Thyroid emergencies are potentially life-threatening clinical diagnoses. This issue presents the most common comorbidities and physical findings seen in patients with decompensated hypothyroidism and thyroid storm. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 1 Pharmacology CME credit, subject to your state and institutional approval. CME expires on 06/01/2028

Sodium disorders can have a wide range of etiologies, including medical conditions, drugs, and environmental stresses. Prompt interpretation and analysis of laboratory results will direct management. Includes 4 AMA PRA Category 1 Credits™. CME expires on 04/01/2028.

The 2025 Lifelong Learning & Self-Assessment Study Guide is designed to prepare emergency medicine physicians to pass the ABEM LLSA exam as well as update you on current topics in emergency medicine. Includes 24 AMA PRA Category 1 Credits™ and 24 Category 2-B credit hours from the American Osteopathic Association. Included as part of the 24 credits, this CME activity is eligible for 2 Cultural Competency credits, 2 Infectious Disease credits, 2 Pain Management credits, 10 Pharmacology credits, 1 Trauma credit. CME expires on 09/01/2027.

This issue reviews the presentation, evaluation, and management of pediatric patients with COVID-19, MIS-C, and long COVID. Includes 4 AMA PRA Category 1 Credits™. CME expires on 07/01/2027.

This issue discusses the various etiologies of epistaxis and provides evidence-based recommendations for the evaluation and management of pediatric epistaxis. Includes 4 AMA PRA Category 1 Credits™. CME expires on 06/01/2027.

This issue provides an evidence-based review of pediatric venous thromboembolism, including the epidemiology, presenting clinical signs and symptoms, diagnostic modalities, and treatment options. Includes 4 AMA PRA Category 1 Credits™. CME expires on 05/01/2027.

Many patients with low-risk electrical injuries can be safely managed in and discharged from urgent care, but clinicians must also be able to recognize high-risk injuries. Includes 4 AMA PRA Category 1 Credit™. Included as part of the 4 credits, this CME activity is eligible 4 Trauma CME credit. CME expires on 04/01/2027.

This issue reviews the definition of a brief resolved unexplained event (BRUE), summarizes the risk-stratification criteria for infants who experience a BRUE, provides management recommendations for patients with a lower-risk BRUE, and also discusses literature published since 2016 that expands on that guidance to include the higher-risk group. Includes 4 AMA PRA Category 1 Credits™. CME expires on 04/01/2027.

Patients who have had a COVID-19 infection may present to urgent care with a wide variety of symptoms that are associated with long COVID. This issue reviews recommendations for managing these patients based on the current state of knowledge about long COVID. Includes 4 AMA PRA Category 1 Credit™. CME expires on 03/01/2027.

Right heart failure can result from many etiologies – cardiovascular, pulmonary, infectious, and chronic disease. Recognition of RHF is essential for managing the underlying etiologies and avoiding decompensation. Includes 4 AMA PRA Category 1 Credits™. CME expires on 02/01/2027.

Patients with symptoms of long COVID may present with a wide variety of complaints that could also be potentially life-threatening non-COVID signs. What does current evidence tell us is the best way to tell the difference? Includes 4 AMA PRA Category 1 Credits™. CME expires on 01/01/2027.

When a patient presents to the ED with hypotension, it is essential to quickly determine the cause, to initiate appropriate treatment and avoid shock and end-organ damage. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 1 Pharmacology CME credit, subject to your state and institutional approval. CME expires on 12/01/2026.

The 2024 Lifelong Learning & Self-Assessment Study Guide is designed to prepare emergency medicine physicians to pass the ABEM LLSA exam as well as update you on current topics in emergency medicine. Includes 26 AMA PRA Category 1 Credits™ and 26 Category 2-B credit hours from the American Osteopathic Association. Included as part of the 26 credits, this CME activity is eligible for 4 Addiction Disorders credits, 1 Geriatrics credit, 5 Infectious Disease credits, 9 Pharmacology credits, 1 Pain Management credit, 2 Palliative Care credits, 1 Patient Safety credit, 1 Terminally Ill Care credit. CME expires on 09/01/2026.

