטי חדש המתמקד ב"טיפול סביר", במקום בהסתמכות מסורתית על הנוהג המקובל בקרב רופאים. מאמר בנושא פורסם לאחרונה בכתב העת JAMA, תחת הכותרת "סטנדרט משפטי חדש
- [PODCAST: Time to Defibrillation](https://emergencymed.org.il/podcast-time-to-defibrillation/קדם-בית-חולים/) - Mar 3, 2025 Contributor: Aaron Lessen, MD Educational Pearls: Quick background info Cardiac arrest is when the heart stops pumping blood for any reason. This is different from a heart attack in which the heart is still working but the muscle itself is starting to die. One cause of cardiac arrest is when the electrical
- [PODCAST RCEM: February 2025](https://emergencymed.org.il/podcast-rcem-february-2025/podcast/) - Feb 13, 2025 Happy Valentine's Day! This month for the February 2025 episode of the RCEM Learning Podcast, we have got a new in EM segments looking at the assessment of PE in younger patients. Becky and Chris detail a guideline on acute adrenal insufficiency, before ending with New Online. If you'd like to email
- [JAMA: Emergency Department Vestibular Rehabilitation Therapy for Dizziness and Vertigo A Nonrandomized Clinical Trial](https://emergencymed.org.il/jama-emergency-department-vestibular-rehabilitation-therapy-for-dizziness-and-vertigo-a-nonrandomized-clinical-trial/articles-2/) - Howard S. Kim, MD, MS1,2; Jacob M. Schauer, PhD3; Ann K. Kan, MS3; et alJoshua B. Alinger, MD, PhD1; Kyle J. Strickland, PT, DPT4; Alexander Garreau, PT, DPT4; Danielle M. McCarthy, MD, MS1; Zachary B. Taylor, MPH1; Ivy L. Fishman, BA1; Kayla M. Muschong, BS1; Heidi R. Roth, PT, DHS5 Author Affiliations Article Information JAMA Netw Open. 2025;8(2):e2459567. doi:10.1001/jamanetworkopen.2024.59567 Key Points Question What is the feasibility of
- [How to Make an Ice Water Bath for Heat Stroke Critical Care Emergency Medicine Environmental](https://emergencymed.org.il/how-to-make-an-ice-water-bath-for-heat-stroke-critical-care-emergency-medicine-environmental/articles-2/) - Written by Aaron Lacy Cold-water immersion is recognized as the fastest way to cool patients with heat stroke. Here’s how to do it in your ED. It’s getting hot in here… dunk ‘em! Heat-related illness kills and maims thousands of patients per year. Given climate trends, this number will continue to rise. The most effective method of lowering core
- [Cost of Saving Lives – Complications of Tourniquets Emergency Medicine EMS Trauma](https://emergencymed.org.il/cost-of-saving-lives-complications-of-tourniquets-emergency-medicine-ems-trauma/articles-2/) - Written by Michael Stocker Nearly one quarter of patients receiving prehospital tourniquet application for traumatic injuries experienced in-hospital complications such as local infection and thromboembolism. Stopping the bleed has risks indeed Tourniquets are widely used in the prehospital setting to address exsanguinating extremity hemorrhage and are associated with lower transfusion rates and may even reduce fasciotomy
- [PODCAST: Portal Vein Thrombosis](https://emergencymed.org.il/podcast-portal-vein-thrombosis/podcast/) - Feb 10, 2025 Contributor: Travis Barlock, MD Educational Pearls: What is Portal Vein Thrombosis? The formation of a blood clot within the portal vein, which carries blood from the gastrointestinal tract, pancreas, and spleen to the liver Not only can this cause problems downstream in the liver, but the backup of venous blood can cause
- [JAMA: Transient Ischemic Attack—Not So Transient After All!](https://emergencymed.org.il/jama-transient-ischemic-attack-not-so-transient-after-all/articles-2/) - Eric E. Smith, MD, MPH1; Babak B. Navi, MD, MS2,3 Author Affiliations Article Information JAMA Neurol. Published online February 10, 2025. doi:10.1001/jamaneurol.2024.5090 related articles icon Related Articles According to conventional thinking, transient ischemic attacks (TIAs) are supposed to resolve without permanent injury to the brain. However, this
- [BMJ: Oral tranexamic acid for immediate use in major trauma: implications for mass casualty events](https://emergencymed.org.il/bmj-oral-tranexamic-acid-for-immediate-use-in-major-trauma-implications-for-mass-casualty-events/articles-2/) - Matthew Warner1, http://orcid.org/0000-0002-3168-7509Jonathon Lowe1,2, http://orcid.org/0000-0002-5187-1952Ed Benjamin Graham Barnard2,3 Correspondence to Dr Jonathon Lowe; Jlowe5@nhs.net Abstract The early administration of tranexamic acid is recognised as significantly reducing mortality in traumatically injured patients with major haemorrhage, typically given via intravenous or intramuscular routes. In the context of mass casualty events, there may exist multiple traumatically injured casualties that would benefit
- [PODCAST: High-Yield Pearls Blitz](https://emergencymed.org.il/podcast-high-yield-pearls-blitz/podcast/) - EM Board Bombs · 251. High-Yield Pearls Blitz Boost your EM knowledge with high-yield, rapid pearls! In this episode, we cover life-saving tips for thyroid storm, beta-blocker overdose, heat stroke, SAH, and Ludwig’s— all in under 10 minutes. Perfect for EM boards or quick clinical refresher. Want to experience the greatest in board studying? Check
- [JAMA: Patient Gowns and Dehumanization During Hospital Admission: A Randomized Clinical Trial](https://emergencymed.org.il/jama-patient-gowns-and-dehumanization-during-hospital-admission-a-randomized-clinical-trial/articles-2/) - Gehani Chamilka Punchihewa 1, Elizabeth Broadbent 1,✉ Abstract This parallel-design double-blind randomized clinical trial examines the effects of patient gowns on feelings of dehumanization among individuals undergoing simulated hospital admission interviews in New Zealand.
- [PODCAST:  Send me on my way…without Cervical Spine Imaging](https://emergencymed.org.il/podcast-send-me-on-my-waywithout-cervical-spine-imaging/קדם-בית-חולים/) - Reference: Leonard JC et al. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. June 2024. Date: Oct 15, 2024 Dr. Tabitha Cheng Guest Skeptic: Dr. Tabitha Cheng is a Southern California native and board-certified emergency medicine physician and completed an EMS
- [NEJM: Adjunctive Middle Meningeal Artery Embolization for Subdural Hematoma](https://emergencymed.org.il/nejm-adjunctive-middle-meningeal-artery-embolization-for-subdural-hematoma/articles-2/) - Authors: Jason M. Davies, M.D., Ph.D., Jared Knopman, M.D., Maxim Mokin, M.D., Ph.D., Ameer E. Hassan, D.O. Robert E. Harbaugh, M.D., Alexander Khalessi, M.D., Jens Fiehler, Ph.D., +37, for the EMBOLISE Investigators Abstract Background: Subacute and chronic subdural hematomas are common and frequently recur after surgical evacuation. The effect of adjunctive middle meningeal artery embolization on the risk of reoperation remains unclear. Methods: In a
- [PODCAST: Clean kill: when intubation kills your pt](https://emergencymed.org.il/podcast-clean-kill-when-intubation-kills-your-pt/education-tips/) - EM Board Bombs · 249. Clean kill: when intubation kills your pt You intubate... and then your patient codes. What did you do wrong? When is "ABC" the wrong order? Let's dive into this nuanced topic in critical care. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the
- [PODCAST: Family Presence during Resuscitation](https://emergencymed.org.il/podcast-family-presence-during-resuscitation/education-tips/) - Show Notes Overview Historical Context: The conversation around allowing family members in the room during resuscitation events began gaining attention in 1987. Since then, the practice has been increasingly encouraged. Current Practices in Pediatrics: Family presence during pediatric resuscitations remains inconsistent, with healthcare provider acceptance ranging from 15% to 85%. Many subspecialists and consultants still request
- [JAMA: Early Restrictive vs Liberal Oxygen for Trauma Patients: The TRAUMOX2 Randomized Clinical Trial](https://emergencymed.org.il/jama-early-restrictive-vs-liberal-oxygen-for-trauma-patients-the-traumox2-randomized-clinical-trial/articles-2/) - Tobias Arleth, MD; Josefine Baekgaard, MD,PhD;VolkertSiersma, PhD;AndreasCreutzburg,MD; Felicia Dinesen, MD; Oscar Rosenkrantz, MD;JohanHeiberg,MD,PhD,DMSc;DanIsbye,MD,PhD; Søren Mikkelsen, MD,PhD;PeterM.Hansen,MD;StineT.Zwisler,MD,PhD;SørenDarling,MD; Louise B. Petersen, MD;MariaC.R.Mørkeberg,MD;MikkelAndersen,MD,PhD; Christian Fenger-Eriksen, MD, PhD; Peder T. Bach, MD;MarkG.VanVledder,MD,PhD; Esther M.M.VanLieshout,PhD,MSc;NikiA.Ottenhof,MD,PhD;IscanderM.Maissan,MD,PhD; Dennis DenHartog,MD,PhD;WolfE.Hautz,MD;DominikA.Jakob,MD;ManuelaIten,MD; Matthias Haenggi, MD;RolandAlbrecht,MD;JochenHinkelbein,MD;MarkusKlimek,MD,PhD; Lars S. Rasmussen,MD,PhD,DMSc;JacobSteinmetz,MD,PhD;fortheTRAUMOX2TrialGroup Abstract Importance: Early administration of supplemental oxygen
- [PODCAST: Rehydration in Pediatric Gastroenteritis](https://emergencymed.org.il/podcast-rehydration-in-pediatric-gastroenteritis/ילדים/) - Jan 27, 2025 Contributor: Meghan Hurley, MD Educational Pearls: Gastroenteritis clinical diagnoses: Diarrhea with or without vomiting and fever Vomiting in the absence of diarrhea has a large list of differential diagnoses, so the combination of diarrhea and vomiting in a patient is helpful to indicate the gastroenteritis diagnosis Symptom timeline is usually 1-3 days,
- [PODCAST: Back Pain in the Big Easy](https://emergencymed.org.il/podcast-back-pain-in-the-big-easy/education-tips/) - EM Board Bombs · 247. Back Pain in the Big Easy Live from New Orleans! We're telling you the ultimate secret to managing back pain in the ED. You'll never guess what works the best to treat acute low back pain (and you might be disappointed to hear it- let's
- [Cold Temps and Hot Takes with Dr. Henry Pitzele](https://emergencymed.org.il/cold-temps-and-hot-takes-with-dr-henry-pitzele/education-tips/) - ACEP Frontline · Cold Temps and Hot Takes with Dr. Henry Pitzele In this episode, I take 20 minutes with Dr. Henry Pitzele about the importance of open minds, open ears, and understanding the realities of politics in emergency medicine.
- [ACC Pathway to Diagnose and Manage Myocarditis Cardiology Emergency Medicine](https://emergencymed.org.il/acc-pathway-to-diagnose-and-manage-myocarditis-cardiology-emergency-medicine/articles-2/) - Written by Vivian Lei This expert consensus document serves as a guide for all clinicians managing myocarditis, including a five-step care pathway, risk stratification framework, and long-term surveillance recommendations. My, oh, myocarditis! We’ve covered myocarditis before. With new clinical advances and an evolving understanding of myocarditis, this document provides a structured five-step care pathway for
- [CLINICAL POLICY : Use of Thrombolytics for the Management of Acute Ischemic Stroke in the Emergency Department](https://emergencymed.org.il/clinical-policy-use-of-thrombolytics-for-the-management-of-acute-ischemic-stroke-in-the-emergency-department/articles-2/) - American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Thrombolytics; \ Bruce M Lo, Christopher R Carpenter, Ken Milne, Peter Panagos, Jason S Haukoos, Deborah B Diercks; Members of the American College of Emergency Physicians (ACEP) Clinical Policies Committee (Oversight Committee); Deborah B Diercks, John D Anderson, Richard Byyny, Christopher R Carpenter, Benjamin W Friedman, Seth R Gemme, Charles J Gerardo, Steven A Godwin, Benjamin W Hatten, Jason S
- [Can We Use PERC-35 to Rule Out PE in Younger Patients?](https://emergencymed.org.il/can-we-use-perc-35-to-rule-out-pe-in-younger-patients/articles-2/) - Written by Millie Cossé The PERC-35 rule was designed to reduce unnecessary testing in individuals ≤35 years old but had an unacceptably high miss-rate. Do they really need further testing? We know from prior studies that the prevalence of pulmonary embolism is 10 times lower in patients aged 18-35 years than in patients >65 years,
- [PODCAST: Grand Rounds - Dr. Lekshmi Kumar - Response to Recovery; Elevating trauma care with prehospital blood transfusions](https://emergencymed.org.il/podcast-grand-rounds-dr-lekshmi-kumar-response-to-recovery-elevating-trauma-care-with-prehospital-blood-transfusions/קדם-בית-חולים/) - Dr. Lekshmi Kumar, Associate Professor of Emergency Medicine at Emory University / Grady Hospital system in Atlanta, Georgia and the EMS director or the city of Atlanta presents grand rounds to kick off the 2025 calendar year! She talks about their collaborative work to create a prehospital blood transfusion program to uplift the trauma care
- [Early Oseltamivir for Hospitalized Adults with Influenza](https://emergencymed.org.il/early-oseltamivir-for-hospitalized-adults-with-influenza/articles-2/) - Written by Sam Parnell Early initiation of oseltamivir on the day of admission significantly reduced the severity of flu-related complications, ICU admissions, and risk of death in hospitalized adults with influenza. Fast and flu-rious: need for speed with oseltamivir! Influenza is a common yet unwelcome occurrence this time of year. Although most patients with influenza
- [64 Minutes – Critical CPR Timepoint in Pediatric Arrest](https://emergencymed.org.il/64-minutes-critical-cpr-timepoint-in-pediatric-arrest/articles-2/) - Written by Joshua Belfer In a cohort of 1,007 children, longer CPR duration after a cardiac arrest lowered the chances of positive neurologic outcomes, with the likelihood of moderate disability or better dropping below 1% after 64 minutes of CPR. The 64-minute tipping point In pediatrics, determining when to terminate a resuscitation is an incredibly
- [PODCAST: Laceration Repair Methods](https://emergencymed.org.il/podcast-laceration-repair-methods/education-tips/) - Contributor: Aaron Lessen, MD Educational Pearls: If a patient sustains a cut, the provider has several options on how to close the wound. If they choose to suture the wound closed, it involves needles both in the form of injecting numbing medication (lidocaine) as well as with the suture itself. Other techniques are “needleless,” like
- [הרצאת CME של ד״ר אפרים קרמר:  FIFA Football World Cup Russia: Emergency Medicine: 14,000 cases in 30 days](https://emergencymed.org.il/הרצאת-cme-של-ד״ר-אפרים-קרמר-fifa-football-world-cup-russia-emergency-medicine-14000-cases-in-30-days/zoom/) - ההרצאה של ד״ר אפרים קרמר מתאריך 20.01.2025 עלתה לאתר ואפשר לצפות בה. Dr. Kramer, is the retired Head Adjunct Professor of Emergency Medicine at the University of the Witwatersrand and ExtraOrdinary Professor of Sport Medicine at the University of Pretoria. He has been fully involved in Academic Emergency Department and Prehospital Emergency Medicine
- [PODCAST: The Physician Led Team: NPPs in the ED with Dr. Brigham Temple - ACEP24](https://emergencymed.org.il/the-physician-led-team-npps-in-the-ed-with-dr-brigham-temple-acep24/ניהול-מלרד/) - ACEP Frontline · The Physician Led Team: NPPs in the ED with Dr. Brigham Temple - ACEP24 In this episode, we talk with Dr. Brigham Temple about the proper utilization and education of non-physician practitioners in the emergency department. It is still the physician led team and every emergency patient should have access to emergency
- [High-velocity nasal insufflation versus noninvasive positive pressure ventilation for moderate acute exacerbation of chronic obstructive pulmonary disease in the emergency department: A randomized clinical trial](https://emergencymed.org.il/high-velocity-nasal-insufflation-versus-noninvasive-positive-pressure-ventilation-for-moderate-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-in-the-emergency-department-a-randomized-cli/articles-2/) - David P Yamane 1 2, Christopher W Jones 3, R Gentry Wilkerson 4, Joshua J Oliver 5, Soroush Shahamatdar 1, Aditya Loganathan 1, Taylor Bolden 1, Ryan Heidish 1, Connor L Kelly 5, Amy Bergeski 6, Jessica S Whittle 6, George C Dungan 2nd 6, Richard Maisiak 7, Andrew C Meltzer 1 Abstract Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) in the emergency department (ED) involve dyspnea, cough, and chest discomfort; frequent exacerbations are associated with increased mortality and reduced
- [“I Can’t Breathe” Means EMERGENCY – Avoiding Restraint Deaths](https://emergencymed.org.il/i-cant-breathe-means-emergency-avoiding-restraint-deaths/articles-2/) - Written by Andrew Hogan Restraint in the prone position is commonly used by law enforcement officers, but this technique impairs effective ventilation and increases the risk of death for restrained individuals. Take “I can’t breathe” statements seriously in this population. A strategy prone to (ventilatory) failure The deaths of Elijah McClain, Eric Garner, and George
- [PODCAST: Serotonin Syndrome](https://emergencymed.org.il/podcast-serotonin-syndrome/podcast/) - Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Serotonin syndrome occurs most commonly due to the combination of monoamine oxidase inhibition with concomitant serotonergic medications like SSRIs Examples of unexpected monoamine oxidase inhibitors Linezolid - a last-line antibiotic reserved for patients with true anaphylaxis to penicillins and cephalosporins Methylene blue - not mentioned in the podcast due
- [PODCAST: Necrotizing Fasciitis](https://emergencymed.org.il/podcast-necrotizing-fasciitis-2/podcast/) - Table of Contents 0:00 – Introduction 0:41 – Overview 1:10 – Types of Necrotizing Fasciitis 2:21 – Pathophysiology & Risk Factors 3:16 – Clinical Presentation 4:06 – Diagnosis 5:37 – Treatment 7:09 – Prognosis and Recovery 7:37 – Take Home points Introduction Necrotizing soft tissue infections can be easily missed in routine cases of soft
- [PODCAST: Shock Types in 15 minutes](https://emergencymed.org.il/podcast-shock-types-in-15-minutes/podcast/) - EM Board Bombs · 245. Shock Types in 15 minutes We’re starting off the year strong with a quick review of the 4 major types of shock and your approach to each one. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here.
- [Does PARAMEDIC-3 and IVIO Change Your Practice?](https://emergencymed.org.il/does-paramedic-3-and-ivio-change-your-practice/articles-2/) - January 3, 2025 Save This Article Edited by Aaron Lacy Yesterday we covered two RCTs (PARAMEDIC-3 and IVIO) that looked at outcomes in OHCA related to an IO vs IV first approach to access. Both studies found no difference in 30-day or neurologically intact survival. No difference? These articles came out in the context of another OHCA IO
- [BMJ: Mass casualty decontamination following a chemical incident: evaluating improvised and interim decontamination protocols in a controlled cross-over volunteer study](https://emergencymed.org.il/bmj-mass-casualty-decontamination-following-a-chemical-incident-evaluating-improvised-and-interim-decontamination-protocols-in-a-controlled-cross-over-volunteer-study/articles-2/) - Louise Davidson1, Felicity Southworth1, Natalie Williams1, Thomas James2, Emily Orchard1, Tim Marczylo2, Samuel Collins3, Richard Amlôt1 Correspondence to Professor Richard Amlôt; richard.amlot@ukhsa.gov.uk Abstract Background On-scene improvised and interim decontamination protocols in the Initial Operational Response to chemical incidents aim for rapid intervention to minimise injury before specialist capabilities arrive. This study examines the effectiveness of UK improvised and interim protocols conducted in sequence. Method A simulant
- [BMJ: אינטובציה אנדוטרכיאלית קדם-אשפוזית לדום לב טראומטי מחוץ לבית החולים ושיפור התוצאות הנוירולוגיות](https://emergencymed.org.il/bmj-אינטובציה-אנדוטרכיאלית-קדם-אשפוזית/articles-2/) - Masaru Suzuki 2 , Ryo Takemura 3 , Junichi Sasaki 1 התכתבות עם ד"ר ריו יאמאמוטו; ryo.yamamoto@gmail.com תַקצִיר רקע חולים עם דום לב טראומטי מחוץ לבית החולים (t-OHCA) דורשים ניהול דרכי אוויר במקום כדי לשמור על חמצון רקמות. עם זאת, היתרונות של אינטובציה אנדוטרכיאלית טרום-אשפוזית נותרו לא ברורים, במיוחד לגבי תוצאות נוירולוגיות. לכן, מחקר זה
- [BMJ: Prehospital endotracheal intubation for traumatic out-of-hospital cardiac arrest and improved neurological outcomes](https://emergencymed.org.il/bmj-אינטובציה-אנדוטרכיאלית-קדם-אשפוזית/articles-2/) - Masaru Suzuki2, Ryo Takemura3, Junichi Sasaki1 Correspondence to Dr Ryo Yamamoto; ryo.yamamoto@gmail.com Abstract Background Patients with traumatic out-of-hospital cardiac arrest (t-OHCA) require on-scene airway management to maintain tissue oxygenation. However, the benefits of prehospital endotracheal intubation remain unclear, particularly regarding neurological outcomes. Therefore, this study aimed to evaluate the association between prehospital intubation and favourable neurological outcomes in
- [JAMA: Workplace Violence in a Large Urban Emergency Department](https://emergencymed.org.il/jama-workplace-violence-in-a-large-urban-emergency-department/articles-2/) - Marla C. Doehring, MD1; Megan Palmer, PhD1; Ashley Satorius, MD1; et alTabitha Vaughn, MSN2; Bruck Mulat, MS3; Andrew Beckman, MD1; Kyra Reed, MD1; Theresa Spech dos Santos, MD1; Benton R. Hunter, MD1 Author Affiliations Article Information JAMA Netw Open. 2024;7(11):e2443160. doi:10.1001/jamanetworkopen.2024.43160 Key Points Question How frequently do health care workers (HCWs) in the emergency department (ED) experience workplace violence (WPV), and are there HCW demographics associated with increased odds
- [דבר יו"ר האיגוד פרופ' מייק דרשר](https://emergencymed.org.il/דבר-יור-האיגוד-פרופ-מייק-דרשר/articles-2/) - שלום לקהילת הרפואה דחופה בישראל זמנים מרגשים ומאתגרים לרפואה דחופה ולמלר"דים בארץ. הדרישות מהמלר"דים עולים מבחינת כמות הפונים ומורכבותם. אנחנו נדרשים מקצועית ומוסדית לטפל באופן יעיל ומהיר בחולים הקשים ביותר – התקפי לב, שבץ, ספסיס, טראומה. מצופה שנהיה ערוכים גם להתפרצויות של מחלות זיהומיות חדשות וישנות ולהיות הקו הראשון בהיערכות ומוכנות לאסונות טבע טרור ומלחמה.
- [Emphysematous Cholecystitis IMAGE](https://emergencymed.org.il/emphysematous-cholecystitis-image/articles-2/) - Emphysematous Cholecystitis
- [EM:Prep 2020 LLSA Review Program Now Available!](https://emergencymed.org.il/emprep-2020-llsa-review-program-now-available/articles-2/) - שתיי הרצאות מתוך Learn more and purchase at http://www.emprep.org.האחת על darucizumab for the Reversal of Dabigatranהשניה על Safety of MRI in Patients With Cardiac Devices הפעל הפעל
- [Pre-Hospital Extracorporeal Cardiopulmonary Resuscitation](https://emergencymed.org.il/pre-hospital-extracorporeal-cardiopulmonary-resuscitation/articles-2/) - תאור מעניין על נסיון של ביצוע אקמו במסגרת טרום בית חולים Matteo Pozzi MD, PhD, Pierre Yves Dubien MD, Eric Cesareo MD, David Pinero MD, Jean Francois Obadia MD, PhD and Jean Christophe Richard MD, PhD Journal of Cardiothoracic and Vascular Anesthesia, 2020-02-01, Volume 34, Issue 2, Pages 571-572, Copyright © 2019 Elsevier Inc. CONVENTIONAL CARDIOPULMONARY resuscitation (CPR) of out-of-hospital cardiac arrest (OHCA) displays dismal outcomes.
- [הרצאת ה CME האחרונה עלתה לאתר Intubating the Acidemic Patient](https://emergencymed.org.il/הרצאת-ה-cme-האחרונה-עלתה-לאתר-intubating-the-acidemic-patient/recourse/) - To the Video Click here Joseph Offenbacher, MD is an Assistant Professor of Emergency Medicine at the New York University (NYU) School of Medicine and an Associate Program Director at the NYU/Bellevue Emergency Medicine Residency Program. He completed the ALLNYC Resident Fellowship in Medical Education Leadership and has also participated as a faculty member at
- [שנה טובה](https://emergencymed.org.il/שנה-טובה/articles-2/) - מאחל האיגוד לרפואה דחופה לכל הצוותים שעובדים יומם ולילה. והחשוב מכול שתיהה לנו שנה שקטה ורגועה מאחל צוות האתר
- [ZOOM Meeting - Topic: Evidence Based Emergency Wound Care](https://emergencymed.org.il/zoom-meeting-topic-evidence-based-emergency-wound-care/articles-2/) - פגישת זום שבועית של WACEM קבוצה בין לאומית אקדמית לרפואה דחופה והפעם נושא הפגישה Evidence Based Emergency Wound Care The World Academic Council of Emergency Medicine www.WACEM.org WACEM has launched the Saturday Virtual Grand Rounds. This is in Continuation of the WACEM-ACAIM Saturday Summit which is running Uninterrupted for more than 75 Weeks. Details: http://beepers365.blogspot.com/
- [הרצאת CME אוקטובר עלתה לאתר](https://emergencymed.org.il/הרצאת-cme-אוקטובר-עלתה-לאתר/education-tips/) - Delayed Sequence Induction (DSI) for the Emergency Medicine Educator:Training Airway Professionalism and Mastery in Six ‘Easy’ Steps Dr. Joseph Offenbacher Joseph Offenbacher, MD is an Assistant Professor of Emergency Medicine at the New York University (NYU) School of Medicine and an Associate Program Director at the NYU/Bellevue Emergency Medicine Residency Program. He completed the ALLNYC
- [December CME:  POCUS and PE with Dr. Joshua Guttman](https://emergencymed.org.il/הרצאת-cme-לחודשש-דצמבר-עלתה-לאתר-pocus-and-pe-with-dr-joshua-guttman/pocus/) - Dr. Joshua Guttman was born and raised in Montreal, Canada. He earned his medical degree at the McGill University Faculty of Medicine and continued to complete a residency in Emergency Medicine at McGillUniversity, where he was chief resident. He then completed a fellowship in EmergencyUltrasound at the Icahn School of Medicine at Mount Sinai, in New York,
- [Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation](https://emergencymed.org.il/angiography-after-out-of-hospital-cardiac-arrest-without-st-segment-elevation/articles-2/) - S. Desch, A. Freund, I. Akin, M. Behnes, M.R. Preusch, T.A. Zelniker, C. Skurk, U. Landmesser, T. Graf, I. Eitel, G. Fuernau, H. Haake, P. Nordbeck, F. Hammer, S.B. Felix, C. Hassager, T. Engstrøm, S. Fichtlscherer, J. Ledwoch, K. Lenk, M. Joner, S. Steiner, C. Liebetrau, I. Voigt, U. Zeymer, M. Brand, R. Schmitz, J.
- [PODCAST: Aortic Dissection (Deep Dive R6 MW)](https://emergencymed.org.il/podcast-aortic-dissection-deep-dive-r6-mw/articles-2/) - Aortic Dissection – when there is a tear in the intima layer of the aorta and the blood dissects the intima away from the media creating a false lumen in the aorta Historical Features Be VERY suspicious with ABRUPT onset of chest/back pain that reaches MAXIMAL SEVERITY immediately after onset of pain. Chest pain or Back
- [NEJM: Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia](https://emergencymed.org.il/nejm-platelet-transfusion-before-cvc-placement-in-patients-with-thrombocytopenia-2/articles-2/) - van Baarle FLF, van de Weerdt EK, van der Velden WJFM, Ruiterkamp RA, Tuinman PR, Ypma PF, van den Bergh WM, Demandt AMP, Kerver ED, Jansen AJG, Westerweel PE, Arbous SM, Determann RM, van Mook WNKA, Koeman M, Mäkelburg ABU, van Lienden KP, Binnekade JM, Biemond BJ, Vlaar APJ. Abstract
- [NEJM: EDITORIAL  Video Laryngoscopy for Intubation — Time for a New Paradigm?](https://emergencymed.org.il/nejm-editorial-video-laryngoscopy-for-intubation-time-for-a-new-paradigm/recourse/) - Endotracheal intubation — a potentially lifesaving procedure that is used for the care of many critically ill patients — demands precision, speed, and skill. It involves the placement of a tube into the trachea to protect the airways while ensuring adequate oxygenation and ventilation for patients who are in respiratory distress or are unable to
- [Migrating Emboli in Branch Retinal Artery Occlusion](https://emergencymed.org.il/migrating-emboli-in-branch-retinal-artery-occlusion/articles-2/) - Alexis Kassotis, M.D., and Tarun Sharma, M.D. A 53-year-old man presented to the emergency department with sudden-onset, painless vision loss in the inferior visual field of the left eye. He had a history of an aortic aneurysm and had recently undergone multiple complex aortic-arch reconstructions. His postoperative course had been complicated by graft thrombosis, for which
- [NEJM: Semaglutide and Cardiovascular Outcomes in Patients With Obesity Without Diabetes](https://emergencymed.org.il/nejm-semaglutide-and-cardiovascular-outcomes-in-patients-with-obesity-without-diabetes/articles-2/) - TAKE-HOME MESSAGE In this international placebo-controlled trial involving 17,604 patients with established cardiovascular disease and a BMI of 27 kg/m2 or greater but without diabetes, once-weekly treatment with semaglutide (2.4 mg) was associated with a 20% reduction in the risk of the composite endpoint of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. Additional benefits in
- [NEJM: Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia](https://emergencymed.org.il/nejm-restrictive-or-liberal-transfusion-strategy-in-myocardial-infarction-and-anemia/articles-2/) - Jeffrey L Carson 1, Maria Mori Brooks 1, Paul C Hébert 1, Shaun G Goodman 1, Marnie Bertolet 1, Simone A Glynn 1, Bernard R Chaitman 1, Tabassome Simon 1, Renato D Lopes 1, Andrew M Goldsweig 1, Andrew P DeFilippis 1, J Dawn Abbott 1, Brian J Potter 1, Francois Martin Carrier 1, Sunil V Rao 1, Howard A Cooper 1, Shahab Ghafghazi 1, Dean A Fergusson 1, William J Kostis 1, Helaine Noveck 1, Sarang Kim 1, Meechai Tessalee 1, Gregory Ducrocq 1, Pedro Gabriel Melo de Barros E Silva 1, Darrell J Triulzi 1, Caroline Alsweiler 1, Mark A Menegus 1, John D Neary 1, Lynn Uhl 1, Jordan B
- [NEJM: Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection](https://emergencymed.org.il/nejm-tenecteplase-for-stroke-at-4-5-to-24-hours-with-perfusion-imaging-selection/articles-2/) - TAKE-HOME MESSAGE This randomized clinical trial assessed whether administering tenecteplase (TNK) beyond the standard-of-care time window improves outcomes in patients with large-/medium-vessel occlusion in the anterior circulation and salvageable tissue on perfusion imaging. More than three-fourths of the patients in this study underwent endovascular thrombectomy (EVT). There was no significant difference between TNK and placebo
- [NEJM: Efficacy of E-Cigarettes for Smoking Cessation](https://emergencymed.org.il/nejm-efficacy-of-e-cigarettes-for-smoking-cessation/articles-2/) - TAKE-HOME MESSAGE In this open-label, randomized, controlled trial involving 1246 adults who smoked five or more cigarettes per day, the addition of e-cigarettes to standard smoking-cessation counseling resulted in greater smoking cessation rates than counseling alone (28.9% vs 16.3%). The rate of serious adverse events was comparable between the study groups. Although not without potential
- [NEJM: Noninvasive Ventilation for Preoxygenation during Emergency Intubation](https://emergencymed.org.il/nejm-noninvasive-ventilation-for-preoxygenation-during-emergency-intubation/articles-2/) - ABSTRACT: BACKGROUND Among critically ill adults undergoing tracheal intubation, hypoxemia increases the risk of cardiac arrest and death. The effect of preoxygenation with noninvasive ventilation, as compared with preoxygenation with an oxygen mask, on the incidence of hypoxemia during tracheal intubation is uncertain. METHODS In a multicenter, randomized trial conducted at 24 emergency
- [NEJM: Tenecteplase for Ischemic Stroke at 4.5 to 24 Hours without Thrombectomy](https://emergencymed.org.il/nejm-tenecteplase-for-ischemic-stroke-at-4-5-to-24-hours-without-thrombectomy/articles-2/) - Yunyun Xiong, M.D., Ph.D., Bruce C.V. Campbell, M.B., B.S., Ph.D., Lee H. Schwamm, M.D., Xia Meng, M.D., Ph.D., Aoming Jin, Ph.D., Mark W. Parsons, M.B., B.S., Ph.D., Marc Fisher, M.D., Yong Jiang, Ph.D., Fengyuan Che, M.D., Lihua Wang, M.D., Ph.D., Li Zhou, M.D., Hongguo Dai, M.D., Xintong Liu, M.D., Yuesong Pan, Ph.D., Chunmiao Duan, M.D.,
- [NEJM: Liberal or Restrictive Transfusion Strategy  in Patients with Traumatic Brain Injury](https://emergencymed.org.il/nejm-liberal-or-restrictive-transfusion-strategy-in-patients-with-traumatic-brain-injury/articles-2/) - A.F. Turgeon, D.A. Fergusson, L. Clayton, M.-P. Patton, X. Neveu, T.S. Walsh, A. Docherty, L.M. Malbouisson, S. Pili-Floury, S.W. English, R. Zarychanski, L. Moore, P.L. Bonaventure, V. Laroche, M. Verret, D.C. Scales, N.K.J. Adhikari, J. Greenbaum, A. Kramer, V.G. Rey, I. Ball, K. Khwaja, M. Wise, D. Harvey, F. Lamontagne, R. Chabanne, A. Algird, S.
- [NEJM: Trial of Endovascular Thrombectomy for Large Ischemic Strokes](https://emergencymed.org.il/nejm-trial-of-endovascular-thrombectomy-for-large-ischemic-strokes/articles-2/) - A. Sarraj, A.E. Hassan, M.G. Abraham, S. Ortega-Gutierrez, S.E. Kasner, M.S. Hussain, M. Chen, S. Blackburn, C.W. Sitton, L. Churilov, S. Sundararajan, Y.C. Hu, N.A. Herial, P. Jabbour, D. Gibson, A.N. Wallace, J.F. Arenillas, J.P. Tsai, R.F. Budzik, W.J. Hicks, O. Kozak, B. Yan, D.J. Cordato, N.W. Manning, M.W. Parsons, R.A. Hanel, A.N. Aghaebrahim, T.Y.
- [PODCAST: EMJ  Journal update monthly top five](https://emergencymed.org.il/podcast-emj-journal-update-monthly-top-five/articles-2/) - BMJ talk medicine · Primary Survey - the highlights of March 2023 Kirsty Challen, Anukiran Ravichandran, Matthew Chun Bond Chiu, Thomas Ludlow, Michael Rosser, Robert Hirst Correspondence to Dr Kirsty Challen, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, Lancashire, UK; kirsty.challen@lthtr.nhs.uk A summary of some of the best papers we published in the March 2023 issue
- [Discharging Patients Against Medical Advice](https://emergencymed.org.il/discharging-patients-against-medical-advice/articles-2/) - Case Vignette Vignette Clement D. Lee, M.D., M.Sc. A 35-year-old man presents to emergency room with body aches and fever. He has a history of intravenous heroin use disorder, with prior emergency room presentations for cellulitis, opiate withdrawal, and passive suicidal ideation. On presentation, his vital signs are notable for a fever of 101.5° and
- [Managing and Preventing Migraine in the Emergency Department: A Review](https://emergencymed.org.il/managing-and-preventing-migraine-in-the-emergency-department-a-review/articles-2/) - MiguelA.Cortel-LeBlanc,MD,MHA*;SerenaL.Orr,MD,MSC;MaeghanDunn,MD;DanielJames,MD;AchelleCortel-LeBlanc,MD Migraine is a leading cause of disability worldwide, and acute migraine attacks are a common reason for patients to seek care in the emergency department. There have been recent advancements in the care of patients with migraine, specifically emerging evidence for nerve blocks and new pharmacological classes of medications like gepants and ditans. This
- [NEJM Case: A 59-Year-Old Woman with Hypotension and Electrocardiographic Changes](https://emergencymed.org.il/nejm-case-a-59-year-old-woman-with-hypotension-and-electrocardiographic-changes/recourse/) - Wilton A. van Klei, M.D., Ph.D., Michele D. Szabo, M.D., and Paul E. Hesterberg, M.D. r. Yuefan Chen (Anesthesia, Critical Care, and Pain Medicine): A 59-year-old woman had hypotension and electrocardiographic (ECG) ST-segment abnormalities after the administration of anesthetic agents while she was in the operating room of this hospital. Eighteen weeks before the current presentation, features of
- [Efficacy and Safety of Recombinant Human Prourokinase in the Treatment of Acute Ischemic Stroke Within 4.5 Hours of Stroke Onset A Phase 3 Randomized Clinical Trial](https://emergencymed.org.il/efficacy-and-safety-of-recombinant-human-prourokinase-in-the-treatment-of-acute-ischemic-stroke-within-4-5-hours-of-stroke-onset-a-phase-3-randomized-clinical-trial/articles-2/) - JAMA Network Open TAKE-HOME MESSAGE Prourokinase is a thrombolytic agent that does not form covalent complexes with protease inhibitors in plasma and, therefore, has the potential advantage of less systemic bleeding and intracranial hemorrhage. In this phase III randomized clinical trial involving more than 600 patients with acute ischemic stroke, recombinant prourokinase and alteplase therapy
- [Ultrasound Guidelines: Emergency, Point-of-Care, and Clinical Ultrasound Guidelines in Medicine](https://emergencymed.org.il/ultrasound-guidelines-emergency-point-of-care-and-clinical-ultrasound-guidelines-in-medicine/articles-2/) - פרסום זה חשוב מאד Sections 1. Introduction 2. Scope of Practice 3. Training and Proficiency 4.Hospital Credentialing and Privileging 5. Specialty Certification 6. Quality and Ultrasound Management 7. Value and Reimbursement 8. Clinical Ultrasound Leadership in Health Care Systems 9. Future Issues 10. Conclusion Tables 1. Emergency Medicine Ultrasound Definitions Figures 1. ACEP 2023 Emergency
- [NEUROGENIC THORACIC OUTLET SYNDROME: AN INDEPTH REVIEW](https://emergencymed.org.il/neurogenic-thoracic-outlet-syndrome-an-indepth-review/articles-2/) - Laura Redman Supervisor: Professor JV Robbs TABLE OF CONTENTS PAGE 1. Literature review 4 1.1 History of Thoracic Outlet Syndrome 1.2 Definition of Thoracic Outlet Syndrome 1.3 Anatomy
- [A novel operational protocol for the establishment of a medical facility for receiving returning hostages: structure, process and outcomes](https://emergencymed.org.il/a-novel-operational-protocol-for-the-establishment-of-a-medical-facility-for-receiving-returning-hostages-structure-process-and-outcomes/articles-2/) - Daniel Trotzky1,2*, Idit Segal1,2, Ronit Koren3, Orna Tal1,2, Gal Pachys4, Galina Goltzman5, Karen Or5, Margarita Alpro4, Ronit Zaidenstein3, Maayan Bachar3, Baruch Berzon3, Roni Enten Vissoker6, Inbar Hartmann7, Miri Avraham8, Vered Shinar9, Ada Azar10 and Osnat Levtzion Korach1 Abstract Background On October 7, 2023, Hamas carried out an unprecedented attack on the State of Israel
- [JAMA: Strategy Optimization for a Combined Procedure in Patients With Atrial Fibrillation The COMBINATION Randomized Clinical Trial](https://emergencymed.org.il/jama-strategy-optimization-for-a-combined-procedure-in-patients-with-atrial-fibrillation-the-combination-randomized-clinical-trial/articles-2/) - Xianfeng Du, MD1,2; Huimin Chu, MD1,2; Bing Yang, MD3; et alJingquan Zhong, MD4; Zhongbao Ruan, MD5; Qi Chen, MD6; Bing Leng, MD7; Siming Tao, MD8; Hengli Lai, MD9; Jianqiu Liang, MD10; Ruiqin Xie, MD11; Ping Ye, MD12; Xianhui Zhou, MD13; Yaodong Li, MD13; Jianping Li, MD14; Yujie Zhao, MD15; Cao Zou, MD16; Hanze Sun, MD17; Xiaorong Li, MD3; Bing Rong, MD4; Gecai Chen, MD5; Jinzhu Hu, MD6; Ji Jia, MD8; Yan Fang, MD9; Zhangqing Xia, MD10; Qian Liu, MD11; Taomei Zuo, MD12; Xuefeng Zhu, MD14; Liang Xu, MD15; Shaohua Yang, MD15; Chenxu Luo, MD1,2; Caijie Shen, MD, PhD1,2; Mingjun Feng, MD1,2; Yongxing Jiang, MD1,2; Guohua Fu, MD1,2; Binhao Wang, MD1,2; Xinzhi Yu, MD1,2; Xiaomin Chen, MD1,2; for the COMBINATION Trial Investigators Author Affiliations Article Information JAMA Netw Open. 2024;7(11):e2445084. doi:10.1001/jamanetworkopen.2024.45084 visual abstract icon Visual Abstract Key PointsQuestion Which combination strategy is superior for long-term efficacy and safety in patients with atrial fibrillation (AF) undergoing a combined procedure of left atrial appendage occlusion and catheter ablation? Findings In this randomized clinical trial of 202
- [Reversal of direct oral anticoagulants: guidance from the SSC of the ISTH](https://emergencymed.org.il/reversal-of-direct-oral-anticoagulants-guidance-from-the-ssc-of-the-isth/articles-2/) - JerroldH.Levy1 | JosephR.Shaw2 | LanaA.Castellucci3 | JeanM.Connors4 | JamesDouketis5 | EdelgardLindhoff-Last6 | BiancaRocca7,8 | CharlesMarcSamama9 | DeborahSiegal3 | JeffreyI.Weitz Abstract The currently approved direct oral anticoagulants (DOACs) are increasingly used in clinical practice. Although serious bleeding risks are lower
- [ACEP Clinical Policy: Critical Issues in the Evaluation of Adult Patients Presenting to the Emergency Department With Acute Blunt Trauma](https://emergencymed.org.il/acep-clinical-policy-critical-issues-in-the-evaluation-of-adult-patients-presenting-to-the-emergency-department-with-acute-blunt-trauma/articles-2/) - From the American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Critical Issues in the Evaluation of Adult Patients Presenting to the Emergency Department with Acute Blunt Abdominal Trauma): Deborah B. Diercks, MD, MSc (Subcommittee Chair) Abhishek Mehrotra, MD Devorah J. Nazarian, MD Susan B. Promes, MD Wyatt W. Decker, MD (Committee Co-Chair)
- [AHA: Stroke Council, American Heart Association Statement for Healthcare Professionals From a Special Writing Group of the Guidelines for the Management of Spontaneous Intracerebral Hemorrhage](https://emergencymed.org.il/aha-stroke-council-american-heart-association-statement-for-healthcare-professionals-from-a-special-writing-group-of-the-guidelines-for-the-management-of-spontaneous-intracerebral-hemorrhage/articles-2/) - I ntracerebral hemorrhage (ICH) is more than twice as common as subarachnoid hemorrhage (SAH) and is much more likely to result in death or major disability than cerebral infarction or SAH. 1 Although 315 randomized clinical therapeutic trials for acute ischemic stroke and 78 trials for SAH were complete or ongoing (oral communication, Cochrane Collaboration,
- [BMJ: Transient Ischaemic attack Emergency Referral (TIER): randomised feasibility trial results](https://emergencymed.org.il/bmj-transient-ischaemic-attack-emergency-referral-tier-randomised-feasibility-trial-results/articles-2/) - Alan Watkins Adrian Edwards,5 Bridie Angela Evans ,2 Khalid Ali,3 Richard Dewar,4 ,1 Lyn Evans,6 Gary A Ford,7 Chelsey Hampton,8 Roger John,6 Charlene Jones,9 Chris Moore ,10 Michael Obiako,4 Alison Porter ,1 Alan Pryce,11 Tom Quinn,12 Anne C Seagrove,1 Helen Snooks,1 Shirley Whitman,11 Nigel Rees Abstract
- [JAMA: Correction Rates and Clinical Outcomes in Hospitalized Adults With Severe Hyponatremia: A Systematic Review and Meta-Analysis](https://emergencymed.org.il/jama-correction-rates-and-clinical-outcomes-in-hospitalized-adults-with-severe-hyponatremia-a-systematic-review-and-meta-analysis/articles-2/) - JuanCarlos Ayus, MD;MichaelL.Moritz,MD;NoraAngélicaFuentes,MD;JhonatanR.Mejia,MD; JuanMartínAlfonso, MD;SaehaShin,MPH;MichaelFralick,MD,PhD,SM;AgustínCiapponi,MD,MSc,PhD Abstract Importance: Hyponatremia treatment guidelines recommend limiting the correction of severe hyponatremia during the first 24 hours to prevent osmotic demyelination syndrome (ODS). Recent evidence suggests that slower rates of correction are associated with increased mortality. Objective: To evaluate the association of sodium correction
- [JAMA: Correction Rates and Clinical Outcomes in Hospitalized Adults With Severe Hyponatremia: A Systematic Review and Meta-Analysis](https://emergencymed.org.il/jama-correction-rates-and-clinical-outcomes-in-hospitalized-adults-with-severe-hyponatremia-a-systematic-review-and-meta-analysis-2/articles-2/) - Xia Meng,MD;ShuyaLi,MD;HongguoDai,MD;GuozhiLu,MD;WeiweiWang,MD;FengyuanChe,MD; YuGeng,MD;MinghuiSun,MD;XiyanLi,MSc;HaoLi,PhD;YongjunWang,MDXia Meng,MD;ShuyaLi,MD;HongguoDai,MD;GuozhiLu,MD;WeiweiWang,MD;FengyuanChe,MD; YuGeng,MD;MinghuiSun,MD;XiyanLi,MSc;HaoLi,PhD;YongjunWang,MD Abstract Importance: Hyponatremia treatment guidelines recommend limiting the correction of severe hyponatremia during the first 24 hours to prevent osmotic demyelination syndrome (ODS). Recent evidence suggests that
- [A Comparison of Ketamine to Midazolam for the Management of Acute Behavioral Disturbance in the Out-of-Hospital Setting](https://emergencymed.org.il/a-comparison-of-ketamine-to-midazolam-for-the-management-of-acute-behavioral-disturbance-in-the-out-of-hospital-setting/articles-2/) - MaeveMuldowney,MBBCh,BAO*;CatherineR.Counts,PhD,MHA;MadisonC.Maider;SamR.Sharar,MD; AndrewM.McCoy,MD,MS;RajenNathwani,MBBS; JessicaJ.Wall,MD,MPH;KillianPache;CharlesMaynard,PhD; ThomasD.Rea,MD,MPH;PeterJ.Kudenchuk,MD;MichaelR.Sayre,MD Abstract Study objective: Acute behavioral disturbance is characterized by altered mental status and psychomotor agitation. Pharmacological sedation may be required, risking potential respiratory compromise. We compared the need for emergent airway support following administration of midazolam or ketamine to treat
- [JAMA: Atrial Fibrillation A Review](https://emergencymed.org.il/jama-atrial-fibrillation-a-review/articles-2/) - ; Mina K. Chung, MD4,5,6; Peter T. Evans, MD2; et al Abstract Importance In the US, approximately 10.55 million adults have atrial fibrillation (AF). AF is associated with significantly increased risk of stroke, heart failure, myocardial infarction, dementia,
- [Retropharyngeal Abscess](https://emergencymed.org.il/retropharyngeal-abscess/recourse/) - Davide Giordano, M.D., and Carmine Pernice, M.D. A 26-year-old woman with a history of recurrent tonsillitis presented to the emergency department with a 2-week history of progressive sore throat and a 7-day history of pain when swallowing, shortness of breath, and fever. She reported no recent sexual contact or throat trauma. On physical examination, there was
- [Podcast : Intranasal Medication Administration for Pediatric Patients](https://emergencymed.org.il/podcast-intranasal-medication-administration-for-pediatric-patients/recourse/) - Aug 2, 2022 Contributor: Aaron Lessen, MD Educational Pearls: Intranasal medication administration is a convenient, quick, and relatively painless option for pediatric patients Often used as an initial medication to help control pain in children prior to establishing an IV Using an atomizer is preferred when administering intranasal medications The syringe should be angled towards
- [PODCAST:  Sedation During Intubation](https://emergencymed.org.il/podcast-sedation-during-intubation/recourse/) - Contributor: Aaron Lessen, MD Educational Pearls: Awareness with recall of paralysis can occur in intubated and ventilated patients receiving paralytic medications Patients who suffer from this effect are at high risk of developing severe PTSD, depression, and suicidal ideations Occurs in approximately 0.1-0.2% of patients undergoing general anesthesia in an OR setting 2021 study showed
- [Podcast : Brugada Criteria for V Tach](https://emergencymed.org.il/podcast-brugada-criteria-for-v-tach/recourse/) - Aug 9, 2022 Contributor: Peter Bakes, MD Educational Pearls: Tachycardia describes a heart rate of >120 beats per minute Wide Complex describes a QRS duration of >120 ms or 3 small boxes on a standard EKG The major differential for a wide complex tachycardia is Ventricular Tachycardia (VT), aka “V Tach”, or Supraventricular Tachycardia (SVT)
- [Podcast : Ring Removal Tricks](https://emergencymed.org.il/6795-2/recourse/) - Aug 23, 2022 Contributor: Jared Scott, MD Educational Pearls: If a patient is in significant pain, a digital block can be helpful. Pain management alone may allow for manual ring removal. Ring cutters and trauma shears with specialized ring cutters can be attempted but will destroy the ring and some materials may be resistant to
- [PODCAST:  Normal ECGs](https://emergencymed.org.il/podcast-normal-ecgs/recourse/) - Aug 22, 2022 Contributor: Jared Scott, MD Educational Pearls: Physicians are typically advised not to trust computer interpretation of ECGs Retrospective study was done of computer interpreted normal ECGs to evaluate the accuracy of such an interpretation 989 ECGs were interpreted as “Normal sinus rhythm, Normal ECG” by proprietary cardiology software on MUSE Cardiology Information
- [Podcast : BVM and PEEP Valve](https://emergencymed.org.il/podcast-bvm-and-peep-valve/articles-2/) - Aug 29, 2022 Contributor: Dylan Luyten, MD Educational Pearls: Positive End Expiratory Pressure (PEEP) is positive pressure within the lungs and maintained throughout the entire respiratory cycle. It is the pressure preventing alveoli from collapsing at the end of exhalation. When using a bag valve mask (BVM) to ventilate patients, always attach the PEEP
- [Podcast : Ketamine for Pain](https://emergencymed.org.il/podcast-ketamine-for-pain/articles-2/) - Sep 7, 2022 Contributor: Lessen, Aaron MD Educational Pearls: Ketamine can be given at 0.2-0.3 mg/kg as subdissociative doses for pain control in the ED Ketamine coadministered with Haldol may reduce agitation A recent study in Iran compared subdissociative Ketamine given with 2.5 mg Haldol to 1 mg/kg Fentanyl for pain control in the ED
- [Podcast : Peripheral IV Flow Rates](https://emergencymed.org.il/podcast-peripheral-iv-flow-rates/recourse/) - Nov 15, 2022 Contributor: Travis Barlock, MD Educational Pearls: Gauge and length of catheter are determinants of flow rate Smaller gauges produce higher flow rate Longer catheters reduce flow rate Common IV gauges produce predictable rates of flow: 20 gauge = 60 cc/min 18 gauge = 105 cc/min 16 gauge = 220 cc/min Central lines
- [Podcast : Cardiac Arrest – Entertainment vs. Reality](https://emergencymed.org.il/podcast-cardiac-arrest-entertainment-vs-reality/articles-2/) - Contributor: Travis Barlock, MD Educational Pearls: Sudden Cardiac Arrest (SCA) is defined as when the heart suddenly stops beating. Immediate treatment for SCA includes Cardiopulmonary Resuscitation (CPR) and defibrillation. This event is commonly depicted in medical dramas as an intense moment but often with the patient surviving and making a full recovery (67-75%). This depiction has
- [JAMA: Shifts in Diagnostic Testing for Headache in the Emergency Department, 2015 to 2021](https://emergencymed.org.il/jama-shifts-in-diagnostic-testing-for-headache-in-the-emergency-department-2015-to-2021/articles-2/) - Dustin G. Mark, MD1,2,3; Brandon H. Horton, MPH3; Mary E. Reed, DrPH3; et alfor the Kaiser Permanente CREST Network Investigators Author Affiliations Article Information JAMA Netw Open. 2024;7(4):e247373. doi:10.1001/jamanetworkopen.2024.7373 Key Points Question Has the diagnostic evaluation of headache in the emergency department recently changed? Findings In a cohort study of 21 emergency departments and 198 109 emergency encounters between 2015 and 2021, computed tomography cerebral angiography use increased
- [JAMA: Shifts in Diagnostic Testing for Headache in the Emergency Department, 2015 to 2021](https://emergencymed.org.il/jama-shifts-in-diagnostic-testing-for-headache-in-the-emergency-department-2015-to-2021-2/articles-2/) - Dustin G Mark 1 2 3, Brandon H Horton 3, Mary E Reed 3; Kaiser Permanente CREST Network Investigators Affiliations expand PMID: 38639937 PMCID: PMC11031686 DOI: 10.1001/jamanetworkopen.2024.7373 Abstract Importance: Subarachnoid hemorrhage is typically diagnosed by noncontrast head computed tomography (CT); lumbar puncture is recommended if computed tomography is nondiagnostic, although CT cerebral angiography has been promoted as an alternative to lumbar puncture in this diagnostic pathway. The
- [Routine Electrocardiogram Screening and Cardiovascular Disease Events in Adults](https://emergencymed.org.il/routine-electrocardiogram-screening-and-cardiovascular-disease-events-in-adults/articles-2/) - Ryuichiro Yagi, MD, MPH1,2; Yuichiro Mori, MD, MPH3; Shinichi Goto, MD, PhD1,4; et alTaku Iwami, MD, PhD5; Kosuke Inoue, MD, PhD6,7 Author Affiliations Article Information JAMA Intern Med. Published online July 1, 2024. doi:10.1001/jamainternmed.2024.2270 Key Points Question What is the evidence on the clinical utility of routine resting electrocardiogram (ECG) screening on cardiovascular risk assessment in
- [VenousThromboembolismProphylaxisinHigh-RiskPediatric Trauma Patients](https://emergencymed.org.il/venousthromboembolismprophylaxisinhigh-riskpediatric-trauma-patients/articles-2/) - Amanda B. Witte, MD1; Kyle Van Arendonk, MD, PhD2; Carisa Bergner, PhD1; et alMartin Bantchev, MS1; Richard A. Falcone Jr, MD, MPH, MMM3; Suzanne Moody, MPA, CCRP3; Heather A. Hartman, MD4; Emily Evans, MS4; Rajan Thakkar, MD2; Kelli N. Patterson, DO, MS, MPH2; Peter C. Minneci, MD, MHSc5; Grace Z. Mak, MD6; Mark B. Slidell, MD7; MacKenton Johnson, BS6; Matthew P. Landman, MD, MPH8; Troy A. Markel, MD8; Charles M. Leys, MD9; Linda Cherney Stafford, MPH9; Jessica Draper, DNP, APRN9; David S. Foley, MD10; Cynthia Downard, MD10; Tracy M. Skaggs, APRN10; Dave R. Lal, MD, MPH1; David Gourlay, MD1; Peter F. Ehrlich, MD, MSc4 Author Affiliations Article Information JAMA Surg. Published online July 31, 2024. doi:10.1001/jamasurg.2024.2487 editorial comment icon Editorial Comment Key Points Question Does the application of high-risk guidelines
- [Temporal Trends in End-Tidal Capnography and Outcomes in Out-of-Hospital Cardiac Arrest: A Secondary Analysis of a Randomized Clinical Trial](https://emergencymed.org.il/temporal-trends-in-end-tidal-capnography-and-outcomes-in-out-of-hospital-cardiac-arrest-a-secondary-analysis-of-a-randomized-clinical-trial/articles-2/) - Michelle M. J. Nassal, MD, PhD;AndoniElola,PhD;Elisabete Aramendi,PhD;XabierJaureguibeitia, PhD; Jonathan R. Powell, MPA;AhamedIdris,MD; BanuPriyaRayaKrishnamoorthy,BS;MohamudR.Daya,MD;TomP.Aufderheide,MD;JestinN.Carlson,MD;ShannonW.Stephens,CCEMT-P; Ashish R. Panchal, MD,PhD;HenryE.Wang,MD Abstract Importance: While widely measured, the time-varying association between exhaled end-tidal carbon dioxide (EtCO2) and out-of-hospital cardiac arrest (OHCA) outcomes is unclear. Objective: To evaluate temporal associations between EtCO2 and return of spontaneous circulation (ROSC) in the Pragmatic Airway
