The ABEM office will close at 4:30 pm ET on Tuesday, December 24, 2024, and reopen on Thursday, January 2, 2025.  

Continuing Certification Requirements: ABEM provides a two-week grace period to meet year-end requirements.
Requirements due December 31, 2024, must be met by 11:59 PM ET on January 15, 2025. 
 

The ABEM office will close at 4:30 pm ET on Tuesday, December 24, 2024, and reopen on Thursday, January 2, 2025.  

Continuing Certification Requirements: ABEM provides a two-week grace period to meet year-end requirements.
Requirements due December 31, 2024, must be met by 11:59 PM ET on January 15, 2025. 
 

EM 2021 LLSA Reading List

Acute Coronary Syndrome

Greenslade JH, Carlton EW, Van Hise C, Cho E, Hawkins T, Parsonage WA, et al. Diagnostic accuracy of a new high-sensitivity troponin I assay and five accelerated diagnostic pathways for ruling out acute myocardial infarction and acute coronary syndrome. Ann Emerg Med 2018 Apr;71(4):439-51.e3.
  • In this cohort with a low prevalence of acute myocardial infarction and acute coronary syndrome, using the Beckman’s Access high-sensitivity troponin I assay with the new Vancouver Chest Pain Rule or No Objective Testing Rule enabled approximately ___________________ of patients to be safely discharged after ___________________ with no further testing.
  • The EDACS, m-ADAPT, or HEART pathway ___________________ half of ED patients to be ___________________ for ___________________.

Airway Management

Bontempo LJ, Manning SL. Tracheostomy emergencies. Emerg Med Clin North Am 2019 Feb;37(1):109-19.

  • Replacement of a dislodged tracheostomy within the first week of placement should be attempted only with ___________________ to reduce the risk of creating a false passage into the soft tissue of the neck.
  • Beyond 48 hours, the most critical and feared hemorrhagic complication is the development of a ___________________.

PreVent Investigators and the Pragmatic Critical Care Research Group. Bag-mask ventilation during tracheal intubation of critically ill adults. N Engl J Med 2019 Feb;380(9):811-21. Pair with associated editorial: Kritek PA, Luks AM. Preventing dogma from driving practice. N Engl J Med. 2019 Feb;380(9):870-71.

  • Among critically ill adults undergoing intubation, patients who receive bag-mask ventilation prior to the procedure had ___________________ and ___________________ than those that did not receive bag-mask ventilation. 
  • According to the PreVent trial published in NEJM, the incidence of ___________________ was lower in the bag-mask ventilation group than in the no-ventilation group.

Asthma

Batabyal RA, O’Connell K. Improving management of severe asthma: BiPAP and beyondClin Ped Emerg Med 2018 Mar;19(1):69-75.

  • Recent meta-analyses evaluating IV magnesium sulfate in children with acute asthma exacerbations found a ___________________ in hospital admission rates in those that received magnesium.
  • Evidence demonstrates that ___________________ systemic corticosteroids are imperative and even a modest delay can ___________________ the likelihood of hospital admission. 

Behavioral Emergencies

Klein LR, Driver BE, Miner JR, Martel ML, Hessel M, Collins JD, et al. Intramuscular midazolam, olanzapine, ziprasidone, or haloperidol for treating acute agitation in the emergency department. Ann Emerg Med 2018 Oct;72(4):374-85.

  • ___________________ achieved more effective sedation in agitated ED patients than olanzapine 10 mg, ziprasidone 20 mg, or haloperidol 5 mg at 15 minutes.
  • Olanzapine 10 mg IM resulted in a greater proportion of patients adequately sedated at 15 minutes compared with ___________________.

Epistaxis

Zahed R, Mousavi Jazayeri MH, Naderi A, Naderpour Z, Saeedi M. Topical tranexamic acid compared with anterior nasal packing for treatment of epistaxis in patients taking antiplatelet drugs: randomized controlled trial. Acad Emerg Med 2018 Mar;25(3):261-66.

  • In the study by Zahed, et al., epistaxis patients that received TXA experienced _________________________________________________________and ___________________ compared to anterior nasal packing. 

Gastrointestinal Emergencies

Young-Fadok TM. Diverticulitis. N Engl J Med 2018 Oct 25;379(17):1635-42.

  • ___________________ and ___________________ has excellent sensitivity and specificity for detection of diverticulitis and is the preferred test for ___________________ and ___________________ such as ___________________ and ___________________. 
  • Inpatient management is indicated for ___________________, __________________________________________________________________________________________________________________or ___________________.

Neurological Emergencies

Edlow JA. Managing patients with transient ischemic attack. Ann Emerg Med 2018 Mar;71(3):409-15.

  • The vast literature on antiplatelet treatment in TIA can be boiled down to a simple recommendation: Unless there is a contraindication, give ___________________.
  • Accumulating evidence shows that secondary stroke prevention—the rapid implementation of multiple interventions—reduces the outcome of stroke by as much as ___________________.

Garro A, Nigrovic LE. Managing peripheral facial palsy. Ann Emerg Med 2018 May;71(5):618-24.

  • The authors of this review recommend adding empiric ___________________, along with ___________________, for patients with peripheral facial nerve palsy, who present during endemic seasons in geographical areas where Lyme disease incidence is high while awaiting Lyme serology results. 
  • Corticosteroids initiated within ___________________ of facial palsy onset in adults increases the likelihood of ___________________, ___________________, and reduces ___________________. 

