AnnalsofEM

Official journal of American College of Emergency Physicians ; #1 cited EM research journal

[AnnalsofEM @AnnalsofEM]

🎙️ The May episode of the Annals of Emergency Medicine podcast is here!

Join Rory Spiegel and Ryan Radecki as they break down the latest research, controversies, and practice-changing developments in emergency medicine. Whether you’re catching up on recent literature or looking for expert perspectives on what’s new in EM, this episode has you covered.

Listen below or wherever you get your podcasts.
https://t.co/G5o4PYJ7qa

#EM #EmergencyMedicine #ERDoc #ED #MedSchool #Medstudent #Residency #Fellowship #NursingSchool #Nursing #PA #PASchool #NP #NPSchool #EMS #EMT #Paramedic #MedicalEducation #MedED #FOAM #FOAMed #MedPodcasts #Medtwitter

[AnnalsofEM @AnnalsofEM]

Does a central PE automatically mean a higher-risk patient?

In this multicenter Annals of Emergency Medicine study of more than 1,700 ED patients with acute PE, central thrombus location was associated with advanced intervention use but not with in-hospital death, clinical deterioration, or 30-day mortality.

The findings suggest that RV dysfunction, tachycardia, and biomarker elevation may provide more clinically relevant information when assessing short-term risk.

Paper: Associations of the Composite Pulmonary
Embolism Shock Score in the Emergency
Department With Short-Term Clinical Outcomes
Weekes AJ, et al. Ann Emerg Med. 2026.

[AnnalsofEM @AnnalsofEM]

How should we approach the medical screening of psychiatric patients in the ED?

A new Annals scoping review examined decades of literature on medical screening practices for adults presenting with psychiatric complaints and highlights where evidence exists, where it doesn’t, and opportunities for future research.

Are we asking the right questions, ordering the right tests, and using our resources effectively?

Read more at https://t.co/Zx6l9DUv6J

#EmergencyMedicine #EM #Psychiatry #Psych #MentalHealth #MedEd #FOAMed #PsychEM #BehavioralHealth

[AnnalsofEM @AnnalsofEM]

🚁 Air ambulances are a critical part of emergency care, helping transport patients with severe trauma, stroke, and other time-sensitive conditions. While air medical safety has improved significantly over the last decade, several high-profile crashes in 2025 have reignited discussions about training, equipment standards, regulation, and how we can make these missions even safer for patients and crews.

This Annals News & Perspective article explores where the field stands today and what changes may lie ahead.

#EMS #EmergencyMedicine #AirSafety

Read more at https://t.co/Zx6l9DUv6J

[AnnalsofEM @AnnalsofEM]

A nurse-led, low-cost school CPR program can scale fast—and spread further than the classroom. Children trained on DIY recycled manikins then taught CPR at home, multiplying reach (~2.4 people per child). Key BLS steps were solid on video; AED actions need strengthening.
As always check it out at Read more at https://t.co/CKdjo6LGmY

#MedED #EmergencyMedicine #CPR #BLS

[AnnalsofEM @AnnalsofEM]

Could IV magnesium help change acute headache management in the ED? ⚡️🧠

A new study in Annals of Emergency Medicine found IV magnesium + acetaminophen improved treatment success, reduced rescue meds, and increased patient satisfaction in acute non-traumatic headaches. 💉

⚠️ Mild adverse effects were slightly more common, and pain score differences may not have been clinically significant.

As always, read the full paper before changing practice. Social media summaries are never a substitute for critical appraisal.

📖 Link in bio / full article on Annals
#EmergencyMedicine #EM #FOAMed #MedEd #MedicalEducation #Migraines #Neuro

[AnnalsofEM @AnnalsofEM]

Does residency structure matter for ABEM performance?

This program-level analysis found:
• No significant difference in median board pass rates between 3- and 4-year EM programs
• Earlier-accredited programs had higher median scores
• Privately sponsored programs showed lower median board scores compared to other ownership models

Read more at https://t.co/CKdjo6LGmY

#EmergencyMedicine #EM #ER #Residency #ABEM #Boards

[AnnalsofEM @AnnalsofEM]

What we carry on shift is rarely just what fits in our pockets.

This piece captures the humor, exhaustion, improvisation, and invisible weight of emergency medicine in a way that will feel deeply familiar to anyone who’s worked in healthcare.

One of those essays that quietly stays with you.

#EmergencyMedicine #EMDocs #WomenInMedicine #MedEd #HealthcareWorkers #ResidencyLife #MedicalHumanities #GraphicMedicine #MedicineAndHumanity #AnnalsOfEM

[AnnalsofEM @AnnalsofEM]

Read about this case and more 👇🏾

https://t.co/NutDudrJso

🔗The Annals of Emergency Medicine:
https://t.co/1IROVqX1Md

[AnnalsofEM @AnnalsofEM]

This study suggests that extracorporeal cardiopulmonary resuscitation (ECPR) may be associated with improved outcomes in selected children with out-of-hospital cardiac arrest. Because the number of children who received ECPR was small, these findings should be interpreted as hypothesis-generating and support further prospective—and ideally randomized—evaluation of pediatric ECPR.

Check it out! Link in Bio

#EmergencyMedicine #EM #Pediatrics #PEM #Peds #CriticalCare #CritCare #EMS #MedED #FOAM #FOAMed #EBM

[AnnalsofEM @AnnalsofEM]

This month’s Annals Resident Collection features steroids in sepsis, smarter CT use in pediatric blunt trauma, and the real risk of deterioration in ED boarders. This is practical evidence to sharpen your clinical judgment where it matters most!