- [Gastric Bypass vs Diet and Cardiovascular Risk Factors: A Nonrandomized Controlled Trial](https://emergencymed.org.il/gastric-bypass-vs-diet-and-cardiovascular-risk-factors-a-nonrandomized-controlled-trial/articles-2/) - Cecilia Karlsson, MD, PhD1,2; Line Kristin Johnson, PhD3; Peter J. Greasley, PhD4; et al Key Points Question Does Roux-en-Y gastric bypass (RYGB) affect cardiovascular risk factors independent of caloric restriction and weight loss? Findings In this nonrandomized controlled study, patients with severe obesity undergoing RYGB demonstrated a clinically meaningful reduction in major atherogenic blood lipids, which was not seen in patients
- [NEJM Video: Spo2 Targets for Adults Receiving Invasive Mechanical Ventilation](https://emergencymed.org.il/nejm-video-spo2-targets-for-adults-receiving-invasive-mechanical-ventilation/recourse/) - Roughly one third of critically ill adults receiving mechanical ventilation die in the hospital. The oxygen-saturation target that would optimize outcomes in these patients is unknown. New research findings are summarized in a short video. Matthew W. Semler, M.D., Jonathan D. Casey, M.D., Bradley D. Lloyd, R.R.T.-A.C.C.S., Pamela G. Hastings, R.R.T.-A.C.C.S., Margaret A. Hays, R.N.,
- [Which low urgent triaged febrile children are suitable for a fast track? An observational European study](https://emergencymed.org.il/which-low-urgent-triaged-febrile-children-are-suitable-for-a-fast-track-an-observational-european-study/articles-2/) - Chantal D Tan ,1 Clementien L Vermont,2 Joany M Zachariasse,1 Ulrich von Both ,3 Enitan D Carrol,4,5 Irini Eleftheriou,6 Marieke Emonts,7,8 Michiel van der Flier,9,10 Jethro Herberg,11 Benno Kohlmaier,12 Michael Levin,13 Emma Lim ,7 Ian K Maconochie,14 Federico Martinon- Torres,15 Ruud G Nijman ,11,14 Marko Pokorn,16 Irene Rivero- Calle,15 Aleksandra Rudzāte,17 Maria Tsolia,6 Werner Zenz,12
- [External validation of a rapid algorithm using high-sensitivity troponin assay results for evaluating patients with suspected acute myocardial infarction](https://emergencymed.org.il/external-validation-of-a-rapid-algorithm-using-high-sensitivity-troponin-assay-results-for-evaluating-patients-with-suspected-acute-myocardial-infarction/articles-2/) - Louise Cullen ,1 Jaimi H Greenslade ,2,3 Laura Stephensen,2,3 Isuru Ranasinghe,4,5 Niranjan Gaikwad,5 Maryam Khorramshahi Bayat,5 Ehsan Mahmoodi,5 Martin Than ,6 Fred Apple,7 William Parsonage,8,9 2022 SAMIE study group Abstract Objective We sought to validate the clinical performance of a rapid assessment pathway incorporating the Siemens Atellica IM high sensitivity cardiac
- [BMJ: Triage in major incidents: development and external validation of novel machine learning-derived primary and secondary triage tools](https://emergencymed.org.il/bmj-triage-in-major-incidents-development-and-external-validation-of-novel-machine-learning-derived-primary-and-secondary-triage-tools/articles-2/) - Yuanwei Xu,1,2 Nabeela Malik ,3,4,5,6 Saisakul Chernbumroong,1,3 James Vassallo,7,8 Damian Keene,4,6 Mark Foster,3,4,6 Janet Lord,3,5 Antonio Belli,3,4 Timothy Hodgetts,9 Douglas Bowley,4,6 George Gkoutos Abstract Background Major incidents (MIs) are an important cause of death and disability. Triage tools are crucial to identifying priority 1 (P1) patients—those needing time-critical, life-saving interventions. Existing
- [EMJ: Predictive performance of the common red flags in emergency department headache patients: a HEAD and HEAD-Colombia study](https://emergencymed.org.il/emj-predictive-performance-of-the-common-red-flags-in-emergency-department-headache-patients-a-head-and-head-colombia-study/articles-2/) - Kevin Chu,1 Anne- Maree Kelly ,2,3 Win Sen Kuan,4 Frances B Kinnear,5,6 Gerben Keijzers,7 Daniel Horner ,8 Said Laribi,9 Alejandro Cardozo,10 Mehmet Akif Karamercan,11 Sharon Klim,2 Tissa Wijeratne,12 Sinan Kamona,13,14 Colin A Graham,15 Richard Body ,16,17 Tom Roberts ,18,19 HEAD and HEAD- Colombia study groups Abstract
- [Pain in the ED: does anyone manage it well?](https://emergencymed.org.il/pain-in-the-ed-does-anyone-manage-it-well/articles-2/) - Linked Articles Sarah Wilson1 Jack Dainty2, Jane Quinlan3, Fiona C Sampson4, David Metcalfe1,5, Liza Keating6 Correspondence to Dr Sarah Wilson, Emergency Department, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK; sarah.wilson2@nhs.net Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the
- [BMJ: Predictive values of indirect ultrasound signs for low risk of acute appendicitis in paediatric patients without visualisation of the appendix on ultrasound](https://emergencymed.org.il/bmj-predictive-values-of-indirect-ultrasound-signs-for-low-risk-of-acute-appendicitis-in-paediatric-patients-without-visualisation-of-the-appendix-on-ultrasound/articles-2/) - Juan Pernía 1, Teresa Cancho 1, Inés Segovia 1, Pilar de Ponga 2, Elena Granda 1, Roberto Velasco 3 4 Affiliations expand PMID: 38729752 DOI: 10.1136/emermed-2023-213466 Abstract Background and objectives: The ability to rule appendicitis in or out using ultrasound is limited by studies where the appendix is not visualised. We determined whether the absence of indirect ultrasound signs
- [External validation of the preHEART score and comparison with current clinical risk scores for prehospital risk assessment in patients with suspected NSTE-ACS](https://emergencymed.org.il/external-validation-of-the-preheart-score-and-comparison-with-current-clinical-risk-scores-for-prehospital-risk-assessment-in-patients-with-suspected-nste-acs/articles-2/) - Jesse P A Demandt ,1 Arjan Koks,2 Dennis Sagel ,3 Rutger Haest,4 Eric Heijmen,5 Eric Thijssen,6 Mohamed el Farissi,1 Rob Eerdekens,1 Pim van der Harst,7 Marcel van ’t Veer,1 Lukas Dekker,1,8 Pim Tonino,1,8 Pieter J Vlaar Abstract Background Emergency Medical Services (EMS) studies
- [BMJ: Evaluation of the prehospital administration of tranexamic acid for injured patients: a state-wide observational study with sex and age-disaggregated analysis](https://emergencymed.org.il/bmj-evaluation-of-the-prehospital-administration-of-tranexamic-acid-for-injured-patients-a-state-wide-observational-study-with-sex-and-age-disaggregated-analysis/articles-2/) - Camille Girardello Mathieu Pasquier ,1,2 Pierre- Nicolas Carron,1,2 Fabrice Dami ,1,2 François- Xavier Ageron 1,2 ,1 Vincent Abstract Background Tranexamic acid (TXA) decreases mortality in injured patients and should be administered as soon as possible. Despite international guidelines recommending TXA in the prehospital setting, its use remains
- [BMJ: Performance of 21 Early Warning System scores in predicting in- hospital deterioration among undifferentiated admitted patients managed by ambulance services](https://emergencymed.org.il/bmj-performance-of-21-early-warning-system-scores-in-predicting-in-hospital-deterioration-among-undifferentiated-admitted-patients-managed-by-ambulance-services/articles-2/) - Gigi Guan ,1,2 Crystal Man Ying Lee,3 Stephen Begg,4 Angela Crombie,5 George Mnatzaganian Abstract Background The optimal Early Warning System (EWS) scores for identifying patients at risk of clinical deterioration among those transported by ambulance services remain uncertain. This retrospective study compared the performance of 21 EWS scores to predict
- [Guidelines for the Use of Transesophageal Echocardiography (TEE) in the ED for Cardiac Arrest](https://emergencymed.org.il/guidelines-for-the-use-of-transesophageal-echocardiography-tee-in-the-ed-for-cardiac-arrest/articles-2/) - Policy statements and clinical policies are the official policies of the American College of Emergency Physicians and, as such, are not subject to the same peer review process as articles appearing in the journal. Policy statements and clinical policies of ACEP do not necessarily reflect the policies and beliefs of Annals of Emergency Medicine and
- [Tranexamic Acid for Traumatic Injury in the Emergency Setting: A Systematic Review and Bias-Adjusted Meta-Analysis of Randomized Controlled Trials](https://emergencymed.org.il/tranexamic-acid-for-traumatic-injury-in-the-emergency-setting-a-systematic-review-and-bias-adjusted-meta-analysis-of-randomized-controlled-trials/articles-2/) - Pieter Francsois Fouche MScMed (ClinEpi), PhD a, Christopher Stein PhD b, Martin Nichols MHlthSc, MBA c, Benjamin Meadley PhD d, Jason C. Bendall MBBS, MM (ClinEpi), PhD c, Karen Smith BSc (Hons), Grad Dip Epi&Biostats, Grad Cert Exec BA, PhD e, David Anderson MBChB f, Suhail A. Doi MBBS, MClinEpid, PhD g Study objective Traumatic injury causes a significant number of deaths due to bleeding. Tranexamic acid (TXA), an antifibrinolytic agent, can reduce bleeding in traumatic injuries and potentially enhance outcomes. Previous reviews suggested potential
- [הרצאת CME של ד"ר אבי עירוני : הגישה לחולה הקריטי בחדר הלם](https://emergencymed.org.il/הרצאת-cme-של-דר-אבי-עירוני-הגישה-לחולה-הק/articles-2/) - ההרצאה עלתה לאתר ד"ר עירוני הוא המנהל של המחלקה לרפואה דחופה במרכז הרפואי על שם חיים שיבא, תל השומר. אחרי סיום התמחות ברפואת פנימית והתמחות על ברפואה דחופה, עבר בקינגסטון, קנדה, תת התמחות בהחייאה, וב2010 חזר לארץ. בנוסף לניהול המחלקה לרפואה דחופה הוא חלק מצוות של המרכז לסימולציה רפואית, אחראי על שלב ב ברפואה דחופה ב10
- [PODCAST: EM Quick Hits 45 ETCO2 in Cardiac Arrest, Organ Donation, Paraphimosis, Medicolegal Myths, QI Corner](https://emergencymed.org.il/em-quick-hits-45-etco2-in-cardiac-arrest-organ-donation-paraphimosis-medicolegal-myths-qi-corner/articles-2/) - “This learning material is sourced from Emergency Medicine Cases [with link to emergencymedicinecases.com] and has been published here with permission as per creative commons copyright” Topics in this EM Quick Hits podcast Anand Swaminathan on continuous quantitative end-tidal CO2 monitoring in cardiac arrest (2:30) Tahara Bhate in QI Corner – sorting out the the dizzy patient (10:00) Andrew Healey on organ
- [PODCAST: EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing](https://emergencymed.org.il/podcast-em-quick-hits-46-wilderness-medicine-bowel-prep-hyponatremia-non-convulsive-status-epilepticus-morel-lavallee-lesions-pacemaker-ecgs-loans-vs-investing/articles-2/) - “This learning material is sourced from Emergency Medicine Cases [with link to emergencymedicinecases.com] and has been published here with permission as per creative commons copyright” Topics in this EM Quick Hits podcast Justin Hensley & Aaron Billin on wilderness medicine (0:38) Elisha Targonsky on bowel prep hyponatremia (Best of University of Toronto EM) (14:23) Brit Long on identification of non-convulsive status
- [PODCAST Flash Pulmonary Edema (aka SCAPE)](https://emergencymed.org.il/podcast-flash-pulmonary-edema-aka-scape/articles-2/) - “Sympathetic Crashing Acute Pulmonary Edema” Pathophysiology – Rapid onset of pulmonary edema caused by sudden hypertension Triggers- Missed Medication, Cocaine, Stress/Anxiety Increase in BP = Increase in afterload Increased afterload causes acute pulmonary edema (in patients with CHF) The worsening pulmonary edema causes shortness of breath which worsens blood pressure and further increases afterload Presentation-
- [ECG Cases 39 – Transient STEMI Pitfalls and Pearls](https://emergencymed.org.il/ecg-cases-39-transient-stemi-pitfalls-and-pearls/articles-2/) - “This learning material is sourced from Emergency Medicine Cases [with link to emergencymedicinecases.com] and has been published here with permission as per creative commons copyright”
- [Does ST Elevation in Lead aVR Require an Emergent Trip to the Catheterization Laboratory?](https://emergencymed.org.il/does-st-elevation-in-lead-avr-require-an-emergent-trip-to-the-catheterization-laboratory/articles-2/) - Michael Brouner, MD1; Jamey Hammock, MD2; Harish Doppalapudi, MD3 Author Affiliations Article Information JAMA Intern Med. 2023;183(3):261-262. doi:10.1001/jamainternmed.2022.5901 Case Presentation Apatient in their 50s with a history of hypertension, chronic obstructive pulmonary disease, heavy alcohol use, and tobacco use presented to the emergency department with a 2-month history of nausea and vomiting that worsened
- [PODCAST: Marine exposures: something's fishy](https://emergencymed.org.il/podcast-marine-exposures-somethings-fishy/education-tips/) - EM Board Bombs · 211. Marine exposures: something's fishy We're talking those impossible-to-remember marine exposures that will always be a thorn in your side on the test. Unless you work on the coast (or Australia), you will never see these. Want to experience the greatest in board studying? Check out our interactive question bank podcast-
- [ECMO Strikes Out in Patients with Acute Myocardial Infarction and Cardiogenic Shock](https://emergencymed.org.il/ecmo-strikes-out-in-patients-with-acute-myocardial-infarction-and-cardiogenic-shock/articles-2/) - David J. Cohen, MD, MSc, reviewing Thiele H et al. N Engl J Med 2023 Aug 26 A major randomized trial showed no mortality difference with extracorporeal membrane oxygenation versus supportive care alone. Despite great strides in managing acute myocardial infarction (AMI), 30-day mortality rates remain at 40% to 50% when cardiogenic shock complicates AMI (AMI-CS). Several percutaneous
- [ACEP: Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Seizures: Approved by the ACEP Board of Directors, April 17, 2024](https://emergencymed.org.il/acep-clinical-policy-critical-issues-in-the-management-of-adult-patients-presenting-to-the-emergency-department-with-seizures-approved-by-the-acep-board-of-directors-april-17-2024/articles-2/) - American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Seizures; Michael D Smith, Christopher S Sampson, Stephen P Wall, Deborah B Diercks; Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee); Deborah B Diercks, John D Anderson, Richard Byyny, Christopher R Carpenter, Benjamin W Friedman, Seth R Gemme, Charles J Gerardo, Steven A Godwin, Sigrid A Hahn, Benjamin W Hatten, Jason S Haukoos, Amy Kaji, Heemun Kwok, Bruce
- [PODCAST: problems and tPA is one](https://emergencymed.org.il/podcast-problems-and-tpa-is-one/podcast/) - This week we ask an important question- can you use the weather to predict patient's INR levels? ......Newsflash, you cannot. Let's talk tPA and contraindications. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here. Cite this podcast as: Briggs, Blake. 214. 99 problems
- [Early Shock – Better VF Outcomes in OHCA](https://emergencymed.org.il/12021/articles-2/) - For every minute of delay to shock in ventricular fibrillation (VF) arrest, the proportion of successful first shocks decreases by 6%. When the first shock is delivered within 2 minutes, success is 95% but drops to 75% when the delay exceeds 6 minutes. Shock early and often, but hopefully just once This large ARREST registry
- [Jugular vein ultrasound and pulmonary oedema in patients with suspected congestive heart failure](https://emergencymed.org.il/jugular-vein-ultrasound-and-pulmonary-oedema-in-patients-with-suspected-congestive-heart-failure/articles-2/) - Background The diagnosis of patients with acute dyspnoea is challenging, as clinical history and physical examination are often nondiagnostic and inaccurate. Consequently, clinicians often rely on the results of chest radiography (CXR) to determine Jugular vein ultrasound and pulmonary oedema in patients with suspected congestive heart failure Timothy Jang a,b,c,d , Chandra Aubin b ,
- [Road to Nowhere - CT for Abdominal GSW No Help - JournalFeed](https://emergencymed.org.il/road-to-nowhere-ct-for-abdominal-gsw-no-help-journalfeed/articles-2/) - In patients presenting with an abdominal gunshot wound with clear indications for operative intervention, a preoperative CT provides no additional benefit and frequently misses injuries. Go straight to OR. Do not pass CT. Do not collect unnecessary imaging. This was a retrospective review of 149 trauma patients over a 6 year period who sustained an
- [PODCAST: Sleigh the Complications: Sedation Pitfalls](https://emergencymed.org.il/podcast-sleigh-the-complications-sedation-pitfalls/podcast/) - Ho ho hold still! Let’s talk about the 3 major complications that can happen with procedural sedation in the ED. All is Calm, Until It’s Not. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake; Husain,
- [AI Research](https://emergencymed.org.il/ai-research/ai/) - אני עורך מחקר על השימוש בבינה מלאכותית (AI) בסיוע לרופאי משפחה ורופאי רפואה דחופה בנושאים הקשורים לאף-אוזן-גרון (אא"ג). במסגרת מחקר זה, אני מחפש את תרומתך החשובה במענה על סקר מקוון הכולל 12 שאלות אנונימיות. השתתפותך תסייע רבות בהבנת התפקיד הפוטנציאלי של בינה מלאכותית בתמיכה בקבלת החלטות קליניות בתחומים אלו. כל התגובות יישארו חסויות לחלוטין. למענה
- [PODCAST: Acute Mesenteric Ischemia](https://emergencymed.org.il/podcast-acute-mesenteric-ischemia-2/podcast/) - In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the December 2024 Emergency Medicine Practice article, Diagnosis and Management of Acute Mesenteric Ischemia in the Emergency Department Introduction to Acute Mesenteric Ischemia Statistics on prevalence and mortality Pathophysiology and Etiology Mesenteric artery embolism Mesenteric artery thrombosis Mesenteric venous thrombosis Non-occlusive mesenteric ischemia Diagnosis Management and Treatment
- [Should You Check Troponin in SVT?](https://emergencymed.org.il/should-you-check-troponin-in-svt/articles-2/) - Written by Caitlin Nicholson This meta-analysis of 500 patients with supraventricular tachycardia (SVT) found that while 46% had elevated troponin levels, only a small proportion experienced major adverse cardiac events (MACE) or required additional cardiac testing. SVT +/- troponin… This meta-analysis included 7 studies, 500 patients, with a mean age of 56 years. 46% of
- [How to Do Awake Intubation](https://emergencymed.org.il/how-to-do-awake-intubation/articles-2/) - This article breaks down patient selection, setup, and special considerations to manage awake intubations, a rarely-utilized but essential technique in emergency airway management. Read on for our step-by-step guide! Stay calm and tube on Awake intubation can be considered in patients with expected difficult airways to prevent can’t oxygenate/can’t ventilate situations. Although rarely performed, the
- [PODCAST:  Cervical Artery Dissection and Drowning and Submersion Injury](https://emergencymed.org.il/podcast-cervical-artery-dissection-and-drowning-and-submersion-injury/podcast/) - ACEP Critical Decisions in Emergency Medicine · August 2022: Cervical Artery Dissection and Drowning and Submersion Injury In the August episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss cervical artery dissection as well as drowning and submersion injury. As always, you’ll hear about the hot topics covered in CDEM’s
- [PODCAST: Criteria for Sepsis](https://emergencymed.org.il/podcast-criteria-for-sepsis/articles-2/) - Reference: Sanchez-Pinto, L.N., et al. Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. JAMA 2024​​. Guest Skeptic: Prof. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Professor for the University of Leicester’s SAPPHIRE group. He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate
- [PODCAST: Geriatric Fever](https://emergencymed.org.il/podcast-geriatric-fever/podcast/) - You are working at Clerkship General when you hear an EMS call on the base command radio. “Clerkship General. We are bringing you a minimally responsive 79 year-old female found lying on the floor inside her apartment. ETA 5 minutes” Initial Vitals: HR: 143 BP: 160/105 Temp: 106.3F RR: 22 O2: 99% Room Air Critical
- [POCUS for Small Bowel Obstruction – What Diameter Clinches It?POCUS for Small Bowel Obstruction – What Diameter Clinches It?](https://emergencymed.org.il/pocus-for-small-bowel-obstruction-what-diameter-clinches-itpocus-for-small-bowel-obstruction-what-diameter-clinches-it/articles-2/) - December 9, 2024 Save This Article Written by Christopher Thom Spoon Feed The diameter threshold with the highest accuracy for detection of small bowel obstruction on ultrasound was 2.75 cm. See the clip, still image, and pro tips below. How to spot SBO on ultrasound This was an analysis of four prior prospective studies on
- [PODCAST:  Glaucoma and TikTok Sun Stare challenge](https://emergencymed.org.il/podcast-glaucoma-and-tiktok-sun-stare-challenge/podcast/) - EM Board Bombs · 242. Glaucoma and TikTok Sun Stare challenge Don’t let this condition blindside you... TikTok challengers beware! This is a classic eye pathology that you must respond to in MINUTES. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here.
- [PODCAST: Subendocardial Ischemia](https://emergencymed.org.il/podcast-subendocardial-ischemia/podcast/) - Dec 9, 2024 Contributor: Travis Barlock MD Educational Pearls: What is the ST segment? The ST segment on an ECG represents the interval between the end of ventricular depolarization (QRS) and the beginning of ventricular repolarization (T-wave). It should appear isoelectric (flat) in a normal ECG. What if the ST segment is elevated? This is
- [PODCAST: An Aura of Talking About Headaches - ACEP Migraine POC Tool](https://emergencymed.org.il/podcast-an-aura-of-talking-about-headaches-acep-migraine-poc-tool/podcast/) - In this episode, we talk with one of the pioneers in migraine medicine, Dr. David Sklar, and returning guest and Ohio State champion, Dr. James "Big Jim" Neuenschwander about headaches, migraines, evaluations, and the new ACEP POC tool to support physicians and staff in the ED. ACEP Frontline · An Aura of Talking About Headaches
- [Ketamine in the Nose for Your Prehospital Traumatic Help?](https://emergencymed.org.il/ketamine-in-the-nose-for-your-prehospital-traumatic-help/articles-2/) - November 21, 2024 Written by Hunter Perala and Ketan Patel Prehospital intranasal ketamine, in addition to fentanyl, did not provide additional analgesic benefit beyond fentanyl alone​, but was safe with no significant side effects. Death to the K-hole? This study is important to emergency medicine providers, especially those managing EMS systems, because it evaluates the
- [PODCAST: Induction Agent Hypotension](https://emergencymed.org.il/podcast-induction-agent-hypotension/קדם-בית-חולים/) - Nov 25, 2024 Contributor: Aaron Lessen MD Educational Pearls: Induction agent selection during rapid sequence intubation involves accounting for hemodynamic stability in the post-intubation setting Many emergency departments use ketamine or etomidate A recent study sought to explore the rates of post-induction hypotension of ketamine compared with propofol Single center retrospective cohort study of patients
- [PODCAAST: Don’t Worry, Be Happy – The Safety of Nitroglycerin Administration in RVMI](https://emergencymed.org.il/podcaast-dont-worry-be-happy-the-safety-of-nitroglycerin-administration-in-rvmi/קדם-בית-חולים/) - Reference: Wilkinson-Stokes M, Betson J, Sawyer S. Adverse events from nitrate administration during right ventricular myocardial infarction: a systematic review and meta-analysis. Emerg Med J. February 2023 Date: January 24, 2024 Guest Skeptic: Dr. Rupinder Sahsi is a fellow EBM enthusiast with academic appointments at McMaster University and Wright State University who works as an emergency physician in Kitchener-Waterloo, Ontario,
- [A Novel Technique for Zipper Release](https://emergencymed.org.il/a-novel-technique-for-zipper-release/articles-2/) - Written by Doug Wallace This animal model study compared the classic median bar technique for zipper skin entrapment release to a novel approach. There was no upside or downside to using the new technique. Chicken skin apparently works well as a penile skin model Zipper entrapment of skin, most commonly penile skin, is a time
- [PODCAST: Spooky Scary Access – IV or IO for OHCA](https://emergencymed.org.il/podcast-spooky-scary-access-iv-or-io-for-ohca/education-tips/) - Date: November 10, 2024 Reference: Couper et al. The Paramedic 3 Trial: A randomized clinical trial of drug route in out-of-hospital cardiac arrest. October 31, 2024 NEJM Access to the SGEM Podcast episode at this LINK. Guest Skeptic: Missy Carter is a PA currently practicing in critical care after having attended the University of Washington’s MEDEX program. An alumnus of
- [How to Diagnose and Treat Pericarditis](https://emergencymed.org.il/how-to-diagnose-and-treat-pericarditis/articles-2/) - November 27, 2024 Written by Caitlin Nicholson Acute pericarditis is a common cause of nonischemic chest pain. In North America, it is typically idiopathic, develops after a viral infection, or follows a cardiac procedure. In areas with higher prevalence, tuberculosis can be an underlying cause of pericarditis. For the majority of patients, treatment with NSAIDs
- [Rocuronium or Succinylcholine – Which Has More Complications?](https://emergencymed.org.il/rocuronium-or-succinylcholine-which-has-more-complications/articles-2/) - November 25, 2024 Written by Jason Lesnick This secondary analysis of 2 RCTs found no significant difference between rocuronium or succinylcholine on first attempt success or severe complications in critically ill patients undergoing endotracheal intubation. Paralytic preference possibilities? This was a secondary analysis of data from the DEVICE and PREOXI trials including 2,339 adult patients undergoing intubation in an
- [PODCAST: Trauma Airway and Airway Trauma](https://emergencymed.org.il/podcast-trauma-airway-and-airway-trauma/קדם-בית-חולים/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured
- [PODCAST, AAEM: The Journal of Emergency Medicine Audio Summary](https://emergencymed.org.il/podcast-aaem-the-journal-of-emergency-medicine-audio-summary-3/podcast/) - Nov 14, 2024 Podcast summary of articles from the October 2024 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include hypertensive emergency, sepsis, SCIWONA, post operative complications, cyclic vomiting, and exertional heat injury Guest speaker is Dr. Matthew Carvey.
- [PODCAST: Low Back Pain](https://emergencymed.org.il/podcast-low-back-pain/podcast/) - November 15, 2024 Sam Ashoo, MD In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the November 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Low Back Pain: A Review of Current Evidence Prevalence and Importance of Back Pain in the ED Differential Diagnosis and Serious Pathologies Patient Expectations and Management Strategies Missed
- [2024 Clinical Practice Guideline Update by the Infectious Diseases Society of America on Complicated Intra-abdominal Infections: Risk Assessment, Diagnostic Imaging, and Microbiological Evaluation in Adults, Children, and Pregnant People](https://emergencymed.org.il/2024-clinical-practice-guideline-update-by-the-infectious-diseases-society-of-america-on-complicated-intra-abdominal-infections-risk-assessment-diagnostic-imaging-and-microbiological-evaluation-in/articles-2/) - Robert A Bonomo 1 2 3 4, Anthony W Chow 5, Morven S Edwards 6, Romney Humphries 7, Pranita D Tamma 8, Fredrick M Abrahamian 9 10, Mary Bessesen 11 12, E Patchen Dellinger 13, Ellie Goldstein 14, Mary K Hayden 15, Keith S Kaye 16, Brian A Potoski 17, Jesús Rodríguez-Baño 18, Robert Sawyer 19, Marion Skalweit 20, David R Snydman 21, Sarah Pahlke 22, Katelyn Donnelly 22, Jennifer Loveless 22 Affiliations Expand PMID: 38965057 DOI: 10.1093/cid/ciae346 Abstract As the first part of an update to the clinical practice guideline on the diagnosis and management of complicated
- [JAMA: How High Should We Set IPAP for Non-Invasive Ventilation in COPD?](https://emergencymed.org.il/jama-how-high-should-we-set-ipap-for-non-invasive-ventilation-in-copd/articles-2/) - November 6, 2024 Written by Jason Lesnick This RCT found high-intensity non-invasive positive pressure ventilation (NPPV) in COPD patients with persistent hypercapnia decreased the need for endotracheal intubation according to prespecified criteria. Stop trying to make COPD HAPPEN, Gretchen This multicenter RCT was performed across 30 hospitals in China from January 2019 to January 2022 and
- [Large- or Small-Bore Chest Tubes for Hemothorax?](https://emergencymed.org.il/large-or-small-bore-chest-tubes-for-hemothorax/articles-2/) - November 8, 2024 Written by Aaron Lacy While there was concern for selection bias in a number of included studies, this systematic review and meta-analysis found that small–bore thoracostomy tubes may be appropriate to use in traumatic hemothorax. David versus Goliath: chest tube edition11 studies including 1,847 patients with traumatic hemothorax (81% blunt trauma) were included
- [PODCAST: Domo Arigato Misuta Roboto – Using AI to Assess the Quality of the Medical Literature](https://emergencymed.org.il/podcast-domo-arigato-misuta-roboto-using-ai-to-assess-the-quality-of-the-medical-literature/education-tips/) - Date: October 28, 2024 Reference: Woelfle T et al. Benchmarking Human–AI collaboration for common evidence appraisal tools. J Clin Epi Sept 2024. Guest Skeptic: Dr. Laura Walker is an Associate Professor of Emergency Medicine and the vice chair for digital emergency medicine at the Mayo Clinic. In addition to finding ways to use technology in emergency department (ED) care,
- [Nuts and bolts of lung ultrasound: utility, scanning techniques, protocols, and findings in common pathologies](https://emergencymed.org.il/nuts-and-bolts-of-lung-ultrasound-utility-scanning-techniques-protocols-and-findings-in-common-pathologies/articles-2/) - Michael Beshara 1 2, Edward A Bittner 1, Alberto Goffi 3 4 5, Lorenzo Berra 1, Marvin G Chang 6 Affiliations Expand Abstract Point of Care ultrasound (POCUS) of the lungs, also known as lung ultrasound (LUS), has emerged as a technique that allows for the diagnosis of many respiratory pathologies with greater accuracy and speed compared to conventional techniques such as chest x-ray and auscultation.
- [PODCAST: Neutropenic Fever](https://emergencymed.org.il/podcast-neutropenic-fever/podcast/) - Contributor: Taylor Lynch, MD Educational Pearls: What is neutropenic fever? Specific type of fever that is seen in cancer patients and other patients with impaired immune systems These patients are highly susceptible to infection Typically occurs 7-10 days after the last chemotherapy dose, this is when the immune system is the weakest It is useful
- [How to Treat Hypertensive Emergency](https://emergencymed.org.il/how-to-treat-hypertensive-emergency/articles-2/) - October 23, 2024 Written by Laura Murphy Hypertensive emergencies are associated with high morbidity and mortality and require specific strategies to diminish pressure-mediated organ injury, depending on the type of hypertensive presentation. A little goes a long way Hypertensive emergency is new or worsening organ injury with severely elevated BP (usually 220/110) or an accelerated
- [PODCAST: Psychogenic Seizures](https://emergencymed.org.il/podcast-psychogenic-seizures/podcast/) - Oct 26, 2024 A highly relevant cast on a potential exam SAQ very relevant to the ED Physician. How do you feel about such a patient? What are the distinguishing features from this compared to epileptic seizures? How do you assess and manage this condition? We delve into this and more in this cast that
- [PODCAST:SGEM Xtra: I’m Just An Ordinary Average Guy – Dr. Mel Herbert](https://emergencymed.org.il/podcastsgem-xtra-im-just-an-ordinary-average-guy-dr-mel-herbert/education-tips/) - Date: August 30, 2024 Guest Skeptic: Dr. Mel Herbert is a famous Emergency Medicine Physician, award-winning educator, entrepreneur and philanthropist. Mel founded both EM:RAP which creates and distributes Emergency Medicine education in over 160 countries. He also started a non-profit company called EM:RAP GO. This is an SGEM Xtra to end Season#12. I chatted with Mel about his new book, “The
- [POODCAST: We are Young…but we can still Understand](https://emergencymed.org.il/poodcast-we-are-youngbut-we-can-still-understand/ילדים/) - Reference: Ma K et al. A national survey of children’s experiences and needs when attending Canadian pediatric emergency departments. PLoS One. June 2024 Date: Oct 1, 2024 Guest Skeptic: Dr. Andrew (Andy) Tagg is an Emergency Physician with a special interest in education and lifelong learning. He is the co-founder of website lead of Don’t Forget the Bubbles (DFTB).
- [The association of intravenous vs. humeral-intraosseous vascular access with patient outcomes in adult out-of-hospital cardiac arrests](https://emergencymed.org.il/the-association-of-intravenous-vs-humeral-intraosseous-vascular-access-with-patient-outcomes-in-adult-out-of-hospital-cardiac-arrests/articles-2/) - Callahan Brebner 1, Michael Asamoah-Boaheng 2, Bianca Zaidel 3, Justin Yap 4, Frank Scheuermeyer 2, Valerie Mok 1, Jacob Hutton 5, Garth Meckler 6, Robert Schlamp 7, Jim Christenson 2, Brian Grunau 8 Affiliations Expand PMID: 39154890 DOI: 10.1016/j.resuscitation.2024.110360 Free article Abstract Aim: While intravenous (IV) vascular access for out-of-hospital cardiac arrest (OHCA) resuscitation is standard, humeral-intraosseous (IO) access is commonly used, despite few supporting data. We investigated the association between IV vs. humeral-IO
- [Can You Spot Cavernous Sinus Thrombosis?](https://emergencymed.org.il/can-you-spot-cavernous-sinus-thrombosis/articles-2/) - October 10, 2024 Written by Caitlin Nicholson Cavernous sinus thrombosis (CST) is a rare but serious thrombophlebitic disease that can be easy to miss in the emergency department setting. This article provides an overview of CST as well as some pearls for clinching this diagnosis for emergency medicine physicians. Let’s shed some light in this
- [LR or NS for Sickle Cell Pain Crisis?](https://emergencymed.org.il/lr-or-ns-for-sickle-cell-pain-crisis/articles-2/) - October 11, 2024 Written by Megan Hilbert For sickle cell patients (particularly Hgb SS) with a vaso-occlusive episode (VOE), large volume resuscitation (>2L) with lactated ringers (LR) has been shown to have improved outcome measures compared to normal saline (NS). Another ding against NS Preclinical research has demonstrated that NS can promote erythrocyte sickling and
- [PODCAST: Laboring Mom in Triage](https://emergencymed.org.il/podcast-laboring-mom-in-triage/podcast/) - You are working at Clerkship General when you hear a woman screaming from triage… It’s baby time! Initial Vitals: HR: 120 RR: Shallow O2: 58% Critical Actions: Place neonate in warmer Administer positive pressure ventilation Obtain pre-ductal pulse ox Check blood glucose Place umbilical vein catheter Administer dextrose
- [PODCAST: Migraines](https://emergencymed.org.il/podcast-migraines/podcast/) - Initial Approach to Diagnosing Migraines: Differentiating between primary headaches (migraine, tension-type, cluster) and secondary causes (e.g., subarachnoid hemorrhage). The importance of patient history and reevaluation after initial treatment. Recognizing the unique presentation of cluster headaches and their management implications. Effective Acute Migraine Treatments: First-line treatments including anti-dopaminergic medications like metoclopramide (Reglan) and prochlorperazine (Compazine), and parenteral NSAIDs like ketorolac
- [PODCAST: Gastroesophegeal Reflux and Gastritis](https://emergencymed.org.il/podcast-gastroesophegeal-reflux-and-gastritis/ילדים/) - In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, I explore the complexities of gastroesophageal reflux (GER) and gastritis in children and adolescents. I’ll make the important distinction between gastritis – which is diagnosed only via endoscopy – and dyspepsia, the term best used to describe the symptoms many patients experience. I’ll dive into
- [PODCAST: Blunt Cerebrovascular Injury](https://emergencymed.org.il/podcast-blunt-cerebrovascular-injury/trauma/) - Sep 30, 2024 Contributor: Travis Barlock MD Educational Pearls: Assessment of head and neck vascular injury due to blunt trauma Symptomatic patients require screening head and neck CT angiography EAST guidelines include the following criteria for a screening CT angiography in blunt head trauma: Unexplained neurological deficits Arterial nosebleed GCS < 6 Petrous bone fracture
- [That’s Twisted – A Review of Pediatric Volvulus](https://emergencymed.org.il/thats-twisted-a-review-of-pediatric-volvulus/articles-2/) - October 3, 2024 Written by Joshua Belfer Pediatric volvulus is associated with a high morbidity and mortality rate but remains a challenging diagnosis. This review highlights pearls and pitfalls of diagnosis and management. A twist, then a shout… Volvulus is the twist of the gastrointestinal tract on itself and can occur at both the gastric
- [Emergency Medicine Postgraduate Year, Laryngoscopic View, and Endotracheal Tube Placement Success](https://emergencymed.org.il/emergency-medicine-postgraduate-year-laryngoscopic-view-and-endotracheal-tube-placement-success/articles-2/) - Dhimitri A Nikolla 1, Joseph Offenbacher 2, Michael D April 3, Silas W Smith 4, Anthony Battista 5, Scott A Ducharme 5, Jestin N Carlson 5, Calvin A Brown 3rd 6 Affiliations Expand Abstract Study objective: Prior work has found first-attempt success improves with emergency medicine (EM) postgraduate year (PGY). However, the association between PGY and laryngoscopic view - a key step in successful intubation - is unknown. We examined
- [PODCAST: I Just Died in Your Arms Tonight – Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes](https://emergencymed.org.il/podcast-i-just-died-in-your-arms-tonight-diagnostic-accuracy-of-d-dimer-for-acute-aortic-syndromes/podcast/) - Date: September 23, 2024 Reference: Essat et al. Diagnostic Accuracy of D-Dimer for Acute Aortic Syndromes: Systematic Review and Meta-Analysis. Annals of Emergency Medicine, May 2024 Guest Skeptic: Dr. Casey Parker is a Rural Generalist from Australia who is also an ultrasounder. Case: You are working a busy shift in a rural emergency department (ED) and your excellent Family
- [Remimazolam for procedural sedation: a future sedative potential in the emergency department?](https://emergencymed.org.il/remimazolam-for-procedural-sedation-a-future-sedative-potential-in-the-emergency-department/articles-2/) - Procedural sedation (PS) is a frequently performed clinical practice in the ED1 aiming to facilitate a state that allows patients to tolerate uncomfortable procedures.2 The ideal agent for PS in the ED should provide anxiolysis, analgesia and amnesia in a rapid and predictable manner, with minimal adverse events and a rapid recovery phase.3 Remimazolam (RMZ) is a novel
- [PODCAST: AAEM: The Journal of Emergency Medicine Audio Summary](https://emergencymed.org.il/podcast-aaem-the-journal-of-emergency-medicine-audio-summary-2/podcast/) - Sep 27, 2024 Podcast summary of articles from the August 2024 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include sepsis, pediatrics, opioids, syncope, and a review of psychiatric patients boarding in the ED. Guest speaker is Dr. Kinda Sweidan.
- [Optimizing Advanced Imaging of the Pediatric Patient in the Emergency Department: Policy Statement](https://emergencymed.org.il/optimizing-advanced-imaging-of-the-pediatric-patient-in-the-emergency-department-policy-statement/articles-2/) - American Academy of Pediatrics Committee on Pediatric Emergency Medicine; Section on Radiology; American College of Emergency Physicians Pediatric Emergency Medicine Committee; American College of Radiology; Jennifer R Marin 1, Todd W Lyons 2, Ilene Claudius 3, Mary E Fallat 4, Michael Aquino 5, Timothy Ruttan 6, Reza J Daugherty 7 Affiliations Expand PMID: 39032991 DOI: 10.1016/j.annemergmed.2024.03.023 Abstract Advanced imaging, including ultrasonography, computed tomography, and magnetic resonance imaging (MRI), is an integral component to the
- [Even a Blind Squirrel…Estimating Gestational Age with AI](https://emergencymed.org.il/even-a-blind-squirrelestimating-gestational-age-with-ai/articles-2/) - September 25, 2024 Written by Megan Hilbert AI-enabled ultrasound devices are able to accurately estimate gestational age (GA) between 14 and 27 weeks when employed by novice users. This is particularly of importance in resource poor settings. Blind sweeps for baby The World Health Organization (WHO) recommends that all pregnant patients receive at least one
- [Lipliner Sign and False Positive FAST – Is Ultrasound Too Smart?](https://emergencymed.org.il/lipliner-sign-and-false-positive-fast-is-ultrasound-too-smart/trauma/) - September 23, 2024 Written by Megan Hilbert Post-processing techniques completed by ultrasound machines to improve spatial resolution have become so advanced that it can now fool us into thinking a FAST exam is positive. The physics is trying to fool me?! False positives on the FAST exam can lead to resource-intensive work-ups that may not
- [PODCAST: Pediatric Hypoglycemia](https://emergencymed.org.il/podcast-pediatric-hypoglycemia/ילדים/) - Sep 16, 2024 Contributor: Taylor Lynch, MD Educational Pearls: When it comes to hypoglycemia, the age dictates possible causes Neonate: Hormonal deficiency Congenital Adrenal Hyperplasia (21-hydroxylase deficiency, 11β-hydroxylase deficiency) Primary or Secondary Adrenal Insufficiency leading to cortisol deficiency Hypopituitarism Inborn errors of metabolism Systemic infection (Under 30 days old should trigger a full infectious workup)
- [Association Between GLP-1 Receptor Agonist Use and the Risk of Parkinson's Disease in Patients With Type 2 Diabetes](https://emergencymed.org.il/association-between-glp-1-receptor-agonist-use-and-the-risk-of-parkinsons-disease-in-patients-with-type-2-diabetes/articles-2/) - Movement Disorders: Official Journal of the Movement Disorder Society TAKE-HOME MESSAGE Although previous research has suggested that GLP-1 receptor agonists (GLP-1RAs) may have a disease-modifying effect on the development of Parkinson's disease (PD), the results of the population studies have not been consistent. The current study compared the risk of PD in older adults (age,
- [PODCAST: Orbital Compartment Syndrome](https://emergencymed.org.il/podcast-orbital-compartment-syndrome-2/trauma/) - Sep 13, 2024 Today's cast is a short and sweet discussion on an exam question regarding Orbital compartment syndrome that was written by our podcast host. This is a recurrently examined topic in both written and osce exams in the ACEM fellowship exams. Please check out the relevant SAQ on artofemergency.com
- [PODCAST: EM Quick Hits 59 Traumatic Coronary Artery Dissection, Proper Use of Insulin, Mesenteric Ischemia, Exercise Associated Hyponatremia, AI for OMI](https://emergencymed.org.il/podcast-em-quick-hits-59-traumatic-coronary-artery-dissection-proper-use-of-insulin-mesenteric-ischemia-exercise-associated-hyponatremia-ai-for-omi/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Topics in this EM Quick Hits podcast Ian Chernoff on traumatic coronary artery dissection (1:05) Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia (15:50) Brit Long & Hans Rosenberg on mesenteric ischemia pearls and pitfalls
- [PODCAST: Migraine Treatment in Cardiovascular Disease](https://emergencymed.org.il/podcast-migraine-treatment-in-cardiovascular-disease/podcast/) - Dec 25, 2023 Contributor: Jorge Chalit, OMS II Educational Pearls: Migraine pathophysiology Primarily mediated through the trigeminovascular system Serotonin, dopamine, and calcitonin gene-related peptide (CGRP) Trigeminovascular system is linked to the trigeminal nucleus caudalis, which relays pain to the hypothalamus and cerebral cortex One effective treatment for acute migraines is -triptan medications 5-HT1D/1B agonists such
- [PODCAST: EKG Criteria for Adenosine](https://emergencymed.org.il/podcast-ekg-criteria-for-adenosine/קדם-בית-חולים/) - Sep 4, 2024 Contributor: Travis Barlock, MD Educational Pearls: SVT: supraventricular tachycardia Pharmacotherapy for SVT includes drugs that block the AV node, such as adenosine EKG criteria before adenosine administration in SVT Regular rhythm Monomorphic: ​​all QRS complexes are identical If the EKG is polymorphic, with QRS complexes displaying changing morphologies, it is unsafe to
- [IO or IV for OHCA?](https://emergencymed.org.il/io-or-iv-for-ohca/articles-2/) - September 4, 2024 Written by Seth Walsh-Blackmore Attempting initial vascular access in the field by intraosseous (IO) vs. intravenous (IV) route made no difference in survival to hospital discharge for out-of-hospital cardiac arrest (OHCA), despite greater IO success rates. The only VICTOR was the trial. Intraosseous access has superior success rates by paramedics in the
- [IM Epinephrine for OHCA – Quicker and Better?](https://emergencymed.org.il/אדרנלין-im-עבור-החייאה-מחוץ-לבית-חולים-ohca/articles-2/) - Written by Michael Stocker In non-traumatic out of hospital cardiac arrest (OHCA), administration of an initial dose of IM epinephrine by EMS prior to an established IV or IO was associated with improved survival outcomes. Epi in the thigh helps more patients survive? This single-center before-and-after study investigated the effect of an initial IM epinephrine
- [אדרנלין IM עבור החייאה מחוץ לבית חולים OHCA - מהיר וטוב יותר?](https://emergencymed.org.il/אדרנלין-im-עבור-החייאה-מחוץ-לבית-חולים-ohca/articles-2/) - נכתב על ידי מייקל סטוקר בדום לב לא טראומטי מחוץ לבית החולים (OHCA), מתן מינון ראשוני של אפינפרין IM על ידי EMS לפני הכנסת IV או IO היה קשור לשיפור תוצאות ההישרדות. אפי בירך עוזר ליותר חולים לשרוד? מחקר זה של מרכז יחיד לפני ואחרי חקר את ההשפעה של מינון IM ראשוני של אפינפרין ב-OHCA
- [Mechanism of Calcium for Hyperkalemia – Not What You Think](https://emergencymed.org.il/mechanism-of-calcium-for-hyperkalemia-not-what-you-think/articles-2/) - Written by Carmen Wolfe Giving calcium for hyperkalemia restores normal cardiac conduction velocity but does not restore resting membrane potential, as is commonly stated. It works, but not how you were always taught… Emergency physicians know that calcium is critical for treatment of hyperkalemia when QRS widening is noted on electrocardiogram (ECG). Despite years of
- [PODCAST CASE:  Nursing Home Transfer](https://emergencymed.org.il/podcast-case-nursing-home-transfer/podcast/) - You are working at Clerkship General when the nurse comes up to you and says, “Hey doc, EMS dropped off this guy named Randy from the memory care unit at the nursing home down the street. He’s in the hall bed outside of room 7. EMS says he’s here for confusion, we will get him
- [The impact of time to defibrillation on return of spontaneous circulation in out-of-hospital cardiac arrest patients with recurrent shockable rhythms](https://emergencymed.org.il/the-impact-of-time-to-defibrillation-on-return-of-spontaneous-circulation-in-out-of-hospital-cardiac-arrest-patients-with-recurrent-shockable-rhythms/articles-2/) - EmadAwada,b,*,BrentKlapthora,MichaelH.Morgana,ScottT.Youngquista,c Abstract Objective: Optimal timing for subsequent defibrillation attempts for Out-of-hospital cardiac arrest (OHCA) patients with recurrent VF/pVT is uncertain. We investigated the relationship between VF/pVT duration and return of spontaneous circulation (ROSC) in OHCA patients with recurrent shockable rhythms. Methods: We analyzed data from the Salt Lake City Fire
- [PODCAST: A can’t-miss neuro emergency!](https://emergencymed.org.il/podcast-a-cant-miss-neuro-emergency/podcast/) - EM Board Bombs · 233. A can’t-miss neuro emergency! There are at least 2 can’t-miss-conditions here on this multiple choice question. The Dog Days of summer ended on Labor Day, so let’s start fall with a scary differential diagnosis of naming that can’t-miss neuro emergency! Want to experience the greatest in board studying? Check out
- [Nonradiology Health Care Professionals Significantly Benefit From AI Assistance in Emergency-Related Chest Radiography Interpretation](https://emergencymed.org.il/nonradiology-health-care-professionals-significantly-benefit-from-ai-assistance-in-emergency-related-chest-radiography-interpretation/articles-2/) - Jan Rudolph, MD; Christian Huemmer, PhD; Alexander Preuhs, PhD; Giulia Buizza, PhD; Boj F. Hoppe, MD; Julien Dinkel, MD; Vanessa Koliogiannis, MD; Nicola Fink, MD; Sophia S. Goller, MD; Vincent Schwarze, MD; Nabeel Mansour, MD; Vanessa F. Schmidt, MD; Maximilian Fischer, MD; Maximilian Jörgens, MD; Najib Ben Khaled, MD; Thomas Liebig, MD; Jens Ricke, MD;
- [Termination of Resuscitation Rules and Survival Among Patients With Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis](https://emergencymed.org.il/termination-of-resuscitation-rules-and-survival-among-patients-with-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis/articles-2/) - Michael A. Smyth, PhD1,2; Imogen Gunson, MSc3; Alison Coppola, MClinRes4; et al Abstract Importance: Termination of resuscitation (TOR) rules may help guide prehospital decisions to stop resuscitation, with potential effects on patient outcomes and health resource use. Rules with high sensitivity risk increasing inappropriate transport of nonsurvivors, while rules without excellent specificity risk missed survivors. Further examination
- [Association Between Exacerbation History and Risk of Myocardial Infarction and Pulmonary Embolism in COPD](https://emergencymed.org.il/association-between-exacerbation-history-and-risk-of-myocardial-infarction-and-pulmonary-embolism-in-copd/articles-2/) - TAKE-HOME MESSAGE Drawing data from the Swedish National Airway Register, this retrospective cohort study compared the number and severity of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) with subsequent incidence of myocardial infarction (MI) and pulmonary embolism (PE). Reviewing data from more than 66,422 patients with COPD followed for a total duration exceeding 265,000
- [PODCAST:  Identifying and Managing Patients With Sepsis and Stridor in Pediatric Patients](https://emergencymed.org.il/podcast-identifying-and-managing-patients-with-sepsis-and-stridor-in-pediatric-patients/ילדים/) - ACEP Critical Decisions in Emergency Medicine · June 2024: Identifying and Managing Patients With Sepsis and Stridor in Pediatric Patients In the June 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss identifying and managing patients with sepsis and stridor in pediatric patients. As always, you’ll also hear about
- [PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study](https://emergencymed.org.il/pecarn-prediction-rule-for-cervical-spine-imaging-of-children-presenting-to-the-emergency-department-with-blunt-trauma-a-multicentre-prospective-observational-study-2/articles-2/) - Julie C Leonard, Monica Harding, Lawrence J Cook, Jeffrey R Leonard, Kathleen M Adelgais, Fahd A Ahmad, Lorin R Browne, Rebecca K Burger, Pradip P Chaudhari, Daniel J Corwin, Nicolaus W Glomb, Lois K Lee, Sylvia Owusu-Ansah, Lauren C Riney, Alexander J Rogers, Daniel M Rubalcava, Robert E Sapien, Matthew A Szadkowski, Leah Tzimenatos, Caleb
- [PODCAST:  I’ve Become So Numb – Serratus Anterior Plane Blocks for Rib Fractures](https://emergencymed.org.il/podcast-ive-become-so-numb-serratus-anterior-plane-blocks-for-rib-fractures/trauma/) - Date: August 19, 2024 Reference: Partyka et al. Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial. JAMA Surg 2024 Guest Skeptic: Dr. Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Interests include information systems and digital
- [PODCAST: ECPR](https://emergencymed.org.il/podcast-ecpr/ילדים/) - This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. ECPR involves using ECMO (Extracorporeal Membrane Oxygenation) to take over heart and lung functions, offering a last-resort option that is becoming more common in large pediatric hospitals. While ECPR shows promise in
- [PROFUNDUS – POCUS-Plus for Aortic Syndromes](https://emergencymed.org.il/profundus-pocus-plus-for-aortic-syndromes/articles-2/) - August 21, 2024 Written by Megan Hilbert Using the aortic dissection detection (ADD) risk score in addition to point-of-care ultrasound (POCUS) and D-dimer, providers can increase their diagnostic accuracy and ensure that the appropriate patients are receiving advanced imaging to make the diagnosis of acute aortic syndrome (AAS). PROFUNDUS? Wow, that’s deep… Acute aortic syndromes
- [PODCAST: The Age Friendly ED - Geriatric Readiness with Dr. Biese](https://emergencymed.org.il/podcast-the-age-friendly-ed-geriatric-readiness-with-dr-biese/podcast/) - ACEP Frontline · The Age Friendly ED - Geriatric Readiness with Dr. Biese This episode features the new steps and CMS requirements on the "age friendly ED" initiative. We are joined by Dr. Biese who breaks down the new requirements and opportunities within EM.