The typical symptoms of pulmonary embolism – chest pain and dyspnea – can signal many other medical conditions, making swift identification of patient risk factors and the use of clinical pretest probability scoring systems essential for improving patient outcomes. Includes 4 AMA PRA Category 1 Credits™. CME expires on 08/01/2026.

Pericarditis and myocarditis can present with chest pain, dyspnea, and fatigue, making them difficult to distinguish from ACS and heart failure. With many different causes, both infectious and noninfectious, a thorough history and examination can narrow the differential. Includes 4 AMA PRA Category 1 Credits™. CME expires on 07/01/2026.

Knowing whether and how to treat hypertensive patients in the ED is challenging, and interpretation of guidelines is vital to improve patient outcomes. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits, subject to your state and institutional approval. CME expires on 06/01/2026.

This issue reviews resuscitation of children in cardiac arrest and highlights practice changes in the 2020 Pediatric Advanced Life Support guidelines. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 1 Pharmacology CME credit. CME expires on 06/01/2026

The Urgent Care EKG Course is designed to take the fear out of reading EKGs, improve your on-the-job performance, and boost your clinical confidence when patients present with common chief complaints that could be anything from innocuous to high-risk heart problems in hiding. Includes 5 AMA PRA Category 1 Credits™. CME expires on 04/01/2026.

Managing patients with gunshot injuries depends on the location of the wounds. This issue outlines best practices for gunshot wounds to the head, neck, chest/abdomen, and extremities. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 04/01/2026.

For ED patients presenting with symptoms of stroke, be alert to risk factors and history suggestive of endocarditis-associated neurologic complications, as thrombolytics are contraindicated. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME credits. CME expires on 03/01/2026.

This issue reviews recommendations for the evidence-based evaluation and risk stratification of patients with chest pain who present to urgent care. Includes 4 AMA PRA Category 1 Credits™. CME expires 11/01/2025.

When a patient presents to the ED in cardiogenic shock or cardiac arrest – including those who have implanted mechanical circulatory support devices – prompt diagnosis and treatment is essential to reduce mortality and improve patient outcomes. Includes 4 AMA PRA Category 1 Credits™. CME expires on 09/01/2025.

For patients presenting with syncope, dyspnea, edema, tachycardia, or chest pain, determining a potentially valvular origin is a key part of management. This issue reviews the signs, symptoms, and findings in aortic and mitral stenosis and regurgitation. Includes 4 AMA PRA Category 1 Credits™. CME expires on 08/01/2025.

Management of the syncopal patient in the UC setting requires distinguishing life-threatening causes from benign ones. Learn the common causes of syncope and the best tools for evaluating syncopal patients. Includes 4 AMA PRA Category 1 Credits™. CME expires 4/1/2028.

Postpartum patients may present with varied signs and symptoms for weeks after a normal delivery. This issue uses a symptom-focused approach in identifying life-threatening causes. No CME for this activity.

This issue reviews causes of cardiac and non-cardiac pediatric chest pain and provides recommendations for a more standardized evaluation in the ED to minimize the risk of missing a life-threatening pathology while reducing unnecessary testing. No CME for this activity

Acute aortic syndromes—aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer—are life-threatening conditions that demand swift recognition and treatment in the ED. This issue presents the latest evidence on managing AAS. No CME for this activity

This issue discusses the management of pediatric transplant patients, with a special focus on general and organ-specific complications after transplantation. Management of hematopoietic stem cell transplant patients is also discussed, since the approach to these patients differs slightly from that of solid organ transplant recipients. No CME for this activity

The 2022 Lifelong Learning & Self-Assessment Study Guide will prepare you for the ABEM LLSA examination as well as update you on current topics in emergency medicine. No CME for this activity.

