It should be the easiest patient of the day. It is just a sore throat. The patient is fine. No signs of epiglottitis or deep space infection. They are clearly going home. But you are working with a curious student, and their questions unearth a tremendous amount of uncertainty. How […]
EBM reviews
85 posts
Why do so many antibiotics get prescribed for a week? Is there something special about 7 days of therapy? Would we ever use the number 7 in any other context? The courses of antibiotics we prescribe are clearly not scientific, which has always made the lecture that patients receive about […]
Pulmonary embolism is probably discussed far more than is truly necessary. It receives more attention than almost any other pathology. We endlessly debate the best algorithms for diagnosis. We add new decision tools almost yearly. However, if there is one aspect of pulmonary embolism that might be under-discussed it is […]
A can’t intubate can’t oxygenate scenario will always be scary, but after years of mental rehearsal and some real world experience, the idea of surgical front of neck access in an adult doesn’t bother me much. (I think that is an important mental space for emergency physicians to find if […]
We are once again buried in a wave of viral respiratory illnesses, and much of the burden of illness is still COVID. I did a pretty thorough review of all COVID antiviral therapies in 2022, both on First10EM and on the EMCases Journal Jam, but that was 2 years ago. […]
Transfusion seems like the simplest intervention in medicine. The patient is losing blood, so let’s put some back in. Not much more complicated than an oil change. Sure, you need to use a specific brand, but as long as the system is topped up, everything should run just fine. Therefore, […]
In a lecture series entitled “Get off the fence”, in which I discuss practice changing evidence based medicine, I have discussed the role of antibiotics in diverticulitis multiple times this year. Although I have discussed the topic previously on First10EM, I wanted to provide a quick summary of the most […]
Over the last decade, I have heard the language around balanced transfusions shift from an ‘interesting new idea’ to the ‘proven standard of care’. Although that is the direction that science is supposed to progress, in this case there is really no science. We only have a single full RCT, […]
This evidence review is the handout for the talk I gave at the Emergency Medicine Cases Summit entitled “Decision rules are ruining medicine”. Clinical decision rules (CDRs) sort of suck There is a common assumption that clinical decision rules must improve decision making and clinical care. This is based on […]