- [Considerations in Mass Casualty and Disaster Management](https://emergencymed.org.il/considerations-in-mass-casualty-and-disaster-management/articles-2/) - Disasters have increased in frequency over the past century. A number of high profile disasters have also dominated news headlines in the past decade raising the media and community awareness, of disasters. This has been across the full spectrum of disasters and as illustrated in Table 1 has included terrorist bombings, hurricanes, earthquakes, tsunamis and
- [TRAUMA: Scanning the aged to minimize missed injury: An EAST multicenter study](https://emergencymed.org.il/11496/trauma/) - Ho, Vanessa P ; Kishawi, Sami K ; Hill, Hannah ; O'Brien, Joseph ; Ratnasekera, Asanthi ; Seng, Sirivan Suon ; Ton, Trieu Hai ; Butts, Christopher A ; Muller, Alison ; Diaz, Jr, Bernardo Fabian ; Baltazar, Gerard A ; Petrone, Patrizio ; Pacheco, Tulio Brasileiro Silva ; Morrissey, Shawna ; Chung, Timothy ;
- [Best Tips for Bougie Use in Airway Management](https://emergencymed.org.il/best-tips-for-bougie-use-in-airway-management/articles-2/) - August 19, 2024 Written by Aaron Lacy This comprehensive article on bougie use during emergency airway management covers all things bougie, with a lot of technical tips. We cover the highlights. Bougie = Life This article goes into a lot of detail regarding bougie use, including general principles and microskills. If you are on the fence
- [נקודה: לרינגוסקופיה ישירה: אבן הבניין למומחיות בדרכי האוויר? כֵּן](https://emergencymed.org.il/נקודה-לרינגוסקופיה-ישירה-אבן-הבניין-ל/recourse/) - אינטובציה של קנה הנשימה של מבוגרים החולים במחלה קשה היא הליך מסוכן הדורש הכנה, מומחיות וגמישות של הרופא. אי אינטובציה בניסיון ראשון שכיח בקרב יותר מ-1.5 מיליון מבוגרים החולים במחלה קשה שעוברים אינטובציה מחוץ לחדר הניתוח מדי שנה. אי אינטובציה בניסיון הראשון קשור לסיכון מוגבר לסיבוכים מסכני חיים. כדי לבצע אינטובציה חירום של קנה הנשימה
- [A Patch-Wearable Cardioverter-Defibrillator for Patients at a Risk for Sudden Cardiac Arrest](https://emergencymed.org.il/a-patch-wearable-cardioverter-defibrillator-for-patients-at-a-risk-for-sudden-cardiac-arrest/articles-2/) - TAKE-HOME MESSAGE This single-arm multicenter study assessed the safety and effectiveness of a novel patch-wearable cardioverter-defibrillator designed to improve compliance and enhance protection against sudden cardiac arrest (SCA) among 305 patients at a risk for SCA due to ventricular tachycardia/fibrillation who were
- [Severe Burn Injuries](https://emergencymed.org.il/severe-burn-injuries/trauma/) - Aug 5, 2024 Contributor: Megan Hurley, MD Educational Pearls: Initial assessment of patients with severe burn injuries begins with ABCs Airway: consider inhalation injury Breathing: circumferential burns of the trunk region can reduce respiratory muscle movement Circulation: circumferential burns compromise circulation Exposure: Important to assess the affected surface area Escharotomy: emergency procedure to release the
- [Potential kidney donors among patients with outof- hospital cardiac arrest and a termination of resuscitation rule](https://emergencymed.org.il/potential-kidney-donors-among-patients-with-outof-hospital-cardiac-arrest-and-a-termination-of-resuscitation-rule/articles-2/) - אחד הנושאים ה"חמים" בעולם הרפואה בכלל וה EMS בפרט בשנים האחרונות הינו נושא תרומת האיברים (בעיקר כליות) ממטופלים שחוו OHCA, ואשר פעולות ההחייאה בהם נכשלו. המטרה = להגדיל משמעותית את פוטנציאל תרומת האיברים בכדי לקצר את זמני ההמתנה הארוכים. כידוע, תוחלת החיים הממוצעת של מטופל על המודיאליזה הינה קצרה משמעותית – שלא לדבר על איכות
- [PODCAST:  Spinal Epidural Hematoma and Abscess and Upper-Extremity Pain Treatments](https://emergencymed.org.il/podcast-spinal-epidural-hematoma-and-abscess-and-upper-extremity-pain-treatments/trauma/) - ACEP Critical Decisions in Emergency Medicine · May 2024: Spinal Epidural Hematoma and Abscess and Upper-Extremity Pain Treatments In the May 2024 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss spinal epidural hematoma and abscess and upper-extremity pain treatments. As always, you’ll also hear about the hot topics covered
- [How to Spot Posterior TIA Presenting with Dizziness](https://emergencymed.org.il/how-to-spot-posterior-tia-presenting-with-dizziness/articles-2/) - August 6, 2024 Written by Shannon Markus Diagnosing patients with a posterior circulation TIA who are experiencing isolated episodic dizziness can be challenging, especially when considering the difficulty in assessing individual symptoms and the small absolute number of these patients. The authors lay out a pragmatic approach for assessment and diagnosis, but the data to
- [Keith Wrenn Always Said, “Presyncope IS Syncope.” He Was Right](https://emergencymed.org.il/keith-wrenn-always-said-presyncope-is-syncope-he-was-right/articles-2/) - July 31, 2024 Written by Caitlin Nicholson This systematic review found that approximately 4%-27% of patients presenting to the ED with presyncope experienced serious outcomes within a 30-day period. Should presyncope be perceived as less worrisome than syncope? Five articles were included in this systematic review, with the primary focus on serious short term outcomes,
- [Trends in Initial Anticoagulation Among US Patients Hospitalized With Acute Pulmonary Embolism 2011-2020](https://emergencymed.org.il/trends-in-initial-anticoagulation-among-us-patients-hospitalized-with-acute-pulmonary-embolism-2011-2020/articles-2/) - Lauren M Westafer 1, Thomas Presti 2, Meng-Shiou Shieh 3, Penelope S Pekow 4, Geoffrey D Barnes 5, Alok Kapoor 6, Peter K Lindenauer 7 Affiliations Expand DOI: 10.1016/j.annemergmed.2024.05.009 Abstract Study objective: Guidelines recommend low-molecular-weight heparin (LMWH) and direct oral anticoagulants (DOACs) rather than unfractionated heparin (UFH) for treatment of acute pulmonary embolism (PE) given their efficacy and reduced risk of bleeding. Using data from
- [Can We Use Lytics for Stroke Patients on a DOAC?](https://emergencymed.org.il/can-we-use-lytics-for-stroke-patients-on-a-doac/articles-2/) - Written by Shannon Markus For acute ischemic stroke patients with recent DOAC ingestion who (1) had their DOAC level measured, (2) had DOAC reversal with idarucizumab, or (3) inadvertently received thrombolytics with DOAC subsequently discovered, there was not evidence of increased significant intracranial hemorrhage associated with off-label thrombolytic therapy. Whoops, just thrombolysed your thin blood…
- [PODCAST: Bad Boys What’cha Gonna Do – Patient Perceptions of Behavioral Flags in the ED](https://emergencymed.org.il/podcast-bad-boys-whatcha-gonna-do-patient-perceptions-of-behavioral-flags-in-the-ed/ניהול-מלרד/) - Reference: Gonzales RE, Seeburger EF, Friedman AB, and Agarwal AK. Patient perceptions of behavioral flags in the emergency department: A qualitative analysis. AEM July 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Department and Program Director of the EM residency
- [PODCAST Case: Pediatric Altered Mental Status](https://emergencymed.org.il/podcast-case-pediatric-altered-mental-status/ילדים/) - You are working at Clerkship General when you hear an EMS call on the radio. “Clerkship General, we are bringing you a 3 year old female with complaints of altered mental status. We are pulling in now.” Initial Vitals: HR: 129 BP: 98/66 Temp: 99.7F RR: 35 O2: 99% Room Air Critical Actions: Check blood
- [Review article: Abdominal pain and diabetes mellitus in the emergency department](https://emergencymed.org.il/review-article-abdominal-pain-and-diabetes-mellitus-in-the-emergency-department/articles-2/) - Sneha Krishna MBBS, Alex Prins FACEM, Adam Morton FRACP Abstract This manuscript seeks to describe diagnostic considerations in individuals with diabetes mellitus presenting to the ED with abdominal pain. It highlights the importance of early investigation with computerised tomography to
- [PODCAST: Vasopressors after ROSC](https://emergencymed.org.il/podcast-vasopressors-after-rosc/קדם-בית-חולים/) - Jul 23, 2024 Contributor: Travis Barlock MD Educational Pearls: Recent study assessed outcomes after ROSC with epinephrine vs. norepinephrine Observational multicenter study from 2011-2018 285 patients received epineprhine and 481 received norepinephrine Epinephrine was associated with an increase in all-cause mortality (primary outcome) Odds ratio 2.6; 95%CI 1.4-4.7; P = 0.002 Higher cardiovascular mortality (secondary
- [The AI Future of Emergency Medicine](https://emergencymed.org.il/the-ai-future-of-emergency-medicine/articles-2/) - Robert J Petrella 1 Affiliations Expand PMID: 38795081 Abstract In the coming years, artificial intelligence (AI) and machine learning will likely give rise to profound changes in the field of emergency medicine, and medicine more broadly. This article discusses these anticipated changes in terms of 3 overlapping yet distinct stages of
- [Is High-Sensitivity Troponin Actually Helping Us?](https://emergencymed.org.il/is-high-sensitivity-troponin-actually-helping-us/articles-2/) - July 26, 2024 Written by Jason Lesnick This RCT of U.S. patients being evaluated for acute MI using a 0/1 hour hs-cTnI protocol, compared to standard care with a 0/3 hour hs-cTnI protocol, didn’t find a difference in the percentage of patients discharged from the ED nor in the rates of 30 day death or
- [PODCAST: PE & Pregnancy](https://emergencymed.org.il/podcast-pe-pregnancy/podcast/) - EM Board Bombs · 230. PE & Pregnancy PE workup? Sure. Oh by the way they're pregnant...yep. Let's discuss how this is workup needs to be simplified and not feared. Also, say goodbye to VQ scans. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its
- [Fluid accumulation syndrome in sepsis and septic shock: pathophysiology, relevance and treatment—a comprehensive review](https://emergencymed.org.il/fluid-accumulation-syndrome-in-sepsis-and-septic-shock-pathophysiology-relevance-and-treatment-a-comprehensive-review/articles-2/) - Carmen Andrea Pfortmueller1* , Wojciech Dabrowski2 , Rob Wise3,4,5, Niels van Regenmortel6,7 and Manu L. N. G. Malbrain2,8,9 Abstract In this review, we aimed to comprehensively summarize current literature on pathophysiology, relevance, diagnosis and treatment of fuid accumulation in patients with sepsis/septic shock. Fluid accumulation syndrome (FAS) is defned as fuid accumulation (any degree,
- [PODCAST:: JUST WHAT I NEEDED – PREOXYGENATION PRIOR TO INTUBATION](https://emergencymed.org.il/podcast-just-what-i-needed-preoxygenation-prior-to-intubation/podcast/) - Reference: Gibbs et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation (The PREOXI trial). NEJM June 2024. Date: July 17, 2024 Guest Skeptic: Dr. Aine Yore is an Emergency Physician, practicing in the Seattle, Washington area for over twenty years. She is the former president of the Washington chapter of ACEP and her career focus outside of clinical
- [PODCAST: Pediatric Meningitis Recognition, Workup and Management View Larger Image](https://emergencymed.org.il/podcast-pediatric-meningitis-recognition-workup-and-management-view-larger-image/ילדים/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” In this EM Cases main episode podcast with Dr. Shannon MacPhee and Dr. Jeanette Comeau we discuss the recognition, risk stratification, decision tools, indications for lumbar puncture in the febrile pediatric patient, tips and trick
- [PODCAST: June 2024 Annals of Emergency Medicine](https://emergencymed.org.il/podcast-june-2024-annals-of-emergency-medicine/podcast/) - Annals of Emergency Medicine · June 2024 In this month's episode of the Annals of Emergency Medicine podcast, Ryan and Rory discuss US-guided regional nerve blocks, outpatient pharmacies in pediatric EDs, Canadian emergency physician burnout, and much more.
- [PODCAST: FINDING PNEUMO…NIA IN FEBRILE INFANTS](https://emergencymed.org.il/podcast-finding-pneumonia-in-febrile-infants/ילדים/) - Reference: Florin TA, et al. Radiographic pneumonia in young febrile infants presenting to the emergency department: secondary analysis of a prospective cohort study. Emerg Med J. 2023 Date: May 29, 2024 Guest Skeptic: Dr. Christina Lindgren is a Pediatric Emergency Medicine Attending at Children’s National Hospital and Assistant Professor of Pediatrics and Emergency Medicine at the The George Washington
- [ACEP Critical Decisions in Emergency Medicine: Envenomation and Acute Vision Loss](https://emergencymed.org.il/acep-critical-decisions-in-emergency-medicine-envenomation-and-acute-vision-loss/education-tips/) - ACEP Critical Decisions in Emergency Medicine · January 2024: Envenomation and Acute Vision Loss In the January episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss the consequences of envenomation and acute vision loss. As always, you’ll hear about the hot topics covered in CDEM’s regular features, including persistent dysuria
- [Presence of Microscopic Hematuria Does Not Predict Clinically Important Intra-Abdominal Injury in Children](https://emergencymed.org.il/presence-of-microscopic-hematuria-does-not-predict-clinically-important-intra-abdominal-injury-in-children/articles-2/) - Stephanie C Papillon 1, Christopher P Pennell 1, Shannara E Bauer 2, Aubrey DiBello 2, Sahal A Master 1, Rajeev Prasad 3, L Grier Arthur, Harsh Grewal Affiliations expand PMID: 38849150 Abstract Objective: Screening for blunt intra-abdominal injury in children often includes directed laboratory evaluation that guides need for computed tomography. We sought to evaluate the use of urinalysis in identifying patients with clinically important intraabdominal
- [PODCAST: GRACE-4 | D-Dimer Only](https://emergencymed.org.il/podcast-grace-4-d-dimer-only/spoon-feed/) - The JournalFeed podcast for the week of July 8-12, 2024. 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.
- [Idiot’s Guide to Odds Ratios](https://emergencymed.org.il/idiots-guide-to-odds-ratios/articles-2/) - That’s right – I will be your guide. The good thing about having an idiot for a guide is that I have to make it simple to understand it myself, which means, hopefully, you will understand it as well. Probability or Odds Probability Probability means the risk of an event happening divided by the total
- [Anatomically vs Physiologically Difficult Airways](https://emergencymed.org.il/anatomically-vs-physiologically-difficult-airways/articles-2/) - July 19, 2024 Written by Samuel Rouleau An analysis of the NEAR database demonstrated a lower first-pass success rate of 89.2% for patients with anatomically difficult airways (ADA) compared to 93.7% in the control group. First-pass success for physiologic difficult airways (PDA) was 92.9% and fell to 87.4% for those with both ADA/PDA. Rain is
- [PODCAST:  Fall with Weakness Guillian Barre Syndrome](https://emergencymed.org.il/podcast-fall-with-weakness-guillian-barre-syndrome/podcast/) - Guillian Barre Syndrome : A progressive, autoimmune acute inflammatory demyelinating polyneuropathy leading to weakne... − Zack Olson, MD and Michael Estephan, MD • 19 hours ago Critical Actions: Treat the Patient’s Pain Perform a detailed neurologic exam (including reflexes) Perform LP Administer IVIG Check NIF or FVC and intubate prior to transfer
- [Missed Opportunities to Diagnose and Treat Asymptomatic Hypertension in Emergency Departments in the United States, 2016-2019](https://emergencymed.org.il/missed-opportunities-to-diagnose-and-treat-asymptomatic-hypertension-in-emergency-departments-in-the-united-states-2016-2019/articles-2/) - Adesuwa Akhetuamhen 1, Kristin Bibbins-Domingo 2, Jahan Fahimi 3, Valy Fontil 4, Robert Rodriguez 3, Ralph C Wang 3 Affiliations expand PMID: 38679548 DOI: 10.1016/j.jemermed.2024.01.006 Abstract Background: Fewer than one-half of U.S. adults with hypertension (HTN) have it controlled and one-third are unaware of their condition. The emergency department (ED) represents a setting to improve HTN control by increasing awareness of asymptomatic hypertension (aHTN) according to
- [ETA…When?? – How Accurate is EMS ETA Estimate?](https://emergencymed.org.il/etawhen-how-accurate-is-ems-eta-estimate/articles-2/) - July 5, 2024 Written by Vivian Lei Prehospital providers tend to underestimate the time to ED arrival for EMS ground transports. An underestimated ETA This was a prospective observational study on the accuracy of the pre-arrival ETA provided by EMS ground units bringing patients to the ED at WellSpan York Hospital in southern Pennsylvania, a
- [PODCAST: Approaching your EM Sub-Internship Clerkship](https://emergencymed.org.il/podcast-approaching-your-em-sub-internship-clerkship/education-tips/) - Dr. Sara Krzyzaniak (Host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Jessica Bod (Yale EM Clerkship Director) who gives thoughtful and thought-provoking insights into the EM sub-intern clerkship. What if you decide to pivot into EM relatively late in your medical school career? What should I be thinking about after the clerkship?
- [Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial](https://emergencymed.org.il/comparison-of-nebulized-ketamine-to-intravenous-subdissociative-dose-ketamine-for-treating-acute-painful-conditions-in-the-emergency-department-a-prospective-randomized-double-blind-double-dummy-c/articles-2/) - Tommy Nguyen 1, Mo Mai 1, Amulya Choudhary 1, Slavic Gitelman 1, Jefferson Drapkin 2, Antonios Likourezos 1, Sarah Kabariti 1, Rukhsana Hossain 1, Karina Kun 3, Ankit Gohel 3, Patrizia Niceforo 3, Michael Silver 1, Sergey Motov 1 Affiliations expand PMID: 38703175 DOI: 10.1016/j.annemergmed.2024.03.024 Abstract Study objective: We aimed to assess and compare the analgesic efficacy and adverse effects of intravenous subdissociative-dose ketamine to nebulized ketamine in emergency department (ED) patients with acute painful
- [How Often Does Central Line Placement Go Wrong?](https://emergencymed.org.il/how-often-does-central-line-placement-go-wrong/articles-2/) - June 26, 2024 Written by Jason Lesnick This systematic review and meta-analysis (SRMA) found that current rates of central venous catheter (CVC)-associated complications occurred in about 3% of line placements. Authors analyzed all associations about central lines This SRMA included 130 English-language observational studies and RCTs done from 7/2015-9/2023 in adult patients that reported complication
- [PODCAST: Food Allergy Management in the ED with Dr. William Weber](https://emergencymed.org.il/podcast-food-allergy-management-in-the-ed-with-dr-william-weber/podcast/) - ACEP Frontline · Food Allergy Management in the ED with Dr. William Weber In this episode, we talk with Dr. William Weber about the management of allergic reactions in the emergency department. There are often "cocktails" that many order, but the key is still early epinephrine. We chat about the approach, timing, and disposition. Resources/Links
- [PODCAST: The CDC Opioid Prescribing Guidelines 2024](https://emergencymed.org.il/podcast-the-cdc-opioid-prescribing-guidelines-2024/education-tips/) - ACEP Frontline · The CDC Opioid Prescribing Guidelines 2024 In this episode of The Frontline, we have a special episode with the CDC discussing the most recent rendition of the opioid prescribing guidelines which focus on SUD prevention, pain management, and medication safety. I am joined by Dr. Kate Vlasica and Dr. Debbie Dowell. www.nejm.org/doi/full/10.1056/NEJMp2211040
- [PODCAST: Snakes. Why'd it have to be snakes?](https://emergencymed.org.il/podcast-snakes-whyd-it-have-to-be-snakes/podcast/) - EM Board Bombs · 227. Snakes. Why'd it have to be snakes? Blake and Iltifat (mostly Blake) geek out over snake trivia, and we cover a classic boards case and management of snake bites. Australians need not listen as they deal with this everyday walking to school. Want to experience the greatest in board studying?
- [Implementation of an eFAST guideline and teaching to improve documentation practices and saving of ultrasound images](https://emergencymed.org.il/implementation-of-an-efast-guideline-and-teaching-to-improve-documentation-practices-and-saving-of-ultrasound-images/articles-2/) - Joseph Rossi MD, Anthony Van Assche MD First published: 19 May 2024 https://doi-org.bengurionu.idm.oclc.org/10.1111/1742-6723.14431 SECTIONS PDF Abstract Objectives To investigate whether implementation of a hospital-based Extended Focused Assessment with Sonography in Trauma (eFAST) guideline and teaching improved documentation and saving of images. Methods A retrospective cohort study was conducted on trauma patients aged ≥16 years presenting to St
- [Cost-effectiveness analysis of an ambulance service-operated specialised cardiac vehicle with mobile extracorporeal cardiopulmonary resuscitation capacity for out-of-hospital cardiac arrests in Queensland, Australia](https://emergencymed.org.il/cost-effectiveness-analysis-of-an-ambulance-service-operated-specialised-cardiac-vehicle-with-mobile-extracorporeal-cardiopulmonary-resuscitation-capacity-for-out-of-hospital-cardiac-arrests-in-queens/articles-2/) - Tan N Doan PhD, Stephen Rashford MBBS, FACEM, Emma Bosley PhD First published: 28 May 2024 https://doi-org.bengurionu.idm.oclc.org/10.1111/1742-6723.14447 SECTIONS PDF Abstract Objective Extracorporeal CPR (E-CPR) has been primarily limited to the in-hospital setting. A few systems around the world have implemented pre-hospital mobile E-CPR in the form of a dedicated cardiac vehicle fitted with specialised equipment and clinicians
- [Just a head knock? Emergency physicians need to get serious about concussion](https://emergencymed.org.il/just-a-head-knock-emergency-physicians-need-to-get-serious-about-concussion/articles-2/) - Alan J Pearce PhD, Peter Wirth MBBS, FACEM, Michelle Fitts PhD First published: 04 June 2024 https://doi-org.bengurionu.idm.oclc.org/10.1111/1742-6723.14452 SECTIONS PDF TOOLS SHARE Abstract Attention and awareness regarding concussion injury in Australia have significantly increased in the last decade. Although most of this increase is because of discussion regarding concussions from sporting endeavours, the majority of concussions are from
- [EM Quick Hits 57 – HIV Diagnosis, Failed Paradigm of STEMI Criteria, Poisoned Patient Airway Management, Spontaneous Bacterial Peritonitis, DIY Investments](https://emergencymed.org.il/em-quick-hits-57-hiv-diagnosis-failed-paradigm-of-stemi-criteria-poisoned-patient-airway-management-spontaneous-bacterial-peritonitis-diy-investments/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Topics in this EM Quick Hits podcast Megan Landes on the importance of diagnosing HIV in the ED (1:10) Jesse McLaren on the failed paradigm of STEMI criteria and ECG tips to identify acute coronary occlusion (22:33) Anand Swaminathan on
- [יעילות רוקח קליני בצוות הטראומה](https://emergencymed.org.il/יעילות-רוקח-קליני-בצוות-הטראומה/articles-2/) - Pharmacists in Trauma: a randomised controlled trial of emergency medicine pharmacists in trauma response teams http://orcid.org/0000-0002-6889-2338Cristina Roman1,2,3,4, Michael Dooley1,3, http://orcid.org/0000-0003-0183-7761Mark Fitzgerald5,6,7, De Villiers Smit2,4, Peter Cameron2,4, http://orcid.org/0000-0002-0508-2450Biswadev Mitra2,4 Correspondence to Dr Cristina Roman, Pharmacy Department, Alfred Health, Melbourne, VIC 3001, Australia; c.roman@alfred.org.au Abstract
- [Tranexamic Acid for Traumatic Injury in the Emergency Setting: A Systematic Review and Bias-Adjusted Meta-Analysis of Randomized Controlled Trials](https://emergencymed.org.il/tranexamic-acid-for-traumatic-injury-in-the-emergency-setting-a-systematic-review-and-bias-adjusted-meta-analysis-of-randomized-controlled-trials-2/articles-2/) - Pieter Francsois Fouche 1, Christopher Stein 2, Martin Nichols 3, Benjamin Meadley 4, Jason C Bendall 3, Karen Smith 5, David Anderson 6, Suhail A Doi 7 Affiliations expand PMID: 37999653 DOI: 10.1016/j.annemergmed.2023.10.004 Abstract Study objective: Traumatic injury causes a significant number of deaths due to bleeding. Tranexamic acid (TXA), an antifibrinolytic agent, can reduce bleeding in traumatic injuries and potentially enhance outcomes. Previous reviews suggested potential TXA benefits but did not consider the
- [POCUS for Pediatric Chest Tube – Is Fifth ICS Too Low?](https://emergencymed.org.il/pocus-for-pediatric-chest-tube-is-fifth-ics-too-low/articles-2/) - June 21, 2024 Written by Megan Hilbert Reliance on landmark guidance for chest tube placement may pose significant safety issues in pediatric patients. Scan that chest before you do the rest! Previous literature has demonstrated that landmark guided placement of chest tubes in the fifth intercostal space (ICS) may not always be safe in adults.
- [PODCAST: Febrile Seizures](https://emergencymed.org.il/podcast-febrile-seizures/ילדים/) - Febrile Seizures are among the most common neurological problema in young children, occurring in 1 out of 50 children between the ages of 6 months and 5 years of age. This episode of PEM Currents: The Pediatric Emergency Medicine Podcast is a Question and Answer style exploration of some of the most common learning points in this
- [PODCAST: Acute Agitation](https://emergencymed.org.il/podcast-acute-agitation/podcast/) - Show Notes Background/Epidemiology •Definition and Scope: Agitation encompasses behaviors from restlessness to severe altered mental states. It’s a common emergency department presentation, often linked with acute medical or psychiatric emergencies. •Significance: Patients with agitation are at high risk for morbidity and mortality, necessitating prompt and effective management to prevent harm to themselves and healthcare providers.
- [The Emergency Department Evaluation of the Adult Patient Who Presents with a First-Time Seizure](https://emergencymed.org.il/the-emergency-department-evaluation-of-the-adult-patient-who-presents-with-a-first-time-seizure/articles-2/) - Jagoda, Andy, MD ; Gupta, Kanika, MD Up to 5% of the population will experience at least 1 nonfebrile seizure at some point during their lifetime. The management of a patient who has had a first-time seizure is driven by the history and physical
- [Does Seatbelt Sign Need Neck CTA to Rule Out BCVI in Children?](https://emergencymed.org.il/does-seatbelt-sign-need-neck-cta-to-rule-out-bcvi-in-children/articles-2/) - June 12, 2024 Written by Carmen Wolfe In the setting of pediatric trauma, patients with a seatbelt sign are at greater risk of blunt cardiovascular injury if they have an injury severity score greater than 15, c-spine fracture, basilar skull fracture, or “other motorized” (i.e. ATV but not MVC) mechanism of injury. BCVI is a
- [PODCAST: Pregnant & Can't Breathe](https://emergencymed.org.il/podcast-pregnant-cant-breathe/podcast/) - EM Board Bombs · 226. Pregnant & Can't Breathe Do we have your attention now? Thought so. And no, before you even ask, you cannot go on diversion. Let’s walk through an odd oral boards case with a twist as we tell you important aspects of the ABEM oral boards exam. Want to experience the
- [Re-DOSE VF… DSED for Shock-Refractory VF?](https://emergencymed.org.il/re-dose-vf-dsed-for-shock-refractory-vf/articles-2/) - June 17, 2024 Written by Amanda Mathews This secondary analysis of the DOSE VF trial found that DSED (dual sequence external defibrillation) was the superior strategy for obtaining ROSC and functional neurologic outcome regardless of whether the patient was in recurrent VF or shock-refractory VF after three standard defibrillation shocks. Time for a re-DOSE The
- [PODCAST: Sympathomimetic Drugs](https://emergencymed.org.il/podcast-sympathomimetic-drugs/podcast/) - Contributor: Taylor Lynch MD Educational Pearls: Overview: Sympathomimetic drugs mimic the fight or flight response, affecting monoamines such as dopamine, norepinephrine, and epinephrine Limited therapeutic use, often abused. Types: Amphetamines: Methamphetamine, Adderall, Ritalin, Vyvanse MDMA (Ecstasy) Cocaine (Both hydrochloride salt & free based crack cocaine) Theophylline (Asthma treatment) Ephedrine (For low blood pressure) BZP, Oxymetazoline
- [PODCAST: Orbital Compartment Syndrome](https://emergencymed.org.il/podcast-orbital-compartment-syndrome/podcast/) - Orbital Compartment Syndrome – needs to be diagnosed CLINICALLY On exam, LOOK for: Proptosis, Ophthalmoplegia, Afferent Pupillary Defect, Vision Loss On exam, FEEL for: Rock hard globe, tense eyelids, resistance to retropulsion IOP > 40 means immediate canthotomy is indicated! Don’t perform if open globe is present Lateral Canthotomy Procedure: Anesthetize, Devascularize, Canthotomy, Cantholysis (inferior crus first)
- [Case study: An unusual and fatal injury: stab wound of a bovine aortic arch anomaly](https://emergencymed.org.il/case-study-an-unusual-and-fatal-injury-stab-wound-of-a-bovine-aortic-arch-anomaly/articles-2/) - Abstract Penetrating trauma of the aortic arch is relatively uncommon, even at busy trauma centers. Such an injury is challenging, especially in a “crashing” patient in whom emergency surgery is undertaken. When this scenario is coupled with an aortic arch abnormality, it may be infinitely more difficult to deal
- [PODCAST: Wide-Complex Tachycardia](https://emergencymed.org.il/podcast-wide-complex-tachycardia/podcast/) - Contributor: Travis Barlock MD Educational Pearls: Wide-complex tachycardia is defined as a heart rate > 100 BPM with a QRS width > 120 milliseconds Wide-complex tachycardia of supraventricular origin is known as SVT with aberrancy Aberrancy is due to bundle branch blocks Mostly benign Treated with adenosine or diltiazem Wide-complex tachycardia of ventricular origin is
- [Circulation:  2022 International Consensus on Cardiopulmonary  Resuscitation and Emergency Cardiovascular  Care Science With Treatment Recommendations:  Summary From the Basic Life Support; Advanced  Life Support; Pediatric Life Support; Neonatal Life  Support; Education, Implementation, and Teams;  and First Aid Task Forces](https://emergencymed.org.il/circulation-2022-international-consensus-on-cardiopulmonary-resuscitation-and-emergency-cardiovascular-care-science-with-treatment-recommendations-summary-from-the-basic-life-support-advanced/articles-2/) - ABSTRACT: This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation
- [VIDEO: Clear Cervical Spine Injuries](https://emergencymed.org.il/clear-cervical-spine-injuries/articles-2/) - Cervical Spine Injuries are fortunately rare in children. this episode is all about learning when to suspect them, how to immobilize the C-spine properly, and which imaging test to choose. It was inspired by a hot-off-the-presses publication from the Pediatric Emergency Care Applied Research Network (PECARN) focused on clinical decision rules for cervical spine imaging
- [PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study](https://emergencymed.org.il/pecarn-prediction-rule-for-cervical-spine-imaging-of-children-presenting-to-the-emergency-department-with-blunt-trauma-a-multicentre-prospective-observational-study/articles-2/) - James F Holmes, Kenneth Yen, Irma T Ugalde, Paul Ishimine, Pradip P Chaudhari, Nisa Atigapramoj, Mohamed Badawy, Kevan A McCarten-Gibbs, Donovan Nielsen, Allyson C Sage, Grant Tatro, Jeffrey S Upperman, P David Adelson, Daniel J Tancredi, Nathan Kuppermann Summary Background Cervical spine injuries in children are uncommon but potentially
- [PODCAST: Pediatric Emergency Medicine Update with Dr. Sorrentino](https://emergencymed.org.il/podcast-pediatric-emergency-medicine-update-with-dr-sorrentino/education-tips/) - ACEP Frontline · Pediatric Emergency Medicine Update with Dr. Sorrentino - ECC24 In this bonus episode, we get a pediatric emergency medicine evidence update with Dr. Annalise Sorrentino from Emerald Coast Conference 2024 in Sandestin, FL.
- [PODCAST:  RCEM Learning June 2024](https://emergencymed.org.il/podcast-rcem-learning-june-2024/podcast/) - June 20240 Jun 7, 2024 Happy June! This month for the June 2024 episode of the RCEM Learning Podcast, Rob and Liz talk us through a New in EM section on nailbed repair in paediatric finger bed injury. We have the first in a two-parter on Sickle Cell Disease in our Guidelines for EM section
- [From the Doorway – How Accurate Is Physician Gestalt in Sepsis?](https://emergencymed.org.il/from-the-doorway-how-accurate-is-physician-gestalt-in-sepsis/articles-2/) - June 6, 2024 Written by Shannon Markus Physician gestalt significantly outperformed existing sepsis screening tools (SIRS, qSOFA, SOFA, and MEWS) in identifying sepsis early in critically ill, undifferentiated patients’ ED courses. Not gonna be replaced by AI anytime soon… The authors evaluated how physician gestalt compared to existing screening tools for the suspicion of sepsis.
- [How Dangerous Are Pauses In Pediatric Chest Compressions?](https://emergencymed.org.il/how-dangerous-are-pauses-in-pediatric-chest-compressions/articles-2/) - June 4, 2024 Written by Michael Stocker Data supporting pediatric cardiac arrest guidelines are limited. This study found increases in the longest pause in chest compressions (CC) during pediatric in-hospital cardiac arrest (pIHCA) were inversely associated with survival and ROSC. When kids arrest, stay on the chest This 27-hospital observational study sought to characterize the
- [PODCAST: Management of Subarachnoid Hemorrhage](https://emergencymed.org.il/podcast-management-of-subarachnoid-hemorrhage/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details
- [Fixed-Dose Ketamine 250mg IM for Prehospital Agitation](https://emergencymed.org.il/fixed-dose-ketamine-250mg-im-for-prehospital-agitation/articles-2/) - Written by Samuel Rouleau A retrospective study of 60 patients who received a fixed-dose ketamine of 250 mg by EMS observed that 6 were intubated in the ED. There was no association between weight-based dose of ketamine and risk for intubation. Agitation? Jump into the K-Hole! This was a single center, multi-EMS agency retrospective study
- [Early Versus Late Advanced Airway Management for Pediatric Patients With Out-of-Hospital Cardiac Arrest](https://emergencymed.org.il/early-versus-late-advanced-airway-management-for-pediatric-patients-with-out-of-hospital-cardiac-arrest/קדם-בית-חולים/) - ABSTRACT Study objective To determine the association between early versus late advanced airway management and improved outcomes in pediatric out-of-hospital cardiac arrest. Methods We performed a retrospective cohort study using data from the out-of-hospital cardiac arrest registry in Japan. We included pediatric patients (
- [Timing of Airway Management in OHCA – Does It Matter?](https://emergencymed.org.il/timing-of-airway-management-in-ohca-does-it-matter/articles-2/) - May 30, 2024 Written by Aaron Lacy In a large retrospective review of patients with out-of-hospital-cardiac-arrest (OHCA) there was a very small, and probably clinically insignificant, association with favorable neurological outcome and survival in those who underwent early as opposed to late advanced airway management. ABC, BAC, CBA? When to do the airway? This study found
- [Timing of Airway Management in OHCA – Does It Matter?](https://emergencymed.org.il/timing-of-airway-management-in-ohca-does-it-matter/articles-2/) - May 30, 2024 Written by Aaron Lacy In a large retrospective review of patients with out-of-hospital-cardiac-arrest (OHCA) there was a very small, and probably clinically insignificant, association with favorable neurological outcome and survival in those who underwent early as opposed to late advanced airway management. ABC, BAC, CBA? When to do the airway? This study found
- [PODCAST:  Malignant Otitis Externa: garlic oil and Reddit](https://emergencymed.org.il/podcast-malignant-otitis-externa-garlic-oil-and-reddit/podcast/) - EM Board Bombs · 224. Malignant Otitis Externa: garlic oil and Reddit This podcast is earresistible. Let's chat about this classic, nasty HEENT infection. There are only 3 major key points you need to know for this one so let's crush it. Want to experience the greatest in board studying? Check out our interactive question
- [PECARN prediction rules for CT imaging of children presenting to the emergency department with blunt abdominal or minor head trauma: a multicentre prospective validation study](https://emergencymed.org.il/pecarn-prediction-rules-for-ct-imaging-of-children-presenting-to-the-emergency-department-with-blunt-abdominal-or-minor-head-trauma-a-multicentre-prospective-validation-study/articles-2/) - James F Holmes 1, Kenneth Yen 2, Irma T Ugalde 3, Paul Ishimine 4, Pradip P Chaudhari 5, Nisa Atigapramoj 6, Mohamed Badawy 2, Kevan A McCarten-Gibbs 6, Donovan Nielsen 7, Allyson C Sage 7, Grant Tatro 8, Jeffrey S Upperman 9, P David Adelson 10, Daniel J Tancredi 11, Nathan Kuppermann 12 Affiliations expand PMID: 38609287 DOI: 10.1016/S2352-4642(24)00029-4 Abstract Background: The intra-abdominal injury and traumatic brain injury prediction rules derived by the Pediatric Emergency Care Applied Research Network (PECARN) were designed
- [Think Outside the Zone – How to Manage Penetrating Neck Injuries](https://emergencymed.org.il/think-outside-the-zone-how-to-manage-penetrating-neck-injuries/articles-2/) - May 20, 2024 Written by Ketan Patel This review article illustrates the evidence-based “no-zone” approach in managing penetrating neck injuries, with a reliance on clinical symptoms as well as multidetector computed tomographic angiography (MDCTA) to mitigate unnecessary invasive tests and negative explorations. Beyond the zone While selective operative management (versus mandatory exploration) of neck injuries
- [What’s the Best Target in the Neck for US Guided Central Access](https://emergencymed.org.il/whats-the-best-target-in-the-neck-for-us-guided-central-access/articles-2/) - May 22, 2024 Written by Chris Thom This was a network meta-analysis of 13 randomized controlled trials comparing 5 different central venous catheterization (CVC) approaches. The supraclavicular subclavian (SupraSCV) demonstrated superior first-attempt success, while artery puncture was similar for all five locations. Aim for the supraclavicular pocket This network meta-analysis included 13 RCTs encompassing 4,418
- [PODCAST: Ischemic Stroke](https://emergencymed.org.il/podcast-ischemic-stroke/podcast/) - MAY 16, 2024 / MIKE ESTEPHAN Symptoms of stroke – weakness, facial droop, slurred speech. vision loss, vertigo, ataxia, confusion or changes to mental status. The “typical” stroke workup – blood glucose level, CTH non-con, CTA head/neck, CT Perfusion, CBC BMP Troponin EKG CXR and Coags. Common stroke mimics – hypoglycemia, drug/alcohol intoxication, Bell’s palsy, aortic dissection, complex migraines, and
- [PODCAST: Underdosing in Status Epilepticus](https://emergencymed.org.il/podcast-underdosing-in-status-epilepticus/ילדים/) - Apr 29, 2024 Contributor: Aaron Lessen MD Educational Pearls: Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus Some ED protocols only give 2 mg initially The maximum recommended dose of levetiracetam (Keppra) is 60 mg/kg or 4.5 g In one retrospective study, only 50% of patients
- [EM Quick Hits 56 – Nitroglycerin in SCAPE, REBOA, Diverticulitis Imaging, CRAO, Penicillin Allergy, Physician Personality](https://emergencymed.org.il/em-quick-hits-56-nitroglycerin-in-scape-reboa-diverticulitis-imaging-crao-penicillin-allergy-physician-personality/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Topics in this EM Quick Hits podcast Justin Morgenstern on the use of high dose nitroglycerin in SCAPE (1:08) Andrew Neill and Leah Flanagan on Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) indications and evidence (8:33) Brit Long on
- [PODCAST: SPEED, GIVE ME WHAT I NEED – TO DIAGNOSE ACUTE AORTIC DISSECTIONS](https://emergencymed.org.il/podcast-speed-give-me-what-i-need-to-diagnose-acute-aortic-dissections/podcast/) - Reference: Gibbons et al. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. AEM February 2024. Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Department at Nassau University Medical Center in
- [PODCAST: BREATHE – SIMPLE ASPIRATION VS. DRAINAGE FOR COMPLETE PNEUMOTHORAXBREATHE – SIMPLE ASPIRATION VS. DRAINAGE FOR COMPLETE PNEUMOTHORAX](https://emergencymed.org.il/podcast-breathe-simple-aspiration-vs-drainage-for-complete-pneumothoraxbreathe-simple-aspiration-vs-drainage-for-complete-pneumothorax/trauma/) - Reference: Marx et al. Simple Aspiration versus Drainage for Complete Pneumothorax: A Randomized Noninferiority Trial. Am J Respir Crit Care Med. 2023 Date: March 22, 2024 Guest Skeptic: Dr. Richard Malthaner holds the prestigious position of Chair/Head of the Division of Thoracic Surgery and serves as the Director of the Thoracic Robotic Program at Western University’s Schulich School
- [PODCAST: DON’T BE FOOLED BY THE MEDS I GOT, I STILL NEED AN ESP BLOCK – FOR MY RIB FRACTURES](https://emergencymed.org.il/podcast-dont-be-fooled-by-the-meds-i-got-i-still-need-an-esp-block-for-my-rib-fractures/trauma/) - Reference: Ramesh S, Ayyan SM, Rath DP, Sadanandan DM. Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. AEM April 2024 Date: April 19, 2024 Guest Skeptic: Dr. Suchismita Datta. She is an Assistant Professor and Director of Research in
- [Case Presentation PODCAST: Stroke Symptoms](https://emergencymed.org.il/case-presentation-podcast-stroke-symptoms/קדם-בית-חולים/) - You are working at Clerkship General when one of the nurses comes and grabs you. “Hey doc, we need you in bed 10. I think this patient is having a stroke.” Initial Vitals: HR: 51 BP: 201/98 Temp: 98.0F RR: 18 O2: 99% (Room Air) Critical Actions: Check a Blood Glucose Activate a Stroke Alert
- [PODCAST: Ketamine in the ED - An Interview with Reuben Strayer, MD](https://emergencymed.org.il/podcast-ketamine-in-the-ed-an-interview-with-reuben-strayer-md/education-tips/) - In this episode, Sam Ashoo, MD and T.R. Eckler, MD interview Reuben J. Strayer, MD, author of the May 2024 Emergency Medicine Practice article, Current Concepts in Ketamine Therapy in the Emergency Department Diving Into Ketamine Use in Emergency Medicine Understanding Ketamine: From Origins to Emergency Use Exploring the Ketamine Brain Continuum Ketamine Dosing and Administration Techniques Combining Ketamine
- [“Healthy” Machine Learning Models Could Reduce Bias](https://emergencymed.org.il/healthy-machine-learning-models-could-reduce-bias/articles-2/) - May 2, 2024 Written by Doug Wallace This medical news article interview highlights the risk of biased data leading to inherently biased medical AI models. The ethics of machine learning in general and approaches to minimize bias are also touched on. Biased Input = Biased Output In an interview discussing the ethics of AI use
- [Emergent Cath Lab Activations with “Normal” Computer ECG Interpretations](https://emergencymed.org.il/emergent-cath-lab-activations-with-normal-computer-ecg-interpretations/articles-2/) - May 3, 2024 Written by Clark Strunk A significant minority of code STEMI patients have an initial normal computer ECG interpretation. Consequently, emergency physicians must remain vigilant to identify signs of OMI regardless of the initial computer ECG interpretation. When the computer says the ECG is not bad, the patient could still need the cath
- [PODCAST: US Guided Nerve Blocks in the ED with Dr. Chase Palisch - TNCEP24](https://emergencymed.org.il/podcast-us-guided-nerve-blocks-in-the-ed-with-dr-chase-palisch-tncep24/pocus/) - ACEP Frontline · US Guided Nerve Blocks in the ED with Dr. Chase Palisch - TNCEP24 In this segment, we dive into some of the key ultrasound guided regional blocks for pain management in the emergency department. We join Dr. Chase Palisch from Vanderbilt University at TNCEP24 in Chattanooga.
