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EMNerd (EMCrit)

Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation

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EMNerd

The Nihilistic Ramblings of Rory Spiegel, MD

EM Nerd-The Case of the Partial Cohort

May 24, 2020 by Rory Spiegel 3 Comments

The global suffering wrought by SARS-CoV-2 pandemic is undeniable. But so is the ferocity with which the world has pursued a cure. And while some potential remedies have held more promise than others, the enthusiasm supporting these novel treatments often outpaced their evidentiary support. In fact, none have demonstrated efficacy backed by high quality randomized […]

EM Nerd: The Case of the Sour Remedy Continues

January 20, 2020 by Rory Spiegel 7 Comments

The use of IV vitamin C as a therapeutic agent in sepsis has caught the hearts and minds of emergency medicine and critical care clinicians. Since the publication of a small single center before and after study by Marik et al in 2017 (1), we have spent countless hours screaming into the void that is […]

EM Nerd-The Case of the Adjacent Contradictions

December 23, 2019 by Rory Spiegel 6 Comments

There has been a long-standing debate in the fields of emergency medicine and critical care regarding the ideal paralytic agent to use during RSI, rocuronium or succinylcholine. This dispute, has even developed slogans such as Roc Rocks, Sux Sucks as one side attempts to definitively proclaim its superiority through witty aspersions. But up until now […]

EM Nerd-Letter to the Editor, a Response

November 11, 2019 by Rory Spiegel 2 Comments

Disclosures: None Recently a letter to the editor was sent to us at the EMCRIT Consortium regarding a recent post I had written about the use of high sensitivity (HS) troponin assays for the work up of ACS in the emergency department. Typically, such remarks are posted in the comments section of the individual blog […]

EM Nerd-The Case of the Indecisive Antidote

October 14, 2019 by Rory Spiegel 8 Comments

Studies examining the use of tranexamic acid (TXA) inescapably seem to pit our methodological rigorous demons against our practical clinical angels.  The CRASH-2 trial published in the Lancet in 2010 by Shakur et al, randomized 20,211 adult trauma patients presenting to 274 hospitals in 40 different countries to receive 1g of TXA over 10 min […]

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