Read more at https://t.co/M06IhatAFZ

#EmergencyMedicine #EM #Resident #Residency #MedEd #MedicalEducation #FOAM #FOAMed #EvidencedBasedMedicine #ScientificJournals #MedTwitter

[AnnalsofEM @AnnalsofEM]

Watchful waiting:
The Power of Patience: High-Impact Insights on Pediatric Abdominal Trauma Observation 🩺🛡️

Can a little extra time in the ED save a child from unnecessary radiation? ⏱️ This massive study of 7,442 children proves that observation is a game-changer for blunt abdominal trauma, but it’s important to understand the full picture,.

💪🏾Why this study is a heavyweight (Strengths):

-Massive Scale: This was a rigorous prospective multicenter cohort study involving children across six level-1 trauma centers,.

-Precision Modeling: Researchers used multivariable logistic regression to adjust for critical factors like age, clinician suspicion, and PECARN risk variables,.

-Proven Safety: The study successfully showed reduced CT use—especially in intermediate-risk cases—without an increase in missed injuries,.

-Standardized Training: Enrolling clinicians underwent standardized training to ensure consistent documentation of clinical findings.

⚠️ Know the fine print (Limitations):

-Setting Matters: The study was conducted in pediatric-specific EDs, so the results might differ in general community hospitals with less pediatric trauma experience.

-Unstructured Observation: There was no set protocol for the observation period; the duration, lab tests, and ultrasound use were left to clinician discretion.

-Older Kids Skew: The study population skewed toward older children, who are often easier to evaluate for abdominal pain and tenderness than younger ones.

-Cost-Effectiveness: No specific cost-effectiveness analysis was conducted for abdominal trauma observation in this study.

🤓The Bottom Line: Choosing to observe rather than scan can safely lower CT utilization with a minimal median increase in ED stay of only 27 minutes.

🔗 Read the full paper here: https://t.co/Ey5kIVouyo

#PediatricTrauma #EmergencyMedicine #EvidenceBasedMedicine #ERDoctor #MedicalResearch

📚Reference: Ishimine P, et al. Emergency Department Observation and Computed Tomography Use in Children With Blunt Abdominal Trauma. Annals of Emergency Medicine. 2026

[AnnalsofEM @AnnalsofEM]

Migraine in the ED: NSAIDs + fluids… but do the fluids actually matter? 💧
This study might make you rethink that reflexive fluids order.

Read more https://t.co/CKdjo6LGmY

#EmergencyMedicine #EMDocs #EM #Neurology #Neuro #Migraine #Headache #EMPharm #Pharm #Pharmacology #FOAMed #MedED #MedicalEducation #EvidencedBasedMedicine #Medtwitter

[AnnalsofEM @AnnalsofEM]

🚨 The overdose you think you’re treating… may not be what it seems.

As emergency and critical care clinicians, we’re trained to recognize opioid toxicity and respond rapidly.
But a new adulterant — medetomidine — is changing that clinical picture.

Patients may initially respond to naloxone… yet remain profoundly sedated.

Hours later, they can develop rapid, severe withdrawal with agitation, hypertension, and delirium — often refractory to standard therapies.

This is not just a variation of opioid toxicity.
It’s a distinct and evolving clinical syndrome that demands awareness at the bedside.

🎧 In this reel, I discuss key insights from a recent review in Annals of Emergency Medicine and share perspectives from one of the authors.

👇🏾For the full review, see:

Lynch MJ, Pizon AF, Yealy DM. Emergence of Medetomidine in the Illicit Drug Supply: Implications for Emergency Care and Withdrawal Management.

📖 Annals of Emergency Medicine (2025)
🔗 https://t.co/ZpU8mB3a3u

#EmergencyMedicine #MedicalEducation #Toxicology #FOAMed #CriticalCare

[AnnalsofEM @AnnalsofEM]

Managing Cannabinoid Hyperemesis Syndrome by Rech, Shalaby, Gage, and Gottlieb in Annals of Emergency Medicine reviews how to recognize CHS in the ED, when to broaden the differential, and which treatments current guidelines support. One of the key takeaways: CHS has no definitive test, droperidol or haloperidol are recommended first-line in current guidelines cited by the authors, and long-term symptom control still centers on cannabis cessation. #EmergencyMedicine #medical #FOAMed #MedEd #cannabinoidhyperemesissyndrome #EM

[AnnalsofEM @AnnalsofEM]

Our reviewers make it possible.
Thank you to the Annals reviewers who dedicate their time to strengthening the science.
✨ Check out this year’s distinguished and top reviewers.
🔗 Check Out https://t.co/2VtFlGiN9q for more!
#EmergencyMedicine #EM #EDDoc #ER #ERDoc #PeerReview #AcademicMedicine #MedEd #MedicalEducation #EvidenceBasedMedicine #FOAM #FOAMed #MedTwitter

[AnnalsofEM @AnnalsofEM]

Rural hospital closures are a growing threat to emergency care access.

Hospitals converting to REH status were already financially distressed, looking more like those that closed than those that remained open.

Ongoing evaluation will be key as the program evolves.
Learn more at https://t.co/Zx6l9DV2Wh

#EmergencyMedicine #EM #RuralEM #RuralMedicine #MedicalEducation #MedED #FOAMed

[AnnalsofEM @AnnalsofEM]

Clinical deterioration is an underappreciated risk of ED boarding.
In a multi-center study of >173,000 admissions, nearly 1 in 25 ED boarders admitted to the floor experienced early clinical deterioration requiring an admission to an advanced level of care, with almost half occurring before leaving the ED. Each additional hour of boarding was independently associated with an increased risk of deterioration, and deterioration carried substantially higher 28-day mortality.
Identifying high-risk patients early may prevent avoidable escalations in care and patient harm. 

#EDBoarding #PatientSafety #EmergencyMedicine #EM #HealthPolicy #SocialMedicine