Risk Management

Ferguson B, Geralds J, Petrey J, Huecker M. Malpractice in emergency medicine-a review of risk and mitigation practices for the emergency medicine provider. J Emerg Med 2018 Nov;55(5):659-65.

  • ___________________ seems to be more predictive of malpractice litigation than the injury experienced.
  • There are consistent diagnoses that are associated with increased litigation incidence including ______________________________________, and ___________________

Substance Misuse, Opioid Misuse

Duber HC, Barata IA, Cioè-Peña E, Liang SY, Ketcham E, Macias-Konstantopoulos W, et al. Identification, management, and transition of care for patients with opioid use disorder in the emergency department. Ann Emerg Med 2018 Oct;72(4):420-31.

  • According to Duber, et al., buprenorphine should not be administered until ___________________.
  • The period of abstinence required both before induction and acute withdrawal treatment will vary in part as a function of ___________________.

Violence

Miller E, McCaw B. Intimate partner violence. N Engl J Med 2019 Feb 28;380(9):850-57.

  • According to Miller, et al., women that experience violence want health care workers to:
    • Talk to them about the violence in a ___________________
    • Be prepared to ask ___________________ times ___________________ pushing for disclosure
    • Offer ___________________ and ___________________ resources for support
Acute Coronary Syndrome
  • In this cohort with a low prevalence of acute myocardial infarction and acute coronary syndrome, using the Beckman’s Access high-sensitivity troponin I assay with the new Vancouver Chest Pain Rule or No Objective Testing Rule enabled approximately one third of patients to be safely discharged after 2-hour risk stratification with no further testing.
  • The EDACS, m-ADAPT, or HEART pathway enabled half of ED patients to be rapidly referred for objective testing.
Airway Management
  • Replacement of a dislodged tracheostomy within the first week of placement should be attempted only with direct visualization via fiberoptic endoscopy to reduce the risk of creating a false passage into the soft tissue of the neck.
  • Beyond 48 hours, the most critical and feared hemorrhagic complication is the development of a tracheo-innominate artery (TIAF) fistula.
  • Among critically ill adults undergoing intubation, patients who receive bag-mask ventilation prior to the procedure had higher oxygen saturations and lower incidence of severe hypoxemia than those that did not receive bag-mask ventilation. 
  • According to the PreVent trial published in NEJM, the incidence of operator-reported aspiration was lower in the bag-mask ventilation group than in the no-ventilation group.
Asthma
  • Recent meta-analyses evaluating IV magnesium sulfate in children with acute asthma exacerbations found a significant decrease in hospital admission rates in those that received magnesium.
  • Evidence demonstrates that early systemic corticosteroids are imperative and even a modest delay can increase the likelihood of hospital admission. 
Behavioral Emergencies
  • Midazolam 5 mg IM achieved more effective sedation in agitated ED patients than olanzapine 10 mg, ziprasidone 20 mg, or haloperidol 5 mg at 15 minutes.
  • Olanzapine 10 mg IM resulted in a greater proportion of patients adequately sedated at 15 minutes compared with haloperidol 5 mg.
Epistaxis
  • In the study by Zahed, et al., epistaxis patients that received TXA experienced faster bleeding cessationless rebleeding at 1 weekshorter ED LOSand higher patient satisfaction compared to anterior nasal packing. 
Gastrointestinal Emergencies
  • CT with IV and PO contrast has excellent sensitivity and specificity for detection of diverticulitis and is the preferred test for diagnosis and complications such as perforation and diffuse peritonitis
  • Inpatient management is indicated for high fever (body temperature >101.5°F [>38.6°C])leukocytosiscomplicated disease on CTimmunosuppressionserious coexisting conditionsa lack of home supporta need for pain controlor an inability to receive oral intake.
Neurological Emergencies
  • The vast literature on antiplatelet treatment in TIA can be boiled down to a simple recommendation: Unless there is a contraindication, give aspirin.
  • Accumulating evidence shows that secondary stroke prevention—the rapid implementation of multiple interventions—reduces the outcome of stroke by as much as 80%.
  • The authors of this review recommend adding empiric doxycycline, along with corticosteroids, for patients with peripheral facial nerve palsy, who present during endemic seasons in geographical areas where Lyme disease incidence is high while awaiting Lyme serology results. 
  • Corticosteroids initiated within three days of facial palsy onset in adults increases the likelihood of recoveryshortens the time of recovery, and reduces synkinesis (involuntary movement)
Risk Management
  • Communication breakdown seems to be more predictive of malpractice litigation than the injury experienced.
  • There are consistent diagnoses that are associated with increased litigation incidence including missed acute myocardial infarctionmissed fractures/foreign bodies, and pediatric meningitis
Substance Misuse, Opioid misuse
  • According to Duber, et al., buprenorphine should not be administered until moderate symptoms of opioid withdrawal have developed.
  • The period of abstinence required both before induction and acute withdrawal treatment will vary in part as a function of the half-life of the opioid last used.
Violence
  • According to Miller, et al., women that experience violence want health care workers to:
    • Talk to them about the violence in a safe and private setting
    • Be prepared to ask multiple times without pushing for disclosure
    • Offer tangible medical and social resources for support

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