Identifying the cause of syncope can be difficult, but a structured ED approach can help separate life-threatening causes from benign ones, reducing hospitalizations and improving care. No CME for this activity

In order to prevent stroke in ED patients with atrial fibrillation, pharmacologic and/or electrical control of rate and/or rhythm are essential, along with risk stratification to determine the need for anticoagulation. No CME for this activity

This issue reviews 3 pediatric syndromes - spina bifida, Down syndrome, and Marfan syndrome - each of which are associated with unique emergent conditions. The issue discusses the pitfalls in interpreting routine testing and reviews diagnostic and therapeutic approaches helpful in evaluating children with these syndromes. No CME for this activity

When a patient presents to the ED with symptoms of STEMI, emergency clinicians must be prepared to initiate coordinated, time-sensitive, and effective diagnostic and treatment strategies, with the ultimate goal of initiation of reperfusion. No CME for this activity

Diagnosis of deep vein thrombosis in the ED requires risk stratification and targeted diagnostic testing. For patients who have a diagnosed DVT, newer strategies for outpatient management of anticoagulation can reduce costs and improve outcomes. CME expired on 10/01/2023. No CME for this activity

This Pharmacology EXTRA CME supplement (free to Emergency Medicine Practice subscribers) provides an evidence-based overview of emergency department management of calcium-channel blocker overdose, beta blocker overdose, and digoxin toxicity, and focuses on the caveats of treatment for each. CME expired on 09/01/2023. No CME for this activity

Infective endocarditis can be difficult to diagnose, given its often subtle presentation and multisystem involvement. This issue presents an evidence-based approach to testing, imaging, and empiric antibiotic therapies. CME expired on 09/01/2023. No CME for this activity

Heart palpitations is a common chief complaint in the ED, and emergency clinicians need to be able to quickly and accurately identify serious tachydysrhythmias to determine treatment that is safe, effective, and comfortable for patients. CME expired on 08/01/2023. No CME for this activity

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) provides an evidence-based overview of imaging modalities for acute stroke in the emergency department as well as identification and management strategies for central retinal artery occlusion. CME expired on 07/01/2023. No CME for this activity

This issue provides a review of common etiologies of failure to thrive and offers recommendations for the management of patients with failure to thrive, with a focus on which diagnostic studies should be obtained and when they are warranted. CME expired on 03/15/2023. No CME for this activity

When patients present to the ED with suspected myocardial infarction, it is critical to differentiate NSTEMI from other cardiac causes and initiate swift, evidence-based management. Review the latest evidence on diagnosis and treatment of NSTEMI. CME expired on 01/01/2023. No CME for this activity

Direct oral anticoagulant agents do not require INR monitoring like warfarin, but managing bleeding complications or reversal requires different strategies1. CME expired on 08/01/2022. No CME for this activity

The spectrum of blunt cardiac injury can range from minor soreness to dysrhythmia, free wall rupture, hemorrhage, and sudden death. This issue reviews the latest evidence on the swift diagnosis of cardiac injury and best strategies for treatment. CME expired on 03/01/2022. No CME for this activity

Although pediatric hypertension is increasing in incidence, it often goes unrecognized in asymptomatic patients. This issue provides recommendations to ensure that asymptomatic patients with hypertension receive appropriate testing and referrals and that patients with a true hypertensive emergency are managed appropriately. CME expired on 03/01/2022. No CME for this activity

Patients with electrical injuries in the ED can suffer trauma, external burns, and occult injuries to deep tissues, affecting all body systems. Fluids, cardiac monitoring, and disposition of low-voltage, high-voltage, and lightning strike injuries can vary. CME expired on 11/01/2021. (No CME for this activity).

From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. (No CME for this activity).

Emergency room management of ADHF including critical decision-making points in resuscitation for both hypertensive and hypotensive patients and a review of newer medications. (No CME for this activity).

Differential diagnosis and treatment of pediatric syncope in the emergency department, including spotting red flags for cardiac syncope. (No CME for this activity).