- [Time-Dependent Benefit of IV Thrombolysis Before Thrombectomy](https://emergencymed.org.il/time-dependent-benefit-of-iv-thrombolysis-before-thrombectomy/articles-2/) - April 23, 2024 Written by Laura Murphy In patients with anterior circulation large-vessel occlusion (LVO) stroke presenting to thrombectomy capable stroke centers, the benefit of intravascular thrombolysis in the setting of endovascular thrombectomy appears to be time-dependent. The earlier, the better… This study included a total of 2,313 patients with anterior circulation large vessel occlusion
- [Continued Controversy Between Contrast and Kidneys](https://emergencymed.org.il/continued-controversy-between-contrast-and-kidneys/articles-2/) - April 26, 2024 Written by Caitlin Nicholson In patients with ACS and concern for STEMI/NSTEMI requiring urgent intervention, randomization to the contrast volume reduction (CVR) group reduced the rate of acute kidney injury (AKI) and sustained kidney damage. Continued controversy between contrast and kidneys… The REMEDIAL IV trial (REnal Insufficiency Following Contrast MEDIA Administration Trial
- [Pediatric EMS VS Ranges to Predict Life-Saving Intervention](https://emergencymed.org.il/pediatric-ems-vs-ranges-to-predict-life-saving-intervention/articles-2/) - April 16, 2024 Written by Michael Stocker Kids frequently present with abnormal vital signs but seldom require prehospital life-saving interventions (LSI). Based on the occurrence of LSI, age-group vital sign ranges were adjusted to better identify critically ill kids. Abnormal respiratory status (RR, SpO2) was strongly associated with prehospital LSI. The kids aren’t alright This
- [PODCAST: Testicular Torsion](https://emergencymed.org.il/podcast-testicular-torsion/ילדים/) - Common during the first year of life as well as during puberty Presents with nausea/vomiting, abdominal pain, and/or testicular pain ALWAYS examine a child for signs of torsion who presents with abdominal pain (especially lower abdominal pain) Look for tenderness, firmness, high riding testicle or testicle with unequal lie, swelling, and the absence of a
- [PODCAST: Takotsubo Cardiomyopathy](https://emergencymed.org.il/podcast-takotsubo-cardiomyopathy/podcast/) - Apr 10, 2024 Contributor: Ricky Dhaliwal, MD Educational Pearls: Takotsubo cardiomyopathy, also known as "broken heart syndrome,” is a temporary heart condition that can mimic the symptoms of a heart attack, including troponin elevations and mimic STEMI on ECG. The exact cause is not fully understood, but it is often triggered by severe emotional or
- [JAMA: Physician Coaching by Professionally Trained Peers for Burnout and Well-Being A Randomized Clinical Trial](https://emergencymed.org.il/jama-physician-coaching-by-professionally-trained-peers-for-burnout-and-well-being-a-randomized-clinical-trial/articles-2/) - Stephanie B. Kiser, MD, MPH1; J. David Sterns, MD, MPH2; Po Ying Lai, MS3; et alNora K. Horick, MS3; Kerri Palamara, MD4 Author Affiliations Article Information JAMA Netw Open. 2024;7(4):e245645. doi:10.1001/jamanetworkopen.2024.5645 Key Points Question Does coaching by professionally trained physician peers reduce burnout and improve well-being, workplace satisfaction, and engagement for physicians? Findings In this randomized clinical trial of 138 physicians, participants who received 3
- [EMS Vital Signs as Mortality Predictors](https://emergencymed.org.il/ems-vital-signs-as-mortality-predictors/articles-2/) - April 15, 2024 Written by Amanda Mathews Low and high extremes of prehospital vital signs were associated with higher rates of hospitalization and in-hospital mortality; however, there was not statistically significant improvement in their model when using age adjusted vital signs. What were those vitals again? Researchers used a national database of EMS encounters within
- [Clinical Policy: Critical Issues in the Evaluation and Management of Adult Out-of-Hospital or Emergency Department Patients Presenting With Severe Agitation: Approved by the ACEP Board of Directors, October 6, 2023](https://emergencymed.org.il/clinical-policy-critical-issues-in-the-evaluation-and-management-of-adult-out-of-hospital-or-emergency-department-patients-presenting-with-severe-agitation-approved-by-the-acep-board-of-directors-o/articles-2/) - April 12, 2024 Written by Laura Murphy This systematic review was conducted to answer the clinical question: Is there a superior parenteral medication or combination of medications for acute management of adult out-of-hospital or emergency department patients with severe agitation? These recommendations do not apply to pediatric, elderly (>65 years), pregnant, or out-of-hospital patients. For these groups,
- [Should We Use New Duke Criteria for Infective Endocarditis?](https://emergencymed.org.il/should-we-use-new-duke-criteria-for-infective-endocarditis/articles-2/) - April 10, 2024 Written by Jason Lesnick This external validation compared the 2023 Duke-International Society for Cardiovascular Infectious Diseases Diagnostic (ISCVID) Criteria against various other criteria for diagnosing infective endocarditis (IE) and found the 2023 Duke-ISCVID Criteria had the best test characteristics. Tomorrow, we’ll dive into the new criteria. The 2023 Duke-International Society for Cardiovascular Infectious
- [PODCAST:  The Crashing Asthmatic – Recognition and Management of Life Threatening Asthma](https://emergencymed.org.il/11071/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” In part 1 of this 2-part podcast series on asthma with Dr. Leeor Sommer and Dr. Sameer Mal we covered asthma mimics, risk stratification, ED treatment and who is safe to go home. We drove home that there are many important
- [PODCAST:  RCEM Learning APRIL  2024](https://emergencymed.org.il/podcast-rcem-learning-april-2024/education-tips/) - Apr 4, 2024 Happy April! This month for the April 2024 episode of the RCEM Learning Podcast Rob and Liz have got two New in EM segments with Andy and Dave looking at ondansetron in ketamine sedation and the use of antibotics in brain injury. We have a Guidelines for EM looking at the management
- [The Top Cardiac Arrest RCTs of 2023](https://emergencymed.org.il/the-top-cardiac-arrest-rcts-of-2023/articles-2/) - April 3, 2024 Written by Ketan Patel and Charles Worth This review article discusses four randomized clinical trials (RCT) focusing on interventions for out-of-hospital-cardiac-arrest (OHCA) that were published in 2023, all of which showed negligible impact on survival for the interventions studied. Minimal gains in OHCA care (and tortured acronyms) INCEPTION Trial – Early Initiation
- [New AHA Statement on Cardiac Cath Lab Activation After OHCA](https://emergencymed.org.il/new-aha-statement-on-cardiac-cath-lab-activation-after-ohca/articles-2/) - April 8, 2024 Written by Laura Murphy The goal of invasive management in the cardiac catheterization laboratory (CCL) is to identify and treat culprit coronary lesion or additional resuscitative measures (such as mechanical circulatory support (MCS) or interventions for massive pulmonary embolism). This is a scientific statement from the American Heart Association (AHA) which provides
- [New Meta-analysis – Should We Do Bougie-First Intubations?](https://emergencymed.org.il/new-meta-analysis-should-we-do-bougie-first-intubations/articles-2/) - April 5, 2024 Written by Alex Clark In this systematic review and meta-analysis to evaluate the use of a bougie versus non-bougie approach (ie. stylet) in intubations of adult patients, a bougie-first approach significantly increased the rate of first-attempt success compared to controls. But what does this say about your intubation strategy? Allow me to introduce…the bougie!
- [Dogma Bust – Paperclips in Penetrating Trauma](https://emergencymed.org.il/dogma-bust-paperclips-in-penetrating-trauma/articles-2/) - April 1, 2024 Written by Clark Strunk The use of radiopaque markers (ROM) in penetrating trauma is based on expert opinion and historical clinical practice; however, there is no high-quality evidence to support their routine use in clinical practice. Quick! Grab the paperclips! This article provides commentary on the use of ROM in penetrating trauma.
- [Spiced RCT: Success and Pain Associated with Intravenous Cannulation in the Emergency Department Randomized Controlled Trial](https://emergencymed.org.il/spiced-rct-success-and-pain-associated-with-intravenous-cannulation-in-the-emergency-department-randomized-controlled-trial/articles-2/) - Tatum Priyambada Mitra 1, Sarah Coulter-Nile 2, Thuvarahan Jegathees 3, Jason Luong 4, Amith Shetty 5, Kevin Lai 6 Free article Abstract Background: Peripheral venous cannulation is one of the most common procedures in medicine. A larger cannula allows higher rates of fluid to be provided if needed in a deteriorating patient; however, it is also perceived that larger-gauge cannula placement
- [PODCAST: Adrenal Crisis](https://emergencymed.org.il/podcast-adrenal-crisis/education-tips/) - Apr 1, 2024 Contributor: Ricky Dhaliwal MD Educational Pearls: Primary adrenal insufficiency (most common risk factor for adrenal crises) An autoimmune condition commonly known as Addison's Disease Defects in the cells of the adrenal glomerulosa and fasciculata result in deficient glucocorticoids and mineralocorticoids Mineralocorticoid deficiency leads to hyponatremia and hypovolemia Lack of aldosterone downregulates Endothelial
- [PODCAST: The Pearls And Pitfalls of Non-Invasive Ventilation with Dr. Steven Haywood - TNCEP24](https://emergencymed.org.il/podcast-the-pearls-and-pitfalls-of-non-invasive-ventilation-with-dr-steven-haywood-tncep24/icu/) - ACEP Frontline · The Pearls And Pitfalls of Non-Invasive Ventilation with Dr. Steven Haywood - TNCEP24 We join Dr. Steven Haywood from TNCEP24 in Chattanooga with a discussion on non-invasive ventilations with the pearls andd pitfalls of airway management. intubationairwayrespiratorysgahfncbipapcpapemergency medicinehealthcaredoctorphysiciantennesseeacepTNCEP
- [Treatment Options for Cough and URI in Children](https://emergencymed.org.il/treatment-options-for-cough-and-uri-in-children/articles-2/) - March 26, 2024 Written by Vivian Lei Clinicians have an important role in advising families on the appropriate evidence-based treatments for upper respiratory tract infections (URTIs) in children. “So what can I do for my kid’s cold?” This BMJ Practice Pointer article summarizes the existing evidence (or lack thereof) for cough and common cold therapies
- [Performance of the 0/2-hour high-sensitivity cardiac troponin T diagnostic protocol in a multisite United States cohort](https://emergencymed.org.il/performance-of-the-0-2-hour-high-sensitivity-cardiac-troponin-t-diagnostic-protocol-in-a-multisite-united-states-cohort/articles-2/) - Academic Emergency Medicine ORIGINAL ARTICLE Open Access Michael W. Supples MD, MPH, Anna C. Snavely PhD, Nicklaus P. Ashburn MD, MS, Brandon R. Allen MD, Robert H. Christenson MD, Richard Nowak MD Abstract Background The diagnostic performance of the high-sensitivity troponin T (hs-cTnT)
- [EMA: Review article: Pre-hospital trauma guidelines and access to lifesaving interventions in Australia and Aotearoa/New Zealand](https://emergencymed.org.il/ema-review-article-pre-hospital-trauma-guidelines-and-access-to-lifesaving-interventions-in-australia-and-aotearoa-new-zealand/articles-2/) - Emergency Medicine Australasia Review Article Open Access Tim Andrews MSPP, Ben Meadley PhD, Belinda Gabbe PhD, Ben Beck PhD, Bridget Dicker PhD, Peter Cameron MBBS, MD Abstract The centralisation of trauma services in western countries has led to an improvement in patient outcomes. Effective trauma systems include a pre-hospital trauma system. Delivery
- [Podcast : Cancer-Related Emergencies](https://emergencymed.org.il/podcast-cancer-related-emergencies/education-tips/) - Mar 25, 2024 Contributor: Travis Barlock, MD Educational Pearls: Cancer-related emergencies can be sorted into a few buckets: Infection Cancer itself and the treatments (chemotherapy/radiation) can be immunosuppressive. Look out for conditions such as sepsis and neutropenic fever. Obstruction Cancer causes a hypercoagulable state. Look out for blood clots which can cause emergencies such as
- [PODCAST: Indications for Exogenous Albumin](https://emergencymed.org.il/podcast-indications-for-exogenous-albumin/podcast/) - Mar 18, 2024 Contributor: Travis Barlock MD Educational Pearls: There are three indications for IV albumin in the ED Spontaneous bacterial peritonitis (SBP) Patients with SBP develop renal failure from volume depletion Albumin repletes volume stores and reduces renal impairment Albumin binds inflammatory cytokines and expands plasma volume Reduced all-cause mortality if IV albumin is
- [Everything You Need to Know About Managing High-Risk PE…Mostly](https://emergencymed.org.il/everything-you-need-to-know-about-managing-high-risk-pemostly/articles-2/) - March 18, 2024 Before we jump into PE, I had a pediatric airway foreign body case recently. No more bilateral decubitus x-rays. It’s high-res, low-dose CT. Know where I learned this? JournalFeed Top Picks! I have learned some game-changing things from Dr. Mattu, and special thanks to Dr. Stephanos with her PEM lit pearls. These videos have
- [Implementing digital emergency medicine: a call to action](https://emergencymed.org.il/implementing-digital-emergency-medicine-a-call-to-action/articles-2/) - Kiran L Grant 1, Jackie Tsang 2, Kendall Ho 3 4 Affiliations expand PMID: 38001328 DOI: 10.1007/s43678-023-00620-0 Abstract As digital technologies continue to impact medicine, emergency medicine providers have an opportunity to work together to harness these technologies and shape their implementation within our healthcare system. COVID-19 and the rapid scaling of virtual care provide an example of how profoundly
- [ADHD Pharmacotherapy and Mortality in Individuals With ADHD](https://emergencymed.org.il/adhd-pharmacotherapy-and-mortality-in-individuals-with-adhd/articles-2/) - Lin Li, PhD1; Nanbo Zhu, MSc1; Le Zhang, PhD1; et al Key Points Question Is initiation of attention-deficit/hyperactivity disorder (ADHD) medication associated with a reduced mortality risk in individuals with ADHD? Findings In this observational, target trial emulation analysis that included 148 578 individuals diagnosed with ADHD in Sweden, initial dispensation of ADHD medication was significantly
- [PODCAST: Rapid Supportive Debriefs](https://emergencymed.org.il/podcast-rapid-supportive-debriefs/education-tips/) - A Tool for Embodying Wellness-Centered Leadership After Stressful Events Dr Greg Wallingford, associate program director for the Hospice and Palliative Medicine Fellowship and course director for the Leadership Curriculum at Dell Medical School at the University of Texas, Austin, shares how his team developed a rapid debriefing tool to support teams after stressful events. He
- [Diagnosis and Management of Aortic Diseases](https://emergencymed.org.il/diagnosis-and-management-of-aortic-diseases/articles-2/) - Marie M.Altenburg, MD;AndrewM.Davis,MD,MPH;JeanneM.DeCara,MD Guideline title 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease Release date December 13, 2022 Developer American College of Cardiology (ACC) and American Heart Association (AHA) Funding source ACC and AHA Target population Adults
- [New Meta-analysis – ECPR vs CPR in Cardiac Arrest](https://emergencymed.org.il/new-meta-analysis-ecpr-vs-cpr-in-cardiac-arrest/articles-2/) - March 14, 2024 Written by Clark Strunk This updated meta-analysis re-demonstrated a benefit for extracorporeal cardiopulmonary resuscitation (ECPR) in reducing overall in-hospital cardiac arrest (IHCA) mortality and improving neurological outcomes after cardiac arrest but also demonstrated a new significant reduction in out of hospital cardiac arrest (OHCA) mortality with ECPR. It’s a go, for ECMO!
- [PODCAST: Grand Rounds - Dr. Rebecca Leff - Fit for Purpose: Emergency Medicine Physicians and Humanitarian Response in Complex Emergencies](https://emergencymed.org.il/podcast-grand-rounds-dr-rebecca-leff-fit-for-purpose-emergency-medicine-physicians-and-humanitarian-response-in-complex-emergencies/education-tips/) - Dr. Leff shares, in her senior resident capstone presentation, a primer on humanitarian efforts, what are basic principles of aid, how to identify the key health needs of populations affected by crises and how EM clinicians can respond to those needs with the greatest impact. She will discuss how to engage responsibly and to anticipate
- [Ketamine for the Win? Induction Agents Compared](https://emergencymed.org.il/ketamine-for-the-win-induction-agents-compared/articles-2/) - March 15, 2024 Written by Charles Worth and Ketan Patel A Bayesian meta-analysis found an 83.2% probability that ketamine lowers mortality compared to etomidate in critically ill patients undergoing intubation. Maybe she’s born with it…maybe it’s ketamine. Current practice guidelines for RSI agents include propofol, etomidate and ketamine. This analysis aimed to identify whether there
- [PODCAST:  Tourniquets](https://emergencymed.org.il/podcast-tourniquets/trauma/) - Feb 27, 2024 Contributor: Ricky Dhaliwal, MD Educational Pearls: What can you do to control bleeding in a penetrating wound? Apply direct pinpoint pressure on the wound as well as proximal to the wound. Build a compression dressing. How do you build a compression dressing? Think about building an upside-down pyramid with the gauze. Consider
- [Lung ultrasound integrated with clinical assessment for the diagnosis of acute decompensated heart failure in the emergency department: a randomized controlled trial](https://emergencymed.org.il/10985/articles-2/) - Pivetta E1,2, Goffi A3,4,5, Nazerian P6, Castagno D7, Tozzetti C8, Tizzani P2,9, Tizzani M2, Porrino G2, Ferreri E2, Busso V2, Morello F2, Paglieri C2, Masoero M10, Cassine E11, Bovaro F10, Grifoni S6, Maule MM1, Lupia E2,12; Study Group on Lung Ultrasound from the Molinette and Careggi Hospitals Abstract
- [PODCAST: DKA and HHS](https://emergencymed.org.il/podcast-dka-and-hhs/education-tips/) - Mar 11, 2024 Contributor: Ricky Dhaliwal, MD Educational Pearls: What are DKA and HHS? DKA (Diabetic Ketoacidosis) and HHS (Hyperosmolar Hyperglycemic State) are both acute hyperglycemic states. DKA More common in type 1 diabetes. Triggered by decreased circulating insulin. The body needs energy but cannot use glucose because it can’t get it into the cells.
- [Appropriate Use of Point-of-Care Ultrasonography in Patients With Acute Dyspnea in Emergency Department or Inpatient Settings: A Clinical Guideline From the American College of Physicians](https://emergencymed.org.il/appropriate-use-of-point-of-care-ultrasonography-in-patients-with-acute-dyspnea-in-emergency-department-or-inpatient-settings-a-clinical-guideline-from-the-american-college-of-physicians/articles-2/) - Amir Qaseem, MD, PhD, MHA; Itziar Etxeandia-Ikobaltzeta, PharmD, PhD; Reem A. Mustafa, MD, MPH, PhD;Devan Kansagara, MD, MCR; Nick Fitterman, MD; and Timothy J. Wilt, MD, MPH; for the Clinical Guidelines Committeeof the American College of Physicians* Description: The American College of Physicians (ACP)developed this guideline to provide clinical recommenda-tions on the appropriate use of point-of-care ultrasonogra-phy (POCUS) in patients with acute dyspnea in emergencydepartment (ED) or inpatient settings to improve the diag-nostic, treatment, and health outcomes of those with sus-pected congestive heart failure, pneumonia, pulmonaryembolism, pleural effusion, or pneumothorax. Methods: The ACP Clinical
- [Golden Years, Hidden Dangers – Blunt Head Trauma in the Elderly](https://emergencymed.org.il/golden-years-hidden-dangers-blunt-head-trauma-in-the-elderly/articles-2/) - March 7, 2024 Written by Sam Parnell This study demonstrated that patients 65 years and older with blunt head trauma are at high risk of significant traumatic brain injuries and poor outcomes even with low-risk mechanisms of injury such as ground level falls and no other high-risk criteria besides advanced age. These findings suggest routine
- [ECMO (aka ECPR) for Refractory OHCA](https://emergencymed.org.il/ecmo-aka-ecpr-for-refractory-ohca/articles-2/) - March 8, 2024 Written by Nickolas Srica This “brass tacks” summary of a recent systematic review found no improvement in favorable neurologic outcomes or reduction of in-hospital mortality for extracorporeal cardiopulmonary resuscitation (ECPR) when compared to standard advanced cardiac life support (ACLS) for refractory out-of-hospital cardiac arrest (OHCA). ECMO, more like EC-no, but not so
- [אפינפרין או דרכי אוויר קודם, ב-החייאה מחוץ לבית חולים (OHCA)?](https://emergencymed.org.il/אפינפרין-או-דרכי-אוויר-קודם-ב-החייאה-מח/articles-2/) - 5 במרץ 2024 נכתב על ידי מייקל סטוקר במבוגרים שהופיעו ל-EMS לאחר OHCA, אלו שקיבלו אפינפרין לפני ניהול מתקדם של דרכי הנשימה (AAM = supraglottic airway, SGA או endotracheal tube) חוו תוצאות טובות יותר ו-ROSC טרום-אשפוזי מאשר אלו שקיבלו AAM לפני אפינפרין. זה היה נכון גם למקצבים ראשוניים מזעזעים ולא ניתנים להלם. Epi לפני נתיב
- [Epinephrine or Airway First in OHCA?](https://emergencymed.org.il/אפינפרין-או-דרכי-אוויר-קודם-ב-החייאה-מח/articles-2/) - March 5, 2024 Written by Michael Stocker In adults presenting to EMS after OHCA, those receiving epinephrine prior to advanced airway management (AAM = supraglottic airway, SGA, or endotracheal tube) experienced better outcomes and prehospital ROSC than those receiving AAM before epinephrine. This was true for both shockable and non-shockable initial rhythms. Epi before advanced
- [JAMA SUMMARY PODCAST: RNAi With Zilebesiran for Hypertension, Timing of IV Thrombolysis Before Thrombectomy for Stroke, Cardiac Amyloidosis Review, and more](https://emergencymed.org.il/jama-summary-podcast-rnai-with-zilebesiran-for-hypertension-timing-of-iv-thrombolysis-before-thrombectomy-for-stroke-cardiac-amyloidosis-review-and-more/podcast/) - Editor’s Summary by Christopher W. Seymour, MD, MSc, Associate Editor of JAMA, the Journal of the American Medical Association, for the March 5, 2024, issue.
- [PODCAST: Home Treatments for Button Battery Ingestion](https://emergencymed.org.il/podcast-home-treatments-for-button-battery-ingestion/ילדים/) - Mar 4, 2024 Contributor: Aaron Lessen MD Educational Pearls: Button batteries cause alkaline corrosion and erosion of the esophagus when swallowed Children swallow button batteries, which create a medical emergency as they can perforate the esophagus A recent study compared various home remedies as first-aid therapy for button battery ingestion Honey, jam, normal saline, Coca-Cola,
- [Ketamine vs Morphine for Acute Pain](https://emergencymed.org.il/ketamine-vs-morphine-for-acute-pain/articles-2/) - March 4, 2024 Written by Samuel Rouleau A meta-analysis of 15 randomized trials found that ketamine had a quicker analgesic effect than morphine, but morphine exhibited sustained reduction in pain at 120 minutes. A tale of two pain receptors This meta-analysis included 15 randomized trials comparing the use of ketamine to morphine for acute pain
- [NOAC + Stroke – Thrombolytic or Not?](https://emergencymed.org.il/noac-stroke-thrombolytic-or-not/articles-2/) - February 28, 2024 Written by Millie Cossé In this retrospective cohort study, there was no increased risk of intracranial hemorrhage, major bleeding, or in-hospital mortality after thrombolytic therapy in patients taking non-vitamin K antagonist oral anticoagulants compared to those not taking anticoagulants, but read the fine print. Maybe you can have it all This cohort
- [PODCAST: Cant stop the bleeding - Mastering epistaxis](https://emergencymed.org.il/podcast-cant-stop-the-bleeding-mastering-epistaxis/podcast/) - Dr. Mike Olson, former EM PA and now ENT attending sits down to talk about epistaxis with Alex and Venk. We go through a pragmatic approach to epistaxis, discuss some nuance cases including telangiectasia, hypertension, and anticoagulation. interventions are key, what patients are most likely to suffer a bad outcome and more. CONTACTS X -
- [PODCAST: Topical Anesthetics in Corneal Abrasions - A Consensus Guideline from ACEP](https://emergencymed.org.il/podcast-topical-anesthetics-in-corneal-abrasions-a-consensus-guideline-from-acep/podcast/) - In this episode, we review a consensus guideline from the American College of Emergency Physicians on the use of topical anesthetics in corneal abrasions. Show notes and references: FOAMcast.org Thanks for listening! Jeremy Faust and Lauren WEstafer
- [How to Treat Infected Kidney Stones](https://emergencymed.org.il/how-to-treat-infected-kidney-stones/articles-2/) - February 22, 2024 Written by Michelle Skuba Gray and Ketan Patel All patients with infected ureteral stones necessitate a urine culture, antibiotics, and urology consultation in the ED, with the majority requiring admission for surgical intervention. Very few, in consultation with urology, who have small, non-obstructing stones and are otherwise young healthy individuals can be
- [New Guidelines for Mild Pediatric  TBI](https://emergencymed.org.il/new-guidelines-for-mild-pediatric-tbi/articles-2/) - February 23, 2024 Exciting news! JournalFeed and Dr. Amal Mattu’s Top Picks Video Series is set to GO LIVE next week! It’s free for Gold Spoon members or you can just get the video series. Watch this trailer and get excited! Written by Amanda Mathews In this systematic review, authors identified clinical practice guideline (CPG) recommendations
- [Management of Conventional Mass Casualty Incidents: Ten Commandments for Hospital Planning](https://emergencymed.org.il/management-of-conventional-mass-casualty-incidents-ten-commandments-for-hospital-planning/articles-2/) - Mauricio Lynn, MD,* Daniel Gurr, MD,† Abdul Memon, MD,† Jennifer Kaliff, RN* The successful management of mass casualty incidents (MCIs) requires standardization of planning, training, and deployment of response. Recent events in the United States, mostimportantly the Hurricane season in 2005, demonstrated a lack of a unified response planat local, regional, state, and federal levels. A standard Israeli protocol for hospital prepared-ness for conventional MCIs, produced
- [New AI-Powered OMI Detector](https://emergencymed.org.il/new-ai-powered-omi-detector/articles-2/) - February 20, 2024 Written by Vivian Lei An artificial intelligence (AI) ECG model outperformed standard STEMI criteria in identifying occlusion myocardial infarction (OMI) confirmed by coronary angiography. An AI-powered OMI-detector Mounting evidence supports reframing the triage of acute coronary syndrome (ACS) based on the presence or absence of occlusive coronary disease (OMI vs. NOMI) rather
- [Computer Interpreted “Normal” ECGs Can Wait?](https://emergencymed.org.il/computer-interpreted-normal-ecgs-can-wait/articles-2/) - February 19, 2024 Written by Rebecca DiFabio and Ketan Patel This single-center prospective study found that in 2,275 ECGs with a computerized interpretation of “normal” and “otherwise normal,” there was a negative predictive value (NPV) of 100% for STEMI, with no final diagnoses of ACS or STEMI, and none required cardiac catheterization that visit. If
- [High-sensitivity troponin testing at the point of care for the diagnosis of myocardial infarction: a prospective emergency department clinical evaluation](https://emergencymed.org.il/high-sensitivity-troponin-testing-at-the-point-of-care-for-the-diagnosis-of-myocardial-infarction-a-prospective-emergency-department-clinical-evaluation/articles-2/) - http://orcid.org/0009-0008-0402-8074Jemima May Curran1, Aleksandra Mergo2, Sarah White1, Bernard L Croal3, http://orcid.org/0000-0003-3812-7026Jamie G Cooper1 Correspondence to Dr Jemima May Curran, Emergency Department, Aberdeen Royal Infirmary, Aberdeen, UK; jemima.curran2@nhs.scot In the ED, laboratory high-sensitivity cardiac troponin (hs-cTn) tests facilitate ‘rule-out’ of myocardial infarction (MI).1 Contemporary point-of-care (POC) troponin tests have inferior analytical sensitivity,2 preventing rapid ‘rule-out’ strategies in near-patient settings. The
- [Why Are More PE Patients Dying?](https://emergencymed.org.il/why-are-more-pe-patients-dying/articles-2/) - February 7, 2024 Written by Carmen Wolfe Mortality in patients with high-risk pulmonary embolism (PE) in the United States increased over the last decade. Surprised? Here’s why this might be true, and what we should do about it. Is PE deadlier than ever? Yesterday, we covered how dangerous high-risk PE is, and mortality in this
- [Endovascular Thrombectomy Treatment Effect in Direct vs Transferred Patients With Large Ischemic Strokes](https://emergencymed.org.il/endovascular-thrombectomy-treatment-effect-in-direct-vs-transferred-patients-with-large-ischemic-strokes/articles-2/) - A Prespecified Analysis of the SELECT2 Trial Amrou Sarraj, MD1; Michael D. Hill, MD2; M. Shazam Hussain, MD3; et alMichael G. Abraham, MD4; Santiago Ortega-Gutierrez, MD5; Michael Chen, MD6; Scott E. Kasner, MD7; Leonid Churilov, PhD8; Deep K. Pujara, MBBS1; Hannah Johns, PhD8; Spiros Blackburn, MD9; Sophia Sundararajan, MD1; Yin C. Hu, MD10; Nabeel A. Herial, MD11; Ronald F. Budzik, MD12; William J. Hicks, MD13; Juan F. Arenillas, MD, PhD14; Jenny P. Tsai, MD15; Osman Kozak, MD16; Dennis J. Cordato, PhD17; Ricardo A. Hanel, MD18; Teddy Y. Wu, PhD19; Pere Cardona Portela, MD20; Chirag D. Gandhi, MD21; Fawaz Al-Mufti, MD21; Laith Maali, MD4; Daniel Gibson, MD22; Natalia Pérez de la Ossa, MD, PhD23; Joanna D. Schaafsma, MD24; Jordi Blasco, MD, PhD25; Navdeep Sangha, MD26; Steven Warach, MD27; Timothy J. Kleinig, PhD28; Faris Shaker, MBChB9; Clark W. Sitton, MD29; Thanh Nguyen, MD30; Johanna T. Fifi, MD31; Pascal Jabbour, MD11; Anthony Furlan, MD1; Maarten G. Lansberg, MD32; Georgios Tsivgoulis, MD33; Cathy Sila, MD1; Nicholas Bambakidis, MD10; Stephen Davis, MD34; Lawrence Wechsler, MD35; Greg W. Albers, MD32; James C. Grotta, MD36; Marc Ribo, MD37; Bruce C. Campbell, MD38; Ameer E. Hassan, MD39; and the SELECT2 Investigators; and the SELECT2 Collaborators Author Affiliations Article Information JAMA Neurol. Published online February 8, 2024.
- [Should We Use Whole Blood for Trauma Patients?](https://emergencymed.org.il/should-we-use-whole-blood-for-trauma-patients/articles-2/) - February 13, 2024 Written by Amanda Mathews Trauma patients who were resuscitated with whole blood compared to component therapy had improved 24-hour mortality and a decrease in the total amount of blood products needed for resuscitation. Parts…or the whole? This was a single-center prospective observational study that used a combination of retrospective and prospective data
- [מרווח ההלם הטוב ביותר לדפיברילציה כפולה?](https://emergencymed.org.il/מרווח-ההלם-הטוב-ביותר-לדפיברילציה-כפו/articles-2/) - 12 בפברואר 2024 נכתב על ידי מייקל סטוקר בחולים עם דום לב מחוץ לבית החולים (OHCA) עם פרפור חדרים עקשן (RVF), היה קשר עם מרווח קצר (< 75ms) דפיברילציה חיצונית רציפה כפולה (DSED) והסתברות גבוהה יותר להפסקת פרפור חדרים (VF) וחזרה של מחזור ספונטני (ROSC) בהשוואה למרווחי DSED ארוכים יותר. תזעזע אותי מהר יותר, רקדן
- [Best Shock Interval for Dual Defibrillation?](https://emergencymed.org.il/מרווח-ההלם-הטוב-ביותר-לדפיברילציה-כפו/articles-2/) - February 12, 2024 Written by Michael Stocker In out-of-hospital cardiac arrest (OHCA) patients with refractory ventricular fibrillation (RVF), there was an association with short-interval (
- [הנחיות לניהול דרכי אוויר טרום-אשפוזיות](https://emergencymed.org.il/הנחיות-לניהול-דרכי-אוויר-טרום-אשפוזיו/articles-2/) - 8 בפברואר 2024 נכתב על ידי אהרון לייסי פאנל של מומחים שמעריך סקירה שיטתית על ניהול דרכי אוויר טרום-אשפוזיות יצר 22 המלצות הנוגעות לאוורור (BVM vs SGA vs ETI), וידאו לרינגוסקופיה (VL) וניהול דרכי אוויר בסיוע תרופתי. ניהול דרכי אוויר טרום-אשפוזי, בטח אין פה מחלוקת? מומחי EMS השתמשו במתודולוגיית GRADE כדי להמליץ ​​מסקירה שיטתית שסיקרנו
- [Guidelines for Prehospital Airway Management](https://emergencymed.org.il/הנחיות-לניהול-דרכי-אוויר-טרום-אשפוזיו/articles-2/) - February 8, 2024 Written by Aaron Lacy A panel of experts appraising a systematic review on prehospital airway management created 22 recommendations relating to ventilation (BVM vs SGA vs ETI), video laryngoscopy (VL), and drug-assisted airway management. Prehospital airway management, surely no controversy here? EMS experts utilized GRADE methodology to make recommendations from a systematic review we covered back in 2021. The
- [קטמין לעומת אטומידייט ב-TBI - גרסה קדם-אשפוזית](https://emergencymed.org.il/קטמין-לעומת-אטומידייט-ב-tbi-גרסה-קדם-אשפו/articles-2/) - 9 בפברואר 2024 נכתב על ידי אהרון לייסי לחולים עם TBI שעברו אינטובציה במסגרת טרום-אשפוזית לא היה הבדל בתמותה של 30 יום בהשוואה לאינדוקציה עם קטמין לעומת אטומיד. האם אנחנו עדיין מדברים על קטמין לעומת אטומיד ב-TBI? מאמר זה היה ניתוח רטרוספקטיבי של מחקר BRAIN-PROTECT מבוסס הולנד, שבחן היבטים רבים של טיפול טרום-אשפוזי של חולים
- [Ketamine vs Etomidate in TBI – Prehospital Version](https://emergencymed.org.il/קטמין-לעומת-אטומידייט-ב-tbi-גרסה-קדם-אשפו/articles-2/) - February 9, 2024 Written by Aaron Lacy Patients with TBI who were intubated in the prehospital setting had no difference in 30-day mortality when comparing induction with ketamine versus etomidate. Are we still talking about ketamine vs etomidate in TBI? This paper was a retrospective analysis of the Netherlands based BRAIN-PROTECT study, which looked at many aspects of
- [PODCAST: Postpartum Psychosis](https://emergencymed.org.il/podcast-postpartum-psychosis/education-tips/) - Feb 9, 2024 In this episode, Kishan and I are back with a bang - a lot has happened over the last 12 months. We discuss an SAQ on a special situation / complex case of Postpartum Psychosis. This is designed to have 3 sub-questions totalling 12 marks. We begin with identifying features on history
- [Timing to First Whole Blood Transfusion and Survival Following Severe Hemorrhage in Trauma Patients](https://emergencymed.org.il/timing-to-first-whole-blood-transfusion-and-survival-following-severe-hemorrhage-in-trauma-patients/articles-2/) - Crisanto M. Torres, MD, MPH1; Kelly M. Kenzik, PhD1; Noelle N. Saillant, MD1; et alDane R. Scantling, DO, MPH1; Sabrina E. Sanchez, MD, MPH1; Tejal S. Brahmbhatt, MD1; Tracey A. Dechert, MD1; Joseph V. Sakran, MD, MPH, MPA2,3,4,5 Author Affiliations Article Information JAMA Surg. Published online January 31, 2024. doi:10.1001/jamasurg.2023.7178 Key Points Question Is the timing of first whole blood transfusion associated with improved
- [International Consensus Criteria for Pediatric Sepsis and Septic Shock](https://emergencymed.org.il/international-consensus-criteria-for-pediatric-sepsis-and-septic-shock/articles-2/) - JAMA: The Journal of the American Medical Association sepsis and septic shock around the world. TAKE-HOME MESSAGE In this study, the authors detailed the updated criteria for pediatric sepsis and septic shock developed and validated by the Society of Critical Care Medicine international task force. Using the novel Phoenix Sepsis Score, the authors showed that
- [2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines](https://emergencymed.org.il/2023-acc-aha-accp-hrs-guideline-for-the-diagnosis-and-management-of-atrial-fibrillation-a-report-of-the-american-college-of-cardiology-american-heart-association-joint-committee-on-clinical-practice/articles-2/) - José A Joglar, Mina K Chung, Anastasia L Armbruster 1, Emelia J Benjamin, Janice Y Chyou, Edmond M Cronin, Anita Deswal 1, Lee L Eckhardt, Zachary D Goldberger, Rakesh Gopinathannair, Bulent Gorenek, Paul L Hess 2, Mark Hlatky, Gail Hogan 3, Chinwe Ibeh, Julia H Indik, Kazuhiko Kido 4, Fred Kusumoto, Mark S Link, Kathleen T Linta 3, Gregory M Marcus, Patrick M McCarthy, Nimesh Patel, Kristen K Patton, Marco V Perez, Jonathan P Piccini, Andrea M Russo 5, Prashanthan Sanders, Megan M Streur, Kevin L Thomas, Sabrina Times 6, James E Tisdale, Anne Marie
- [ACTT-1 | CODA RCT | Steroids Sore Throat | Podcast Learning RCT | Neurons or Nephrons](https://emergencymed.org.il/actt-1-coda-rct-steroids-sore-throat-podcast-learning-rct-neurons-or-nephrons/spoon-feed/) - It’s the JournalFeed Podcast for the week of Nov 16-20, 2020. We cover ACTT-1 – remdesivir for COVID-19, CODA RCT – antibiotics or surgery for appendicitis, steroids for sore throat, how to learn more from podcasts, and whether creatinine screening makes a difference before imaging stroke patients.
- [Bigger Bag, Higher ROSC? Impact of BVM Size on OHCA](https://emergencymed.org.il/bigger-bag-higher-rosc-impact-of-bvm-size-on-ohca/articles-2/) - FROM Resuscitation February 2, 2024 Written by Ketan Patel Tidal volume (TV) delivered is hard to control during cardiac arrest, and evidence has shown that over-ventilation can be detrimental in physiological parameters integral to cardiac arrest survival. Small bags were thus integrated into a single EMS system to help combat over-ventilation. Paradoxically, large bags
- [PODCAST:  Headache](https://emergencymed.org.il/podcast-headache/education-tips/) - FEBRUARY 1, 2024 / ZACK / 0 COMMENTS You are working at Clerkship General when the next chart is put in your rack. It’s a 41-year-old female with a chief complaint of headache. Initial Vitals: HR: 56 BP: 172/93 Temp: 98.8F RR: 18 O2: 97% Critical Actions: Check a Blood Glucose Diagnose Preecclampsia/Ecclampsia Administer Magnesium Treat the Hypertension Discuss
- [Podcast: Low GCS and Intubation](https://emergencymed.org.il/podcast-low-gcs-and-intubation/education-tips/) - Jan 29, 2024 Contributor: Aaron Lessen MD Educational Pearls: Is the adage, “GCS of 8, you’ve got to intubate” accurate? A recent study published in the November 2023 issue of JAMA attempted to answer this question. Design Multicenter, randomized trial, in France from 2021 to 2023. 225 patients experiencing comatose in the setting of acute
- [Grandma MIGHT Have Hit Her Head…CT or Not?](https://emergencymed.org.il/grandma-might-have-hit-her-headct-or-not/articles-2/) - January 24, 2024 Written by Nickolas Srica Overall rates of intracranial hemorrhage (ICH) in patients >65 years of age with either definite or uncertain head trauma were found to be 11.4% and 1.7%, respectively, leading these authors to recommend head CT imaging on all geriatric patients presenting with possible head trauma. Five grandparents jumping on
- [Can We Seriously Consider Non-op Management of Appendicitis?](https://emergencymed.org.il/can-we-seriously-consider-non-op-management-of-appendicitis/articles-2/) - January 15, 2024 FROM NEJM Written by Seth Walsh-Blackmore This expert opinion piece recommends consideration of nonoperative antibiotic treatment for select cases of uncomplicated acute appendicitis. Who is happy keeping an appy? Acute appendicitis is a widespread and actionable pathology seen by EPs in all practice settings. The majority
- [PODCAST: JAMA, Mood Symptoms After Dobbs, Prostate Cancer Treatment Outcomes, Speech and Language Delay Screening in Children, and more](https://emergencymed.org.il/podcast-jama-mood-symptoms-after-dobbs-prostate-cancer-treatment-outcomes-speech-and-language-delay-screening-in-children-and-more/podcast/) - Editor’s Summary by Kristin Walter, MD, MS, Deputy Editor of JAMA, the Journal of the American Medical Association, for the January 23/30, 2024, issue.
- [PODCAST: EM Quick Hits 54 Button Battery Ingestion, C. difficile, ECG in Tox, Bed Bugs, Fibrinogen in Trauma, Cold Air for Croup](https://emergencymed.org.il/podcast-em-quick-hits-54-button-battery-ingestion-c-difficile-ecg-in-tox-bed-bugs-fibrinogen-in-trauma-cold-air-for-croup/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” EM Quick Hits 54 Button Battery Ingestion, C. difficile, ECG in Tox, Bed Bugs, Fibrinogen in Trauma, Cold Air for Croup " data-title="EM Quick Hit 54" data-caption="" aria-label="EM Quick Hit 54">View Larger Image Topics in
- [Podcast : Family Presence in Cardiac Resuscitation](https://emergencymed.org.il/podcast-family-presence-in-cardiac-resuscitation/ניהול-מלרד/) - Jan 22, 2024 Contributor: Aaron Lessen MD Educational Pearls: A 2013 study randomized families of those in cardiac arrest into two groups: Actively offered patients’ families the opportunity to observe CPR Follow standard practice regarding family presence (control group) Of the 266 relatives that received offers to observe CPR, 211 (79%) accepted vs. 43% in
- [PODCAST: Pulmonary Embolism](https://emergencymed.org.il/podcast-pulmonary-embolism/podcast/) - Diagnosing PE: Step 1: Consciously consider the diagnosis Step 2: Risk Stratify into low, intermediate, and high risk Step 3: Choose appropriate testing based on pre-test probability Classification of PE High Risk/Massive PE: Hemodynamic Instability Intermediate Risk/Submassive PE: Right Heart Strain without instability ; or PESI Class 3+ Low Risk/Non-Massive PE: Everything else (no instability,
- [PODCAST: December 2023 Annals of Emergency Medicine](https://emergencymed.org.il/podcast-december-2023-annals-of-emergency-medicine/podcast/) - Annals of Emergency Medicine · December 2023 In the December podcast for Annals of Emergency Medicine, Rory and Ryan are joined by guest host Tehreem Rehman to discuss such topics as cost-shifting economics, emergency department crowding, and a diverse assortment of topics relevant to geriatric emergency medicine.
- [High-Sensitivity vs Conventional Troponin HEART Pathway](https://emergencymed.org.il/high-sensitivity-vs-conventional-troponin-heart-pathway/articles-2/) - January 18, 2024 Written by Laura Murphy Use of a high-sensitivity troponin (hsTn) HEART pathway resulted in a small (but significant) increase in percentage of patients diagnosed with acute myocardial infarction (AMI) during index ED visit, and a small but significant decreased in diagnosis of AMI within 30 days after the visit when compared with
- [A Bolus of Coca-Cola for Esophageal Food Impaction?](https://emergencymed.org.il/a-bolus-of-coca-cola-for-esophageal-food-impaction/articles-2/) - January 19, 2024 Written by Doug Wallace Ever tried having your patient drink Coca-Cola to relieve an esophageal food bolus? This interesting and well-designed multicenter RCT suggests limited efficacy of this off-label approach. The cold, crisp taste of coke Esophageal bolus obstructions are commonly seen in EM practice, particularly during the holidays and times of
- [PODCAST: Stroke In Pregnant and Postpartum Patients- An Interview With Dr Srinivansan](https://emergencymed.org.il/podcast-stroke-in-pregnant-and-postpartum-patients-an-interview-with-dr-srinivansan/podcast/) - In this episode, Sam Ashoo, MD, interviews Vasisht Srinivasan, MD, FACEP one of the authors of the December 2023 Emergency Medicine Practice EXTRA article, Emergency Department Management of Stroke in Pregnant and Postpartum Patients Epidemiology Evidence Causes Risk Factors Differential Diagnosis Prehospital Care ED History and Physical Exam Labs Imaging ED BP Management Specific Ischemic Stroke Therapies Specific Hemorrhagic
- [CME Video:  Evidence Based Approaches to Managing the Initially ‘Failed’ Airway](https://emergencymed.org.il/cme-evidence-based-approaches-to-managing-the-initially-failed-airway/articles-2/) - Dr. Joseph Offenbacher Joseph Offenbacher, MD is an Assistant Professor of Emergency Medicine at the New York University (NYU) School of Medicine and an Associate Program Director at the NYU/Bellevue Emergency Medicine Residency Program. He completed the ALLNYC Resident Fellowship in Medical Education Leadership and has also participated as a faculty member at the Harvard
- [PODCAST: Frostbite & chill?](https://emergencymed.org.il/podcast-frostbite-chill/trauma/) - EM Board Bombs · 207. Frostbite & chill? We're breaking the ice and welcoming you to 2024, the Year of Your Boards. Let's talk about a high-yield wintery EM topic to kick off the year! Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind
- [Podcast: Penetrating Neck Injuries](https://emergencymed.org.il/podcast-penetrating-neck-injuries/trauma/) - Jan 10, 2024 Contributor: Ricky Dhaliwal MD Educational Pearls: Three zones of the neck with different structures and risks for injuries: Zone 1 is the most caudal region from the clavicle to the cricoid cartilage Zone 2 is from the cricoid cartilage to the angle of the mandible Zone 3 is superior to the angle
- [Short-Stay Units vs Routine Admission From the Emergency Department in Patients With Acute Heart Failure The SSU-AHF Randomized Clinical Trial](https://emergencymed.org.il/short-stay-units-vs-routine-admission-from-the-emergency-department-in-patients-with-acute-heart-failure-the-ssu-ahf-randomized-clinical-trial/articles-2/) - Peter S. Pang, MD, MS1; David A. Berger, MD2; Simon A. Mahler, MD, MS3; et al Key Points Question Instead of hospital admission from the emergency department, does a short-stay unit (SSU) strategy of care improve quality of life for lower-risk patients with acute heart failure?
- [Cath Lab Management of the Comatose Adult With Out-of-Hospital Cardiac Arrest](https://emergencymed.org.il/cath-lab-management-of-the-comatose-adult-with-out-of-hospital-cardiac-arrest/articles-2/) - TAKE-HOME MESSAGE This scientific statement updates the approach to managing resuscitated patients and those with ongoing cardiac arrest, emphasizing the evolving role of the catheterization lab in their care. The cardiac catheterization lab is vital in the chain of survival — offering diagnostic, therapeutic, and resuscitative support, particularly for cases related to coronary artery disease.
- [High-Dose Nitroglycerin for SCAPE – But How High?](https://emergencymed.org.il/high-dose-nitroglycerin-for-scape-but-how-high/articles-2/) - January 10, 2024 Written by Millie Cossé High-dose nitroglycerin improves outcomes in patients with sympathetic crashing acute pulmonary edema (SCAPE) without significant side effects when compared to low-dose nitroglycerin. What is your eSCAPE plan? SCAPE is a vicious cycle: Increased sympathetic tone leads to increased vasoconstriction and afterload, worsening heart failure. Simultaneously, this vasoconstriction promotes
- [REBOA or Thoracotomy – Which Is Better?](https://emergencymed.org.il/reboa-or-thoracotomy-which-is-better/articles-2/) - January 12, 2024 Written by Michael Stocker Traumatic cardiac arrest patients receiving either resuscitative endovascular balloon occlusion of the aorta (REBOA) or resuscitative thoracotomy (RT) experienced similar outcomes, though time to successful occlusion of the aorta took significantly longer with REBOA. The limiter? Common femoral artery (CFA) access. Rock, paper, scissors, balloon, forceps This study
- [Best POCUS Papers Made Easy? Count Me In!](https://emergencymed.org.il/best-pocus-papers-made-easy-count-me-in/articles-2/) - Written by Megan Hilbert This expert panel from Canada has compiled a list of what they deem to be the most influential POCUS papers with regard to cardiac arrest as well as evaluation of shock. Whether you want to further educate yourself or guide your residents to learn more on the subject, this primer is
- [New – 2023 AHA ACLS Updates](https://emergencymed.org.il/new-2023-aha-acls-updates/articles-2/) - Written by Amanda Mathews In this focused update to the AHA Guidelines for Cardiopulmonary Resuscitation (last updated 2020), the study group recommended against routine use of calcium in cardiac arrest while recommending for a targeted temperature control strategy in patients who do not follow commands post ROSC, among other recommendations. Throw away your calcium and
- [Circulation: Arterial Thromboembolism in Patients With Atrial Fibrillation and CHA2DS2-VASc 1: A Nationwide Study](https://emergencymed.org.il/circulation-arterial-thromboembolism-in-patients-with-atrial-fibrillation-and-cha2ds2-vasc-1-a-nationwide-study/articles-2/) - TAKE-HOME MESSAGE This study involving patients with atrial fibrillation examined the difference in arterial thromboembolism incidence among subgroups within a CHA2DS2-VASc score of 1 using data from Danish registries (2000–2021). Among patients in the CHA2DS2-VASc 1 subgroups (hypertension, heart failure, diabetes, vascular disease, and age 65–74 years), no statistical distinction was found. The cumulative incidence
- [Venous Thromboembolism Prophylaxis in Patients With Critical Illness With a Low Body Weight](https://emergencymed.org.il/venous-thromboembolism-prophylaxis-in-patients-with-critical-illness-with-a-low-body-weight/articles-2/) - TAKE-HOME MESSAGE In this multicenter retrospective cohort study, the authors compared the effects of standard-dose venous thromboembolism (VTE) prophylaxis with those of reduced-dose VTE prophylaxis in patients who are critically ill with a body weight of ≤50 kg. Although reduced-dose prophylaxis was associated with a significantly lower rate of composite bleeding, the rate of VTE was
- [EMMA : Mid Interview Season Check-In](https://emergencymed.org.il/emma-mid-interview-season-check-in/education-tips/) - Dr. Sara Krzyzaniak (Host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Aaron Kraut (University of Wisconsin PD) in this insightful, rapid-fire, practical episode through the lens of residency program directors. What does the ERAS data show so far? Have there been any surprises or changes during interview season? Has the program signaling option
- [Post-Cardiac Arrest Critical Care | Spoon Feed Version](https://emergencymed.org.il/post-cardiac-arrest-critical-care-spoon-feed-version/articles-2/) - Written by Aaron Lacy Buckle up, we have a lot to talk about today! Today we are covering a new, joint scientific statement from the American Heart Association and Neurocritical Care Society regarding care of patients who suffered cardiac arrest and subsequently had ROSC. The journey of 1,000 miles starts with a single ROSC, or something
- [PODCAST: Pediatric UTI and Pneumonia](https://emergencymed.org.il/podcast-pediatric-uti-and-pneumonia/ילדים/) - In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the January 2024 Pediatric Emergency Medicine Practice article, Management of Pediatric Urinary Tract Infections in the Emergency Department, and the January 2024 Evidence Based Urgent Care article on Pediatric Community-Acquired Pneumonia: Diagnosis and Management in the Urgent Care Setting. UTI Epidemiology and Nomenclature Prehospital Care ED History and Physical Exam Infants
- [Episode : Syncope in Children](https://emergencymed.org.il/episode-syncope-in-children/ילדים/) - Show Notes Initial Evaluation and Management: Similar initial workup for children and adults: checking glucose levels for hypoglycemia and conducting an EKG. The history and physical exam are crucial. Dextrose Administration in Children: Explanation of the ‘rule of 50s’ for determining the appropriate dextrose solution and dosage for children. ECG Analysis: Importance of ECG in
- [Podcast : Nerve Blocks](https://emergencymed.org.il/podcast-nerve-blocks/podcast/) - Jan 1, 2024 Contributor: Meghan Hurley MD Educational Pearls: What is a nerve block? A nerve block is the medical procedure of injecting anesthetic into the area around a nerve to block pain signals. They are typically done with ultrasound guidance. Are nerve blocks effective? Most of the information we have about nerve blocks is
- [How to Diagnose Guillain-Barré Syndrome](https://emergencymed.org.il/how-to-diagnose-guillain-barre-syndrome/articles-2/) - Written by Carmen Wolfe Is Guillain-Barre Syndrome (GBS) on your differential for neurologic symptoms? Let’s review this high morbidity/mortality disease. Feeling “weak” about making this diagnosis? We got you! Guillain-Barre Syndrome (GBS) is an immune-mediated disease affecting peripheral nerves. Molecular mimicry is the proposed etiology, with cases developing around 4-6 weeks after exposure to bacterial
- [Direct Oral Challenge – Bye-Bye Penicillin Allergy!](https://emergencymed.org.il/direct-oral-challenge-bye-bye-penicillin-allergy/articles-2/) - Written by Ketan Patel While removing low risk amoxicillin allergies in the pediatric ED by direct oral challenge (DOC) may be effective, numerous factors play a role in reliable implementation. Excuses or lack of feasibility? This is a cohort study across 3 different teaching PEDs where patients were stratified as a low or high-risk allergy
- [PODCAST: JEM November 2023 Podcast Summary](https://emergencymed.org.il/podcast-jem-november-2023-podcast-summary/podcast/) - Dec 29, 2023 Podcast summary of articles from the November 2023 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include toxicology, pyloric stenosis, lateral canthotomy, rapid sequence intubation, discharge AMA, and posterior circulation stroke. Guest speaker is Dr. Dustyn Whitesel.
