Dr. Andrew Worster and the BEEM (Best Evidence in Emergency Medicine) group from McMaster University has teamed up with EM Cases, Justin Morgenstern (@First10EM) and Rory Spiegel (@EMNerd_) to bring you a blog that blends the BEEM critical appraisals in a case-based, interactive, practice-changing format. In each post we choose the most important literature on a given topic and run through a case, learning how to apply evidence based medicine to our practice. Welcome to BEEM Cases!
Shortness of breath is a very common chief complaint in the emergency department, but despite our familiarity with this symptom, management is not always straightforward. The differential diagnosis is extensive, including the common cardiorespiratory conditions, but extending to toxicologic, hematologic, neuromuscular, metabolic, and psychiatric causes. Over the past decade, we have seen the widespread adoption of new technologies to help us manage these patients. This post will look at some new evidence on two of those technologies: noninvasive positive pressure ventilation (NIPPV) and ultrasound (POCUS). We will answer 3 questions based on 3 systematic reviews using the BEEM critical appraisal framework...
Urolithiasis is one of the more frequent diagnoses we are faced with in the Emergency Department, with an estimated 1 million ED visits due to renal colic. As such we are tasked with its diagnosis, prognosis and treatment. The following is a brief summation of the evidence regarding some of the most frequent questions encountered when diagnosing and managing urolithiasis. Four questions are answered by Rory Spiegel on this BEEM Cases. What is the optimal initial imaging modality for the diagnostic work-up of urolithiasis? Once the diagnosis of renal colic has been made what is the most efficacious analgesic strategy? Is there clinical utility to IV fluid administration in the management of renal colic? What is the use of medical expulsion therapy in the management of urolithiasis?
Dr. Andrew Worster and the BEEM (Best Evidence in Emergency Medicine) group from McMaster University has teamed up with EM Cases, Justin Morgenstern (@First10EM) and Rory Spiegel (@EMNerd_) to bring you a blog that blends [...]