The Skeptics Guide to Emergency Medicine

Reference: Sax DR, et al. Emergency Severity Index Version 4 and Triage of Pediatric Emergency Department Patients. JAMA Pediatrics, October 2024 Date: February 12, 2025 Guest Skeptic: Dr. Brandon Ho is a graduating pediatric emergency medicine fellow at Children’s National Hospital in Washington DC and soon to be attending physician at Seattle Children’s. His research […] The post SGEM#471: Are ESI Levels Accurate for Triage of Pediatric Patients? first appeared on The Skeptics Guide to Emergency Medicine.

Emergency department crowding is scrutinized, debunking the myth that non-urgent patients are to blame. The discussion highlights the vital need for precise definitions of crowding and warns against mislabeling that could harm patient care. It also addresses systemic issues like staffing shortages and the unique challenges faced in rural settings. There’s an emphasis on evidence-based solutions tailored to local needs rather than ineffective approaches, advocating for hospital-wide strategies to improve patient flow and reduce wait times.

A recent talk explored five pivotal studies in emergency medicine, offering insights into innovative pre-oxygenation techniques and the reliability of various trial methodologies. Key highlights included a critical analysis of pediatric cervical spine injuries and the effectiveness of pre-hospital sedation. The discussion also delved into the challenges posed by publication bias and the importance of addressing anticoagulant reversal in hemorrhage cases, making for a compelling and informative session.

Date: February 22, 2025 Guest Skeptic: Nicholas Peoples, who is a medical student at Baylor College of Medicine in Houston, Texas. Nick’s career has been an exciting blend of global health and emergency medicine. In 2015, Nick was part of the first-ever class to study at Duke University’s new campus in China, where he earned […] The post SGEM Xtra: On the Boulevard of Broken Dreams – Citation Errors in the Biomedical Literature first appeared on The Skeptics Guide to Emergency Medicine.

Reference: Pessano S, et al. Positioning for lumbar puncture in newborn infants. Cochrane Database Syst Rev. December 2023 Date: February 7, 2025 Guest Skeptic: Dr. Lauren Rosenfeld is a PGY-3 emergency medicine resident at George Washington University. She is also a new podcast host for Emergency Medicine Residents’ Association (EMRA) Cast Series. Case: A five-day-old […] The post SGEM #470: Here We Go Up Up Up or Lateral for Infant Lumbar Punctures first appeared on The Skeptics Guide to Emergency Medicine.

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 is […] The post SGEM#469: You Take My Breath Away – D-dimer for Ruling out PE in High-Risk Patients first appeared on The Skeptics Guide to Emergency Medicine.

Dr. Aaron Skolnick, an Assistant Professor at Mayo Clinic specializing in emergency medicine, dives into the complexities of diagnosing sepsis. He discusses the promising potential of Monocyte Distribution Width (MDW) as a rapid biomarker for early detection. Skolnick highlights the challenges of identifying sepsis due to its nonspecific symptoms and critiques existing diagnostic methodologies. The conversation also covers the biases in observational studies versus randomized control trials, and evaluates the clinical implications of MDW in emergency settings.

Dr. Ross Prager, an intensivist and adjunct professor, dives into the revolutionary role of AI in clinical research. He highlights how AI enhances patient eligibility screening and data analysis while stressing the need for human insight. The ethical implications of AI, including data privacy and bias, are discussed candidly. Prager also emphasizes the importance of maintaining high quality in systematic reviews despite automation. Listeners gain insights into the future of AI in healthcare and the critical balance required to harness its potential responsibly.

Join emergency medicine experts Tabitha Cheng, an EMS fellowship-trained physician, Julie Leonard, a pediatric EM attending and research leader, and Caleb Ward, a dedicated principal investigator in pediatrics. They dive into the latest advancements in cervical spine injury assessments in children, discussing innovative risk stratification systems and the PCARN decision rule. The conversation touches on the importance of minimizing radiation exposure and the evolving role of cervical collars in emergency care. They also explore collaborative approaches to enhancing pediatric care outcomes.

Date: January 9, 2025 Reference: White et al. Evidence of questionable research practices in clinical prediction models. BMC Med 2023 Guest Skeptic: Dr. Jestin Carlson is the Program Director for the AHN-Saint Vincent EM Residency in Erie Pennsylvania.  He is the former National Director of Clinical Education for US Acute Care Solutions and an American […] The post SGEM#466: I Love ROC-n-Roll…But Not When It’s Hacked first appeared on The Skeptics Guide to Emergency Medicine.