- [Podcast : Thrombolytics for Minor Strokes](https://emergencymed.org.il/podcast-thrombolytics-for-minor-strokes/podcast/) - Dec 20, 2023 Contributor: Aaron Lessen MD Educational Pearls: How is the severity of a stroke assessed? Strokes are assessed by the NIH Stroke Scale (NIHSS), this scale has different tasks, such as asking the person to repeat words, move their arms, or follow simple instructions. The maximum score is 42 but any score over
- [Association Between Daily Alcohol Intake and Risk of All-Cause Mortality](https://emergencymed.org.il/association-between-daily-alcohol-intake-and-risk-of-all-cause-mortality/articles-2/) - A Systematic Review and Meta-analyses JinhuiZhao,PhD;TimStockwell,PhD;TimNaimi,MD;SamChurchill,MSc;JamesClay,MSc;AdamSherk,PhD Key Points Question What is the association between mean daily alcohol intake and all-cause mortality? Findings This systematic review and meta-analysis of 107 cohort studies involving more than 4.8 million participants found no significant reductions in risk of all-cause mortality for
- [Balanced crystalloids (RInger’s lactate) versus normal Saline in adults with diabetic Ketoacidosis in the Emergency Department (BRISK-ED): a pilot randomised controlled trial](https://emergencymed.org.il/balanced-crystalloids-ringers-lactate-versus-normal-saline-in-adults-with-diabetic-ketoacidosis-in-the-emergency-department-brisk-ed-a-pilot-randomised-controlled-trial/articles-2/) - Justin W Yan ,1,2 Ahmed Slim,2,3 Kristine Van Aarsen,2,3 Yun- Hee Choi,4 Christopher Byrne,1,2 Naveen Poonai ,4,5,6 Haley Collins,7 Kristin K Clemens Abstract Background Current diabetic ketoacidosis (DKA) treatment guidelines recommend using normal saline (NS); however, NS may delay DKA resolution by causing more hyperchloremic metabolic acidosis
- [Safety and efficacy of a nitrous oxide procedural sedation programme in a paediatric emergency department: a decade of outcomes](https://emergencymed.org.il/safety-and-efficacy-of-a-nitrous-oxide-procedural-sedation-programme-in-a-paediatric-emergency-department-a-decade-of-outcomes/articles-2/) - Sean Croughan ,1,2 Michael Barrett ,1,3 Ronan O’Sullivan,4 Aidan Beegan,5,6 Carol Blackburn1,3 Abstract Background Nitrous oxide (N2O) has multiple benefits in paediatric procedural sedation (PPS), but use is restricted by its limited analgesic properties. Analgesic potency could be increased by combining N2O and
- [A streamlined Emergency Department approach to moderate risk chest pain in patients with no pre-existing coronary artery disease: A pilot study](https://emergencymed.org.il/a-streamlined-emergency-department-approach-to-moderate-risk-chest-pain-in-patients-with-no-pre-existing-coronary-artery-disease-a-pilot-study/articles-2/) - Christopher L Jones MBBCh, MRCEM, FACEM, DipMEd, Robyn Gallagher, Paddy Quinn MBBCh, BAO, Nick S R Lan MBBS (Hons), MClinUs, MClinRes (Dist), PgDip (Dist), David-Raj Thomas MD, BSc, MPH, Christopher Wood DCRR, Christopher Lau, Weng Man Sofia Chow, Vikram Raju MBBS, FRANZCR, James M Rankin MBBS, FRACP, FCSANZ, Abdul Rahman Ihdayhid MBBS (Hons), PhD, FRACP, Glenn Arendts MBBS, MMed, PhD, FACEM Abstract
- [Core temperature following pre‐hospital induction of anaesthesia in trauma patients](https://emergencymed.org.il/core-temperature-following-pre‐hospital-induction-of-anaesthesia-in-trauma-patients/articles-2/) - Roy Fischer BHB, MBChB, FCICM, PGDipCU, Paul F Lambert BSc (Hons), PhD, BMBS, FANZCA, GradCertAeromedRetRoy Fischer BHB, MBChB, FCICM, PGDipCU, Paul F Lambert BSc (Hons), PhD, BMBS, FANZCA, GradCertAeromedRet Abstract Introduction Hypothermia is a well-recognised finding in trauma patients, which can occur even in warmer climates. It is an independent
- [Effect of Noninvasive Airway Management of Comatose Patients With Acute Poisoning A Randomized Clinical Trial](https://emergencymed.org.il/effect-of-noninvasive-airway-management-of-comatose-patients-with-acute-poisoning-a-randomized-clinical-trial/articles-2/) - Yonathan Freund, MD, PhD1,2; Damien Viglino, MD, PhD3; Marine Cachanado, MSc4; et al Key Points Question In patients with suspected poisoning and Glasgow Coma Scale score less than 9, is a conservative airway strategy of withholding intubation associated with a reduction of death, intensive care unit length of stay, and hospital length
- [PODCAST: ACEP Clinical Policy: Sedation of the Agitated Patient](https://emergencymed.org.il/podcast-acep-clinical-policy-sedation-of-the-agitated-patient/סדציה/) - This epsiode reviews the new clinical policy from the American College of Emergency Physicians (ACEP) on medication for acutely agitated patients needing parenteral sedation.
- [PODCAST: Bleeding traumas & Ghost Riding](https://emergencymed.org.il/podcast-bleeding-traumas-ghost-riding/trauma/) - EM Board Bombs · 205. Bleeding traumas & Ghost Riding Time to jump into the holiday spirit by talking about bleeding trauma patients. Practical, real-world knowledge for ALL! Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here.
- [Good Bagging in CPR Saves Lives?](https://emergencymed.org.il/good-bagging-in-cpr-saves-lives/articles-2/) - December 18, 2023 / Airway, EMS, Resuscitation Written by Michael Stocker For the majority of out-of-hospital cardiac arrest (OHCA) patients undergoing 30:2 compressions to breaths CPR prior to definitive airway placement, bag-valve mask (BVM) ventilations did not achieve adequate lung volumes most of the time. Receiving adequate BVM ventilations >50% of the time was associated with significantly higher rates
- [The Real Risks of Boarding in the Emergency Department](https://emergencymed.org.il/the-real-risks-of-boarding-in-the-emergency-department/articles-2/) - December 15, 2023 / ED Operations, Medicine/Geriatrics Written by Amanda Mathews In this large, multicenter prospective cohort study in France, researchers found that patients ≥75 years who were admitted overnight boarding in the ED had higher rates of in-hospital mortality, length of stay, and adverse events. The real risks of boarding This study cohort included 97 Emergency Departments
- [PODCAST: Shock Deep Dive](https://emergencymed.org.il/podcast-shock-deep-dive/podcast/) - DECEMBER 17, 2023 / MIKE ESTEPHAN Shock – A state of deranged physiology characterized by systemic, widespread hypoperfusion Hypovolemic Shock Hemorrhage Volume Loss (vomiting/diarrhea, dehydration) Cardiogenic Shock ACS, Myocarditis, CHF, Valve failure, Endocarditis, etc Obstructive Shock Massive PE, Tension Pneumothorax, Cardiac Tamponade Distributive Shock SIRS (Septic Shock, Pancreatitis, Severe Burns) Anaphylactic Shock Neurogenic Shock Adrenal Crisis
- [2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation](https://emergencymed.org.il/2023-acc-aha-accp-hrs-guideline-for-the-diagnosis-and-management-of-atrial-fibrillation/articles-2/) - TAKE-HOME MESSAGE The key take-home messages from the 2023 guidelines for the diagnosis and management of atrial fibrillation (AF) focus on the new AF classification using stages, recognizing AF as a disease continuum requiring diverse strategies to address risk factors. Emphasis is placed on early rhythm control, with catheter ablation receiving a class I indication
- [PODCAST:  Zero Warning | Scott Weingart on frameworks for no-notice critical patients](https://emergencymed.org.il/podcast-zero-warning-scott-weingart-on-frameworks-for-no-notice-critical-patients/education-tips/) - Dec 11, 2023 When a critical patient lands on your department's doorstep without prior notice, even the most seasoned professionals can find themselves momentarily at a loss — wondering what steps to take first and how to prioritize actions in those crucial initial seconds. What do I do first, what do I do next? What’s
- [PODCAST: Antithrombotic Regimens for LVADs, Cannabis in Pregnancy, Hepatitis C in Black Individuals, and more](https://emergencymed.org.il/podcast-antithrombotic-regimens-for-lvads-cannabis-in-pregnancy-hepatitis-c-in-black-individuals-and-more/podcast/) - Editor’s Summary by Kristin Walter, MD, MS, Senior Editor of JAMA, the Journal of the American Medical Association, for the December 12, 2023, issue.
- [Amiodarone and pulmonary toxicity in atrial fibrillation: a nationwide Israeli study](https://emergencymed.org.il/amiodarone-and-pulmonary-toxicity-in-atrial-fibrillation-a-nationwide-israeli-study/articles-2/) - TAKE-HOME MESSAGE In this population-based observational study involving 6039 individuals with incident atrial fibrillation, amiodarone exposure was not significantly associated with an increased risk of interstitial lung disease or primary lung disease after a median follow-up period of 4.2 years. After inverse probability treatment weighting, amiodarone exposure was associated with a 35% reduced risk of
- [ABCDE of prehospital ultrasonography: a narrative review](https://emergencymed.org.il/abcde-of-prehospital-ultrasonography-a-narrative-review-2/articles-2/) - Abstract Prehospital point-of-care ultrasound used by nonradiologists in emergency medicine is gaining ground. It is feasi-ble on-scene and during aeromedical transport and allows health-care professionals to detect or rule out potentialharmful conditions. Consequently, it impacts decision-making in prioritizing care, selecting the best treatment, andthe most suitable transport mode and destination. This increasing relevance of prehospital ultrasonography is due toadvancements in ultrasound
- [How to Manage Non-Convulsive Status Epilepticus](https://emergencymed.org.il/how-to-manage-non-convulsive-status-epilepticus/articles-2/) - December 5, 2023 / Neurology, Pharmacy/Pharmacology By Laura Murphy This is a review of the diagnosis and management of non-convulsive status epilepticus (NCSE) in the emergency department. Nonspecific signs and symptoms at presentation make it challenging to identify, which can lead to under-diagnosis and delay in treatment. NCSE: Something’s just not right NCSE is a form of status
- [Ketamine vs Etomidate RCT- Which Causes Higher SOFA Score?](https://emergencymed.org.il/ketamine-vs-etomidate-rct-which-causes-higher-sofa-score/articles-2/) - December 4, 2023 / Airway, Critical Care Written by Jason Lesnick This single center RCT found no difference in maximum Sequential Organ Failure Assessment (SOFA) score between critically ill adult ED patients receiving ketamine vs etomidate for rapid sequence intubation (RSI). Etomidate for everyone or keep on keepin’ on with ketamine This study was a single center, parallel-group, partially
- [PODCasT:  RCEM Learning December 2023](https://emergencymed.org.il/podcast-rcem-learning-december-2023/education-tips/) - Dec 4, 2023 This month for the December 2023 episode of the RCEM Learning Podcast we welcome our new co-host Liz Farah. Merry Christmas!. We discuss two New in EM segments looking at overnight boarding of older patients in the ED and mortality and looking at the use of opioids in treating back pain. Rob
- [PODCAST: Dialysis Emergencies: no, not just hyperK](https://emergencymed.org.il/podcast-dialysis-emergencies-no-not-just-hyperk/education-tips/) - EM Board Bombs · 203. Dialysis Emergencies: no, not just hyperK What if we told you the biggest killer of dialysis patients wasn't hyperkalemia? What that blow your mind? Wait until we talk about Santa... Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind
- [Developing an implementation intervention for managing acute vertigo in the emergency department](https://emergencymed.org.il/developing-an-implementation-intervention-for-managing-acute-vertigo-in-the-emergency-department-2/articles-2/) - David Herdman ,1 Hena Ahmad,2 George Antoniades,3 Gokul Bailur,3 Arun Pajaniappane,1 Phil Moss David Herdman ,1 Hena Ahmad,2 George Antoniades,3 Gokul Bailur,3 Arun Pajaniappane,1 Phil Moss Abstract Background There are evidence-based bedside tests for diagnosing acute vertigo, but no evidence-based strategies to support clinicians in implementing them. The purpose
- [Ultrasonography in thoracic and abdominal stab wound injury: results from the FETTHA study](https://emergencymed.org.il/ultrasonography-in-thoracic-and-abdominal-stab-wound-injury-results-from-the-fettha-study-2/articles-2/) - Donia Bouzid1,2,3,4, Alexy Tran-Dinh1,5,6, Brice Lortat-Jacob5, Enora Atchade5, Sylvain Jean-Baptiste5, Parvine Tashk5, Aurelie Snauwaert5, Nathalie Zappella5, Pascal Augustin5, Quentin Pellenc7, Yves Castier1,6,7, Lara Ribeiro8, Augustin Gaudemer9, Antoine Khalil1,9,10, Philippe Montravers1,5,10, http://orcid.org/0000-0003-4698-3287Sebastien Tanaka5,11 on behalf of the Bichat stab wounds injury study group Correspondence to Dr Sebastien Tanaka, APHP, Paris, Île-de-France, France; sebastien.tanaka@aphp.fr Abstract Background While the role of Extended Focused Assessment with Sonography in
- [2023 American Heart Association and American Academy of Pediatrics Focused Update on Neonatal Resuscitation: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care2023 American Heart Association and American Academy of Pediatrics Focused Update on Neonatal Resuscitation: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care](https://emergencymed.org.il/2023-american-heart-association-and-american-academy-of-pediatrics-focused-update-on-neonatal-resuscitation-an-update-to-the-american-heart-association-guidelines-for-cardiopulmonary-resuscitation-an/articles-2/) - Nicole K. Yamada, Edgardo Szyld, Marya L. Strand, Emer Finan, Jessica L. Illuzzi, Beena D. Kamath-Rayne, Vishal S. Kapadia, Susan Niermeyer, Georg M. Schmölzer, Amanda Williams, Gary M. Weiner, Myra H. Wyckoff, Henry C. Lee and on behalf of the American Heart Association and American Academy of Pediatrics Originally published16 Nov 2023https://doi.org/10.1161/CIR.0000000000001181Circulation. 2023;0 Other version(s) of this article Abstract This 2023 focused update to the
- [Asymptomatic Brugada – A Silent Danger](https://emergencymed.org.il/asymptomatic-brugada-a-silent-danger/articles-2/) - November 30, 2023 / Cardiology Written by Megan Hilbert Risk stratification of patients with asymptomatic Brugada remains a clinical dilemma and makes expectant guidance difficult. This article has demonstrated the highest risk of arrythmia in those with spontaneous type-1 BrECG (Brugada ECG) as compared to those with drug-induced-only BrECG. Note: For ease of reading, further mention of
- [PODCAST: Pediatric Toxic Ingestions](https://emergencymed.org.il/podcast-pediatric-toxic-ingestions/ילדים/) - Pediatric Toxic Ingestions Dec 1 2023 In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the December 2023 Pediatric Emergency Medicine Practice article, Management of Pediatric Toxic Ingestions in the Emergency Department. Need help now? Call the Poison Help Line at: 1‑800‑222‑1222 Epidemiology Prehospital Care ED History and Physical Exam Diagnostic Studies Labs EKG
- [PODCAST: MVA](https://emergencymed.org.il/podcast-mva/trauma/) - You are working at Clerkship General when you hear and EMS call on the radio. “Clerkship General, we are activating a trauma alert. We are bringing you a 33 year old male from a high-speed single vehicle collision” Initial Vitals: HR: 65 BP: 88/50 Temp: 97.0F RR: 20 O2: 96% Room Air Critical Actions: Apply
- [Podcast : Opioids for Low Back and Neck Pain](https://emergencymed.org.il/podcast-opioids-for-low-back-and-neck-pain/podcast/) - Nov 20, 2023 Contributor: Jared Scott MD Educational Pearls: Should we use opioids to treat low back and neck pain? The OPAL Trial, published in The Lancet, in June 2023, attempted to answer this very question. Objective: Investigate the efficacy and safety of a short course of opioid analgesic (oxycodone-naloxone) for acute low back pain
- [PODCAST: EM Quick Hits 52 Infant Vomiting, Orbital Cellulitis, Prehospital TXA in Trauma, Prevention and Treatment of Delirium, Procedural Skills Decay, Altitude Sickness](https://emergencymed.org.il/podcast-em-quick-hits-52-infant-vomiting-orbital-cellulitis-prehospital-txa-in-trauma-prevention-and-treatment-of-delirium-procedural-skills-decay-altitude-sickness/education-tips/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” " data-title="EM Quick Hits 52" data-caption="" aria-label="EM Quick Hits 52"> Topics in this EM Quick Hits podcast Sarah Reid on an approach to infant vomiting (1:08) Brit Long on orbital cellulitis essentials (10:45) Justin Morgenstern on update on TXA for
- [High or Low Fluid Volume in Sepsis? New Meta-analysis](https://emergencymed.org.il/high-or-low-fluid-volume-in-sepsis-new-meta-analysis/articles-2/) - November 21, 2023 / Critical Care Written by Caitlin Nicholson This updated systematic review and meta-analysis showed no statistically significant difference in all-cause mortality or serious adverse events in sepsis patients given low vs higher fluid volumes. Volume of fluid resuscitation in sepsis continues to be dealer’s choice… This study revised a prior systematic review and meta-analysis
- [How to Manage Precipitous Delivery and Complications](https://emergencymed.org.il/how-to-manage-precipitous-delivery-and-complications/articles-2/) - November 22, 2023 / OB/GYN, Pediatrics Written by Julie Brown Although infrequent, precipitous vaginal deliveries in the ED occur and are associated with higher rates of maternal and fetal complications. Here’s how you can be prepared to manage these deliveries and common complications. Top things I don’t want to hear on shift…”She’s crowning in trauma room 3″ In
- [Is REBOA Dead? The UK-REBOA RCT](https://emergencymed.org.il/is-reboa-dead-the-uk-reboa-rct/articles-2/) - November 15, 2023 / Trauma Written by Michael Stocker In the first ever randomized clinical trial (RCT) of resuscitative endovascular balloon occlusion of the aorta (REBOA), exsanguinating patients receiving REBOA and standard care suffered greater mortality than those receiving standard care alone. But don’t throw those balloons away just yet, this study had significant limitations. REBOA is
- [Syncope While Driving and the Risk of a Subsequent Motor VehicleCrash](https://emergencymed.org.il/syncope-while-driving-and-the-risk-of-a-subsequent-motor-vehiclecrash/articles-2/) - John A. Staples, MD, MPH Shannon Erdelyi, MSc Ketki Merchant, MSc, MBBS Donald A. Redelmeier, MD Herbert Chan, PhD Jeffrey R. Brubacher, MD Published:November 07, 2023DOI:https://doi.org/10.1016/j.annemergmed.2023.09.015 Study objective Syncope that occurs while driving can result in a motor vehicle crash. Whether individuals with a prior syncope-related crash exhibit an exceptional risk of subsequent crash remains
- [Podcast: Viral Respiratory Infections in Children](https://emergencymed.org.il/podcast-viral-respiratory-infections-in-children/ילדים/) - Nov 13, 2023 Contributor: Jared Scott MD Educational Pearls A recently published study assessed the burden of respiratory viruses in a longitudinal cohort of children from 0 to 2 years of age The children in the study received nasal swab PCR testing weekly to determine infectivity They were also monitored for symptoms via weekly text
- [Can We Simplify a HEART Score to a HET Score?](https://emergencymed.org.il/can-we-simplify-a-heart-score-to-a-het-score/articles-2/) - November 13, 2023 / Cardiology Written by Jacob Altholz Both the HEART- and HET-score (using history, ECG changes, and high-sensitivity troponin) performed similarly when risk-stratifying ACS rule-out patients, but the HET-score had higher overall diagnostic accuracy. Should we move this from our HEART to our HET? This study was broken into two phases in which adults with
- [How to Lower Your Mortality (And Your Patients) – One Step at a Time](https://emergencymed.org.il/how-to-lower-your-mortality-and-your-patients-one-step-at-a-time/articles-2/) - November 14, 2023 / Cardiology, Wellness Editor’s note: We usually don’t cover preventive medicine. But I found this article to be very encouraging for my own wellness and thought you might as well. ~Clay Smith Written by Vivian Lei There is a nonlinear inverse dose-response trend between daily step count and all-cause death and cardiovascular disease, with progressive risk
- [PODCAST: Grand Rounds - Dr. Heather Murray - Diagnostic error in the ED - Lets talk about it](https://emergencymed.org.il/10500/education-tips/) - In this episode, Dr. Heather Murray, from Queen's University Department of Emergency Medicine presents the landscape of diagnostic errors in emergency medicine from the perspective of why they might occur, what can be done when they happen, and how we might minimize them in the future.
- [Podcast:  Sedation Pearls](https://emergencymed.org.il/podcast-sedation-pearls/סדציה/) - Nov 6, 2023 Contributor: Travis Barlock MD Educational Pearls: Common sedatives used in the Emergency Department and a few pearls for each. Propofol Type: Non-barbiturate sedative hypnotic agonizing GABA receptors. Benefit: Quick on and quick off (duration of action is approximately 2-7 minutes), helpful for suspected neurologic injury so the patient can wake up and
- [PODCAST: Anticoagulant Reversal Updates with 'Big Jim' Neuenschwander - ACEP23](https://emergencymed.org.il/podcast-anticoagulant-reversal-updates-with-big-jim-neuenschwander-acep23/podcast/) - ACEP Frontline · Anticoagulant Reversal Updates with 'Big Jim' Neuenschwander - ACEP23 In this episode, we chat once again with Dr. Jim Neuenschwander about anticoagulant reversal and when to pull the trigger on some of the big dollar agents.
- [Are Overnight Stays in the Emergency Department Problematic?](https://emergencymed.org.il/are-overnight-stays-in-the-emergency-department-problematic/articles-2/) - Paul S. Mueller, MD, MPH, FACP, reviewing Roussel M et al. JAMA Intern Med 2023 Nov 6 Risk for death was 40% higher in older adults who stayed in the ED overnight before admission to the hospital. Hospital staffing and bed shortages can result in prolonged emergency department (ED) stays for patients who are awaiting admission, but prolonged
- [Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome](https://emergencymed.org.il/diagnosis-of-acute-aortic-syndrome-in-the-emergency-department-dashed-study-an-observational-cohort-study-of-people-attending-the-emergency-department-with-symptoms-consistent-with-acute-aortic-syn/articles-2/) - :Rachel McLatchie1, Matthew J Reed1,2, Nicola Freeman1, Richard A Parker3, Sarah Wilson4, Steve Goodacre5, Alicia Cowan6, Jessica Boyle7, Benjamin Clarke1, Ellise Clarke1 on behalf of the DAShED investigators Correspondence to Professor Matthew J Reed, Emergency Medicine Research Group Edinburgh (EMERGE), Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK; mattreed@ed.ac.uk Abstract Background The diagnosis
- [A clinical decision rule to rule out bloodstream infection in the emergency department: retrospective multicentric observational cohort study](https://emergencymed.org.il/a-clinical-decision-rule-to-rule-out-bloodstream-infection-in-the-emergency-department-retrospective-multicentric-observational-cohort-study/articles-2/) - Jonathan Pehlivan,1 Delphine Douillet ,2,3 Riou Jérémie,4,5 Clément Perraud,2 Alexandre Niset,6 Matthieu Eveillard,7 Rachel Chenouard,7 Rafael Mahieu 8,9 Abstract Background We aimed to identify patients at low risk of bloodstream infection (BSI) in the ED. Methods We derived and validated a prediction model to rule out BSI in the ED without the
- [Transfusion Trigger – New AABB Guidelines for Adults and Children](https://emergencymed.org.il/transfusion-trigger-new-aabb-guidelines-for-adults-and-children/articles-2/) - November 10, 2023 / Hematology/Oncology, Pediatrics Written by Clay Smith For hemodynamically stable adults and children, 7g/dL is the best transfusion trigger, with a few exceptions. Liberal or conservative? At least transfusion triggers are clear Transfusion of PRBCs can be life saving, but it also comes with risks. Volume overload is 1 in 125, febrile reaction 1 in 160,
- [PODCAST: RCEM Learning November 2023](https://emergencymed.org.il/podcast-rcem-learning-november-2023/podcast/) - November 20230 Nov 1, 2023 This month for the November 2023 episode of the RCEM Learning Podcast we've got a New in EM segment looking at the INTERACT3 trial looking at blood pressure targets following intracerebral haemorrhage. We then have Becky and Chris discussing the British Thoracic Society's new guidance on spontaneous pneumothorax. We then
- [PODCAST:  Electrical Storm](https://emergencymed.org.il/podcast-electrical-storm/podcast/) - Show Notes Background/Overview of VT: Definition: What makes it a storm Three or more sustained episodes of VF, VT, or appropriate ICD shocks in a 24-hour period Pathophysiology: Understanding the origin and mechanism Sympathetic drive/adrenergic surge Underlying pathology: Sodium channelopathies, infiltrative disease like cardiac sarcoidosis, etc. RF’s / trigger / population (reversible cause in ~25%
- [What impact would reducing low-acuity attendance have on emergency department length of stay? A discrete event simulation modelling study](https://emergencymed.org.il/what-impact-would-reducing-low-acuity-attendance-have-on-emergency-department-length-of-stay-a-discrete-event-simulation-modelling-study/articles-2/) - http://orcid.org/0000-0002-2776-4014Hazel Squires1, http://orcid.org/0000-0002-1701-0577Suzanne Mason1, http://orcid.org/0000-0002-4484-7401Colin O'Keeffe1, Susan Croft1, George Millington2 Correspondence to Dr Hazel Squires, Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield S1 4DA, UK; h.squires@sheffield.ac.uk Abstract Background Long waiting times in the ED have been shown to cause negative outcomes for patients.
- [How Accurate Is an US + Fast MRI Pediatric Appendicitis Protocol?](https://emergencymed.org.il/how-accurate-is-an-us-fast-mri-pediatric-appendicitis-protocol/articles-2/) - October 31, 2023 / Imaging, Pediatrics, Surgery Written by Megan Hilbert After a non-diagnostic screening ultrasound for appendicitis, a rapid-MRI has high clinical accuracy in establishing the appropriate diagnosis (appendicitis or not) in a pediatric patient population. Are you ‘appy now? This was a prospective cohort study completed in Canada to evaluate rapid-MRI (instead of interval repeat US) as
- [How to Diagnose and Treat Encephalitis](https://emergencymed.org.il/how-to-diagnose-and-treat-encephalitis/articles-2/) - November 2, 2023 / Infectious Disease, Neurology Written by Carmen Wolfe Encephalitis can be cryptic – here are the latest updates for diagnosis and treatment. Help, help – brain on fire! Encephalitis, inflammation of the brain parenchyma, should be suspected in patients with decreased level of consciousness, personality change, or new psychiatric symptoms. Common infectious causes include HSV-1
- [PODCAST:  Modern Migraine Management in Emergency Medicine with Dr. Diamond](https://emergencymed.org.il/podcast-modern-migraine-management-in-emergency-medicine-with-dr-diamond/podcast/) - ACEP Frontline · Modern Migraine Management in Emergency Medicine with Dr. Diamond In this episode, we chat with headache and migraine specialist, Dr. Merle Diamond about the management of migraines in the emergency department. A great deal has changed over the past two decades and now we have tools that are more effective and safer
- [PODCAST : Bradyarrhythmias](https://emergencymed.org.il/podcast-bradyarrhythmias/podcast/) - Oct 23, 2023 Contributor: Dylan Luyten MD Educational Pearls: What is a Bradyarrhythmia? Also known as a bradyarrhythmia, it is an irregular heart rate that is also slow (below 60 beats per minute). What can cause it? Complete heart block AKA third-degree AV block; identified on ECG by a wide QRS, and complete dissociation between
- [AHA Guideline | 10 Tips Life-Threatening Toxicity From Poisoning](https://emergencymed.org.il/aha-guideline-10-tips-life-threatening-toxicity-from-poisoning/articles-2/) - October 25, 2023 / Cardiology, Critical Care, Pharmacy/Pharmacology, Toxicology Written by Clay Smith Here are ten tips from the AHA for the next super-sick poisoned patient you encounter. This paper is so toxic This new AHA guideline helps us manage patients with cardiac arrest or life-threatening toxicity from a poisoning. Phone a friend – call a toxicologist or poison center. Severe
- [When to Crack the Pediatric Chest – New Guidelines](https://emergencymed.org.il/when-to-crack-the-pediatric-chest-new-guidelines/articles-2/) - October 24, 2023 / Pediatrics, Surgery, Trauma Written by Clay Smith Emergency department thoracotomy (EDT) is recommended in pulseless pediatric patients with signs of life (SOL)* who have penetrating thoracic/abdominopelvic trauma; if pulseless with SOL* and blunt trauma, a conditional recommendation is made. When to crack the pediatric chest EAST EDT guidelines for adults recommend EDT in more scenarios. Also, WEST found (in
- [Developing an implementation intervention for managing acute vertigo in the emergency department](https://emergencymed.org.il/developing-an-implementation-intervention-for-managing-acute-vertigo-in-the-emergency-department/airway/) - David Herdman1, Hena Ahmad2, George Antoniades3, Gokul Bailur3, Arun Pajaniappane1, http://orcid.org/0000-0002-5551-6261Phil Moss3 Correspondence to Dr David Herdman, Audiovestibular Medicine, St George's University Hospitals NHS Foundation Trust, London, SW17 0QT, UK; David.Herdman@stgeorges.nhs.uk Abstract Background There are evidence-based bedside tests for diagnosing acute vertigo, but no evidence-based strategies to support clinicians in implementing them. The purpose
- [Hot Topics in RSI – Guidelines from The Society of Critical Care Medicine](https://emergencymed.org.il/hot-topics-in-rsi-guidelines-from-the-society-of-critical-care-medicine/articles-2/) - October 18, 2023 / Airway, Critical Care, Pain/Sedation/Procedure, Pharmacy/Pharmacology Written by Seth Walsh-Blackmore Positioning, preoxygenation, medication selection, and other questions surrounding emergent rapid sequence intubation (RSI) are addressed by an expert panel. Some pre-intubation contemplation RSI is the norm for intubation outside the operating room, but there are substantial variations in provider approach. A Society of Critical Care Medicine panel
- [How Useful Is Lactate Clearance Anyway?](https://emergencymed.org.il/how-useful-is-lactate-clearance-anyway/articles-2/) - October 20, 2023 / Critical Care, Infectious Disease Written by Millie Cossé Don’t hang your hat on lactate clearance to assess therapeutic response to resuscitation in sepsis; there are too many confounders, and initial clearance does not necessarily project clinical course. Just another lab to trend This study included 4,775 patients with clinical suspicion of infection who had
- [Added Value of an Advanced Workup After the First Seizure](https://emergencymed.org.il/added-value-of-an-advanced-workup-after-the-first-seizure/articles-2/) - TAKE-HOME MESSAGE Challenging the established approach to a clinical workup for new-onset epilepsy, using data from 1010 patients who presented with a first-ever seizure event, the authors showed that overnight long-term EEG and MRI had higher sensitivities than
- [PODCAST: EMJ October 2023](https://emergencymed.org.il/podcast-emj-october-2023/podcast/) - Oct 20, 2023 This month Susie and Raj discuss a paper called You may think that the consultants are great, and they know everything, but they don't, exploring how new emergency medicine consultants experience uncertainty. And then in the 2nd part of this months podcast Noel and Stephen discuss a systematic review called Why is
- [Test Characteristics of Emergency Medicine-Performed Point-of-Care Ultrasound for the Diagnosis of Acute Cholecystitis: A Systematic Review and Meta-analysis](https://emergencymed.org.il/test-characteristics-of-emergency-medicine-performed-point-of-care-ultrasound-for-the-diagnosis-of-acute-cholecystitis-a-systematic-review-and-meta-analysis/articles-2/) - Samuel J. Wilson, MD Rajiv Thavanathan, MD Wei Cheng, PhD Joanna Stuart, BSc Daniel J. Kim, MD Peter Glen, MD, MSc Shauna Duigenan, MD Risa Shorr, MLS Michael M. Woo, MD Jeffrey J. Perry, MD, MSc Published:October 18, 2023DOI:https://doi.org/10.1016/j.annemergmed.2023.09.005 Acute cholecystitis accounts for up to 9% of hospital admissions for acute abdominal pain, and best practice entails early surgical management. Ultrasound is
- [Review article: Accuracy of emergency physician performed point-of-care ultrasound of the thoracic aorta: A systematic review and narrative synthesis of the literature](https://emergencymed.org.il/review-article-accuracy-of-emergency-physician-performed-point-of-care-ultrasound-of-the-thoracic-aorta-a-systematic-review-and-narrative-synthesis-of-the-literature/articles-2/) - William Thomas MBBS, GradDipSurgAnat, GradCertClinUS, Jonathan Henry MBChB, MClinUS, CCPU, AFRACMA, FACEM, Jay Ee Chew MD, Manuja Premaratne MBBS, FRACP, FSCCT, FCSANZ, Gabriel Blecher MBBS (Hons), PGradDipMan, MSc (Epi), CCPU, FACEM, Darsim L Haji MBChB, PhD, PGradDipCritCareEcho, FACEM … See fewer authors First published: 26 June 2023 https://doi-org.ezproxy.bgu.ac.il/10.1111/1742-6723.14262 Abstract Point-of-care ultrasound (POCUS) is becoming
- [PODCAST: REBOA: Resuscitative Endovascular Balloon Occlusion of the Aorta](https://emergencymed.org.il/podcast-reboa-resuscitative-endovascular-balloon-occlusion-of-the-aorta/trauma/) - In this episode, we review Resuscitative endovascular balloon occlusion of the aorta (REBOA), notably dissecting the recent Jansen et al trial in JAMA. Shownotes / References: FOAMcast.org
- [Can cardiovascular reserve index (CVRI) on arrival to the trauma unit detects massive hemorrhage and predicts developing hemorrhage? observational prospective cohort study](https://emergencymed.org.il/can-cardiovascular-reserve-index-cvri-on-arrival-to-the-trauma-unit-detects-massive-hemorrhage-and-predicts-developing-hemorrhage-observational-prospective-cohort-study/articles-2/) - Shaya, Yossia,b; Stein, Michaela,c; Gershovitz, Lirone; Furer, Ariele; Khalaf, Ananb; Drescher, Michael J. MDa,b; Gabbay, Uri MD, MPHa,f Author Information International Journal of Surgery ():10.1097/JS9.0000000000000826, October 5, 2023. | DOI: 10.1097/JS9.0000000000000826 Abstract Background: The detection of hemorrhage in trauma casualties may be delayed owing to compensatory mechanisms. This study aimed to evaluate whether
- [PODCAST: JEM August 2023 Podcast Summary](https://emergencymed.org.il/podcast-jem-august-2023-podcast-summary/podcast/) - Oct 13, 2023 Podcast summary of articles from the August 2023 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include EMS and COVID, COVID intubations, pediatric EMS handoffs, pediatric headaches, post operative complications, and the ED use of bicarbonate. Guest speaker is Dr. James O'Hora.
- [Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury The CRYOSTAT-2 Randomized Clinical Trial](https://emergencymed.org.il/early-and-empirical-high-dose-cryoprecipitate-for-hemorrhage-after-traumatic-injury-the-cryostat-2-randomized-clinical-trial/articles-2/) - Ross Davenport, PhD1; Nicola Curry, MD2; Erin E. Fox, PhD3; et alHelen Thomas, MSc4; Joanne Lucas, MSc5; Amy Evans, MMedSci5; Shaminie Shanmugaranjan, BSc5; Rupa Sharma, BSc5; Alison Deary, MSc5; Antoinette Edwards, MA6; Laura Green, MD1; Charles E. Wade, MD3; Jonathan R. Benger, MD7; Bryan A. Cotton, MD3; Simon J. Stanworth, MD, DPhil8; Karim Brohi, MD1; for the CRYOSTAT-2 Principal Investigators Author Affiliations Article Information JAMA. Published online October 12, 2023. doi:10.1001/jama.2023.21019 Key Points Question Does transfusion of early and empirical high-dose cryoprecipitate in
- [Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage The UK-REBOA Randomized Clinical Trial](https://emergencymed.org.il/emergency-department-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients-with-exsanguinating-hemorrhage-the-uk-reboa-randomized-clinical-trial/articles-2/) - Jan O. Jansen, PhD1,2; Jemma Hudson, PhD1; Claire Cochran, MSc1; et alGraeme MacLennan, MSc1; Robbie Lendrum, MBChB3; Sam Sadek, MBBS4; Katie Gillies, PhD1; Seonaidh Cotton, PhD1; Charlotte Kennedy, MSc5; Dwayne Boyers, PhD5; Gillian Ferry, MSc1; Louisa Lawrie, PhD1; Mintu Nath, PhD6; Samantha Wileman, PhD1; Mark Forrest, BSc1; Karim Brohi, MBBS7; Tim Harris, MBBS3; Fiona Lecky, PhD8; Chris Moran, MD9; Jonathan J. Morrison, PhD10; John Norrie, MSc11; Alan Paterson, DPhil12; Nigel Tai, MS13; Nick Welch14; Marion K. Campbell, PhD1; and the UK-REBOA Study Group Author Affiliations Article Information JAMA. Published online October 12, 2023. doi:10.1001/jama.2023.20850 Key Points Question Does the addition of resuscitative endovascular balloon occlusion of
- [PODCAST: Grand Rounds - Dr. Arya Mohabbat - Central Sensitization: a syndrome of multiple difficult-to-explain chronic debilitating symptoms](https://emergencymed.org.il/podcast-grand-rounds-dr-arya-mohabbat-central-sensitization-a-syndrome-of-multiple-difficult-to-explain-chronic-debilitating-symptoms/podcast/) - So many people come to emergency departments with unexplained recurrent pains, fatigues, gastrointestinal symptoms and more - when there seems like no way we can help them, Dr. Mohabbat offers us some insight into what might be happening and how we can help be a positive experience in these patient's and family's lives. Listen to
- [LANCET: An urgent call for the immediate release of Israeli hostages](https://emergencymed.org.il/lancet-an-urgent-call-for-the-immediate-release-of-israeli-hostages/articles-2/) - The past few days have been harrowing for Israel. We are in shock at the greatest loss of civilian life since the establishment of the state of Israel in 1948.1 Civilians—Jewish, Christian, and Muslim—were massacred on a scale that is incomprehensible, in a calculated act of terror. Jewish families have been massacred in their homes,
- [PODCAST: Anticoag Reversal: try spelling these drugs](https://emergencymed.org.il/podcast-anticoag-reversal-try-spelling-these-drugs/education-tips/) - EM Board Bombs · 193. Anticoag Reversal: try spelling these drugs If there was an option of taking boards or just doing a spelling bee and correct pronunciation on all the anticoagulant drugs, which one would be easier? Let's quickly review this high yield subject and common ED scenario. Want to experience the greatest in
- [How to Identify Errors – “Would You Have Done Something Differently?”](https://emergencymed.org.il/how-to-identify-errors-would-you-have-done-something-differently/articles-2/) - October 9, 2023 / ED Operations, Education, Practice of EM Written by Doug Wallace Asking EPs the question – “Would you have done something differently? (WYHDSD)” – was found to have high sensitivity (97.4%) and NPV (99.8%) in predicting medical error. Specificity was lower at 92.9%. Hindsight is 20/20 Medical errors are a significant concern, with numerous studies demonstrating their
- [Cauda Equina Syndrome – Spoon-Feed Version](https://emergencymed.org.il/cauda-equina-syndrome-spoon-feed-version/articles-2/) - October 6, 2023 / Neurosurgery, Orthopedics Written by Jason Lesnick Cauda equina syndrome (CES) is a spinal emergency. This is a practical guide for diagnosis and management as well as review of recent literature published on the topic. Oh no – the horse’s tail is under pressure! The authors reference a study that estimates 1 in 300 patients
- [PODCAST: June 2023, Pericarditis Presentations in the Emergency Department and Esophageal Emergencies](https://emergencymed.org.il/podcast-june-2023-pericarditis-presentations-in-the-emergency-department-and-esophageal-emergencies/education-tips/) - ACEP Critical Decisions in Emergency Medicine · June 2023: Pericarditis Presentations in the Emergency Department and Esophageal Emergencies In the June episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss pericarditis presentations in the emergency department and esophageal emergencies. As always, you’ll hear about the hot topics covered in CDEM’s
- [PODCAST: On The Streets,  Hydrofluoric Acid Case Review](https://emergencymed.org.il/podcast-on-the-streets-hydrofluoric-acid-case-review/ילדים/) - Sep 29, 2023 Contributors: Kalen Abbott, MD - EM Physician and Medical Director for AirLife Denver Brendan Reiss - Flight Nurse AirLife Denver Matt Spoon - Flight Paramedic AirLife Denver Jordan Ourada - EMS Coordinator at Swedish Medical Center and Paramedic Summary: In this episode, hosted by Jordan Ourada, Brendan Reiss and Matt Spoon present
- [PODCAST: Substance Use in Adolescents](https://emergencymed.org.il/podcast-substance-use-in-adolescents/ילדים/) - In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the October 2023 Pediatric Emergency Medicine Practice article, Substance Use in Adolescents: Recognition and Management in the Emergency Department and the October 2023 Emergency Medicine Practice article, Evidence-Based Emergency Department Management of Migraine and Other Primary Headaches Substance Use In Adolescents Epidemiology Risk Factors Differential Diagnosis Prehospital Care ED History and
- [PODCAST:  RCEM Learning October 2023](https://emergencymed.org.il/podcast-rcem-learning-october-2023/podcast/) - This month for the October 2023 episode of the RCEM Learning Podcast we’ve got a New in EM segment looking at the CT FIRST study looking at routine head-to-pelvis CT scan post-arrest. We then move to an RCEM ASC Interview Megamix where I have a chat with ten presenters from this week's RCEM ASC about
- [Podcast : Increased Intracranial Pressure and the Cushing Reflex](https://emergencymed.org.il/podcast-increased-intracranial-pressure-and-the-cushing-reflex/podcast/) - Oct 2, 2023 Contributor: Travis Barlock MD Education Pearls: The Cushing Reflex is a physiologic response to elevated intracranial pressure (ICP) Cushing’s Triad: widened pulse pressure (systolic hypertension), bradycardia, and irregular respirations Increased ICP results from systolic hypertension, which causes a parasympathetic reflex to drop heart rate, leading to Cushing’s Triad. The Cushing Reflex is
- [Are there differences in the relationship between respiratory rate and oxygen saturation between patients with COVID-19 and those without COVID-19? Insights from a cohort-based correlational study](https://emergencymed.org.il/are-there-differences-in-the-relationship-between-respiratory-rate-and-oxygen-saturation-between-patients-with-covid-19-and-those-without-covid-19-insights-from-a-cohort-based-correlational-study/articles-2/) - Mikael Laredo ,1,2 Claire Vandiedonck ,3 Òscar Miró,4 Juan González del Castillo,5 Aitor Alquézar-Arbé, 6 Javier Jacob,7 Pascual Piñera,8 Bruno Mégarbane 1 Abstract Background Physicians have observed patients with COVID-19 without respiratory distress despite marked hypoxaemia and extensive radiographic abnormalities, a controversial phenomenon called ‘silent hypoxaemia’.
- [Effect of intranasal sufentanil on acute post-traumatic pain in the emergency department: a randomised controlled trial](https://emergencymed.org.il/effect-of-intranasal-sufentanil-on-acute-post-traumatic-pain-in-the-emergency-department-a-randomised-controlled-trial/articles-2/) - Stefano Malinverni ,1 Bernard Kreps ,2 Thibault Lucaccioni ,1 Fatima-Zohra Bouazza ,1 Magali Bartiaux ,1 Alain Plumacker ,1 Andreea Pascu,1 Pierre Youatou Towo 1 Abstract Background Intranasal sufentanil is a potent opioid which can be used in patients with
- [Identifying Objective Performance Errors During Intubation](https://emergencymed.org.il/identifying-objective-performance-errors-during-intubation/articles-2/) - October 4, 2023 / Airway, Technology Written by Aaron Lacy Using intubation videos, this group identified 13 key performance errors that occur during laryngoscopy. Read more to see what the proceduralists did wrong. Take your airway QI to the next level A feature of videolaryngoscopes is the ability to record and review footage of the laryngoscopy, but this can
- [New App for Pediatric Cardiac Arrest](https://emergencymed.org.il/new-app-for-pediatric-cardiac-arrest/articles-2/) - September 28, 2023 / Pediatrics, Resuscitation, Technology Written by Denrick Cooper We’re trying something new! Watch quick videos, with my personal take on the articles we cover each week and more! Here’s the JournalFeed YouTube channel link. ~Clay This RCT found residents using a pediatric cardiac arrest app better adhered to the pediatric cardiac arrest algorithm when compared to those using
- [New ACEP Clinical Policy on Acute Ischemic Stroke](https://emergencymed.org.il/new-acep-clinical-policy-on-acute-ischemic-stroke/articles-2/) - September 27, 2023 / Stroke Written by Laura Murphy We’re trying something new! Watch quick videos, with my personal take on the articles we cover each week and more! Here’s the JournalFeed YouTube channel link. ~Clay This ACEP Clinical Policy examined four specific clinical questions related to ED management of acute ischemic stroke, which are summarized below. Brain-Busters: Some
- [PODCAST: BBQ and brain masses](https://emergencymed.org.il/podcast-bbq-and-brain-masses/trauma/) - EM Board Bombs · 191. BBQ and brain masses Like pork? May want to set down your BBQ sandwich before listening to this episode. Let’s talk about a rare diagnosis and a great differential for brain masses.
- [PODCAST: Advanced Trauma Life Support (ATLS)](https://emergencymed.org.il/podcast-advanced-trauma-life-support-atls/trauma/) - Sep 25, 2023 Contributor: Meghan Hurley MD Educational Pearls: What is ATLS? Advanced Trauma Life Support (ATLS) is a systematic and comprehensive approach to the evaluation and management of trauma patients It was developed by the American College of Surgeons (ACS) The key components include the Primary Survey ("ABCDE"), the Secondary Survey, Definitive Care, and
- [Point-of-care ultrasound-guided versus standard reduction of displaced distal radius fractures in the emergency department: a randomised controlled clinical trial](https://emergencymed.org.il/point-of-care-ultrasound-guided-versus-standard-reduction-of-displaced-distal-radius-fractures-in-the-emergency-department-a-randomised-controlled-clinical-trial/articles-2/) - http://orcid.org/0000-0002-0080-3642Svenja L Haak1,2, Marion G Borgstede3, Renate Stolmeijer4, Bas WJ Bens4, Annemieke E Boendermaker5, http://orcid.org/0000-0003-0849-452XBrigitta (Britt) YM van der Kolk1, http://orcid.org/0000-0002-0353-4011Jan C ter Maaten6, http://orcid.org/0000-0002-1462-6130Ewoud er Avest4, Heleen Lameijer2 Correspondence to Dr Svenja L Haak, Emergency Medicine, Isala, Zwolle, 8025 AB, The Netherlands; s.l.haak@umcg.nl Abstract Background During closed reduction of displaced
- [PODCAST: Respiratory viral panels](https://emergencymed.org.il/podcast-respiratory-viral-panels/podcast/) - Just because you can test for dozens of viruses with a single swab should you? Is this actually measuring a current infection, or a recent virus from which the child has since recovered. And what about the cost? Are these tests expensive (spoiler alert: They are!). Learn about the situations when we should get these
- [Thoracic outlet syndrome: wide literature for few cases. Status of the art](https://emergencymed.org.il/thoracic-outlet-syndrome-wide-literature-for-few-cases-status-of-the-art/articles-2/) - Pietro Emiliano Doneddu1 • Daniele Coraci2,3 • Paola De Franco2 • Ilaria Paolasso2 • Pietro Caliandro1 • Luca Padua1,2 Abstract Despite its low prevalence and incidence, considerable debate exists in the literature on thoracic outlet syndrome (TOS). From literature analysis on nerve entrapments, we realized
- [Long-Term Incidence of Ischemic Stroke Following Transient Ischemic Attack](https://emergencymed.org.il/long-term-incidence-of-ischemic-stroke-following-transient-ischemic-attack/articles-2/) - Circulation TAKE-HOME MESSAGE This study investigated the long-term risk of subsequent ischemic stroke in 21,500 patients who experienced a first transient ischemic attack (TIA) compared with that of 86,000 individuals from the general population and 21,500 patients who experienced a first-time ischemic stroke (control group).
- [Mortality Trends After Primary PCI in Patients With STEMI](https://emergencymed.org.il/mortality-trends-after-primary-pci-in-patients-with-stemi/articles-2/) - Journal of the American College of Cardiology TAKE-HOME MESSAGE This registry-based study analyzed 19,613 patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI) in Western Denmark from
- [Rethinking Appropriate ETT Insertion Depth in Children](https://emergencymed.org.il/rethinking-appropriate-ett-insertion-depth-in-children/articles-2/) - Written by Aaron Lacy Formula-based calculations for ETT depth in pediatric patients are based on a linear curve, despite children’s growth not being linear or uniform. Looking at age, height, and weight, these authors provide ETT depth recommendations based on calculated best-fit curves. Not too deep, not too shallow: The Goldilocks zone for ETT depth Given
- [BP Wildly Varies With Wrong Cuff Size](https://emergencymed.org.il/bp-wildly-varies-with-wrong-cuff-size/articles-2/) - September 20, 2023 / Medicine/Geriatrics Written by Jason Lesnick This randomized controlled trial demonstrated a clinically significant difference in blood pressure measurements when inappropriately sized BP cuffs were used on patients. Not too big, not too small, but just right Prior studies looking at measuring BP using an automated oscillometric BP device have been limited by observational
- [Should We Do Brain Imaging on Suspected Infective Endocarditis Patients?](https://emergencymed.org.il/should-we-do-brain-imaging-on-suspected-infective-endocarditis-patients/articles-2/) - September 19, 2023 / Imaging, Infectious Disease Written by Millie Cossé Among patients with infective endocarditis (IE), 39% of neurologically “asymptomatic” patients had a cerebral embolic event (CEE) on neuroimaging, and a new surgical indication was established in 19% of these cases. CEEs were seen in 73% of neurologically symptomatic patients. But there were some issues with this
- [PODCAST, Pediatric Constipation: Diagnosis, X-Rays, and more](https://emergencymed.org.il/podcast-pediatric-constipation-diagnosis-x-rays-and-more/ילדים/) - Where else is the poop going to be? Constipation is by and large a clinical diagnosis. This episode reviews how to make the diagnosis, red flags, and why X-Rays don’t necessarily help assess stool burden adequately in most children. This podcast episode is designed to disseminate the important work of Choosing Wisely, an initiative of the
- [RCEM Learning September 2023](https://emergencymed.org.il/rcem-learning-september-2023/education-tips/) - September 20230 Sep 5, 2023 This month for the September 2023 episode of the RCEM Learning Podcast we've got a New in EM segment looking at the SQUID protocol for DKA. We then move from last month's discussion on Head Injuries and move to Concussion and speak to two experts on the topic and how
- [PODCAST: Persistent Sinusitis Treatments | All About Priapism](https://emergencymed.org.il/podcast-persistent-sinusitis-treatments-all-about-priapism/spoon-feed/)
- [POCUS for the diagnosis of peritonsillar abscess](https://emergencymed.org.il/pocus-for-the-diagnosis-of-peritonsillar-abscess/articles-2/) - September 18, 2023 / ENT/Face, Ultrasound Written by Megan Hilbert While it doesn’t have great specificity, the sensitivity of ultrasound makes it a viable first step in making the diagnosis of peritonsillar abscess. Sore throats and sound waves In Emergency Medicine, not all sore throats and “hot potato” voices are the same. It is important to establish the
- [PODCAST: The Rheumatoid Arthritis POC Tool with Dr. Marsha Ford](https://emergencymed.org.il/podcast-the-rheumatoid-arthritis-poc-tool-with-dr-marsha-ford/podcast/) - ACEP Frontline · The Rheumatoid Arthritis POC Tool with Dr. Marsha Ford In this bonus episode of the podcast, we talk with Dr. Marsha Ford about the new RA point-of-care tool to help physicians with the evaluation, diagnosis, and management in the emergency department.
