EM Pharmacotherapy Guidelines and Position Statements: Resource for ED Rotations

Several years ago I created a resource for my ED rotation that I share with pharmacy students, pharmacy residents, and EM physician residents. It contains most of the guidelines and position statements on EM drug therapy that I utilize most often and is updated as new iterations are published. We’d like to share this tool with you to be used/modified to meet your rotation needs.

Last updated: February 22, 2018
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By Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP|2026-06-16T16:11:48-07:00Jun 12, 2017|Tox & Medications|

Little Patients, Big Medicine Podcast: Lactate in Pediatric Sepsis

The first recording from Little Patients, Big Medicine: the Pediatric Emergency Medicine (PEM) Podcast. This is an exciting interview with Dr. Halden Scott, a PEM physician at Children’s Hospital Colorado, about the use of lactate measurement in pediatric sepsis. Dr. Scott is one of the premier pediatric sepsis researchers, with a specific focus on the use of lactate measurement in the ED. We talk about the Sepsis-3 definitions and whether pediatrics will eventually follow them, Dr. Scott’s previous work on lactate use in the pediatric ED, and her new article published in March of 2017 on the association between elevated lactate in the ED and 30-day mortality in children. ^1–6
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By Jason Woods, MD|2026-06-16T16:11:51-07:00Jun 7, 2017|Infectious Disease, Pediatrics|

Trick: Linear Ultrasound Transducers in Intrauterine Pregnancy Evaluation

The volume of women presenting to the emergency department (ED) with newly diagnosed first-trimester pregnancies and suspected ectopic pregnancies sometimes seems like an infinitely growing number. As ED physicians, proper identification of an intrauterine pregnancy (IUP) in these patients is of paramount importance and the initial imaging test of choice for many has become bedside point-of-care ultrasound (POCUS).

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By Amy Phillips, MD|2019-11-10T21:32:28-08:00Jun 4, 2017|Ob/Gyn, Tricks of the Trade, Ultrasound|

Traumatic Bleeding in Anticoagulated Patients: 5 Other Sources Beyond the Brain

When a patient is started on anticoagulant therapy, the purpose is to prevent clot formation or propagation. Anticoagulants can improve morbidity and mortality by maintaining cardiac stent patency, reducing the propagation of pulmonary emboli, or preventing formation of intra-cardiac thrombi.^1,2 Unfortunately even after minor trauma, these medications can cause major problems. When a patient on clopidogrel is in a motor vehicle collision (MVC) or an elderly patient on warfarin falls out of their bed, the once life-improving therapy becomes potentially life-threatening. It is important for emergency care providers to maintain a high index of suspicion for life-threatening bleeds in all patients on anticoagulation following even minor injuries. The purpose of this discussion is to look beyond the intracranial hemorrhages (ICH) and to consider 5 other sources of bleeding that can occur in anticoagulated patients.

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By Jillian Bores, MD|2026-06-16T16:11:42-07:00May 29, 2017|Heme-Oncology, Trauma|

Ultrasound For The Win! – 20F with First Trimester Vaginal Bleeding #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where point-of-care ultrasound changed the management of a patient’s care or aided in the diagnosis. In this case, a 20-year-old woman presents with first-trimester vaginal bleeding.

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By Eunice Choi, DO|2019-11-10T23:20:22-08:00May 15, 2017|Ob/Gyn, Ultrasound, Ultrasound for the Win|

PEM Pearls: Search & Rescue of Ear Foreign Bodies – Picking the Right Tool

While ear foreign bodies can happen at any age, the majority occur in children less than 7 years of age.¹ The younger the patient, the less likely they are cooperative with the exam and, therefore, the less chance of successful foreign body removal. The first attempt at removal is the best, so it is important to make it count. Similarly, different types of foreign bodies call for different “tools” for removal. It is important to understand when to attempt removal in the emergency department (ED) and what tools are available. This blog post will help you optimize your first pass success at foreign body removal by understanding what tools are at your disposal.

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By Josh Bukowski, MD|2017-10-26T14:32:51-07:00May 8, 2017|ENT, Pediatrics, PEM Pearls|

ACMT Toxicology Visual Pearls: Exotic Viper Envenomation

A man was bitten twice on the dorsal radial aspect of his right hand while feeding his pet West African Bush Viper. The patient immediately tied multiple tourniquets around his right arm before presenting to the emergency department. During examination he is complaining of swelling and severe pain in his right upper extremity, but has no other complaints. What are the appropriate next steps in managing this patient?

Apply ice to the bites
Measure compartment pressures in the right arm and forearm
Perform a fasciotomy
Remove the tourniquets and order hematologic studies
Use a venom extractor to reduce venom burden

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By Bryan Judge, MD, FACMT|2019-11-12T19:07:23-08:00May 1, 2017|ACMT Visual Pearls, Tox & Medications|