- [PODCAST: Grand Rounds - Dr. Alex Niven - Difficult airway management, an intensivist’s perspective](https://emergencymed.org.il/grand-rounds-dr-alex-niven-difficult-airway-management-an-intensivists-perspective/podcast/) - In this chapter, Dr. Alex Niven, renowned critical care physician and educator, provides a mirror for us to see our current state of emergency airway management - for its opportunities for improvement, innovations and best practices. This evidence fueled presentation is a must-listen for any emergency healthcare physician or provider. CONTACTS Youtube -https://www.youtube.com/@AlwaysonEM X -
- [PODCAST: Organophosphate Poisoning](https://emergencymed.org.il/podcast-organophosphate-poisoning/education-tips/) - Introduction Used as pesticides Used as weapons (nerve agents) Sarin Gas, VX Gas, Novichok Transdermal, Inhalation, Ingestion Clinical Presentation Muscarinic Activation (Dumbels Mnemonic) Defication Urination Myosis Bradycardia, Bronchospasm, and Bronchorrhea “The Killer B’s” Emesis Lacrimation Salivation and Sweating Nicotinic Activation Muscle weakness and paralysis CNS Activation Respiratory Depression Altered Mental Status Seizures Treatment Atropine Reverses
- [Understanding pre-hospital blood transfusion decision-making for injured patients: an interview study](https://emergencymed.org.il/understanding-pre-hospital-blood-transfusion-decision-making-for-injured-patients-an-interview-study/articles-2/) - http://orcid.org/0000-0002-7147-6861Max E R Marsden1,2, Suzie Kellett3, Rahul Bagga4, Jared M Wohlgemut1, Richard L Lyon5,6, Zane B Perkins1,7, Katie Gillies8, Nigel RM Tai1,2 Correspondence to Mr Max E R Marsden, Centre for Trauma Sciences, Barts and The London School of Medicine and Dentistry Blizard Institute, London, UK; Max.Marsden1@nhs.net Abstract Background Blood transfusion
- [PODCAST: Traumatic Dental Emergencies part II](https://emergencymed.org.il/podcast-traumatic-dental-emergencies-part-ii/articles-2/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” In this part 2 of our 2-part podcast series on dental emergencies we cover traumatic dental emergencies. Dental trauma is common and often associated with facial trauma. In this episode Dr. Chris Nash and Dr. Richard Ngo answer
- [PODCAST:  Atraumatic Dental Emergencies part I](https://emergencymed.org.il/podcast-atraumatic-dental-emergencies-part-i/articles-2/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Here’s the problem: About 1% of all visits to the ED are for dental complaints, yet most of us have little training on how to recognize and manage dental emergencies. There are a multitude
- [ECG in Weakness and Neurological Symptoms](https://emergencymed.org.il/ecg-in-weakness-and-neurological-symptoms/articles-2/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” In this ECG Cases blog we review how the ECG can help in diagnosing a variety of causes of generalized weakness and acute neurological symptoms. Written by Jesse McLaren; Peer Reviewed and edited by
- [How to Treat Priapism](https://emergencymed.org.il/how-to-treat-priapism/articles-2/) - September 15, 2023 / Urology Written by Jason Lesnick Priapism is a semi-rare time sensitive emergent disease, and this article is a summary of guidelines for diagnosis and management. “Call your doctor if an erection lasts longer than four hours” Priapism is defined as an erection lasting >4 hours. These guidelines were developed by the American Urological
- [NEJM: The Worldwide Impact of Modifiable Cardiovascular Risk Factors](https://emergencymed.org.il/nejm-the-worldwide-impact-of-modifiable-cardiovascular-risk-factors/articles-2/) - Harlan M. Krumholz, MD, SM, reviewing The Global Cardiovascular Risk Consortium. N Engl J Med 2023 Aug 26 Quantifying the region- and sex-specific consequences of these risk factors can help to shape policy efforts and patient care. We know the traditionally identified modifiable cardiovascular risk factors: body-mass index, systolic blood pressure, non–high-density lipoprotein cholesterol level, tobacco smoking, and
- [PODCAST: When it all goes bad with the LVAD with Dr. Matthew Kennedy - MEMA23](https://emergencymed.org.il/podcast-when-it-all-goes-bad-with-the-lvad-with-dr-matthew-kennedy-mema23/podcast/) - ACEP Frontline · When it all goes bad with the LVAD with Dr. Matthew Kennedy - MEMA23 In this episode from MEMA23 in Michigan, we chat with Dr. Matthew Kennedy about the evaluation and management of the most common LVAD presentations. It way be rare for most emergency departments, but it's important to know what
- [PODCAST: EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn’s Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients View Larger Image](https://emergencymed.org.il/podcast-em-quick-hits-51-methylene-blue-in-septic-shock-tmj-dislocation-crohns-disease-analgesia-for-renal-colic-inhaled-steroids-for-asthma-hypocalcemia-in-bleeding-trauma-pa/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Topics in this EM Quick Hits podcast Anand Swaminathan on the role of methylene blue in septic shock (0:39) Nour Khatib on TMJ dislocation reduction techniques (5:51) Hans Rosenberg on a phenotypic approach to Crohn’s disease emergencies (10:31) Gil Yehudaiff on
- [PODCAST: Sepsis, burn the stopwatches](https://emergencymed.org.il/podcast-sepsis-burn-the-stopwatches/podcast/) - EM Board Bombs · 189. Sepsis: burn the stopwatches We promise this isn't clickbait. Hospital administrators take note. We're covering what's important in sepsis care. Take a guess what we won't be covering.... It begins with an L and ends in -actate. Want to experience the greatest in board studying? Check out our interactive question
- [PODCAST:  Airway Management in Obesity](https://emergencymed.org.il/podcast-airway-management-in-obesity/קדם-בית-חולים/) -  Sep 11, 2023 Contributor: Aaron Lessen MD Educational Pearls: Why is airway management more difficult in obesity? Larger body habitus causes the chest to be above the head when the patient is lying supine, creating difficult angles for intubation. Reduced Functional Residual Capacity (FRC) causes these patients to deoxygenate much more quickly, reducing the
- [How to Spot Ischemia in RBBB Patients](https://emergencymed.org.il/how-to-spot-ischemia-in-rbbb-patients/articles-2/) - September 6, 2023 / Cardiology Written by Christian Gerhart In non-ischemic right bundle branch block (RBBB) ECGs, we expect discordant ST depression and T wave inversions in leads V1-V3. ST segment elevation, or even an isoelectric ST segment, in these leads is abnormal and should make us concerned for ischemia. See below. Be afraid of the RBBB
- [How to Manage Blast Injuries](https://emergencymed.org.il/how-to-manage-blast-injuries/articles-2/) - September 8, 2023 / Critical Care, EMS, Trauma Written by Michael Stocker Blast injuries combine common polytrauma mechanisms – blunt, penetrating, burns – with the unique pathophysiology of blast wave injuries, and mass casualty scenarios. While rare, these patients are resource-intensive, prone to delayed yet rapid clinical deterioration, and carry high morbidity and mortality. Close only counts in horseshoes
- [Prehospital early warning scores for adults with suspected sepsis: retrospective diagnostic cohort study](https://emergencymed.org.il/prehospital-early-warning-scores-for-adults-with-suspected-sepsis-retrospective-diagnostic-cohort-study/articles-2/) - http://orcid.org/0000-0003-0803-8444Steve Goodacre1, Laura Sutton1, http://orcid.org/0000-0002-6659- 930Ben Thomas1, http://orcid.org/0000-0001-6513-100XOlivia Hawksworth1, Khurram Iftikhar2, Susan Croft2, Gordon Fuller1, Simon Waterhouse1, Daniel Hind1, Mike Bradburn1, http://orcid.org/0000-0003-0220- 223Michael Anthony Smyth3, Gavin D Perkins3, Mark Millins4, Andy Rosser5, http://orcid.org/0000-0002-1361-2714Jon M Dickson1, Matthew Joseph Wilson1 Correspondence to Professor Steve Goodacre, The University of Sheffield, Sheffield S10 2TN, UK; s.goodacre@sheffield.ac.uk Abstract Background Ambulance services need to identify and prioritise patients with sepsis
- [Ultrasonography in thoracic and abdominal stab wound injury: results from the FETTHA study](https://emergencymed.org.il/ultrasonography-in-thoracic-and-abdominal-stab-wound-injury-results-from-the-fettha-study/articles-2/) - Donia Bouzid1,2,3,4, Alexy Tran-Dinh1,5,6, Brice Lortat-Jacob5, Enora Atchade5, Sylvain Jean-Baptiste5, Parvine Tashk5, Aurelie Snauwaert5, Nathalie Zappella5, Pascal Augustin5, Quentin Pellenc7, Yves Castier1,6,7, Lara Ribeiro8, Augustin Gaudemer9, Antoine Khalil1,9,10, Philippe Montravers1,5,10, http://orcid.org/0000-0003-4698-3287Sebastien Tanaka5,11 on behalf of the Bichat stab wounds injury study group Correspondence to Dr Sebastien Tanaka, APHP, Paris, Île-de-France, France; sebastien.tanaka@aphp.fr Abstract Background While the role of Extended Focused Assessment with Sonography in
- [Potential Hazards of Thrombolysis for Mild Stroke](https://emergencymed.org.il/potential-hazards-of-thrombolysis-for-mild-stroke/articles-2/) - Seemant Chaturvedi, MD, reviewing Sykora M et al. Neurology 2023 Jul 5 Thrombolysis was associated with higher rates of brain hemorrhage and deterioration in patients with mild strokes. The potential role of intravenous thrombolysis (IVT) for patients with acute, mild ischemic strokes is controversial. With recent positive trials of dual antiplatelet therapy for mild stroke, comparative data are
- [NEJM: Should Patients with Atrial High-Rate Episodes Without Atrial Fibrillation Receive Anticoagulation?](https://emergencymed.org.il/nejm-should-patients-with-atrial-high-rate-episodes-without-atrial-fibrillation-receive-anticoagulation/articles-2/) - Behnood Bikdeli, MD, MS, reviewing Kirchhof P et al. N Engl J Med 2023 Aug 25 Edoxaban did not benefit older adults at risk for stroke who did not have AF on surface ECG and led to excess major bleeding events. Atrial high-rate episodes (AHREs) represent a potentially heterogenous group of atrial arrhythmias detected by implantable cardiac devices.
- [Podcast : Carbamazepine (Tegretol) Overdose](https://emergencymed.org.il/podcast-carbamazepine-tegretol-overdose/podcast/) - Contributor: Aaron Lessen MD Educational Pearls: What is Carbamazepine (Tegretol)? Carbamazepine is an anti-epileptic drug with mood-stabilizing properties that is used to treat bipolar disorder, epilepsy, and neuropathic pain. It functions primarily by blocking sodium channels which can prevent repetitive action potential firing. What are the symptoms of an overdose? Common initial signs include diminished
- [podcast:  Hemophilia, if paper cuts could kill](https://emergencymed.org.il/podcast-hemophilia-if-paper-cuts-could-kill/education-tips/) - You spent wayyyyy too much time learning G6PD in med school. Don’t remember that? Yeah, we don’t either. But it’s okay- time to cover a much more important hematology subject: hemophilia. How to manage bleeding, what to look out for, and how to easily nail it on the boards. Want to experience the greatest in
- [Clinical Performance Measures for Emergency Department Care for Adults With Intracranial Hemorrhage](https://emergencymed.org.il/clinical-performance-measures-for-emergency-department-care-for-adults-with-intracranial-hemorrhage-2/articles-2/) - KoriS.Zachrison,MD,MSc*;JoshuaN.Goldstein,MD,PhD;EdwardJauch,MD,MS;RyanP.Radecki,MD; TracyE.Madsen,MD,PhD;OpeoluAdeoye,MD,MS;JohnA.Oostema,MD,MS;V.RamanaFeeser,MD;LathaGanti,MD,; BruceM.Lo,MD,MBA;WilliamMeurer,MD,MS;MitraCorral,MS,MPH;CraigRothenberg,MPH;AnshitaChaturvedi,MD,MPH; PawanGoyal,MD;ArjunK.Venkatesh,MD,MBA Though select inpatient-based performance measures exist for the care of patients with nontraumatic intracranial hemorrhage, emergency departments lack measurement instruments designed to support and improve care processes in the hyperacute phase. To address this, we propose a set of measures applying a syndromic (rather than diagnosis-based) approach
- [Myth Bust – Does Croup Really Get Better in Cold Air?](https://emergencymed.org.il/myth-bust-does-croup-really-get-better-in-cold-air/articles-2/) - August 30, 2023 / Infectious Disease, Pediatrics Written by Clay Smith Is taking a croupy child outdoors in the cold air a myth or evidence-based practice? Turns out, the RCT shows it actually works! Not much cold outside air right now…but the concept makes sense Dexamethasone and nebulized racemic epinephrine are the core treatments for croup. Mist doesn’t hurt
- [Survival by time-to-administration of amiodarone, lidocaine, or placebo in shock-refractory out-of-hospital cardiac arrest](https://emergencymed.org.il/survival-by-time-to-administration-of-amiodarone-lidocaine-or-placebo-in-shock-refractory-out-of-hospital-cardiac-arrest/articles-2/) - Joshua R. Lupton MD, MPH, MPhil, Matthew R. Neth MD, Ritu Sahni MD, MPH, Jonathan Jui MD, Lynn Wittwer MD, Craig D. Newgard MD, MPH, Mohamud R. Daya MD, MSc First published: 04 March 2023 https://doi-org.ezproxy.bgu.ac.il/10.1111/acem.14716 Citations: 1 Supervising Editor: Dr. Jill Stoltzfus. Abstract Background Amiodarone and lidocaine have not been shown
- [A Real-World Experience: Retrospective Review of Point-of-Care Ultrasound Utilization and Quality in Community Emergency Departments](https://emergencymed.org.il/a-real-world-experience-retrospective-review-of-point-of-care-ultrasound-utilization-and-quality-in-community-emergency-departments/articles-2/) - 2023 Smalley, Courtney M.; Simon, Erin L.; Muir, McKinsey R.; Fertel, Baruch S. ABSTRACT Introduction: Point-of-care ultrasound (POCUS) is commonly used in the emergency department (ED) as a rapid diagnostic tool. Emergency medicine (EM) has been
- [Silver Trauma Review Clinic: a novel model of care to manage non-operative injuries in older patients](https://emergencymed.org.il/silver-trauma-review-clinic-a-novel-model-of-care-to-manage-non-operative-injuries-in-older-patients/articles-2/) - Hannah Smyth , Deirdre Breslin, Lorcán Mullany, Vinny Ramiah, Roisin Riches, Rico Laguna, Paula Morgan, Colm Byrne Correspondence to Dr Hannah Smyth, Mater Misericordiae University Hospital, Dublin, D07 R2WY, Ireland; hmsmyth@tcd.ie Abstract Background Increasing numbers of older patients are presenting to the ED following trauma.
- [PODCAST: Vasopressors](https://emergencymed.org.il/podcast-vasopressors/education-tips/) - We go over the essential and complex topic of vasopressors in the ED. Hosts: Brian Gilberti, MD Catherine Jamin, MD Show Notes Introduction Host: Brian Gilberti, MD Guest: Catherine Jamin, MD Associate professor of Emergency Medicine at NYU Langone Health Vice Chair of Operations Triple-boarded in Emergency Medicine, Internal Medicine, and Critical Care Medicine Topic:
- [PODCAST: Get a Grip on Hand Injuries with Dr. Ben Schoener - MEMA23](https://emergencymed.org.il/podcast-get-a-grip-on-hand-injuries-with-dr-ben-schoener-mema23/trauma/) - ACEP Frontline · Get a Grip on Hand Injuries with Dr. Ben Schoener - MEMA23 Another episode featuring Dr. Ben Schoener from the Michigan Emergency Medicine Assembly from MCEP. We talk about hand injuries and presentations in the emergency department with management pearls and pitfalls.
- [Subsegmental PE – Hold the Anticoagulation?](https://emergencymed.org.il/subsegmental-pe-hold-the-anticoagulation/articles-2/) - August 29, 2023 / Venous Thromboembolism Written by Samuel G. Rouleau Structured surveillance without anticoagulation of patients with isolated subsegmental pulmonary embolism (ssPE) rarely occurs in community practice. After applying CHEST guidelines, ~5% of patients with isolated subsegmental PE are eligible for surveillance. Small PE? Fat chance…of surveillance without anticoagulation Pulmonary emboli confined to the subsegmental
- [Point- of- care ultrasound- guided regional anaesthesia: the superficial cervical plexus block for a patient with a clavicle fracture](https://emergencymed.org.il/point-of-care-ultrasound-guided-regional-anaesthesia-the-superficial-cervical-plexus-block-for-a-patient-with-a-clavicle-fracture/articles-2/) - מומלץ לגשת לדף של ה BMJ Case presentation A right-hand dominant woman aged 46 years with a history of opiate use disorder presents to the ED following a right clavicle injury. While riding to work, the patient fell off her bicycle, landing on her right shoulder. She denies any
- [BMJ: Impact of serial cardiopulmonary point- of- care ultrasound exams](https://emergencymed.org.il/bmj-impact-of-serial-cardiopulmonary-point-of-care-ultrasound-exams/articles-2/) - Michael Dan Arvig ,1,2,3 Annmarie Touborg Lassen ,3,4,5 Peter Haulund Gæde,6,7 Stefan Wernblad Gärtner,1,8 Casper Falster ,9,10 Inge Raadal Skov,9,10 Henrik Ømark Petersen,4,11 Stefan Posth,3,4 Christian B Laursen9,10 Abstract Background Serial point-of-care ultrasound (PoCUS) can potentially improve acute patient care through treatment adjusted to the dynamic ultrasound findings. The objective was
- [BMJ: Predictors of parental anxiety in a paediatric emergency department](https://emergencymed.org.il/bmj-predictors-of-parental-anxiety-in-a-paediatric-emergency-department/articles-2/) - Sarah R Martin ,1,2,3 Isaac Hung,2,4 Theodore W Heyming,3,5 Michelle A Fortier,2,6,7 Zeev N Kain1,2,7,8 Correspondence to Dr Zeev N Kain, Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, USA; zkain@uci.edu Abstract Background Children experience significant anxiety in the paediatric ED. Although research from preoperative and primary care samples indicates
- [New ACEP Clinical Policy on Mild TBI](https://emergencymed.org.il/new-acep-clinical-policy-on-mild-tbi/articles-2/) - August 25, 2023 / Imaging, Neurosurgery, Trauma Written by Laura Murphy ACEP has issued an updated Clinical Policy to provide evidence-based guidelines for management of adult patients presenting to the ED with mild traumatic brain injury based on systematic review of available literature. (Head) bang for the buck Traumatic brain injury leads to significant number of hospitalizations and causes
- [Sepsis Prediction Model for Determining Sepsis vs SIRS, qSOFA, and SOFA](https://emergencymed.org.il/sepsis-prediction-model-for-determining-sepsis-vs-sirs-qsofa-and-sofa/articles-2/) - Adam R. Schertz, MD, MS1,2; Kristin M. Lenoir, MPH3; Alain G. Bertoni, MD, MPH1,3; et alBeverly J. Levine, PhD4; Morgana Mongraw-Chaffin, PhD5; Karl W. Thomas, MD1,2 Author Affiliations Article Information JAMA Netw Open. 2023;6(8):e2329729. doi:10.1001/jamanetworkopen.2023.29729 Key Points Question Does the Sepsis Prediction Model (SPM) outperform other sepsis prediction scores with respect to validity and timeliness? Findings This cohort study of 60 507 adult admissions found that although balanced
- [PODCAST: The Boarding Crisis in EM with Dr. Ben Zaniello and Jody Lon](https://emergencymed.org.il/the-boarding-crisis-in-em-with-dr-ben-zaniello-and-jody-lon/education-tips/) - ACEP Frontline · The Boarding Crisis in EM with Dr. Ben Zaniello and Jody Long In this episode, we chat with Dr. Ben Zaniello and Jody Long about leveraging technology to help alleviate the boarding crisis in EM. Nearly every ED deals with it and COVID only made it worse. We talk about the problems
- [PODCAST: Septic Joint in Children](https://emergencymed.org.il/podcast-septic-joint-in-children/ילדים/) - General Pain in joint for pediatric patient has a broad differential, including transient synovitis and septic arthritis Transient synovitis, also known as toxic synovitis, is a common condition affecting kids aged 3-10 and often occurs after a viral infection. It is typically self-limiting and not considered a serious condition. Septic arthritis is an infection in
- [Does Low Dose Ketamine or Etomidate Prevent Post-Induction Hypotension in Unstable Patients?](https://emergencymed.org.il/does-low-dose-ketamine-or-etomidate-prevent-post-induction-hypotension-in-unstable-patients/articles-2/) - August 21, 2023 / Airway, Critical Care, Pharmacy/Pharmacology Written by Joshua Campbell There is no association between the weight-based drug dose of etomidate or ketamine and post-intubation hypotension. Does sedative dose matter? Experts have long recommended reducing the dose of sedative used during RSI in hemodynamically unstable patients to reduce the risk of worsening post-intubation hypotension, despite little data
- [Rosen and Barkin s 5-Minute Emergency Medicine Consult](https://emergencymed.org.il/rosen-and-barkin-s-5-minute-emergency-medicine-consult/articles-2/) - Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices.However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences fromapplication of the information in this book and make no warranty, expressed or implied, with respect to the currency,completeness, or accuracy
- [Podcast : Nausea Treatments - Droperidol vs Ondansetron RCT](https://emergencymed.org.il/podcast-nausea-treatments-droperidol-vs-ondansetron-rct/education-tips/) - Contributor: Aaron Lessen MD Educational Pearls: A recent randomized controlled trial compared ondansetron 8 mg IV with droperidol 2.5 mg IV for the treatment of nausea & vomiting in the emergency department. Overall, droperidol and ondansetron had similar primary outcomes in acute nausea control Symptom improvement in 93% of patients receiving droperidol vs. 87% receiving
- [Intubation for patients with overdose: Time to move on from the Glasgow Coma Scale](https://emergencymed.org.il/intubation-for-patients-with-overdose-time-to-move-on-from-the-glasgow-coma-scale/articles-2/) - Richard AF Pellatt FACEM, MBChB, BA (Hons), Katherine Isoardi FACEM, GradDipClinTox, BMed, Gerben Keijzers MSc (Biomed Health Sci), MBBS, FACEM, PhD Abstract Patients frequently present to the ED with drug overdose and reduced conscious level leading to coma. There is considerable practice variation around which patients require
- [Measuring emergency physician productivity and work patterns](https://emergencymed.org.il/measuring-emergency-physician-productivity-and-work-patterns/articles-2/) - Peter Freeman MBChB, FRCEM, FACEM Abstract I propose a methodology to compare individual emergency physician (EP) work patterns. This is intended to generate discussion within the specialty. A work pattern graph shows individual EP productivity and, assuming the EPs case selection is similar, can be used to compare group
- [Suicidal Ideation is Insensitive to Suicide Risk after ED Discharge](https://emergencymed.org.il/suicidal-ideation-is-insensitive-to-suicide-risk-after-ed-discharge/articles-2/) - SAEM · Suicidal Ideation is Insensitive to Suicide Risk after ED Discharge Abstract Objectives: We describe the Columbia-Suicide Severity Rating Scale (C-SSRS)–Clinical Practice Screener’s ability to predict suicide and emergency department (ED) visits for self-harm in the year following an ED encounter.Methods: Screening data from adult patients’ first ED encounter during a
- [Guidelines for reasonable and appropriate care in the emergency department (GRACE): Recurrent, low-risk chest pain in the emergency department](https://emergencymed.org.il/guidelines-for-reasonable-and-appropriate-care-in-the-emergency-department-grace-recurrent-low-risk-chest-pain-in-the-emergency-department/articles-2/) - Paul I. Musey Jr. MD, MSc, Fernanda Bellolio MD, MS, Suneel Upadhye MD, MSc, Anna Marie Chang MD, MSCE, Deborah B. Diercks MD, MSc, Michael Gottlieb MD, Erik P. Hess MD, MSc, Michael C. Kontos MD, Bryn E. Mumma MD, MAS, Marc A. Probst MD, MS, John H. Stahl, Jason P. Stopyra MD, Jeffrey A. Kline MD, Christopher R. Carpenter MD, MSc Abstract
- [Podcast : Arterial Blood Gas (ABG) vs Venous Blood Gas (VBG)](https://emergencymed.org.il/podcast-arterial-blood-gas-abg-vs-venous-blood-gas-vbg/education-tips/) - Aug 14, 2023 Contributor: Aaron Lessen MD Educational Pearls: What is measured in an ABG/VBG? Blood values for oxygen tension (pO2), carbon dioxide tension (pCO2), acidity (pH), oxyhemoglobin saturation, and bicarbonate (HCO3) in either arterial or venous blood Other tests can measure methemoglobin, carboxyhemoglobin, hemoglobin levels, base excess, and lactate What are they used for?
- [Between “Nonsurvivable” and “Brain Death”](https://emergencymed.org.il/between-nonsurvivable-and-brain-death/articles-2/) - Sanjana Salwi, MD1 Author Affiliations Article Information JAMA Neurol. 2023;80(8):773-774. doi:10.1001/jamaneurol.2023.1423 The mother’s eyes are clamped shut. Her nails dig into her husband’s forearm. The room is silent except for the quiet creaking of the conference room chair as she rocks back and forth. There is no way to soften the blow. So, I speak directly.
- [Does Prehospital Transfusion of Pediatric Trauma Patients Save Lives?](https://emergencymed.org.il/does-prehospital-transfusion-of-pediatric-trauma-patients-save-lives/articles-2/) - August 15, 2023 / Pediatrics, Trauma Written by Millie Cossé A reduction in both 24-hour and in-hospital mortality was seen among children who received a transfusion after traumatic injury in the prehospital setting compared to those who were transfused in the emergency department. They’re not bleeding salt water This retrospective cohort study examined 559 patients age 0 to
- [NEJM PODCAST: The Double-Edged Sword of AI, with Dr. Ziad Obermeyer](https://emergencymed.org.il/nejm-podcast-the-double-edged-sword-of-ai-with-dr-ziad-obermeyer-2/education-tips/) - In this thought-provoking episode, Dr. Ziad Obermeyer delves into the complex issues of bias, safety, and generalizability of medical AI. Dr. Obermeyer emphasizes the importance of machine learning researchers’ task formulation, an often-overlooked yet significant determinant of bias in AI algorithms. Highlighting the dual impact of machine learning, he compares two of his works that demonstrate how
- [OPAL RCT – No More Opioids for Back Pain](https://emergencymed.org.il/opal-rct-no-more-opioids-for-back-pain/articles-2/) - August 11, 2023 / Orthopedics, Pain/Sedation/Procedure, Pharmacy/Pharmacology Written by Vivian Lei Opioid pain medications offer no benefit compared to placebo for patients with acute back or neck pain. Stone-cold data on opioids: The OPAL trial Acute neck and back pain are extremely common reasons for visits to emergency departments and primary care clinics. Prescribing an opioid medication for pain
- [Accuracy of physician gestalt in prediction of significant abdominal and pelvic injury in adult blunt trauma patients](https://emergencymed.org.il/accuracy-of-physician-gestalt-in-prediction-of-significant-abdominal-and-pelvic-injury-in-adult-blunt-trauma-patients/articles-2/) - Nicole M Rodriguez 1, William R Mower 2, Ali S Raja 3, Malkeet Gupta 2 4, Juan Carlos Montoy 1, Blair Parry 3, Virginia Chan 1, Angela H K Wong 1, James Wilcox 4, Alexandra Quiñones 4, Robert M Rodriguez 1 Affiliations expand PMID: 37363986 DOI: 10.1111/acem.14768 Abstract Objective: Focusing on potential missed injury rates and sensitivity of low-risk of injury predictions, we sought to evaluate the accuracy of physician gestalt in predicting clinically significant
- [Thyroid Storm – Spoon-Feed Version](https://emergencymed.org.il/thyroid-storm-spoon-feed-version/articles-2/) - August 9, 2023 / Endocrine Written by Jason Lesnick Thyroid storm is a high-risk, low-prevalence disease that mimics multiple other emergent diagnoses due to its most common features being fever, altered mental status, and cardiovascular dysfunction. There’s a storm brewing in your patient’s neck Thyroid storm (TS) is a life-threatening condition defined as exaggerated signs and symptoms
- [PODCAST: Struggling to Breath and Pump it Up with Dr. Jayna Gardner-Gray - MEMA23](https://emergencymed.org.il/podcast-struggling-to-breath-and-pump-it-up-with-dr-jayna-gardner-gray-mema23/education-tips/) - ACEP Frontline · Struggling to Breath and Pump it Up with Dr. Jayna Gardner-Gray - MEMA23 We recorded live at MEMA23(Michigan Emergency Medicine Assembly) with Michigan ACEP. In this segment, we chat with Dr. Jayna Gardner-Gray about the management of hypoxemic respiratory failure as well as post-arrest care. ACEP23 registration is OPEN!!!
- [PODCAST:  RCEM Learning August 20230](https://emergencymed.org.il/podcast-rcem-learning-august-20230/education-tips/) - Aug 1, 2023 This month for the August 2023 episode of the RCEM Learning Podcast we’ve got a New in EM segment looking at the STANDING Algorithm in Vertigo. We then continue hearing from Becky & Chris about the new NICE head injury guidelines which is the exciting conclusion to our two parter. We then
- [PODCAST: Rabies: don't mess with skunks](https://emergencymed.org.il/podcast-rabies-dont-mess-with-skunks/ילדים/) - EM Board Bombs · 187. Rabies: don't mess with skunks Skunks, bats, foxes, dogs, and even raccoons. Friendly Disney animals? Not anymore. Let’s talk about rabies- when to vaccinate, when not to, and good board-relevant info that will help you save a patient’s wallet (and life too). Want to experience the greatest in board studying?
- [השפעות גודל השרוול על דיוק קריאות לחץ הדם](https://emergencymed.org.il/השפעות-גודל-השרוול-על-דיוק-קריאות-לחץ-ה/recourse/) - Junichi Ishigami, MD, MPH1; Jeanne Charleston, RN1; Edgar R. Miller III, MD, PhD1,2; et alKunihiro Matsushita, MD, PhD1,2; Lawrence J. Appel, MD, MPH1,2; Tammy M. Brady, MD, PhD2 Author Affiliations Article Information JAMA Intern Med. Published online August 7, 2023. doi:10.1001/jamainternmed.2023.3264 נקודות מרכזיות שאלה מהי ההשפעה של שימוש בשרוול בגודל רגיל של לחץ דם ללא
- [Effects of Cuff Size on the Accuracy of Blood Pressure Readings](https://emergencymed.org.il/השפעות-גודל-השרוול-על-דיוק-קריאות-לחץ-ה/recourse/) - Junichi Ishigami, MD, MPH1; Jeanne Charleston, RN1; Edgar R. Miller III, MD, PhD1,2; et alKunihiro Matsushita, MD, PhD1,2; Lawrence J. Appel, MD, MPH1,2; Tammy M. Brady, MD, PhD2 Author Affiliations Article Information JAMA Intern Med. Published online August 7, 2023. doi:10.1001/jamainternmed.2023.3264 Key Points Question What is the effect of using a regular size blood pressure (BP) cuff regardless of an individual’s mid-upper
- [PODCAST: Alcohol Use Disorder(AUD) Management In EM with Dr. Casey Grover](https://emergencymed.org.il/podcast-alcohol-use-disorderaud-management-in-em-with-dr-casey-grover/podcast/) - ACEP Frontline · Alcohol Use Disorder(AUD) Management In EM with Dr. Casey Grover In this segment, we talk about alcohol use disorder treatment strategies within the emergency department. We discuss medication based management, bridging, and drawbacks. ACEP23 registration is now OPEN!!! For the first time ever, those who register for all four days of ACEP23
- [Sports-Related Sudden Cardiac Arrest in Older Adults](https://emergencymed.org.il/sports-related-sudden-cardiac-arrest-in-older-adults/articles-2/) - TAKE-HOME MESSAGE This prospective study investigated the prevalence and characteristics of sports-related sudden cardiac arrest (SrSCA) among individuals aged 65 years or older in two US regions (catchment population, approximately 1.85 million). Of the 4078 out-of-hospital SCAs in this age group, 77 (1.9%; men, 91%) were SrSCAs, which were mostly associated with activities such as
- [Association of Exposure to Extreme Temperature Events and Fine Particulate Matter With Myocardial Infarction–Related Mortality](https://emergencymed.org.il/association-of-exposure-to-extreme-temperature-events-and-fine-particulate-matter-with-myocardial-infarction-related-mortality/articles-2/) - CIRCULATION: TAKE-HOME MESSAGE This time-stratified case–crossover study investigated the impact of extreme temperature events and fine particulate matter (PM2.5) on myocardial infarction (MI)–related mortality. Of 202,678 MI-related deaths from 2015 to 2020, heat waves were associated with a higher risk of MI-related mortality (OR, 1.18–1.74) compared with cold spells (OR, 1.04–1.12). Exposure to PM2.5 also increased
- [Podcast : How to Apply a Painful Stimulus](https://emergencymed.org.il/podcast-how-to-apply-a-painful-stimulus/recourse/) - Contributor: Travis Barlock MD Educational Pearls: When might you need to apply a painful stimulus in a medical setting? The main reason is to assess the patient's level of consciousness, such as when they are waking up from anesthesia or have potentially suffered a brain injury. It can be part of the Glasgow Coma Scale
- [JAMA: Meta-Analysis: Most Effective Exercises for Reducing Blood Pressure](https://emergencymed.org.il/jama-meta-analysis-most-effective-exercises-for-reducing-blood-pressure/articles-2/) - Emily Harris Article Information JAMA. Published online August 2, 2023. doi:10.1001/jama.2023.13616 Isometric exercises, which involve contracting muscles to hold the body in position without moving, are best for lowering resting blood pressure, according to results from 270 randomized clinical trials involving 15 827 participants. After isometric exercises, which include activities such as wall squats, combined training tended to reduce
- [Accuracy of physicians' intuitive risk estimation in the diagnostic management of pulmonary embolism: an individual patient data meta-analysis](https://emergencymed.org.il/accuracy-of-physicians-intuitive-risk-estimation-in-the-diagnostic-management-of-pulmonary-embolism-an-individual-patient-data-meta-analysis/recourse/) - Rosanne van Maanen 1, Emily S L Martens 2, Toshihiko Takada 3, Pierre-Marie Roy 4, Kerstin de Wit 5, Sameer Parpia 6, Noémie Kraaijpoel 7, Menno V Huisman 8, Philip S Wells 9, Grégoire Le Gal 9, Marc Righini 10, Yonathan Freund 11, Javier Galipienzo 12, Nick van Es 13, Jeanet W Blom 14, Karel G M Moons 15, Frans H Rutten 16, Maarten van Smeden 15, Frederikus A Klok 8, Geert-Jan Geersing 16, Kim Luijken 15 Abstract Background: In patients clinically suspected of having pulmonary embolism (PE), physicians often rely on
- [CT FIRST – Full Body CT Post-OHCA – Does CT Help?](https://emergencymed.org.il/ct-first-full-body-ct-post-ohca-does-ct-help/articles-2/) - August 2, 2023 / Critical Care, Imaging, Resuscitation Written by Clay Smith A full-body CT protocol in resuscitated adults with out of hospital cardiac arrest (OHCA) more often – and more quickly – found the cause of arrest than standard of care CT but did not improve neurologically intact survival. R2, fire up the scanner…or not Yesterday we covered a retrospective
- [Adverse Clinical Outcomes Among Patients With Acute Low-risk Pulmonary Embolism and Concerning Computed Tomography Imaging Findings](https://emergencymed.org.il/adverse-clinical-outcomes-among-patients-with-acute-low-risk-pulmonary-embolism-and-concerning-computed-tomography-imaging-findings/articles-2/) - Connor O'Hare 1, Kelsey A Grace 1, William J Schaeffer 1 2, S Nabeel Hyder 3, Michael Stover 1, Amber L Liles 4, Minhaj S Khaja 4, James A Cranford 1, Keith E Kocher 1, Geoffrey D Barnes 3, Colin F Greineder 1 5 6 Affiliations expand Free PMC article Abstract Importance: Most patients presenting to US emergency departments (EDs) with acute pulmonary embolism (PE) are hospitalized, despite evidence from multiple society-based guidelines recommending
- [How Helpful Is CT Post-Non Trauma Arrest?](https://emergencymed.org.il/how-helpful-is-ct-post-non-trauma-arrest/articles-2/) - Written by Clark Strunk Computed tomography (CT) after out-of-hospital cardiac arrest (OHCA) often identifies clinically important pathology such as the etiology of the arrest, traumatic injuries from resuscitation, and consequences from inadequate perfusion. One, two, CT for you… OHCA is a relatively common and important presentation to the emergency department, and identification of the etiology
- [Safety and Effectiveness of Self-Administered Intranasal Etripamil for Atrioventricular Nodal–Dependent Supraventricular Tachycardia](https://emergencymed.org.il/safety-and-effectiveness-of-self-administered-intranasal-etripamil-for-atrioventricular-nodal-dependent-supraventricular-tachycardia/articles-2/) - TAKE-HOME MESSAGE The RAPID study is a large-scale multicentre, randomised, placebo-controlled, event-driven trial conducted in North America and Europe that assessed the effectiveness and safety of etripamil — a fast-acting L-type calcium-channel blocker — for terminating atrioventricular nodal–dependent paroxysmal supraventricular tachycardia (PSVT) events. The study involved using a self-administered etripamil nasal spray in a non-healthcare
- [Point-of-care ultrasound for the diagnosis of Fournier gangrene](https://emergencymed.org.il/point-of-care-ultrasound-for-the-diagnosis-of-fournier-gangrene/pocus/) - http://orcid.org/0000-0001-6857-1430Fiona Chen, http://orcid.org/0000-0001-8896-7512Emily Neill, Sally Graglia Correspondence to Dr Fiona Chen, Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA; Fiona.Chen@ucsf.edu Case presentation A 57-year-old man with a history of recently diagnosed diabetes mellitus presented to the ED with 2 weeks of perineal pain and swelling. He was seen at an urgent care centre
- [PODCAST: Is charcoal EVER the right answer?](https://emergencymed.org.il/podcast-is-charcoal-ever-the-right-answer/podcast/) - EM Board Bombs · 186. Is charcoal EVER the right answer? We’re covering a unique overdose you might have seen before: bupropion. Also, we’re covering some weird pearls for toxicology. Let’s get to it in this short, action-packed episode. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the
- [PODCAST: We Are All TickED Off - Tick Management in EM](https://emergencymed.org.il/podcast-we-are-all-ticked-off-tick-management-in-em/education-tips/) - ACEP Frontline · We Are All TickED Off - Tick Management in EM n this episode, we chat with Dr. Chris Amato and Dr. Lise Nigrovic about data, management, and prevention of tick related illnesses within the emergency department. ACEP23 Registration is now OPEN!!! ACEP23 Registration Now Includes Free Access to Virtual ACEP23! For the
- [PODCAST: Transverse Myelitis and Guillain-Barré Syndrome and Traumatic Spinal Cord Injury](https://emergencymed.org.il/podcast-transverse-myelitis-and-guillain-barre-syndrome-and-traumatic-spinal-cord-injury/podcast/) - ACEP Critical Decisions in Emergency Medicine · March 2023: Transverse Myelitis and Guillain-Barré Syndrome and Traumatic Spinal Cord Injury In the March episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss transverse myelitis and Guillain-Barré syndrome as well as traumatic spinal cord injury. As always, you’ll hear about the hot
- [NEJM PODCAST: The Double-Edged Sword of AI, with Dr. Ziad Obermeyer](https://emergencymed.org.il/nejm-podcast-the-double-edged-sword-of-ai-with-dr-ziad-obermeyer/education-tips/) - In this thought-provoking episode, Dr. Ziad Obermeyer delves into the complex issues of bias, safety, and generalizability of medical AI. Dr. Obermeyer emphasizes the importance of machine learning researchers’ task formulation, an often-overlooked yet significant determinant of bias in AI algorithms. Highlighting the dual impact of machine learning, he compares two of his works that
- [Recalibrating…HEART Score with High-Sensitivity Troponin T](https://emergencymed.org.il/recalibratingheart-score-with-high-sensitivity-troponin-t/articles-2/) - July 28, 2023 / Cardiology Written by Jason Lesnick A recalibrated HEART score ≤ 3 utilizing hs-cTnT ruled out MACE (adjudicated type 1 MI, unplanned coronary revascularization, and all cause death) at 30 days at a sensitivity of 98.5% and NPV of 99.7% with the ability to discharge 46.5% of patients in this cohort. Don’t break my
- [Podcast : Hypocalcemia](https://emergencymed.org.il/podcast-hypocalcemia/cme/) - Show Notes Swami’s CoreEM Post Hypocalcemia Repletion: IV calcium supplementation with 100-300 mg Ca2+ raises serum Ca2+ by 0.5 – 1.5 mEq For acute but mild symptomatic hypocalcemia: 200-1000mg calcium chloride IV or 1-2g IV calcium gluconate over 2 hours For severe hypocalcemia: 1g calcium chloride IV or 1-2g IV calcium gluconate IV over
- [Low-Dose Aspirin and the Risk of Stroke and Intracerebral Bleeding in Healthy Older People Secondary Analysis of a Randomized Clinical Trial](https://emergencymed.org.il/low-dose-aspirin-and-the-risk-of-stroke-and-intracerebral-bleeding-in-healthy-older-people-secondary-analysis-of-a-randomized-clinical-trial/articles-2/) - Geoffrey C. Cloud, MB, BS1; Jeff D. Williamson, MD2; Le Thi Phuong Thao, PhD3; et alCammie Tran, MPH3; Charles B. Eaton, MD4; Rory Wolfe, PhD3; Mark R. Nelson, PhD5; Christopher M. Reid, PhD3,6; Anne B. Newman, MD7; Jessica Lockery, PhD3; Sharyn M. Fitzgerald, PhD3; Anne M. Murray, MD8; Raj C. Shah, MD9; Robyn L. Woods, PhD3; Geoffrey A. Donnan, MD10; John J. McNeil, PhD3 Author Affiliations Article Information JAMA Netw Open. 2023;6(7):e2325803. doi:10.1001/jamanetworkopen.2023.25803 visual abstract icon Visual Abstract Key Points Question In a primary prevention setting, does long-term, daily low-dose aspirin treatment affect the incidence of stroke or intracerebral bleeding? Findings This secondary
- [ChatGPT vs Physician Message Responses – Who Won?](https://emergencymed.org.il/chatgpt-vs-physician-message-responses-who-won/articles-2/) - July 26, 2023 / Technology Written by Doug Wallace Verified physician answers to patient questions on a public social media forum were compared to Chatbot answers to the same questions by rating the quality and empathy of responses. Guess who won? ChatGPT vs Physicians: FIGHT! Artificial Intelligence (AI) utilization is on the rise in health care settings,
- [Podcast:  Alcohol Withdrawal and Delirium Tremens](https://emergencymed.org.il/podcast-alcohol-withdrawal-and-delirium-tremens/podcast/) - Jul 24, 2023 Contributor: Travis Barlock MD Educational Pearls: Alcohol binds the GABA receptor, which produces an inhibitory response, hence the “depressive” effects of ethanol beverages. Over time, alcohol downregulates the GABA receptors, leading to unopposed glutamate activity. Given that glutamate is excitatory, this can lead to seizures. Alcohol also suppresses REM sleep; in patients
- [Dose  BMI Is the Only Measure Needed to Predict Mortality Risk?](https://emergencymed.org.il/dose-bmi-is-the-only-measure-needed-to-predict-mortality-risk/articles-2/) - Mounting Evidence Suggests That BMI Isn’t the Only Measure Needed to Predict Mortality Risk Kate Ruder, MSJ Article Information JAMA. Published online July 19, 2023. doi:10.1001/jama.2023.13602 JAMA Medical News Anew study builds on evidence that body mass index (BMI) alone does not fully capture risk of death, particularly for a US population that is increasingly obese and racially diverse.
- [Is This Patient REALLY Penicillin-Allergic? Try the PEN-FAST Decision Tool](https://emergencymed.org.il/is-this-patient-really-penicillin-allergic-try-the-pen-fast-decision-tool/articles-2/) - July 19, 2023 / Pharmacy/Pharmacology, Pulmonary/Allergy Written by Andy Hogan PEN-FAST is a clinical decision-making tool that effectively identifies patients with self-reported penicillin allergy who are at negligible risk of hypersensitivity reaction after exposure to these antibiotics. Don’t be too (PEN) FAST to skip the penicillins Many first-line antibiotics for ED use are penicillin derivatives, and clinicians often
- [Trends and Seasonality of Emergency Department Visits and Hospitalizations for Suicidality Among Children and Adolescents in the US from 2016 to 2021](https://emergencymed.org.il/trends-and-seasonality-of-emergency-department-visits-and-hospitalizations-for-suicidality-among-children-and-adolescents-in-the-us-from-2016-to-2021/articles-2/) - Youngran Kim, PhD1; Trudy Millard Krause, DrPH1; Scott D. Lane, PhD2 Key Points Question Did trends and seasonal patterns of suicidality among children and adolescents change after the onset of the COVID-19 pandemic in March 2020? Findings This cross-sectional study of 73 123 emergency department (ED) visits and hospitalizations for suicidality found that the incidence of ED visits and hospitalizations increased from 2016 to 2021,
- [עלו 3 מאמרים חדשים לאזור קדם בית חולים באתר](https://emergencymed.org.il/עלו-3-מאמרים-חדשים-לאזור-קדם-בית-חולים-ב/articles-2/) - חברים יקרים אעלתי שלושה מאמרים שד"ר סטרוגו שלח לציוותי מד"א. המאמרים נמצאים באזור קדם בית חולים באתר לחץ כאן
- [שילוב טלמדיסין כחלק אינטגראלי מהמענה של מערך ה EMS](https://emergencymed.org.il/שילוב-טלמדיסין-כחלק-אינטגראלי-מהמענה/articles-2/) - שילוב טלמדיסין כחלק אינטגראלי מהמענה של מערך ה EMS תופס תאוצה ברחבי העולם – לאור עליה משמעותית בפניה לשירותי רפואת החירום, המחסור בצוותים, והצורך במציאת פתרונות מתקדמים. המאמר המצ"ב מתאר מהלך כזה שבוצע ונמדד במערך ה EMS של אאכן (גרמניה). עד לא מזמן המערך היה מושתת על רופאים (לרוב מרדימים או רופאי רפואה דחופה) שהיו
- [שימוש בקטאמין להפסקת פירכוס בילדים](https://emergencymed.org.il/9878/articles-2/) - מאמר מעניין בנושא שעסקנו בו לאחרונה – פרכוסים בילדים. מידי שנה צוותים שלנו מטפלים במאות מקרים של פרכוס בילדים. הפרוטוקול הקיים במד"א (ובעולם) מאפשר מתן מידאזולם (תוך ורידי, תוך שרירי, תוך שלדי, ונזאלי) לצורך הפסקת הפרכוס. 2 בעיות עם פרוטוקול זה = אחוז מסויים מהילדים לא יגיבו לטיפול גם לאחר מתן מינון מקסימלי (בעבודה שעשינו
- [נתיב אוויר בהחייאה בקדם בית חולים](https://emergencymed.org.il/נתיב-אוויר-בהחייאה-בקדם-בית-חולים/articles-2/) - מאמר המדגים את הקושי ביצירת guidelines אחידים ולאורך זמן. בעבר, חלק מובנה בניהול מטופל עם OHCA היה אינטובציה בשלב מוקדם. לאחר מכן פורסמו מספר עבודות שהראו כי מטופלים שעברו החייאה שכללה אינטובציה שרדו פחות מאשר מטופלים שנתיב האוויר שלהם נוהל באמצעות מפוח ומנתב אוויר או התקן סופראגלוטי. ההסבר לממצאים אלו היה שביצוע אינטובציה במהלך פעולות
- [Diagnosis and Management of Priapism](https://emergencymed.org.il/diagnosis-and-management-of-priapism/articles-2/) - Richard J. Fantus, MD1; Robert E. Brannigan, MD2; Andrew M. Davis, MD, MPH3 Guideline titles Priapism in People With and Without Sickle Cell Disease: Acute Diagnosis and Treatment Release dates November 2021 and July 2022 Developer and funding source American Urological Association (AUA) and Sexual Medicine Society of North America (SMSNA) Target population Males, including those with hematologic and oncologic disorders (eg, sickle cell disease [SCD]; chronic
- [Podcast: Thyrotoxicosis](https://emergencymed.org.il/podcast-thyrotoxicosis/podcast/) - Jul 20, 2023 Contributor: Travis Barlock MD Educational Pearls: Clinical picture: A patient comes in with altered mental status, tachycardia, fever, elevated T4, and low TSH. What’s the diagnosis?... Thyrotoxicosis secondary to Graves’ Disease. How do you treat thyrotoxicosis? First, give a beta-blocker such as propranolol. This suppresses the elevated adrenergic activity. Second, give a
- [PODCAST: EMJ July 2023](https://emergencymed.org.il/podcast-emj-july-2023/podcast/) - Jul 21, 2023 This month we look at a paper dealing with Performance of a prehospital HEART score in patients with possible myocardial infarction a prospective evaluation and also one on methocarbamol vs diazepam in management of acute lower back pain
- [PODCAST: Academic Life in Emergency Medicine](https://emergencymed.org.il/podcast-academic-life-in-emergency-medicine/ניהול-מלרד/) - We discuss the changes made, why they were done, and potential sticking points for medical students while completing the application. We also do a deeper dive on "program signaling". What is it, how many programs can EM applicants list, and nuanced decisions to consider. Audio engineer: Kellen Vu
- [Factors contributing to death of major trauma victims with haemorrhage: A retrospective case–control study](https://emergencymed.org.il/factors-contributing-to-death-of-major-trauma-victims-with-haemorrhage-a-retrospective-case-control-study/articles-2/) - Brennan Carne MBChB, Aditya Raina BSc, MBChB, Roshit Bothara BSc, MBChB, BMedSc (Hons), DCH, Andrew McCombie PhD, Dominic Fleischer MBChB, FACEM, Laura R Joyce MBChB, FACEM, MMedEd, BMedSc (Hons), CCPU Abstract Objective To identify factors associated with death secondary to haemorrhage following major trauma. Methods A retrospective case–control study was conducted on data from adult major
- [Early sepsis in Australia and New Zealand: A point-prevalence study of haemodynamic resuscitation practices](https://emergencymed.org.il/early-sepsis-in-australia-and-new-zealand-a-point-prevalence-study-of-haemodynamic-resuscitation-practices/articles-2/) - Sandra L Peake BMBS, BSc (Hons), FCICM, PhD, Anthony Delaney MBBS, MSc, PhD, FACEM, FCICM, Mark Finnis MBBS, MBiostat, FCICM … See all authors Abstract Objective Optimal resuscitation of sepsis-induced hypotension is uncertain, particularly the role of restrictive fluid strategies, leading to variability in usual practice. The objective of this study is to
- [The Effect of Ketamine versus Etomidate for Rapid Sequence Intubation on Maximum SOFA Score: A Randomized Clinical Trial](https://emergencymed.org.il/the-effect-of-ketamine-versus-etomidate-for-rapid-sequence-intubation-on-maximum-sofa-score-a-randomized-clinical-trial/education-tips/) - Sarah KS Knack , Matthew E Prekker , Johanna C Moore , Lauren R Klein , Alexandra H Atkins , James J Miner , Brian E Driver ABSTRACT Background The use of induction agents for rapid sequence intubation (RSI) has been associated with hypotension in critically ill patients. Choice of
- [EM Quick Hits 50 Normal Unenhanced CT Renal Colic DDx, Perichondritis, Magnesium in Pediatric Asthma, Steroids for Pneumonia, OMI Cath Lab Activation](https://emergencymed.org.il/em-quick-hits-50-normal-unenhanced-ct-renal-colic-ddx-perichondritis-magnesium-in-pediatric-asthma-steroids-for-pneumonia-omi-cath-lab-activation/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” EM Quick Hits 50 Normal Unenhanced CT Renal Colic DDx, Perichondritis, Magnesium in Pediatric Asthma, Steroids for Pneumonia, OMI Cath Lab Activation " data-title="EM Quick Hits 50 CARD" data-caption="" aria-label="EM Quick Hits 50 CARD">View
- [Treatment of Intermediate-Risk Pulmonary Embolism](https://emergencymed.org.il/treatment-of-intermediate-risk-pulmonary-embolism/articles-2/) - Robert Smyth, M.D., Christopher Kabrhel, .D., M.P.H., and Timothy Morris, M.D. Case VignetteA Woman with a Pulmonary EmbolismRobert Smyth, M.D.A 33-year-old woman presents to her local rural health center with acute-onset dyspnea and chest pain. She has no relevant medical history and takes a combined oral contraceptive for birth control. On examination, she has no fever, and
- [PODCAST: Neonatal Fever: tiny humans, big infections](https://emergencymed.org.il/podcast-neonatal-fever-tiny-humans-big-infections/education-tips/) - EM Board Bombs · 184. Neonatal Fever: tiny humans, big infections It’s already July again? Hello new interns! Hopefully you don’t have the worst luck ever and are starting in the Pediatric ED… but let's be honest, we're all scared of neonates. Let's talk Neonatal Fever: tiny humans, BIG infections. Want to experience the greatest
- [PODCAST: The Ischemic EKG Deep Dive](https://emergencymed.org.il/podcast-the-ischemic-ekg-deep-dive/cme/) - The 6 STEMI Equivalents: Posterior MI ST Depression V2/V3 (or STE in V7-V9) Right Ventricular MI STE V1 associated with inferior MI ; or STE V4R-V6R Wellens Syndrome Type A: Biphasic T-waves V2/3 Type B: Deep Symmetric T-wave Inversion V2/V3 De Winter’s T Wave ST Depression with a large, symmetric, upright T wave STE avR
- [Taking the Lead – Does an Emergency Physician Led Trauma Team Impact Outcome?](https://emergencymed.org.il/taking-the-lead-does-an-emergency-physician-led-trauma-team-impact-outcome/articles-2/) - July 17, 2023 / Trauma Written by Michelle Skuba Gray This large multi-center retrospective cohort study found no difference in overall risk-adjusted mortality for severely injured trauma patients treated by a surgeon versus non-surgeon trauma team leader (TTL). Interchangeable, to a point This study advocates that EM physicians are equally capable as surgeons to be TTL for
- [PODCAST: EMJ summary of some of the best paper we published in the July 2023](https://emergencymed.org.il/podcast-emj-summary-of-some-of-the-best-paper-we-published-in-the-july-2023/קדם-בית-חולים/) - https://emjbmj.podbean.com/e/iv-paracetamol-trumps-opiates-managing-prehospital-self-harm-and-empowering-waiting-patients-july-2023-s-primary-survey/A summary of some of the best paper we published in the July 2023 issue of the Emergency Medicine Journal. Rick and Sarah talk through topics on Pre Hospital assessment of chest pain, management of pain in the emergency department and some thoughts on improving the experience for the waiting patient. Read the highlights: https://emj.bmj.com/content/40/7/471 The
- [PODCAST: Anticoagulant Reversal Quick Hits with Dr. Steven Haywood - ACEP22.](https://emergencymed.org.il/anticoagulant-reversal-quick-hits-with-dr-steven-haywood-acep22/education-tips/) - ACEP Frontline · Anticoagulant Reversal Quick Hits with Dr. Steven Haywood - ACEP22 In this episode from ACEP22 in San Francisco, we talk with Dr. Steven Haywood about anticoagulant reversal strategies. ACEP23 registration is open! Save $50 on registration with my promo code FRONTLINE at acep.org/acep23.
- [PODCAST:  RCEM Learning July 2023](https://emergencymed.org.il/podcast-rcem-learning-july-2023/podcast/) - July 20230 Jul 4, 2023 This month for the July 2023 episode of the RCEM Learning Podcast we've got a New in EM segment looking at the highly publicised PATCH-trauma trial looking at the use of TXA in trauma. We then hear from Becky & Chris about the new NICE head injury guidelines which is
- [NEJM: Prehospital Tranexamic Acid for Severe Trauma](https://emergencymed.org.il/nejm-prehospital-tranexamic-acid-for-severe-trauma-2/articles-2/) - Abstract BACKGROUND Whether prehospital administration of tranexamic acid increases the likelihood of survival with a favorable functional outcome among patients with major trauma and suspected trauma-induced coagulopathy who are being treated in advanced trauma systems is uncertain. METHODS We randomly assigned adults with major trauma who
- [Predicting Arrhythmic Event Score in Patients With Brugada Syndrome](https://emergencymed.org.il/predicting-arrhythmic-event-score-in-patients-with-brugada-syndrome/articles-2/) - TAKE-HOME MESSAGE In this study, a risk-stratification score was developed for the prediction of major arrhythmic events (MAE) — defined as sudden cardiac arrest, sudden cardiac death, sustained ventricular tachycardia, ventricular fibrillation, or appropriate ICD therapy — in patients with Brugada syndrome (BrS). The Predicting Arrhythmic Event (PAT) score was constructed on the basis of
- [Ventricular Arrhythmias Associated With the Use of Over-the-Counter and Recreational Opioids](https://emergencymed.org.il/ventricular-arrhythmias-associated-with-the-use-of-over-the-counter-and-recreational-opioids/articles-2/) - Journal of the American College of Cardiology TAKE-HOME MESSAGE This large database analysis of American and Canadian patients sought to evaluate the risk of ventricular arrhythmia associated with the use of over-the-counter opioids, specifically loperamide and mitragynine (kratom, an over-the-counter herbal supplement commonly used for opioid withdrawal). The
- [How to Get the Best Glottic View in Kids](https://emergencymed.org.il/how-to-get-the-best-glottic-view-in-kids/articles-2/) - July 14, 2023 / Airway, Pediatrics Written by Vivian Lei Emergency intubation in children has similar procedural success rates when directly or indirectly lifting the epiglottis. When indirectly lifting the epiglottis, engagement of the median glossoepiglottic fold is associated with better visualization and success. The view is better with VL Kids are less tolerant of prolonged and multiple intubation attempts
- [ACEP Clinical Policy – Appendicitis](https://emergencymed.org.il/acep-clinical-policy-appendicitis/articles-2/) - July 13, 2023 / Imaging, Surgery Written by Vivian Lei This ACEP clinical policy covers issues in the evaluating and managing ED patients with suspected appendicitis including clinical prediction rules, comparative imaging modalities, and need for IV contrast in CT imaging. Still a hot topic: appendicitis This ACEP clinical policy was updated recently for ED patients with acute
- [Patterns of change in prehospital spinal motion restriction: A retrospective database review](https://emergencymed.org.il/דפוסי-שינוי-בהגבלת-תנועת-עמוד-השדרה-לפ/אורתופדיה/) - Neil McDonald MPhil, Dean Kriellaars PhD, Rob T. Pryce PhD Abstract Background Acute management of trauma patients with potential spine injuries has evolved from uniform spinal immobilization (SI) to spinal motion restriction (SMR). Little research exists describing how these changes have been implemented. This study aims to describe and analyze the practice of SMR in one emergency
- [דפוסי שינוי בהגבלת תנועת עמוד השדרה לפני בית החולים: סקירת מסד נתונים רטרוספקטיבית](https://emergencymed.org.il/דפוסי-שינוי-בהגבלת-תנועת-עמוד-השדרה-לפ/אורתופדיה/) - Neil McDonald MPhil , Dean Kriellaars PhD , Rob T. Pryce PhD אבסטרקט רקע כללי ניהול אקוטי של חולי טראומה עם פציעות פוטנציאליות בעמוד השדרה התפתח מקיבוע מוחלט של עמוד השדרה (SI) להגבלת תנועה בעמוד השדרה (SMR). קיימים מחקרים ספורים המתארים כיצד השינויים הללו יושמו. מחקר זה נועד לתאר ולנתח את הפרקטיקה של SMR בסוכנות
- [Evaluating a new emergency department avoidance service for older people: patient and relative experiences](https://emergencymed.org.il/evaluating-a-new-emergency-department-avoidance-service-for-older-people-patient-and-relative-experiences/articles-2/) - Leanne Greene ,1 Rachel Lane,1 Maria Crotty,1 Craig Whitehead,1 Elizabeth Potter,1 Petra Bierer,2 Kate Laver בעברית : אשפוז בית Abstract Background High emergency department (ED) usage by older individuals for non-emergencies is a global concern. ED avoidance initiatives have proven effective in addressing this issue.
- [DOACS Better than Warfarin in A-fib Even in CKD Patients](https://emergencymed.org.il/doacs-better-than-warfarin-in-a-fib-even-in-ckd-patients/articles-2/) - July 6, 2023 / Cardiology, Pharmacy/Pharmacology, Renal Written by Seth Walsh-Blackmore Analysis of multiple prior RCTs finds direct oral anticoagulants (DOAC) have improved safety and efficacy vs. warfarin in atrial fibrillation (AF) even as renal function decreases to as low as 25 mL/min. DOACs awesome AF in CKD? Patient compliance with outpatient anticoagulation (AC) for AF is improved when
- [NEJM: Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults](https://emergencymed.org.il/nejm-video-versus-direct-laryngoscopy-for-tracheal-intubation-of-critically-ill-adults/articles-2/) - Prekker ME, Driver BE, Trent SA, Resnick-Ault D, Seitz KP, Russell DW, Gaillard JP, Latimer AJ, Ghamande SA, Gibbs KW, Vonderhaar DJ, Whitson MR, Barnes CR, Walco JP, Douglas IS, Krishnamoorthy V, Dagan A, Bastman JJ, Lloyd BD, Gandotra S, Goranson JK, Mitchell SH, White HD, Palakshappa JA, Espinera A, Page DB, Joffe A, Hansen
- [Mid-Arm Point in PAEDiatrics (MAPPAED) An effective procedural aid for safe pleural decompression in trauma](https://emergencymed.org.il/mid-arm-point-in-paediatrics-mappaed-an-effective-procedural-aid-for-safe-pleural-decompression-in-trauma/articles-2/) - Nuala Quinn MBChB, FRCPI, Grantley Ward B-BMed, MD, Cyril Ong FRCR, FRANZCR, David Krieser MBBS, FRACP, Robert Melvin MBBS, FACEM … See all authors First published: 23 November 2022 https://doi.org/10.1111/1742-6723.14141 Abstract Objective Life-threatening thoracic trauma requires emergency pleural decompression and thoracostomy and chest drain insertion are core trauma procedures. Reliably determining a safe
- [Review article:Non-penetrating neck artery dissection in young adults:Not tobe missed](https://emergencymed.org.il/review-articlenon-penetrating-neck-artery-dissection-in-young-adultsnot-tobe-missed/articles-2/) - Raeed Deen MD, MMedStats, Calyb Austin MD, Andrew Bullen MBBS, FRACS First published: 22 March 2023 https://doi-org.ezproxy.bgu.ac.il/10.1111/1742-6723.14202 Abstract Young adults who present to the ED with neck pain following non-penetrating, seemingly trivial trauma to the neck, are at risk of neck artery dissection and subsequent stroke. Sport-related neck injury is the chief cause.
- [Comparison of Injuries Associated With Electric Scooters, Motorbikes, and Bicycles in France, 2019-2022](https://emergencymed.org.il/comparison-of-injuries-associated-with-electric-scooters-motorbikes-and-bicycles-in-france-2019-2022/articles-2/) - Arthur James, MD, PhD1; Anatole Harrois, MD, PhD2; Paer-Selim Abback, MD3; et alJean Denis Moyer, MD4; Caroline Jeantrelle, MD5; Jean-Luc Hanouz, MD, PhD4,6; Mathieu Boutonnet, MD7,8; Thomas Geeraerts, MD, PhD9; Anne Godier, MD, PhD10; Julien Pottecher, MD, PhD11; Delphine Garrigue-Huet, MD12; Jean Cotte, MD13; Jean Pasqueron, MD14; Arnaud Foucrier, MD5,15; Tobias Gauss, MD16; Mathieu Raux, MD, PhD17; for the French Observatory for Major Trauma (TraumaBase) Author Affiliations Article Information JAMA Netw Open. 2023;6(6):e2320960. doi:10.1001/jamanetworkopen.2023.20960 Key Points Question What is the severity of injuries associated with electric scooters (e-scooters) compared with motorbikes or bicycles? Findings In this cohort study of 5233 patients referred in
- [PODCAST: Must Know Drug Interactions in Emergency Medicine View Larger Image](https://emergencymed.org.il/podcast-must-know-drug-interactions-in-emergency-medicine-view-larger-image/podcast/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” Drug interaction-related morbidity and mortality is highly under-recognized in Emergency Medicine. Patients who present with altered level of awareness, delirium, syncope and falls are often admitted to hospital without a definitive diagnosis; and only
- [PODCAST: All in this Together - Wellness and Recovery with Dr. Jay Kaplan - ACEP22](https://emergencymed.org.il/all-in-this-together-wellness-and-recovery-with-dr-jay-kaplan-acep22/education-tips/) - ACEP Frontline · All in this Together - Wellness and Recovery with Dr. Jay Kaplan - ACEP22 In this episode which was recorded at ACEP22, we talk with Dr. Jay Kaplan about burnout with tools to promote wellness and recovery.
- [2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association/American Stroke Association](https://emergencymed.org.il/2023-guideline-for-the-management-of-patients-with-aneurysmal-subarachnoid-hemorrhage-a-guideline-from-the-american-heart-association-american-stroke-association/articles-2/) - Hoh BL, Ko NU, Amin-Hanjani S, Hsiang-Yi Chou S, Cruz-Flores S, Dangayach NS, Derdeyn CP, Du R, Hänggi D, Hetts SW, Ifejika NL, Johnson R, Keigher KM, Leslie-Mazwi TM, Lucke-Wold B, Rabinstein AA, Robicsek SA, Stapleton CJ, Suarez JI, Tjoumakaris SI, Welch BG. Abstract Aim: The
- [Managing Peritonsillar Abscess](https://emergencymed.org.il/managing-peritonsillar-abscess/articles-2/) - Brit Long, MD*; Michael Gottlieb, MD Peritonsillar abscess is defined as a collection of pus between the palatine tonsil capsule and the pharyngeal muscles. It most often affects the superior pole of the tonsil and, after that, the middle and inferior poles. The condition may be preceded by pharyngitis or tonsillitis, or it may occur without
- [Management of low back pain in Australian emergency departments for culturally and linguistically diverse populations from 2016 to 2021](https://emergencymed.org.il/management-of-low-back-pain-in-australian-emergency-departments-for-culturally-and-linguistically-diverse-populations-from-2016-to-2021-2/articles-2/) - Qiuzhe Chen ,1 Chris G Maher,1 Eileen Rogan,2 Gustavo Machado Abstract Background Disparate care in the ED for minority populations with low back pain is a long-standing issue reported in the USA. Our objective was to compare care delivery
- [Prevalence and Prognosis of Sepsis-Induced Cardiomyopathy](https://emergencymed.org.il/prevalence-and-prognosis-of-sepsis-induced-cardiomyopathy/articles-2/) - TAKE-HOME MESSAGE The authors of this systematic review and meta-analysis aimed to evaluate the prevalence and impact of sepsis-induced cardiomyopathy. A total of 16 studies were included in the final meta-analysis, and the findings show a 20% prevalence of sepsis-induced cardiomyopathy among patients with sepsis. The development of sepsis-induced cardiomyopathy was associated with a significant
- [Concussion – How Long Does It Really Take To Recover?](https://emergencymed.org.il/concussion-how-long-does-it-really-take-to-recover/articles-2/) - June 27, 2023 / Neurology, Sports Medicine Written by Ketan Patel Post-concussion return to functional baseline occurs early for symptoms, balance, and mental status along with partial neurocognitive functioning. Visual-memory and reaction-time recovery, however, lag behind the other groups post-concussion. Why does this matter? A variety of tests are utilized in the post-concussive period to gauge an athlete’s
- [PODCAST: Alice in Wonderland Jeopardy](https://emergencymed.org.il/podcast-alice-in-wonderland-jeopardy/education-tips/) - Jun 26, 2023 Contributor: Chris Holmes MD Educational Pearls: “It’s a poor sort of memory that only works backwards” - Transient Global Amnesia A syndrome with sudden retrograde memory loss in which patients cannot retain new information Characterized by perseveration in frequent intervals Typically improves within hours MRI is normal initially Alice In Wonderland Syndrome
- [PODCAST: Curtain Call: Retinal Detachment](https://emergencymed.org.il/podcast-curtain-call-retinal-detachment/education-tips/) - EM Board Bombs · 181. Curtain Call: Retinal Detachment Flashes, floaters, and other vision changes. Nothing will help you in the history or exam to diagnose a retinal detachment in the ED. Your saving grace is bedside ultrasound. Let's talk what you'll see, how to diagnose, and important differentials. Dr. Glaucomflecken would be proud. We
- [Guidelines for reasonable and appropriate care in the emergency department 3 (GRACE-3): Acute dizziness and vertigo in the emergency department](https://emergencymed.org.il/guidelines-for-reasonable-and-appropriate-care-in-the-emergency-department-3-grace-3-acute-dizziness-and-vertigo-in-the-emergency-department/articles-2/) - Edlow JA, Carpenter C, Akhter M, Khoujah D, Marcolini E, Meurer WJ, Morrill D, Naples JG, Ohle R, Omron R, Sharif S, Siket M, Upadhye S, E Silva LOJ, Sundberg E, Tartt K, Vanni S, Newman-Toker DE, Bellolio F. Abstract This third Guideline for Reasonable and
- [Characteristics of Medical Evacuation by Train in Ukraine, 2022](https://emergencymed.org.il/characteristics-of-medical-evacuation-by-train-in-ukraine-2022/articles-2/) - Stig Walravens, MD1,2; Albina Zharkova, MD, PhD3; Anja De Weggheleire, MD, MPH1; et alMarie Burton, MPH4; Jean-Clément Cabrol, MD4; James S. Lee, MD, MSc1,5 Author Affiliations Article Information JAMA Netw Open. 2023;6(6):e2319726. doi:10.1001/jamanetworkopen.2023.19726 Key Points Question How can medical evacuation trains be implemented in a war zone and what type of patients can be expected? Findings This case series describes medical evacuation by train during the 2022 Ukraine conflict using
- [Imaging Manifestations of Wandering Spleen with Torsion](https://emergencymed.org.il/imaging-manifestations-of-wandering-spleen-with-torsion/education-tips/) - ULTRASOUND IN EMERGENCY MEDICINE|ARTICLES IN PRESS Tangna Wu Shaopiao Chen Lingling Qin Min Zhang Abstract Background: A wandering spleen (WS) is a rare clinical entity characterized by a spleen located in the lower part of the
- [ChatGPT: A Valuable Tool for Emergency Medical Assistance](https://emergencymed.org.il/chatgpt-a-valuable-tool-for-emergency-medical-assistance/articles-2/) - Joseph El Dahdah, MD Joseph Kassab, MD 1 Michel Chedid El Helou, MD 1 Andrew Gaballa, MD Stephen Sayles III, MD Michael P. Phelan, MD Published:June 17, 2023DOI:https://doi.org/10.1016/j.annemergmed.2023.04.027 Introduction Currently, the physician-patient relationship is becoming a triad, with patients relying more on online symptom research. In November 2022, Chat Generative Pretrained Transformer (ChatGPT),
- [Intracranial Intraosseous Catheter Placement to Temporize an Epidural Hematoma](https://emergencymed.org.il/intracranial-intraosseous-catheter-placement-to-temporize-an-epidural-hematoma/education-tips/) - WilliamWeber,MD,MPH*;TeriCampbell,MSN;ThomasPapandria,MSN;ArjangAhmadpour,MD Acute epidural hematomas can lead to rapid neurologic decompensation and death. Epidural hematomas may require emergency surgical clot removal, but many patients live far away from a trauma center. This case report describes a pediatric patient with an acute epidural hematoma with significant neurologic compromise who initially presented to a nontrauma center. The emergency
- [PODCAST: April 2023 : Identifying Illnesses of Bioterrorism and Emergency Presentations of Upper GI Bleeds](https://emergencymed.org.il/podcast-april-2023-identifying-illnesses-of-bioterrorism-and-emergency-presentations-of-upper-gi-bleeds/education-tips/) - ACEP Critical Decisions in Emergency Medicine · April 2023 : Identifying Illnesses of Bioterrorism and Emergency Presentations of Upper GI Bleeds n the April episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss illnesses of bioterrorism as well as upper GI bleeds. As always, you’ll hear about the hot topics
- [Cervical spine injuries in adults ≥ 65 years after low-level falls - A systematic review and meta-analysis](https://emergencymed.org.il/cervical-spine-injuries-in-adults-≥-65-years-after-low-level-falls-a-systematic-review-and-meta-analysis/recourse/) - Jessica McCallum 1, Debra Eagles 2, Yongdong Ouyang 3, Jamie Vander Ende 4, Christian Vaillancourt 5, Christophe Fehlmann 6, Risa Shorr 7, Monica Taljaard 8, Ian Stiell 9 Affiliations expand PMID: 36893628 Abstract Background: Adults ≥ 65 are at risk of cervical spine (C-spine) injury, even after low-level falls. The objectives of this systematic
- [EM Quick Hits 49 Stroke Management Update, Intussusception, 5 Penetrating Trauma Tips, Skin Foreign Body Hack, CT Radiation Risk, Emergency Fund](https://emergencymed.org.il/em-quick-hits-49-stroke-management-update-intussusception-5-penetrating-trauma-tips-skin-foreign-body-hack-ct-radiation-risk-emergency-fund/articles-2/) - “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” " data-title="EM Quick Hit 49 June 2023" data-caption="" aria-label="EM Quick Hit 49 June 2023">View Larger Image Topics in this EM Quick Hits podcast Anand Swaminathan on endovascular therapy for large vessel occlusion ischemic stroke (0:38) Sarah
- [Sedation and Analgesia for Reduction of Pediatric Ileocolic Intussusception](https://emergencymed.org.il/sedation-and-analgesia-for-reduction-of-pediatric-ileocolic-intussusception/recourse/) - Naveen Poonai, MD1; Daniel M. Cohen, MD2; Doug MacDowell, BA2; et alRakesh D. Mistry, MD, MS3; Santiago Mintegi, MD, PhD4; Simon Craig, MBBS5; Damian Roland, MD6,7; Michael Miller, PhD1; Itai Shavit, MD8; and the Paediatric Emergency Research Networks (PERN) PAINT Study Group Author Affiliations Article Information JAMA Netw Open. 2023;6(6):e2317200. doi:10.1001/jamanetworkopen.2023.17200 Key Points Question What is the prevalence of opioid analgesia and sedation for reduction of pediatric ileocolic intussusception and what is their association with intestinal perforation and failed reduction? Findings In this cross-sectional
- [Primary Spontaneous Pneumothorax – Needle Or Not?](https://emergencymed.org.il/primary-spontaneous-pneumothorax-needle-or-not/recourse/) - June 7, 2023 / Pain/Sedation/Procedure, Pulmonary/Allergy, Surgery Written by Megan Hilbert Primary spontaneous pneumothorax (PSP) may be most cost-effectively managed by observation alone in the appropriate patient population. Why does this matter? The British Thoracic Society guidelines currently indicate placement of pleural drain for symptomatic pneumothorax greater than 2cm in size on chest X-ray. This paper demonstrated that observation
- [Comparison of Resuscitation Quality in Simulated Pediatric and Adult Out-of-Hospital Cardiac Arrest](https://emergencymed.org.il/comparison-of-resuscitation-quality-in-simulated-pediatric-and-adult-out-of-hospital-cardiac-arrest/articles-2/) - Matthew Hansen 1, Grace Walker-Stevenson 2, Nathan Bahr 2, Tabria Harrod 2, Garth Meckler 3, Carl Eriksson 4, Jeanne-Marie Guise 5 Affiliations expand PMID: 37195659 PMCID: PMC10193176 DOI: 10.1001/jamanetworkopen.2023.13969 Abstract Importance: Mortality from pediatric out-of-hospital cardiac arrest (OHCA) is high and has not improved in decades, unlike adult mortality. The low frequency of pediatric OHCA and weight-based medication and equipment needs may lead to lower quality of pediatric resuscitation compared with adults. Objective: To
- [ביצועים של HEART score טרום-אשפוזי בחולים עם אוטם שריר הלב אפשרי: הערכה פרוספקטיבית](https://emergencymed.org.il/ביצועים-של-heart-score-טרום-אשפוזי-בחולים-עם-אוט/articles-2/) - Jamie G Cooper1,2, James Ferguson1, Lorna A Donaldson3, Kim M M Black1, Kate J Livock1, Judith L Horrill1, Elaine M Davidson4, Neil W Scott5, Amanda J Lee5, Takeshi Fujisawa6,7, Kuan Ken Lee6, Atul Anand6, Anoop S V Shah8, Nicholas L Mills6,9 Correspondence to Dr Jamie G Cooper, Emergency Department, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN,
- [Performance of a prehospital HEART score in patients with possible myocardial infarction: a prospective evaluation](https://emergencymed.org.il/ביצועים-של-heart-score-טרום-אשפוזי-בחולים-עם-אוט/articles-2/) - Jamie G Cooper1,2, James Ferguson1, Lorna A Donaldson3, Kim M M Black1, Kate J Livock1, Judith L Horrill1, Elaine M Davidson4, Neil W Scott5, Amanda J Lee5, Takeshi Fujisawa6,7, Kuan Ken Lee6, Atul Anand6, Anoop S V Shah8, Nicholas L Mills6,9 Correspondence to Dr Jamie G Cooper, Emergency Department, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK;
- [Point-of-care ultrasound in the assessment of appendicitis](https://emergencymed.org.il/point-of-care-ultrasound-in-the-assessment-of-appendicitis/recourse/) - Michael Jarvis Boyle1, Margaret Lin-Martore2, Sally Graglia1 Correspondence to Dr Michael Jarvis Boyle, Emergency Medicine, University of California San Francisco, San Francisco, CA 94143-0203, USA; michael.boyle@ucsf.edu Case presentation A 15-year-old boy presents to the ED with 1 day of periumbilical non-radiating abdominal pain. The pain, described as a stinging sensation, started gradually 1 day prior to presentation after eating lunch
- [PODCAST:  Agitation](https://emergencymed.org.il/podcast-agitation/articles-2/) - You are working at Clerkship General when you hear an EMS call on the radio… “CLERKSHIP GENERAL – We are bringing you an agitated and combative 30 year old male, we’ll see you in 5 minutes.” Initial Vitals: BP: 192/105 HR: 134 RR: 22 O2: 99% (Room Air) Temp: 98.8 F Critical Actions: Administer Sedation
- [NEJM: Early versus Later Anticoagulation for Stroke with Atrial Fibrillation](https://emergencymed.org.il/nejm-early-versus-later-anticoagulation-for-stroke-with-atrial-fibrillation/articles-2/) - Fischer, Urs M.D.Koga, Masatoshi M.D., Ph.D.Strbian, Daniel Ph.D.Branca, Mattia Ph.D.Abend, Stefanie B.Sc.Trelle, Sven M.D.Paciaroni, Maurizio M.D.Thomalla, Götz M.D.Michel, Patrik M.D.Nedeltchev, Krassen M.D.Bonati, Leo H. M.D.Ntaios, George M.D.Gattringer, Thomas Ph.D.Sandset, Else-Charlotte Ph.D.Kelly, Peter M.D.Lemmens, Robin Ph.D.Sylaja, P.N. M.D.Aguiar de Sousa, Diana Ph.D.Bornstein, Natan M. M.D.Gdovinova, Zuzana M.D., Ph.D.Yoshimoto, Takeshi M.D., Ph.D.Tiainen, Marjaana M.D., Ph.D.Thomas, Helen R.N.Krishnan,
- [RESEARCH ARTICLE PDF/EPUB  Tools Share Jump to Abstract Footnotes Supplemental Material Shorter Door-to-Needle Times Are Associated With Better Outcomes After Intravenous Thrombolytic Therapy and Endovascular Thrombectomy for Acute Ischemic Stroke](https://emergencymed.org.il/research-article-pdf-epub-tools-share-jump-to-abstract-footnotes-supplemental-material-shorter-door-to-needle-times-are-associated-with-better-outcomes-after-intravenous-thrombolytic-therapy-and-endo/articles-2/) - Shumei Man, Nicole Solomon, Brian Mac Grory, Brooke Alhanti, Ken Uchino, Jeffrey L. Saver, Eric E. Smith, Ying Xian, Deepak L. Bhatt, Lee H. Schwamm, Muhammad Shazam Hussain and Gregg C. Fonarow Originally published18 May 2023https://doi.org/10.1161/CIRCULATIONAHA.123.064053Circulation. 2023;0 Abstract BACKGROUND: Existing data and clinical trials could not determine whether faster intravenous thrombolytic therapy (IVT) translates into better long-term functional outcomes after
- [Defining Successful Intubation on the First Attempt Using Both Laryngoscope and Endotracheal Tube Insertions: A Secondary Analysis of Clinical Trial Data](https://emergencymed.org.il/defining-successful-intubation-on-the-first-attempt-using-both-laryngoscope-and-endotracheal-tube-insertions-a-secondary-analysis-of-clinical-trial-data/recourse/) - Stacy A. Trent MD, MPH a b, Brian E. Driver MD c, Matthew E. Prekker MD, MPH c d, Christopher R. Barnes MD e, Joseph M. Brewer MD g, Kevin C. Doerschug MD h, John P. Gaillard MD i, Kevin W. Gibbs MD j, Shekhar Ghamande MD k, Christopher G. Hughes MD l, David R. Janz MD, MSc o p, Akram Khan MD r, Steven H. Mitchell MD f, David B. Page MD s t, Todd W. Rice MD m, Derek W. Russell MD u, Wesley H. Self MD n, Lane M. Smith MD, PhD i, Susan Stempek PA v, Derek J. Vonderhaar MD q…Matthew W. Semler MD, MSc m Study objectives Successful intubation on the first attempt has historically been defined as successful placement of an endotracheal tube (ETT) using a single laryngoscope insertion.
- [PODCAST: Head Injury Updates; Roadside to Resus](https://emergencymed.org.il/podcast-head-injury-updates-roadside-to-resus/articles-2/) - May 18, 2023 The last time we took a good look at head injuries was back in 2018 in our Roadside to Resus episodes and for all of the foundational stuff on incidence, assessment, management and loads more make sure you go and check that episode out. But this episode is one of our new
- [PODCAST: Eye Irrigation and tide pod challenge (yes, its back!). EM Board Bombs](https://emergencymed.org.il/podcast-eye-irrigation-and-tide-pod-challenge-yes-its-back-em-board-bombs/articles-2/) - EM Board Bombs · 178. Eye Irrigation and tide pod challenge (yes, its back!) Things are so crazy on TikTok now they are running out of challenges. time to recycle old ones? Enter the Tide pod challenge. Let’s talk eye irrigation and this critically tested vision emergency. Want to experience the greatest in board studying?
- [NEJM:  Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia](https://emergencymed.org.il/nejm-platelet-transfusion-before-cvc-placement-in-patients-with-thrombocytopenia/articles-2/) - Floor L.F. van Baarle, M.D., Emma K. van de Weerdt, M.D., Ph.D., Walter J.F.M. van der Velden, M.D., Ph.D., Roelof A. Ruiterkamp, M.Sc., Pieter R. Tuinman, M.D., Ph.D., Paula F. Ypma, M.D., Ph.D., Walter M. van den Bergh, M.D., Ph.D., Astrid M.P. Demandt, M.D., Emile D. Kerver, M.D., A.J. Gerard Jansen, M.D., Ph.D., Peter E. Westerweel, M.D., Ph.D., Sesmu M. Arbous, M.D., Ph.D., Abstract
- [Low-Risk Acute PE – What Influences Admission Decision?](https://emergencymed.org.il/low-risk-acute-pe-what-influences-admission-decision/articles-2/) - May 29, 2023 / Venous Thromboembolism Written by Chris Thom In a retrospective cohort of patients with acute pulmonary embolism (PE) and a low pulmonary embolism severity index (PESI) score, increased heart rate and bilateral PE were factors associated with physicians’ decision for hospitalization. Why does this matter? In the US, approximately half of DVTs are discharged
- [PODCAST: Tactical EMS And Care In The Warm Zone - Dr. Brian Springer](https://emergencymed.org.il/podcast-tactical-ems-and-care-in-the-warm-zone-dr-brian-springer/articles-2/) - ACEP Frontline · Tactical EMS And Care In The Warm Zone - Dr. Brian Springer In further efforts to get people the life saving care they need as soon as possible, we chat about tactical EMS/medicine. We focus on some of the realities with steps towards better preparedness and training.
- [Podcast : Critical Care Medications - Vasopressors](https://emergencymed.org.il/podcast-critical-care-medications-vasopressors/articles-2/) - May 29, 2023 Contributor: Travis Barlock MD Educational Pearls: Three categories of pressors: inopressors, pure vasoconstrictors, and inodilators Inopressors: Epinephrine - nonselective beta- and alpha-adrenergic agonism, leading to increased cardiac contractility, chronotropy (increased heart rate), and peripheral vasoconstriction. Dose 0.1mcg/kg/min. Levophed (norepinephrine) - more vasoconstriction peripherally than inotropy; useful in most cases of shock. Dose 0.1mcg/kg/min.
- [Bystander cardiopulmonary resuscitation and cardiac rhythm change over time in patients with out-of-hospital cardiac arrest](https://emergencymed.org.il/bystander-cardiopulmonary-resuscitation-and-cardiac-rhythm-change-over-time-in-patients-with-out-of-hospital-cardiac-arrest/articles-2/) - Keita Shibahashi, Taichi Kato, Mayu Hikone, Kazuhiro Sugiyama FULL PDF Tertiary Emergency Medical Center, Metropolitan Bokutoh Hospital, Sumida-ku, Japan Correspondence to Dr Keita Shibahashi, Tertiary Emergy Medical Center, Metropolitan Bokutoh Hospital, Sumida-ku, 130-8575, Japan; kshibahashi@yahoo.co.jp Abstract Background Whether and how bystander cardiopulmonary resuscitation (CPR) modifies the cardiac rhythm after out-of-hospital cardiac arrest (OHCA) over time remains
- [Best CPR Quality In Children – 1 Or 2 Hands, 2 Thumbs, 2 Fingers?](https://emergencymed.org.il/best-cpr-quality-in-children-1-or-2-hands-2-thumbs-2-fingers/articles-2/) - May 25, 2023 / Pediatrics, Resuscitation Written by Joel Schirding Spoon Feed Using a 1-handed technique in infants 1yr resulted in deeper compressions, closer to AHA guideline recommendations, but compliance with rate and depth were mediocre regardless of technique. Why does this matter? There have been few in-vivo pediatric studies on CPR
- [Autopsy By CT – What Can Post-Mortem CT Teach Us About Trauma Care?](https://emergencymed.org.il/autopsy-by-ct-what-can-post-mortem-ct-teach-us-about-trauma-care/articles-2/) - May 24, 2023 / Trauma Written by Vivian Lei Spoon Feed Information gathered from post-mortem CT shows that fatal injury patterns in blunt trauma are similar for those who die prior to ED arrival vs. after arrival. The frequent identification of unevacuated pneumothorax and endotracheal tube misplacement suggests that mandatory surgical chest decompression and tube placement confirmation
- [PODCAST: Angioedema After Thrombolysis](https://emergencymed.org.il/podcast-angioedema-after-thrombolysis/articles-2/) - Contributor: Aaron Lessen, MD Educational Pearls: What is thrombolysis? Thrombolysis is performed by administration of a medication that promotes the body’s natural ability to break up clots. These medications include Alteplase (tPA) and Tenecteplase (TNK). The main side effect of using such an agent is bleeding which typically occurs at puncture sites but can also occur
- [PODCAST: Wrist Fractures: Live from SAEM'23!](https://emergencymed.org.il/podcast-wrist-fractures-live-from-saem23/articles-2/) - EM Board Bombs · 177. Wrist Fractures: Live from SAEM'23! Marlena and Iltifat are LIVE from SAEM’23. This is their recording from the conference. We cover all wrist fractures, what you need to know, how to manage, and why you almost never need to consult Orthopedics. Want to experience the greatest in board studying? Check
- [מעט פפופולריות          As Ozempic’s Popularity Soars, Here’s What to Know About Semaglutide and Weight Loss](https://emergencymed.org.il/מעט-פפופולריות-as-ozempics-popularity-soars-heres-what-to-know-about-semaglutide-and-weight-loss/articles-2/) - Melissa Suran, PhD, MSJ Article Information Although semaglutide may not ring a bell, the drug has been popping up in news headlines and social media feeds since last year. That’s because the branded version called Ozempic has surged in popularity—and notoriety—for its off-label use as a weight-loss medication. Here’s what to know about this in-demand drug. What Is Semaglutide? Semaglutide is a
- [The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics](https://emergencymed.org.il/the-squid-protocol-subcutaneous-insulin-in-diabetic-ketoacidosis-impacts-on-ed-operational-metrics/articles-2/) - Richard T. Griffey MD, MPH, Ryan M. Schneider MSN, ACNP-BC, CPPS, Margo Girardi MD, Julianne Yeary Pharm D, BCCCP, Craig McCammon Pharm D, BCCCP … See all authors First published: 12 February 2023 Abstract Background Studies using fast-acting subcutaneous (SQ) insulin analogs in diabetic ketoacidosis (DKA) have demonstrated efficacy, safety, and cost-effectiveness, allowing treatment of mild-to-moderate (MTM)-severity DKA patients in non–intensive
- [Opioids For Abdominal Pain – Are We Influencing Rate Of Return?](https://emergencymed.org.il/opioids-for-abdominal-pain-are-we-influencing-rate-of-return/recourse/) - May 18, 2023 / GI, Pain/Sedation/Procedure Written by Gabby Leonard Patients who are discharged from the emergency department after presenting with abdominal pain and receiving opioids have 57% greater odds of return within 30 days. This population is also at higher risk for adverse effects from these medications. Why does this matter? Abdominal pain is the most common
- [Airway-Occluding Mucus Plugs and Mortality in Patients With Chronic Obstructive Pulmonary Disease](https://emergencymed.org.il/airway-occluding-mucus-plugs-and-mortality-in-patients-with-chronic-obstructive-pulmonary-disease/articles-2/) - Alejandro A. Diaz, MD, MPH1,2; José L. Orejas, MD1,2; Scott Grumley, MD3; et alHrudaya P. Nath, MD3; Wei Wang, PhD2,4; Wojciech R. Dolliver, MD1; Andrew Yen, MD5; Seth J. Kligerman, MD5,6; Kathleen Jacobs, MD5; Padma P. Manapragada, MD3; Mostafa Abozeed, MD, MSc, PhD3; Muhammad Usman Aziz, MD3; Mohd Zahid, MD3; Asmaa N. Ahmed, MD, MBBCh, MSc3; Nina L. Terry, MD3; Ruben San José Estépar, MSc2,7; Victor Kim, MD8; Barry J. Make, MD9; MeiLan K. Han, MD10; Sushilkumar Sonavane, MD11; George R. Washko, MD, MSc1,2; Michael Cho, MD, MPH1,2,12; Raúl San José Estépar, PhD2,7 Author Affiliations Article Information JAMA. Published online May 21, 2023. doi:10.1001/jama.2023.2065 Key PointsQuestion Are mucus plugs that occlude airways identified on computed tomography scans in patients with chronic obstructive pulmonary disease
- [PODCAST: Shake and Bake...Talking Seizures And LPs - Dr. Fontenette - ACEP22](https://emergencymed.org.il/podcast-shake-and-bake-talking-seizures-and-lps-dr-fontenette-acep22/articles-2/) - ACEP Frontline · Shake and Bake...Talking Seizures And LPs - Dr. Fontenette - ACEP22 n this episode, we jump back to a couple of talks from ACEP22 with Dr. Rod Fontenette talking about seizure management and the evolution of LPs in EM. Two separate topics, though they segue just fine.
- [PODCAST: Lumbar Punctures (Deep Dive R9 MW)](https://emergencymed.org.il/podcast-lumbar-punctures-deep-dive-r9-mw/articles-2/) - Indications for LP: CNS infection, SAH, Guillian Barree, IIH Contraindications for LP: Space occupying lesion with mass effect ; severe thrombocytopenia and coagulopathy; cellulitis over LP site or concern for epidural abscess ; traumatic injury to spine Complications for LP: Post LP Headache, spinal hematoma, brainstem herniation Technique for LP: Positioning is everything. Use US if necessary. Check for
- [Chest Pain Management Using Prehospital Point-of-Care Troponin and Paramedic Risk Assessment](https://emergencymed.org.il/טיפול-בכאבי-חזה-באמצעות-טרופונין-טרום/articles-2/) - Luke P. Dawson, MBBS, MPH1,2,3; Emily Nehme, MBiostats2,4; Ziad Nehme, PhD2,4,5; et alElla Zomer, PhD2; Jason Bloom, MBBS1,6; Shelley Cox, PhD2,4; David Anderson, MBChB4,5,7; Michael Stephenson, BHlthSci, GradDipHlthSci2,4,5; Jocasta Ball, PhD2; Jennifer Zhou, MBBS1; Jeffrey Lefkovits, MBBS2,3; Andrew J. Taylor, MBBS, PhD1,8; Mark Horrigan, MBBS9,10; Derek P. Chew, MBBS, MPH, PhD11; David Kaye, MBBS, PhD1,6; Louise Cullen, MBBS, PhD12; Cathrine Mihalopoulos, PhD2; Karen Smith, PhD2,4,5; Dion Stub, MBBS, PhD1,2,6 Author Affiliations Article Information JAMA Intern Med. 2023;183(3):203-211. doi:10.1001/jamainternmed.2022.6409 Key PointsQuestion Could paramedic risk stratification and point-of-care troponin testing result in cost savings for acute chest pain care at a population level? Findings In this economic evaluation of 188 551 patients attended by ambulance for chest pain
- [טיפול בכאבי חזה באמצעות טרופונין טרום-אשפוזי נקודתי טיפול והערכת סיכונים של הפרמדיק](https://emergencymed.org.il/טיפול-בכאבי-חזה-באמצעות-טרופונין-טרום/articles-2/) - Luke P. Dawson, MBBS, MPH1,2,3; Emily Nehme, MBiostats2,4; Ziad Nehme, PhD2,4,5; et alElla Zomer, PhD2; Jason Bloom, MBBS1,6; Shelley Cox, PhD2,4; David Anderson, MBChB4,5,7; Michael Stephenson, BHlthSci, GradDipHlthSci2,4,5; Jocasta Ball, PhD2; Jennifer Zhou, MBBS1; Jeffrey Lefkovits, MBBS2,3; Andrew J. Taylor, MBBS, PhD1,8; Mark Horrigan, MBBS9,10; Derek P. Chew, MBBS, MPH, PhD11; David Kaye, MBBS, PhD1,6;
- [Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department](https://emergencymed.org.il/diagnostic-accuracy-of-unenhanced-computed-tomography-for-evaluation-of-acute-abdominal-pain-in-the-emergency-department/recourse/) - Hiram Shaish 1, Justin Ream 2, Chenchan Huang 3, Jonathan Troost 4, Sonia Gaur 5, Ryan Chung 6, Sooah Kim 3, Hanisha Patel 1, Jeffrey H Newhouse 1, Shokoufeh Khalatbari 4, Matthew S Davenport 7 8 Affiliations expand Abstract Importance: Intravenous (IV) contrast medium is sometimes withheld due to risk of complication or lack of availability in patients undergoing computed tomography (CT) for abdominal pain. The risk from withholding contrast medium is
- [Podcast : High-Dose Nitroglycerin in SCAPE  (Sympathetic Crashing Acute Pulmonary Edema)](https://emergencymed.org.il/podcast-high-dose-nitroglycerin-in-scape-sympathetic-crashing-acute-pulmonary-edema/articles-2/) - Contributor: Aaron Lessen MD Educational Pearls: SCAPE (Sympathetic Crashing Acute Pulmonary Edema), formerly known as flash pulmonary edema, is a life-threatening condition due to a sudden sympathetic surge that leads to hypertensive heart failure, pulmonary edema, hypoxia, and respiratory distress. The initial treatment for SCAPE stabilization is BiPAP to assist with ventilation. Pharmacological treatment for SCAPE
- [PODCAST: PTU vs MMI | CT Ped C-Spine](https://emergencymed.org.il/ptu-vs-mmi-ct-ped-c-spine/articles-2/) - Episode 17 • 13th May 2023 • JournalFeed • Nick Zelt
- [PODCAST:  Acetaminophen Poisoning – Pitfalls in Assessment and Management](https://emergencymed.org.il/podcast-acetaminophen-poisoning-pitfalls-in-assessment-and-management/articles-2/) - This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per creative commons copyright” A whopping 1 billion doses of acetaminophen (or paracetamol, as it’s called in some countries) are taken safely each year. With that much acetaminophen being ingested it’s no surprise that about 10,000 people in
- [NEJM: Decompressive Craniectomy versus Craniotomy for Acute Subdural Hematoma](https://emergencymed.org.il/nejm-decompressive-craniectomy-versus-craniotomy-for-acute-subdural-hematoma/articles-2/) - P.J. Hutchinson, H. Adams, M. Mohan, B.I. Devi, C. Uff, S. Hasan, H. Mee, M.H. Wilson, D.K. Gupta, D. Bulters, A. Zolnourian, C.J. McMahon, M.G. Stovell, Y.Z. Al‑Tamimi, M.K. Tewari, M. Tripathi, S. Thomson, E. Viaroli, A. Belli, A.T. King, A.E. Helmy, I.S. Timofeev, S. Pyne, D.P. Shukla, D.I. Bhat, A.R. Maas, F. Servadei, G.T.
- [Resident Physician Work Hours – Association With Harm And Occupational Injury](https://emergencymed.org.il/resident-physician-work-hours-association-with-harm-and-occupational-injury/recourse/) - May 12, 2023 / Education, Wellness Written by Doug Wallace Working extended duration shifts (≥ 24 hours) and > 48 hours/week were associated with an increased risk of medical errors, adverse events, MVAs, occupational exposures, percutaneous injuries, and attentional failures regardless of experience level in a large nationwide prospective cohort study. Why does this matter? Resident work hours
- [PODCAST: EMJ Primary Survey - the highlights of May 2023](https://emergencymed.org.il/podcast-emj-primary-survey-the-highlights-of-may-2023/articles-2/) - BMJ talk medicine · Primary Survey - the highlights of May 2023 Rick Body, University of Manchester and Manchester University NHS Foundation Trust, and Sarah Edwards, University Hospitals of Derby NHS Foundation Trust, cover the pick of the papers from EMJ's May 2023 issue. In this edition, we cover papers on shoulder dislocation, blunt chest
- [PODCAST: The Epidemic of ED Violence - Dr. Graham Snyder ACEP Frontline](https://emergencymed.org.il/podcast-the-epidemic-of-ed-violence-dr-graham-snyder-acep-frontline/articles-2/) - ACEP Frontline · The Epidemic of ED Violence - Dr. Graham Snyder Violence and assaults in the emergency department are a growing challenge putting everyone in the environment at risk. In this episode, we talk with Dr. Graham Snyder about his November article in EP Monthly about violence, some of the causes, and some strategies
- [CT C-Spine Negative? Clear The Kid’s Collar](https://emergencymed.org.il/ct-c-spine-negative-clear-the-kids-collar/articles-2/) - Written by Amanda Mathews In this large, single-institution retrospective review of pediatric blunt trauma patients, no clinically significant injuries (requiring operative intervention) were missed when using multi-detector CT scan as the imaging modality of choice. Why does this matter? We have been taught that pediatric anatomy makes it more likely for children to have ligamentous
- [Management of low back pain in Australian emergency departments for culturally and linguistically diverse populations from 2016 to 2021](https://emergencymed.org.il/management-of-low-back-pain-in-australian-emergency-departments-for-culturally-and-linguistically-diverse-populations-from-2016-to-2021/recourse/) - Qiuzhe Chen1, Chris G Maher1, Eileen Rogan2, http://orcid.org/0000-0002-8544-0448Gustavo Machado1 Correspondence to Qiuzhe Chen, The University of Sydney Institute for Musculoskeletal Health, Sydney, New South Wales, Australia; qiuzhe.chen@sydney.edu.au Abstract Background Disparate care in the ED for minority populations with low back pain is a long-standing issue reported in the USA. Our objective was to compare
- [Point of care ultrasound impact in acute heart failure hospitalization: A retrospective cohort study](https://emergencymed.org.il/point-of-care-ultrasound-impact-in-acute-heart-failure-hospitalization-a-retrospective-cohort-study/articles-2/) - José Atilio Núñez-Ramos MD, MSc a b, Daniel Camilo Aguirre-Acevedo MSc, PhD c, María Camila Pana-Toloza MD, MSc b Abstract Background Acute decompensated heart failure (ADHF) is one of the most frequent causes of emergency department (ED) visits. Point-of-Care Ultrasound (POCUS) is a reliable, easy-to-use, and available tool for an accurate diagnosis of ADHF. We aimed to analyze
- [Pre-hospital modified shock index for prediction of massive transfusion and mortality in trauma patients](https://emergencymed.org.il/pre-hospital-modified-shock-index-for-prediction-of-massive-transfusion-and-mortality-in-trauma-patients/articles-2/) - Il-Jae Wang MD a, Byung-Kwan Bae MD a, Sung-Wook Park MD a, Young-Mo Cho MD a, Dae-Sup Lee MD b, Mun-Ki Min MD b, Ji-Ho Ryu MD b, Gil-Hwan Kim MD c, Jae-Hoon Jang MD d Abstract Background Modified shock index (MSI) is a useful predictor in trauma patients. However, the value of prehospital MSI (preMSI) in trauma patients is unknown. The aim of this study was to investigate the accuracy of preMSI in predicting massive transfusion (MT)
- [PODCAST: Ain't Easy Being Wheezy - Asthma POC Tool with Dr. Charles Emerman](https://emergencymed.org.il/podcast-aint-easy-being-wheezy-asthma-poc-tool-with-dr-charles-emerman/articles-2/) - ACEP Frontline · Ain't Easy Being Wheezy - Asthma POC Tool with Dr. Charles Emerman Joined today by Dr. Charles Emerman MD, Department Chair of Emergency Medicine at Metrohealth/Case Western Reserve University to discuss the latest and greatest in best practices related to our asthmatic patients. Dr. Emerman offers up solutions for quick identification and
- [Is Delayed Sequence Intubation (DSI) Safe In Trauma?](https://emergencymed.org.il/is-delayed-sequence-intubation-dsi-safe-in-trauma/articles-2/) - May 5, 2023 / Airway Written by Aaron Lacy When compared to rapid sequence intubation (RSI), this RCT showed decreased peri-intubation hypoxemic events and increased first attempt success in agitated and delirious ED patients with major trauma who underwent delayed sequence intubation (DSI). Why does this matter? Proper preparation when intubating is crucial. Adequate preoxygenation, running through procedural checklists, and optimal
- [Do STEMI Equivalents Post-ROSC Need Immediate Cath?](https://emergencymed.org.il/do-stemi-equivalents-post-rosc-need-immediate-cath/articles-2/) - May 3, 2023 / Cardiology, Resuscitation Written by Jason Lesnick In patients with ROSC after OHCA, these ‘STEMI equivalents’ do not appear to accurately diagnose ACS based on this study. Why does this matter? Currently, if a post-ROSC ECG is obtained and there is not a STEMI, there is evidence that delayed cardiac catheterization is equivalent to immediate
- [Medical and End-of-Life Decision-Making Preferences in Adolescents and Young Adults with Advanced Heart Disease and Their Parents](https://emergencymed.org.il/medical-and-end-of-life-decision-making-preferences-in-adolescents-and-young-adults-with-advanced-heart-disease-and-their-parents/articles-2/) - Melissa K. Cousino, PhD1,2; Victoria A. Miller, PhD3; Cynthia Smith, RN1; et alHeang M. Lim, MD1; Sunkyung Yu, MS1; Ray Lowery, BA1; Karen Uzark, PhD, PNP1,2; Emily M. Fredericks, PhD1; Joanne Wolfe, MD, MPH4; Elizabeth D. Blume, MD4; Kurt R. Schumacher, MS, MD1 Author Affiliations Article Information JAMA Netw Open. 2023;6(5):e2311957. doi:10.1001/jamanetworkopen.2023.11957 Key Points Question What are the medical and end-of-life decision-making preferences of adolescents and young adults (AYA) with advanced heart disease? Findings In this cross-sectional survey study of 56 patients, the majority of AYA participants stated a
- [PODCAST: Case -Altered Mental Status](https://emergencymed.org.il/podcast-case-altered-mental-status/articles-2/) - You are working at Clerkship General when the charge nurse comes and grabs you… “Hey doc, we need you in room 2, this kid looks sick…” Initial Vitals: BP: 68/40 HR: 128 RR: 22 O2: 99% (Room Air) Temp: 103.5F Critical Actions: Diagnose Meningitis and Perform Lumbar Puncture Give Empiric Antibiotics Treat Septic Shock Give
- [Effect of Routine Invasive vs Conservative Strategy in Older Adults With Frailty and Non–ST-Segment Elevation Acute Myocardial Infarction A Randomized Clinical Trial](https://emergencymed.org.il/effect-of-routine-invasive-vs-conservative-strategy-in-older-adults-with-frailty-and-non-st-segment-elevation-acute-myocardial-infarction-a-randomized-clinical-trial/articles-2/) - Juan Sanchis, PhD1; Héctor Bueno, PhD2; Gema Miñana, PhD1; et al Key Points Question Does a routine invasive strategy improve outcomes in older adults with frailty and non–ST-segment elevation acute myocardial infarction (NSTEMI)? Findings In this prematurely terminated randomized clinical trial of 167 older adult patients with frailty and NSTEMI, a routine invasive vs conservative strategy did not significantly
- [PODCAST: Cardiogenic Shock: the heart doesn't care about your sepsis protocol](https://emergencymed.org.il/podcast-cardiogenic-shock-the-heart-doesnt-care-about-your-sepsis-protocol/recourse/) - EM Board Bombs · 174. Cardiogenic Shock: the heart doesn't care about your sepsis protocol Hypotensive patient? Just reflexively give 30 cmL/kg, trend lactates, and broad spec antibiotics right? NOPE. Turns out, the heart could really care less. In fact, it might just decide to kill the patient if you do that. Let’s talk about
- [PODCAST: RCEM Learning May 20230](https://emergencymed.org.il/podcast-rcem-learning-may-20230/recourse/) - May 1, 2023 This month for the May 2023 episode of the RCEM Learning Podcast we’ve got two New in EM segments which shoulder relocation technique is best and the use of TXA in haemoptysis. We then speak with Tessa Davis of Don't Forget The Bubbles fame and her top tips for delivering teaching online.
- [PODCAST: BMJ talk medicine - Primary Survey - the highlights of April 2023](https://emergencymed.org.il/podcast-bmj-talk-medicine-primary-survey-the-highlights-of-april-2023/articles-2/) - BMJ talk medicine · Primary Survey - the highlights of April 2023
- [Clinical Performance Measures for Emergency Department Care for Adults With Intracranial Hemorrhage](https://emergencymed.org.il/clinical-performance-measures-for-emergency-department-care-for-adults-with-intracranial-hemorrhage/articles-2/) - Kori S. Zachrison, MD, MSc Joshua N. Goldstein, MD, PhD Edward Jauch, MD, MS Anshita Chaturvedi, MD, MPH Pawan Goyal, MD Arjun K. Venkatesh, MD, MBA Show all authors Published:April 19, 2023DOI:https://doi.org/10.1016/j.annemergmed.2023.03.015 Though select inpatient-based performance measures exist for the care of patients with nontraumatic intracranial hemorrhage, emergency departments lack measurement instruments designed to support and improve care processes in the
- [FOCUS may detects wall motion abnormalities in patients with ACS, A retrospective study](https://emergencymed.org.il/focus-may-detects-wall-motion-abnormalities-in-patients-with-acs-a-retrospective-study/articles-2/) - Alexander Bracey MD a, Lyndsay Massey MD b, Andrew C. Pellet MD a, Henry C. Thode PhD b, Thomas R. Holman MD a, Adam J. Singer MD b, Matthew McClure DO b, Michael A. Secko MD b Abstract Background Chest pain is a common presentation to the Emergency Department (ED) with roughly 6 million visits a year. The primary diagnostic modality for the identification of acute coronary syndrome (ACS) is the electrocardiogram (ECG), which is used to screen for electrocardiographic findings representing acute coronary occlusion. It is known that the ischemia generated by an
- [Extracorporeal cardiopulmonary resuscitation for cardiac arrest](https://emergencymed.org.il/extracorporeal-cardiopulmonary-resuscitation-for-cardiac-arrest/articles-2/) - Review Mathias J. Holmberga,b , Guillaume Geric,d , Sebastian Wibergb,e , Anne-Marie Guerguerianf , Michael W. Donninob,g , Jerry P. Nolanh , Charles D. Deakini , Lars W. Andersena,b,⁎ , for the International Liaison Committee on Resuscitation’s (ILCOR) Advanced Life Support and Pediatric Task Forces Aim: To assess the use of extracorporeal cardiopulmonary resuscitation (ECPR),
- [PODCAST: Non-Traditional RSI](https://emergencymed.org.il/podcast-non-traditional-rsi/articles-2/) - Apr 24, 2023 Contributor: Meghan Hurley, MD Educational Pearls: Two main reasons to choose non-traditional RSI Anatomically challenging airway Physiologically difficult patients: hypoxia, metabolic acidosis, hemodynamic instability Ketamine may help patients remain hemodynamically stable In critical patients, it is important to consider non-traditional RSI medications to improve outcomes References 1. Lyon RM, Perkins ZB, Chatterjee D,
- [בעד ונגד האם אנטובציה עם וידאו לרינגוסקופי צריכה להיות הבסיס לאינטובציה](https://emergencymed.org.il/בעד-ונגד-האם-אנטובציה-עם-וידאו-לרינגוס/articles-2/) - April 26, 2023 / Airway Written by Rebecca White בדיקת וידאו לרינגוסקופיה (VL) הראתה יתרונות על פני לרינגוסקופיה ישירה (DL) בספרות, אך האם זו צריכה להיות הגישה העיקרית לאינטובציה? שני הרופאים המרדימים מתווכחים ביניהם. למה זה משנה? ראינו שוב ושוב ש-VL מגביר את שיעור ההצלחה בנסיון ראשון ומביא פחות תוצאות שליליות כולל אינטובציה של הוושט
- [Pro-Con | Should VL Be Standard Of Care For Intubation?](https://emergencymed.org.il/בעד-ונגד-האם-אנטובציה-עם-וידאו-לרינגוס/articles-2/) - April 26, 2023 / Airway Written by Rebecca White Video laryngoscopy (VL) has shown advantages over direct laryngoscopy (DL) in the literature, but should it be the primary approach to intubation? These two anesthesiologists debate. Why does this matter? We’ve seen repeatedly that VL increases first-pass success rate and results in fewer adverse outcomes including esophageal intubation and hypoxemia. Is it

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- [מי אנחנו](https://emergencymed.org.il/מי-אנחנו/) - האיגוד הישראלי לרפואה דחופה מאגד את רופאי המחלקות לרפואה דחופה בארץ וכן רופאים העוסקים בנושא במסגרת מד"א ומוקדים קהילתיים לרפואה דחופה כדוגמת "טרם". הרפואה הדחופה הוכרה כמקצוע התמחות בשנת 1999. התמחות-על זו נמשכת 30 חודשים, וניתן לעשותה לאחר מומחיות בכירורגיה כללית, רפואה פנימית, הרדמה, רפואת ילדים או רפואת משפחה. בשנת 2003 נערכו בחינות ההתמחות הראשונות.
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- [כנס האיגוד לרפואה דחופה 2021](https://emergencymed.org.il/כנס-האיגוד-לרפואה-דחופה-2021/)
- [כאבי גב תחתון וחולשת רגליים אצל גבר בן 40](https://emergencymed.org.il/כאבי-גב-תחתון-וחולשת-רגליים-אצל-גבר-בן-40/) - אנמנזה:גבר בן 40 עם היסטוריה של יתר לחץ דם ואי-היענות לתרופות מגיע למלר"ד מתלונן על הופעה פתאומית של כאבי גב תחתון הקשורים לחולשה וחוסר תחושה של רגלו השמאלית. הכאב התרחש לפתע כשהמטופל התכופף כדי להרים את בנו. מתאר את כאב הגב שלו כ"קריעה" עם קרינה במורד רגלו השמאלית, מדרג את הכאב ברמה של 10 (בסולם
- [תשובה לכאבי גב תחתון וחולשת רגליים אצל גבר בן 40](https://emergencymed.org.il/תשובה-לכאבי-גב-תחתון-וחולשת-רגליים-אצל/) - האבחנה היא דיסקציה של אבי העורקים מסוג B. ה-CTA מדגים דיסקציה של אבי העורקים מסוג B, שמתחילה דיסטלית למוצא של העורק סוקלביה השמאלי, המשתרעת לאורך אבי העורקים החזה ואל תוך האילק השמאלי, האיליק החיצוני השמאלי ועורק הירך השמאלי (איורים 10.1 ו-10.2). אינטימל פלפ נראה גם בציר הצליאק, בעורק המזנטרי העליון ובעורק הכליה השמאלי (איור 10.1, לוחות
- [נפילה באוטובוס](https://emergencymed.org.il/נפילה-באוטובוס/) - הִיסטוֹרִיָהאישה בת 65 חזרה הביתה באוטובוס. כשהאוטובוס התקרב לתחנה, רכב יצא מלפנים מה שגרם לנהג לבלום בפתאומיות. האישה נזרקה קדימה ונפצעה בזרועה על מעקה מתכת באוטובוס. היא אומרת לך שיש לה הרבה כאבים והיא יכולה להרגיש משהו זז. היד הושמה במתלה רחב.בְּדִיקָההזרוע השמאלית נפוחה מאוד בהשוואה לצד השני וניתן לחוש קרפיטוס מעל השפאט של ההומרוס.
- [חולשת הגפיים התחתונות אצל אישה בת 26 - תשובה](https://emergencymed.org.il/חולשת-הגפיים-התחתונות-אצל-אישה-בת-26-תשו/) - האבחנה היא מורסה אפידורלית בעמוד השדרה עם דחיסה של חוט השדרה.בדיקת MRI, שהדגימה מסה אפידורלית פארה-מרכזית גב ימנית מ-T3 עד T8 הדוחסת את חוט השדרה החזה, דוחפת אותו אל הצד האחורי של גופי החוליות הסמוכים (איורים 47.147.3). המטופלת קיבלה אנטיביוטיקה IV (נפצילין וונקומיצין), DecadronR 10 מ"ג IV,נלקחה לחדר הניתוח. בוצעה דה-קומפרסיה של T2-T9 באמצעות ניתוחי
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- [כאבי חזה לסירוגין בחולה בן 46](https://emergencymed.org.il/כאבי-חזה-לסירוגין-בחולה-בן-46/) - מקרהגבר בן 46 ללא היסטוריה רפואית משמעותית הוצג במחלקה לרפואה דחופה (ED) 6 שעות לאחר פרק של 20 דקות של כאבי חזה וסחרחורת שהתרחשו במנוחה וחלפו באופן ספונטני. יומיים קודם לכן, הוא דיווח על אפיזודה דומה של 20 דקות של כאבים בחזה ודיאפורה. המטופל עישן כיום 30 סיגריות ביום והיה לו היסטוריה של עישון של
- [כאבים בחזה לסרוגין בחולה בן 46 תשובה](https://emergencymed.org.il/כאבים-בחזה-לסרוגין-בחולה-בן-46-תשובה/) - אִבחוּןתסמונת Wellens מסוג Aמה לעשות אחר כךג בצע אנגיוגרפיה כליליתהמפתח לאבחנה הנכונה הוא ההכרה שגל T הדו-פאזי ב-Leads V2 ו-V3 ב-ECG בחולה עם כאבים בחזה לאחרונה עשוי לרמז על חסימת עורקים כליליים קרובה. שחרור הביתה (בחירה A) אינה מומלצת, ואקו-לב דובוטמין (בחירה C) אסורה בחולים עם אנגינה לא יציבה מתמשכת. בחירה D אינה נכונה מכיוון
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- [אישור הסכמה של Mint Mail](https://emergencymed.org.il/optin_confirmation/)
- [הצגת מקרים - פודקסטטים](https://emergencymed.org.il/podcastcase/) - PODCAST: Nondisabling Stroke Recognition and Management 15/11/2025 אין תגובות Podcast: Play in new window | DownloadPodcast: Play in new window | Download “This learning material is sourced from Emergency Medicine Cases and has been published here with permission as per קרא עוד » PODCAST: Prehospital blood pressure treatment 11/11/2025 אין תגובות Episode 51: Managing the
- [הרצאות וובינרים האיגוד לרפואה דחופה](https://emergencymed.org.il/הרצאות-הוובינר-האיגוד/) - וובינר ניהול טראומה ראשונית ונפשית בזמן מלחמה ב-1 בנובמבר התקיים וובינר שעסק בניהול טראומה ראשונית ונפשית, במסגרת מיזם “איגודים נפגשים” של האיגוד הישראלי לרפואת המשפחה, שאירח את איגוד הפסיכיאטריה בישראל ואת האיגוד הישראלי לרפואה דחופה, ובוצע בהפקת אי־מד.בוובינר, שבו השתתפו כ 400 רופאים ורופאות, שיתפו מניסיונם ד”ר צחי סלוצקי, סגן מנהל בית החולים סורוקה, רופא
- [תגיות](https://emergencymed.org.il/questions/tags/) - [anspress]
- [Activities](https://emergencymed.org.il/questions/activities/) - [anspress]
- [Categories](https://emergencymed.org.il/questions/categories/) - [anspress]
- [Ask a question](https://emergencymed.org.il/questions/ask/) - [anspress]
- [פרופיל](https://emergencymed.org.il/questions/profile/) - [anspress]
- [שאלות](https://emergencymed.org.il/questions/) - [anspress]
- [Activate](https://emergencymed.org.il/activate/)
- [העלאת פוסט](https://emergencymed.org.il/העלאת-פוסט/) - [wpforms id="9667"]
- [memberlogin](https://emergencymed.org.il/memberlogin/) - [wpforms id="9039" title="false" description="false"]
- [אירועים קרובים](https://emergencymed.org.il/אירועים-קרובים/) - אירועים כנס טוקסיקולוגיה בינלאומי בהדסה עין כרם 31 מרץ 26 The 32 Annual Scientific Assembly of AAEM 11 אפר 26 Seattle, [fullcalendar type=event]
- [הצגות מקרים](https://emergencymed.org.il/הצגות-מקרים/) - שבר ירך המבוגרים כאבי גב תחתון וחולשת רגליים אצל גבר בן 40 בת 65 נפילה באוטובוס חולשת הגפיים התחתונות אצל אישה בת 26 כאבי בטן חדים כאבי חזה לסירוגין בחולה בן 46
- [מאתר איגוד הפארמדקים פודקאסטים ועוד](https://emergencymed.org.il/parmdicisrael/) - [custom-twitter-feeds feed=3]
- [קדם בית חולים - בשיתוף מד"א](https://emergencymed.org.il/prehospital/) - מאמרים עם תקציר מאגף רפואה מד"א מאמרים בנושא קדם בית חולים
- [Satisfaction Survey](https://emergencymed.org.il/satisfaction-survey/) - [wpforms id="7255" title="false" description="true"]
- [social wall](https://emergencymed.org.il/social-wall/) - [custom-twitter-feeds feed=2]
- [מאמרים ופודקסטים בנושא ילדים](https://emergencymed.org.il/מאמרים-ופודקסטים-בנושא-ילדים/) - BMJ: Modifiers of the effectiveness of point-of-care troponin testing and determinants of concordance between diagnostic pathway recommendations and disposition in patients with chest pain: a post hoc analysis of a randomised controlled trial 02/03/2026 אין תגובות Viola IL Thulin ,1 Gard Mikael Sæle Myrmel,2 Silje Marie Farestveit Jordalen,1 Ole Christian Lekven ,1,2 Jeyaseelan Krishnapillai,1,2 Ole-Thomas
- [הועדה לבחינת עבודת הרופאות והרופאים ברפואה דחופה בישראל](https://emergencymed.org.il/הועדה-לבחינת-עבודת-הרופאות-והרופאיםב/)
- [הועדה לבחינת עבודת הרופאות והרופאים ברפואה דחופה בבתי החולים בישראל](https://emergencymed.org.il/הועדה-לבחינת-עבודת-הרופאות-והרופאים-ב/) - מזמינה אתכם להשתתף בישיבת זום ובימי עיון. 1. עבודת הוועדה: סקירה, עדכון והמלצות.דיון בהשתתפות הקהל. 1. אבני הדרך מחזון למציאות.*דיון בשולחן עגול.יום שלישי 17/05 08:00-16:00 בכפר המכביה, רמת גן.2. התמחות מבוססת מיומנויות.*דיון בשולחן עגול.יום רביעי 24/05 08:00-16:00 בכפר המכביה, רמת גן.* הרשמה לימי עיון ללא עלות, מוגבלת במקומות. [wpforms id="6233"]
- [רישום לתחרות החייאה](https://emergencymed.org.il/רישום-לתחרות-החייאה/) - ימים שעות דקות שניות ההרשמה לתחרות הסתיימה
- [כאבי בטן חדים תוצאות סקר](https://emergencymed.org.il/כאבי-בטן-חדים-תוצאות-סקר/) - [wpforms_poll form_id="5896" field_id="11" label="true" counts="true"] [wpforms_poll form_id="5896" field_id="13" label="true" counts="true"] [wpforms_poll form_id="5885" field_id="3" label="true" counts="true"] [wpforms_poll form_id="5885" field_id="4" label="true" counts="true"] [wpforms_poll form_id="5885" field_id="5" label="true" counts="true"] [wpforms_poll form_id="5913" field_id="3" label="true" counts="true"] [wpforms_poll form_id="5913" field_id="8" label="true" counts="true"] [wpforms_poll form_id="5913" field_id="4" label="true" counts="true"] [wpforms_poll form_id="5913" field_id="7" label="true" counts="true"]
- [תשובות  ב](https://emergencymed.org.il/תשובות-ב/) - תשובות .1 תשובה א. לחולה זה יש כאב אפיגסטרי חוזר, המיוחס למחלת ריפלוקס גסטרו-ושט. עם זאת, העובדה שהסימפטומים שלה נשלטו בצורה גרועה עם מונעי חומצה בעבר מעידה על כך שהאבחנה כנראה לא מדויקת. הסימפטומים החוזרים שלה נגרמים ככל הנראה על ידי מחלת דרכי המרה, וההצגה הנוכחית שלה חשודה ביותר למחלת דרכי מרה מסובכת כגון דלקת
- [כאבי בטן חדים](https://emergencymed.org.il/כאבי-בטן-חדים/) - המקרה שהבאתי הפעם שונה בעריכה מהפעמים הקודמות. ההסבר לאחר הצגת המקרה ארוך יותר ומובא כלימוד הנושא.לאחר מכן יש שאלות נוספות בנושא הכללי. לבסוף הוספתי סקר קצר לבדיקת העדפות שלכם ערן אתה עובד במחלקה לרפואה דחופה (ED) של בית חולים כפרי עם 15 מיטות ללא יכולות סריקת CT, ואישה בת 25, בריאה בעבר, מגיעה להערכת כאבי בטן. המטופלת
- [הפורומים](https://emergencymed.org.il/הפורומים/) - [bbp-forum-index] [bbp-topic-index]
- [חולשת הגפיים התחתונות אצל אישה בת 26](https://emergencymed.org.il/חולשת-הגפיים-התחתונות-אצל-אישה-בת-26/) - אנמנזה:בת 26 עם היסטוריה רפואית משמעותית להשמנה ודום נשימה חסימתי בשינה הגיעה למלר"ד באמבולנס והתלוננה על חולשה מתקדמת, דו-צדדית בגפיים התחתונות. היא דיווחה שמהבוקר היא לא יכלה לשאת משקל או להזיז את רגליה. היא גם דיווחה על חוסר תחושה בשתי הרגליים, כמו גם על חוסר יכולת להטיל שתן.היא חוותה תסמינים דמויי הצטננות ושפעת החל מספר
- [טיפול רב מקצועי בסנקופה](https://emergencymed.org.il/טיפול-רב-מקצועי-בסנקופה/)
- [נפילה באוטובוס דיון](https://emergencymed.org.il/נפילה-באוטובוס-דיון/) - לגברת הזו יש שבר ספירלי פרוקסימלי בעצם ההומרלי. פציעה זו קשורה לפציעה מסוג סיבובי כגון החזקת מסילה והשלכה קדימה. יכולה להיות פגיעה משמעותית ברקמות הרכות ודימום פנימי, ולכן יש להעריך זאת במקביל ולתעד. בנוסף, העצב הרדיאלי עוטף את החלק האמצעי של עצם הזרוע בחריץ הספירלי ועשוי להיפצע עד 18% משברים באמצע הציר, ולכן ההערכה צריכה
- [חומרים לקורס מתמחים ברפואה](https://emergencymed.org.il/חומרים-לקורס-מתמחים-ברפואה/)
- [טויטר](https://emergencymed.org.il/twitter/) - [wptelegram-ajax-widget username="MOHreport" width="100%" height="500px"] [custom-twitter-feeds screenname="nejm"] [custom-twitter-feeds screenname="AnnalsofEM"]
- [הרצאות לקורס מתמחים](https://emergencymed.org.il/הרצאות-לקורס-מתמחים/) - video laryngoscopy tips and troubleshooting פריט ברשימה #2 פריט ברשימה #3
- [פרסומים והודעות של ועד האיגוד לרפואה דחופה](https://emergencymed.org.il/פרסומים-והודעות-של-ועד-האיגוד-לרפואה-ד/) - חברי הועד של האיגוד לרפואה דחופה יו"ר: פרופ' מייק דרשר מזכיר: ד"ר ערן טל-אורגזברית: ד"ר טניה הדרחבר ועד: ד"ר צחי סלוצקיחבר ועד : ד"ר ריק יהונתן ועדת ביקורת :ד"ר שאדן סלאמה יוסףד"ר דברה ווסטד"ר מירב סלוטקי הודעות ופרסומים של הועד הרצאת CME של חודש ינואר עלתה לאתר 28/01/2026 אין תגובות הרצאתו של Dr. Lloyd Tannenbaum: High Risk
- [לוח זמנים קורס רפואה דחופה למתמחים](https://emergencymed.org.il/לוח-זמנים-קורס-רפואה-דחופה-למתמחים/) - The National Israeli Course in Emergency Medicine Timetable 2021-22 מחזור ו'VenueTopicDayAssaf HarofehAirway (A)Tues 05/10Assaf HarofehAirway (A)Wed 20/10Shaare ZedekP.O.C.U.S (F)Tues 09/11AssutaBreathing/Circulation (B/C)Friday 19/11Shaare Zedek/ AssutaOrthopedics (D/E)Friday 10/12Assaf HarofehCritical Care/ResuscitationTues 28/12Assaf HarofehMechanical VentilationFriday 07/01Assaf HarofehCardioresp. EmergenciesTues 18/01Assaf HarofehProcedural SedationTues 08/02AssutaCommunication SkillsFriday 18/02Assaf HarofehPediatricsTues 08/03IchilovMinor TraumaFriday 25/03Assaf HarofehMajor TraumaTues 12/04Bnei TzionSurgeryFriday 29/04Assaf HarofehEndo /Met. EmergenciesTues 10/05HadassahHem/Onco. EmergenciesFriday
- [תמונת מצב יומית](https://emergencymed.org.il/תמונת-מצב-יומית/) - [corona country="Israel" title="ישראל" style="3" dark_mode="no" label_total="פעילים " label_confirmed="מאומתים" label_deaths="מתים" label_recovered="מחלימים"]
- [תמונת מצב יומית](https://emergencymed.org.il/elementor-447/) - [corona_statistic_together] [cvct-advance id="1509"] [corona_ticker countries="Isreal,USA,China" ]
- [תגובות הצעות](https://emergencymed.org.il/תגובות-הצעות/) - יש להרשם ולהתחבר לאתר על מנת לפרסם
- [העלאת פוסט חדש](https://emergencymed.org.il/העלאת-פוסט-חדש/) - פרסום הפוסט יתבצע לאחר בקרה של מנהל האתר שם פרטי שם משפחה אימייל טלפון בחר אפשרות אחת מאמר הצעה לשיפור בקשה הודעה שליחה
- [קורס מתמחים רפואה דחופה](https://emergencymed.org.il/קורס-מתמחים-רפואה-דחופה/) - לתכני הקורס לחץ כאן The National Israeli Course in Emergency Medicine Timetable 2020-21 מחזור ה' Semester 1 Venue Supervisor Subject Editor Topic Day Assaf Harofe Debra West Debra West Advanced Airway Management Tuesday 03/03 Beilinson Moshe Sharist Nadav Granot Yosef Eisenberg ECGs & CXRs (Cardiopulmonary skillset) Friday 20/03 Assaf Harofe Marganit Sasson Marganit
- [העלאת מאמרים](https://emergencymed.org.il/upload-articles/) - כל ההגשות של המאמרים הודעות יעברו ביקורת ואז יעלו לאתר [usp_name] [usp_email][usp_name label="שם מלא" required="true"][usp_title label="נושא הפרסום" required="true"][usp_category label="קטגורית הפרסום" type="dropdown" multiple="true" required="true"][usp_content label="תוכן הפרסום (רצוי האבסטקט)" rows="10" richtext="false" required="true"][usp_files label="קובץ" multiple="true" required="false"][usp_remember label="זכור אותי"] [usp_captcha] [usp_agree label="מסכים לתנאי האתר" default="true"]
- [קורס מתמחים ברפואה דחופה](https://emergencymed.org.il/קורס-מתמחים-ברפואה-דחופה/) - כאן יפרסמו מטלות וחומרים של קורס המתמחים ברפואה דחופה ד"ר דברה ווסט נעים להכיר: ד"ר דברה ווסט, מנהלת המחלקה לרפואה דחופה (מלר"ד) בבית החולים הציבורי אסותא אשדוד. מי אני: "אני נשואה ואם לארבעה, נולדתי באוסטרליה ועליתי לישראל ב-1994. התמחיתי ברפואה פנימית וברפואה דחופה בביה"ח שערי צדק בירושלים, ניהלתי את המיון הכירורגי באיכילוב, וכעת מנהלת את
- [שאלון אלימות כלפי צוות רפואי](https://emergencymed.org.il/שאלון-אלימות-כלפי-צוות-רפואי/)
- [עידכוני וידיאו לקורונה](https://emergencymed.org.il/עידכוני-וידיאו-לקורונה/) - עידכון מה AMA
- [UPLOAD post](https://emergencymed.org.il/upload-post/) - [user-submitted-posts]
- [שליחת מאמר לאתר](https://emergencymed.org.il/שליחת-מאמר-לאתר/)
- [countdown](https://emergencymed.org.il/countdown/)
- [count down](https://emergencymed.org.il/count-down/) - [wpcdt-countdown id="2551"] [wpcdt-countdown id="2512"]
- [רישום לדיוור של האיגוד לרפואה דחופה](https://emergencymed.org.il/maillistreg/) - [mc4wp_form id="301"]
- [sticky footer](https://emergencymed.org.il/sticky-footer/) - הכנס השנתי שלר רפואה דחופה. המלר"ד בעידן הקורונה מתרחש בעוד: [wpcdt-countdown id="2512"] הרשם לכנס
- [לוח ארועים](https://emergencymed.org.il/לוח-ארועים-2/)
- [רפואת חרום טרום בית חולים](https://emergencymed.org.il/רפואת-חרום-טרום-בית-חולים/) - בעריכת ד"ר אורן ווכאט [facebook-page-plugin href="emergency.medicine.israel"]
- [האיגוד לרפואה דחופה](https://emergencymed.org.il/האיגוד-לרפואה-דחופה/) - מצב הקורנה בארץ זמן אמת מצב הקורונה בעולם BMJ: Modifiers of the effectiveness of point-of-care troponin testing and determinants of concordance between diagnostic pathway recommendations and disposition in patients with chest pain: a post hoc analysis of a randomised controlled trial 02/03/2026 אין תגובות Viola IL Thulin ,1 Gard Mikael Sæle Myrmel,2 Silje Marie Farestveit
- [סירטונים בנושא POCUS](https://emergencymed.org.il/סירטונים-הנושא-pocus/) - [origincode_videogallery id="3"]
- [Slide Anything Popup Preview](https://emergencymed.org.il/slide-anything-popup-preview/) - [slide-anything id='477']
- [פגישת זום הקרובה](https://emergencymed.org.il/פגישת-זום-הקרובה/) - [zoom_join_via_browser meeting_id="82472869979" login_required="no" help="yes" title="פגישה" height="600px" disable_countdown="no"]
- [האיגוד בתקשורת](https://emergencymed.org.il/האיגוד-בתקשורת/)
- [תמונת מצב](https://emergencymed.org.il/תמונת-מצב/) - [doc id=1550]
- [סרטוני אנטומיה לרפואה דחופה](https://emergencymed.org.il/סרטוני-אנטומיה-לרפואה-דחופה/) - סידרת סירטוני אנטומיה לרפואה דחופהשפורסמו באתר VIMEO [origincode_videogallery id="4"]
- [Video from the CDC about COVID-19](https://emergencymed.org.il/elementor-445/)
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- [רפואה דחופה בפייסבוק](https://emergencymed.org.il/elementor-777/)
- [Kids are Alright](https://emergencymed.org.il/נסיון/) - Kids are Alright - Angelo Mikrogianakis from EMU 365 on Vimeo.
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## הטמפלטים שלי

- [Site Header](https://emergencymed.org.il/?elementor_library=site-header) - אזור תוכן
- [אלמנטור פריט לולאה #12799](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-8) - אלמנטור פריט לולאה #12799
- [Article Template](https://emergencymed.org.il/?elementor_library=אלמנטור-פוסט-יחיד-12731) - Article Template 03.03.25 Viola IL Thulin ,1 Gard Mikael Sæle Myrmel,2 Silje Marie Farestveit Jordalen,1 Ole Christian Lekven ,1,2 Jeyaseelan Krishnapillai,1,2 Ole-Thomas Steiro,2 Richard Body ,3,4 Paul O Collinson ,5 Fred Apple,6 Louise Cullen ,7,8,9 Tone Merete Norekvål,2,10 Torbjørn Wisløff,11,12 Kjell Vikenes ,2,10 Rune Oskar Bjørneklett,1,13 Torbjørn Omland,12,14 Kristin Moberg Aakre Abstract. Introduction While point-of-care (POC)
- [אלמנטור פריט לולאה #12697](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-7) - אלמנטור פריט לולאה #12697 לפרטים נוספים
- [אלמנטור פריט לולאה #13121](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-10) - אלמנטור פריט לולאה #13121
- [em case](https://emergencymed.org.il/?elementor_library=em-case) - em case Date 15.02.23 Viola IL Thulin ,1 Gard Mikael Sæle Myrmel,2 Silje Marie Farestveit Jordalen,1 Ole Christian Lekven ,1,2 Jeyaseelan Krishnapillai,1,2 Ole-Thomas Steiro,2 Richard Body ,3,4 Paul O Collinson ,5 Fred Apple,6 Louise Cullen ,7,8,9 Tone Merete Norekvål,2,10 Torbjørn Wisløff,11,12 Kjell Vikenes ,2,10 Rune Oskar Bjørneklett,1,13 Torbjørn Omland,12,14 Kristin Moberg Aakre Abstract. Introduction While point-of-care
- [אלמנטור פוטר #12752](https://emergencymed.org.il/?elementor_library=אלמנטור-פוטר-12752) - אזור תוכן
- [אלמנטור פריט לולאה #12942](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-9) - אלמנטור פריט לולאה #12942 להאזנה לפודקסט להאזנה לפודקסט
- [אלמנטור פריט לולאה #12488](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-5) - אלמנטור פריט לולאה #12488 לפרטים נוספים
- [אלמנטור עמוד יחיד #12987](https://emergencymed.org.il/?elementor_library=אלמנטור-עמוד-יחיד-12987) - אלמנטור עמוד יחיד #12987
- [search1](https://emergencymed.org.il/?elementor_library=search1)
- [אלמנטור פריט לולאה #12932](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-9)
- [אלמנטור פריט לולאה #12926](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-9)
- [אלמנטור פריט לולאה #12920](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-9)
- [Login](https://emergencymed.org.il/?elementor_library=login) - אזור תוכן
- [Events Template](https://emergencymed.org.il/?elementor_library=אלמנטור-פוסט-יחיד-12673) - Events Template Event Website Viola IL Thulin ,1 Gard Mikael Sæle Myrmel,2 Silje Marie Farestveit Jordalen,1 Ole Christian Lekven ,1,2 Jeyaseelan Krishnapillai,1,2 Ole-Thomas Steiro,2 Richard Body ,3,4 Paul O Collinson ,5 Fred Apple,6 Louise Cullen ,7,8,9 Tone Merete Norekvål,2,10 Torbjørn Wisløff,11,12 Kjell Vikenes ,2,10 Rune Oskar Bjørneklett,1,13 Torbjørn Omland,12,14 Kristin Moberg Aakre Abstract. Introduction While point-of-care
- [אלמנטור פריט לולאה #12503](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-6) - אלמנטור פריט לולאה #12503
- [Default Kit](https://emergencymed.org.il/?elementor_library=default-kit)
- [אלמנטור פריט לולאה #11637](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-4) - אלמנטור פריט לולאה #11637
- [אלמנטור פריט לולאה #11629](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-3)
- [אלמנטור פריט לולאה #11617](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה-2)
- [אלמנטור פריט לולאה #11609](https://emergencymed.org.il/?elementor_library=אלמנטור-פריט-לולאה)
- [אלמנטור ארכיון #3652](https://emergencymed.org.il/?elementor_library=אלמנטור-ארכיון-3652) - טמפלט: אלמנטור ארכיון #3652 BMJ: Modifiers of the effectiveness of point-of-care troponin testing and determinants of concordance between diagnostic pathway recommendations and disposition in patients with chest pain: a post hoc analysis of a randomised controlled trial 02/03/2026 אין תגובות Viola IL Thulin ,1 Gard Mikael Sæle Myrmel,2 Silje Marie Farestveit Jordalen,1 Ole Christian Lekven
- [אלמנטור פוסט יחיד #3569](https://emergencymed.org.il/?elementor_library=אלמנטור-פוסט-יחיד-3569) - אלמנטור פוסט יחיד #3569 מערכת האיגוד אפריל 25, 2021 12:45 pm Viola IL Thulin ,1 Gard Mikael Sæle Myrmel,2 Silje Marie Farestveit Jordalen,1 Ole Christian Lekven ,1,2 Jeyaseelan Krishnapillai,1,2 Ole-Thomas Steiro,2 Richard Body ,3,4 Paul O Collinson ,5 Fred Apple,6 Louise Cullen ,7,8,9 Tone Merete Norekvål,2,10 Torbjørn Wisløff,11,12 Kjell Vikenes ,2,10 Rune Oskar Bjørneklett,1,13 Torbjørn
- [korona status](https://emergencymed.org.il/?elementor_library=korona-status) - [display_covid_19_data countries="Israel" bg_color="#6A67F1"]

## אירועים

- [The 32 Annual Scientific Assembly of AAEM](https://emergencymed.org.il/events/the-32-annual-scientific-assembly-of-aaem/) - Registration is now open for AAEM’s 32nd Annual Scientific Assembly (AAEM26) in Seattle, Washington! Secure your spot now for five days of cutting-edge emergency medicine education, hands-on training, and networking with the brightest minds in the field. REGISTER NOW At AAEM26, you will: Get evidence-based clinical updates from world-renowned experts Participate in immersive workshops and
- [כנס טוקסיקולוגיה בינלאומי בהדסה עין כרם](https://emergencymed.org.il/events/כנס-טוקסיקולוגיה-בינלאומי-בהדסה-עין-כ/) - כנס טוקסיקולוגיה – רפואה דחופה המחלקה לרפואה דחופה, הדסה עין כרם, מזמינה אתכם.ן להשתתף בכנס טוקסיקולוגיה מקצועי ומעמיק. הרצאות ועדכונים קליניים עם מומחים, ודיון במקרי אמת מהשטח. 📅 31.03.26 ⏰ 08:00–17:00 📍 הדסה עין כרם 🌍 הכנס מתקיים באנגלית 👉 למידע נוסף ולינק לרישום: https://lp.vp4.me/wh7r

## מקומות

- [The Westin Seattle](https://emergencymed.org.il/locations/the-westin-seattle/)
- [הדסה עין כרם](https://emergencymed.org.il/locations/הדסה-עין-כרם-2/)
- [1st Faculty of Medicine](https://emergencymed.org.il/locations/1st-faculty-of-medicine/)
- [Hotel Park](https://emergencymed.org.il/locations/hotel-park/)
- [מרכז הכנסים אבניו](https://emergencymed.org.il/locations/מרכז-הכנסים-אבניו/)
- [Budapest](https://emergencymed.org.il/locations/budapest/)
- [Intercontinental Miami](https://emergencymed.org.il/locations/intercontinental-miami/)
- [המשכן לאומנויות הבמה](https://emergencymed.org.il/locations/המשכן-לאומנויות-הבמה/)
- [Charles University](https://emergencymed.org.il/locations/charles-university/)
- [Complesso Del Seraphicum](https://emergencymed.org.il/locations/complesso-del-seraphicum/)
- [הדסה עין כרם](https://emergencymed.org.il/locations/הדסה-עין-כרם/)
- [מאכז הכננסים אבניו](https://emergencymed.org.il/locations/מאכז-הכננסים-אבניו/)
- [בית חיל האוויר](https://emergencymed.org.il/locations/בית-חיל-האוויר/)
- [כפר המכביה](https://emergencymed.org.il/locations/כפר-המכביה-2/)
- [כפר המכביה](https://emergencymed.org.il/locations/כפר-המכביה/)
- [אודטריום בית שלום מרכז רפואי שמיר  (אסף הרופא)](https://emergencymed.org.il/locations/אודטריום-בית-שלום-מרכז-רפואי-שמיר-אסף/)
- [ישראל היפה](https://emergencymed.org.il/locations/ישראל-היפה/)
- [אקספו גני התערוכה תל אביב](https://emergencymed.org.il/locations/אקספו-גני-התערוכה-תל-אביב/)
- [מרכז טכנולוגיה וסימולציה ע"ש ניסים דואק בביה"ח איכילוב](https://emergencymed.org.il/locations/מרכז-טכנולוגיה-וסימולציה-עש-ניסים-דוא/)
- [מרכז הכנסים אבניו, קרית שדה התעופה](https://emergencymed.org.il/locations/מרכז-הכנסים-אבניו-קרית-שדה-התעופה/)
- [המרכז לסימולציות רפואיות](https://emergencymed.org.il/locations/המרכז-לסימולציות-רפואיות/)
- [המרכז לטכנולגיה וסימולציה](https://emergencymed.org.il/locations/המרכז-לטכנולגיה-וסימולציה/)
- [Kay Bailey Hutchison Convention Center](https://emergencymed.org.il/locations/kay-bailey-hutchison-convention-center/)
- [מלון דן פנורמה](https://emergencymed.org.il/locations/מלון-דן-פנורמה-2/)
- [מלון דן פנורמה](https://emergencymed.org.il/locations/מלון-דן-פנורמה/)
- [מלון דן אכדיה הרצליה](https://emergencymed.org.il/locations/מלון-דן-אכדיה-הרצליה/)
- [מלון הילטון תל-אביב](https://emergencymed.org.il/locations/מלון-הילטון-תל-אביב/)
- [מרכז רפואי אסף הרופא](https://emergencymed.org.il/locations/מרכז-רפואי-אסף-הרופא/)
- [מרכז רפואי יצחק שמיר (אסף הרופא)](https://emergencymed.org.il/locations/מרכז-רפואי-יצחק-שמיר-אסף-הרופא/)
- [מלון אלמא](https://emergencymed.org.il/locations/מלון-אלמא/)
- [סיטי טאור](https://emergencymed.org.il/locations/סיטי-טאור/)
- [דן פנורמה תל-אביב](https://emergencymed.org.il/locations/דן-פנורמה-תל-אביב-3/)
- [דן פנורמה תל-אביב](https://emergencymed.org.il/locations/דן-פנורמה-תל-אביב-2/)
- [דן פנורמה תל-אביב](https://emergencymed.org.il/locations/דן-פנורמה-תל-אביב/)
- [מלון דיוויד אינטרקונטיננטל תל אביב](https://emergencymed.org.il/locations/מלון-דיוויד-אינטרקונטיננטל-תל-אביב-2/)
- [מלון דיוויד אינטרקונטיננטל תל אביב](https://emergencymed.org.il/locations/מלון-דיוויד-אינטרקונטיננטל-תל-אביב/)
- [Convention & Exhibition Center Seoul korea](https://emergencymed.org.il/locations/convention-exhibition-center-seoul-korea-2/)
- [Convention & Exhibition Center Seoul korea](https://emergencymed.org.il/locations/convention-exhibition-center-seoul-korea/)

## News Tickers

- [חדשות הבריאות](https://emergencymed.org.il/ticker/חדשות-הבריאות/)

## קטגוריות

- [ללא קטגוריה](https://emergencymed.org.il/category/ללא-קטגוריה-3/)
- [קורס מתמחים ברפואה דחופה](https://emergencymed.org.il/category/recourse/) - קורס למתמחים ברפואה דחופה
- [הודעות האיגוד לרפואה דחופה](https://emergencymed.org.il/category/igud/) - הודעות של ועד האיגוד לרפואה דחופה
- [articles](https://emergencymed.org.il/category/articles-2/)
- [Education Tips](https://emergencymed.org.il/category/education-tips/)
- [blog](https://emergencymed.org.il/category/blog/)
- [קורונה](https://emergencymed.org.il/category/ללא-קטגוריה-3/korona/) - כל מה שקשור לקורונה
- [ZOOM](https://emergencymed.org.il/category/zoom/)
- [קדם בית חולים](https://emergencymed.org.il/category/קדם-בית-חולים/)
- [trauma](https://emergencymed.org.il/category/trauma/)
- [POCUS](https://emergencymed.org.il/category/pocus/)
- [סדציה](https://emergencymed.org.il/category/סדציה/)
- [ICU](https://emergencymed.org.il/category/icu/)
- [ילדים](https://emergencymed.org.il/category/ילדים/)
- [ספסיס](https://emergencymed.org.il/category/ספסיס/)
- [ניהול מלר"ד](https://emergencymed.org.il/category/ניהול-מלרד/)
- [spoon feed](https://emergencymed.org.il/category/spoon-feed/)
- [CME](https://emergencymed.org.il/category/cme/)
- [podcast](https://emergencymed.org.il/category/podcast/)
- [Stroke](https://emergencymed.org.il/category/stroke/)
- [קרדיולוגיה](https://emergencymed.org.il/category/קרדיולוגיה/)
- [airway](https://emergencymed.org.il/category/airway/)
- [Sedation](https://emergencymed.org.il/category/sedation/)
- [זהומים](https://emergencymed.org.il/category/זהומים/)
- [החייאה](https://emergencymed.org.il/category/החייאה/)
- [נירולוגיה](https://emergencymed.org.il/category/נירולוגיה/)
- [Sepsis](https://emergencymed.org.il/category/sepsis/)
- [מתמחים](https://emergencymed.org.il/category/מתמחים/)
- [הרעלות](https://emergencymed.org.il/category/הרעלות/)
- [גירייטריה](https://emergencymed.org.il/category/גירייטריה/)
- [סכרת](https://emergencymed.org.il/category/סכרת/)
- [PE](https://emergencymed.org.il/category/pe/)
- [כלי דם](https://emergencymed.org.il/category/כלי-דם/)
- [כאב](https://emergencymed.org.il/category/כאב/)
- [כירורגיה](https://emergencymed.org.il/category/כירורגיה/)
- [summary](https://emergencymed.org.il/category/summary/)
- [סרטי הדרכה](https://emergencymed.org.il/category/סרטי-הדרכה/)
- [אורתופדיה](https://emergencymed.org.il/category/אורתופדיה/)
- [דימות](https://emergencymed.org.il/category/דימות/)
- [פרמקולוגיה](https://emergencymed.org.il/category/פרמקולוגיה/)
- [Imaging](https://emergencymed.org.il/category/imaging/)
- [video](https://emergencymed.org.il/category/video/)
- [אורטופדיה](https://emergencymed.org.il/category/אורטופדיה/)
- [Case Presentation](https://emergencymed.org.il/category/case-presentation/)
- [אלרגיה](https://emergencymed.org.il/category/אלרגיה/)
- [חינוך רפואי](https://emergencymed.org.il/category/חינוך-רפואי/)
- [אורולוגיה](https://emergencymed.org.il/category/אורולוגיה/)
- [המטולוגיה](https://emergencymed.org.il/category/המטולוגיה/)
- [אא"ג](https://emergencymed.org.il/category/אאג/)
- [מד"א](https://emergencymed.org.il/category/מדא/)
- [פרמדיקים](https://emergencymed.org.il/category/פרמדיקים/)
- [ללא קטגוריה](https://emergencymed.org.il/category/ללא-קטגוריה-3/)
- [airway](https://emergencymed.org.il/category/airway/)
- [articles](https://emergencymed.org.il/category/articles-2/)
- [CME](https://emergencymed.org.il/category/cme/)
- [Case Presentation](https://emergencymed.org.il/category/case-presentation/)
- [Education Tips](https://emergencymed.org.il/category/education-tips/)
- [Imaging](https://emergencymed.org.il/category/imaging/)
- [spoon feed](https://emergencymed.org.il/category/spoon-feed/)
- [trauma](https://emergencymed.org.il/category/trauma/)
- [אא"ג](https://emergencymed.org.il/category/אאג/)
- [אורתופדיה](https://emergencymed.org.il/category/אורתופדיה/)
- [ילדים](https://emergencymed.org.il/category/ילדים/)
- [קדם בית חולים](https://emergencymed.org.il/category/קדם-בית-חולים/)
- [החייאה](https://emergencymed.org.il/category/החייאה/)
- [חינוך רפואי](https://emergencymed.org.il/category/חינוך-רפואי/)
- [מתמחים](https://emergencymed.org.il/category/מתמחים/)
- [ניהול מלר"ד](https://emergencymed.org.il/category/ניהול-מלרד/)
- [נירולוגיה](https://emergencymed.org.il/category/נירולוגיה/)
- [פרמדיקים](https://emergencymed.org.il/category/פרמדיקים/)
- [קורס מתמחים ברפואה דחופה](https://emergencymed.org.il/category/recourse/) - קורס למתמחים ברפואה דחופה
- [קרדיולוגיה](https://emergencymed.org.il/category/קרדיולוגיה/)
- [פרמקולוגיה](https://emergencymed.org.il/category/פרמקולוגיה/)
- [פסיכיאטריה](https://emergencymed.org.il/category/פסיכיאטריה/)
- [ECMO](https://emergencymed.org.il/category/ecmo/)
- [נשימה](https://emergencymed.org.il/category/נשימה/)
- [Elderly](https://emergencymed.org.il/category/elderly/)
- [Head Injury](https://emergencymed.org.il/category/head-injury/)
- [simulation](https://emergencymed.org.il/category/simulation/)
- [אנדוקינולוגיה](https://emergencymed.org.il/category/אנדוקינולוגיה/)
- [יתר לחץ דם](https://emergencymed.org.il/category/יתר-לחץ-דם/)
- [פה ולסת](https://emergencymed.org.il/category/פה-ולסת/)
- [ראומטולוגיה](https://emergencymed.org.il/category/ראומטולוגיה/)
- [מיילדות](https://emergencymed.org.il/category/מיילדות/)
- [Shock](https://emergencymed.org.il/category/shock/)
- [גאסטרו](https://emergencymed.org.il/category/גאסטרו/)
- [bleeding](https://emergencymed.org.il/category/bleeding/)
- [AI](https://emergencymed.org.il/category/ai/)
- [case podcast](https://emergencymed.org.il/category/case-podcast/)
- [עיניים](https://emergencymed.org.il/category/עיניים/)
- [הריון](https://emergencymed.org.il/category/הריון/)
- [טביעה](https://emergencymed.org.il/category/טביעה/)
- [היפוטרמיה](https://emergencymed.org.il/category/היפוטרמיה/)
- [מחקר](https://emergencymed.org.il/category/מחקר/)
- [COPD](https://emergencymed.org.il/category/copd/)
- [עמוד שידרה](https://emergencymed.org.il/category/עמוד-שידרה/)
- [היפרטרמיה](https://emergencymed.org.il/category/היפרטרמיה/)
- [פרכוס](https://emergencymed.org.il/category/פרכוס/)
- [ספורט](https://emergencymed.org.il/category/ספורט/)
- [כוויות](https://emergencymed.org.il/category/כוויות/)
- [ורטיגו](https://emergencymed.org.il/category/ורטיגו/)
- [Patient Safety](https://emergencymed.org.il/category/patient-safety/)
- [Asthma](https://emergencymed.org.il/category/asthma/)
- [DVT](https://emergencymed.org.il/category/dvt/)
- [אפילפסיה](https://emergencymed.org.il/category/אפילפסיה/)
- [TIA](https://emergencymed.org.il/category/tia/)
- [הנשמה](https://emergencymed.org.il/category/הנשמה/)
- [אונקולוגיה](https://emergencymed.org.il/category/אונקולוגיה/)
- [massive transfusions](https://emergencymed.org.il/category/massive-transfusions/)
- [Alzheimer](https://emergencymed.org.il/category/alzheimer/)
- [מוטס](https://emergencymed.org.il/category/מוטס/)
- [renal colic](https://emergencymed.org.il/category/renal-coolic/)
- [Anaphylaxis](https://emergencymed.org.il/category/anaphylaxis/)
- [אק"ג](https://emergencymed.org.il/category/אקג/)
- [ticker](https://emergencymed.org.il/category/ticker/)
- [Breaking](https://emergencymed.org.il/category/break/) - הודעות חשובות שיופיעו בעמוד הראשון
- [fever](https://emergencymed.org.il/category/fever/)
- [Dementia](https://emergencymed.org.il/category/dementia/)
- [TBI](https://emergencymed.org.il/category/tbi/)
- [ECG](https://emergencymed.org.il/category/ecg/)
- [sport](https://emergencymed.org.il/category/sport/)
- [ACS](https://emergencymed.org.il/category/acs/)

## תגיות

- [ON-LINE](https://emergencymed.org.il/tag/online/) - הארוע וירטואלי
- [Trauma](https://emergencymed.org.il/tag/trauma/)
- [Hematology/Oncology](https://emergencymed.org.il/tag/hematology-oncology/)
- [Pharmacy/Pharmacology](https://emergencymed.org.il/tag/pharmacy-pharmacology/)
- [Imaging](https://emergencymed.org.il/tag/imaging/)
- [Cardiology](https://emergencymed.org.il/tag/cardiology/)
- [Airway](https://emergencymed.org.il/tag/airway/)
- [Pediatrics](https://emergencymed.org.il/tag/pediatrics/)
- [Anticoagulation](https://emergencymed.org.il/tag/anticoagulation/)
- [Critical Care](https://emergencymed.org.il/tag/critical-care/)
- [Resuscitation](https://emergencymed.org.il/tag/resuscitation/)
- [Infectious Disease](https://emergencymed.org.il/tag/infectious-disease/)
- [Pulmonary/Allergy](https://emergencymed.org.il/tag/pulmonary-allergy/)
- [ENT/Face](https://emergencymed.org.il/tag/ent-face/)
- [Neurology](https://emergencymed.org.il/tag/neurology/)
- [Pain/Sedation/Procedure](https://emergencymed.org.il/tag/pain-sedation-procedure/)
- [Ultrasound](https://emergencymed.org.il/tag/ultrasound/)
- [Stroke](https://emergencymed.org.il/tag/stroke/)
- [Venous Thromboembolism](https://emergencymed.org.il/tag/venous-thromboembolism/)
- [חינוך רפואי](https://emergencymed.org.il/tag/חינוך-רפואי/)
- [כירורגיה](https://emergencymed.org.il/tag/כירורגיה/)
- [bnews](https://emergencymed.org.il/tag/bnews/)
- [Meningitis](https://emergencymed.org.il/tag/meningitis/)
- [Bacteremia](https://emergencymed.org.il/tag/bacteremia/)

## אירוע Categories

- [בין לאומי](https://emergencymed.org.il/events/categories/international-events/)
- [אירוע בארץ](https://emergencymed.org.il/events/categories/conferences-israel/)
- [כנס בחו"ל](https://emergencymed.org.il/events/categories/כנס-בחול/)
- [טוקסיקולוגיה](https://emergencymed.org.il/events/categories/טוקסיקולוגיה/)