This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders: hypokalemia and hyperkalemia. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits. CME expires on 11/1/2019

Systematic review of the basic life support factors for cardiac arrest, including chest compression technique during CPR and rapid defibrillation of shockable rhythms (ventricular tachycardia, ventricular fibrillation), and common underlying causes of cardiac arrest. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits. CME expires on 10/1/2019

This issue focuses on the clinical evaluation and treatment of patients with acute rheumatic fever by offering a thorough review of the literature on diagnosis and recommendations on appropriate treatment. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Infectious Disease CME and 0.25 Pharmacology CME credits. CME expires on 8/1/2019

This study guide, available online, is designed to prepare emergency medicine physicians to pass the ABEM exam, as required to maintain board certification. It includes our "pass-or-it's-free" guarantee. (CME expired 11/30/2023).

Focuses on the diagnosis and treatment of patients with blunt injuries to the chest, ribs and lung. Decision rules for chest x-ray, CT and bedside lung ultrasonography; treatment controversies including the limitations of needle thoracostomy using standard needle, chest tube placement, and chest tube size. Also airway and ventilation management. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits. CME expires on 06/01/2019.

This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits. CME expires on 5/1/2019

Spontaneous intracerebral hemorrhage is a neurological emergency,made more complicated when patients are anticoagulated. Reversal of anticoagulation must be initiated simultaneously with diagnosis, treatment, and disposition. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke CME credits and 2 Pharmacology CME credits. CME expires on 12/01/2018.

Reviews signs and symptoms of myocarditis and pericarditis in children, diagnostic tests, and treatment strategies for both conditions. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 1.5 Pharmacology CME credits. CME expires on 07/01/2018.

Reviews the differential diagnosis and identification of different types of cardiac dysrhythmias and discusses preferred treatment options for various wide-complex tachycardias. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.25 Pharmacology CME credits. CME expires on 07/01/2018.

This issue reviews the presentation, diagnostic criteria, and management of Kawasaki disease in the emergency department. Emergency clinicians should consider Kawasaki disease as a diagnosis in pediatric patients presenting with prolonged fever, as prompt evaluation and management can significantly decrease the risk of serious cardiac sequelae.

This review evaluates the literature and current evidence, including controversies and recent American Heart Association guidelines, to support a best-practice approach to the diagnosis and treatment of patients with spontaneous subarachnoid hemorrhage.

This review summarizes current indications for permanent pacing, reviews epidemiologic data relevant to implant complications, and describes a clinical approach to the patient with potential pacing malfunction.

This review presents the electrocardiographic findings seen in common bradydysrhythmias and emphasizes prompt recognition of these patterns. Underlying etiologies that may accompany these conduction abnormalities are discussed, including bradydysrhythmias that are reflex mediated (including trauma induced) and those with metabolic, environmental, infectious, and toxicologic causes. Evidence regarding the management of bradydysrhythmias in the emergency department is limited; however, there are data to guide the approach to the unstable bradycardic patient. When decreased end-organ perfusion is present, the use of atropine, beta agonists, and transcutaneous or transvenous pacing may be required.

Since the 2008 issue of Emergency Medicine Practice on TIA was published, there have been numerous studies focusing on improving risk stratification and early management strategies in TIA. This update will provide the best available evidence on diagnosing and managing TIAs.

This issue presents a review of the current evidence guiding the emergency medicine approach to the diagnosis and treatment of pulmonary embolism.

This issue of Emergency Medicine Practice focuses on advances in knowledge that should fundamentally change how we treat trauma patients in hemorrhagic shock. The best available evidence from the literature suggests that we must shift away from the paradigms that have guided emergency clinicians in the past.

This issue of Emergency Medicine Practice presents a synopsis of the latest evidence regarding the pathophysiology, diagnosis, and treatment of emergent complications of SCD.

Cardiac arrest is one of the most intense clinical scenarios faced by the emergency clinician. The challenges are twofold: restarting spontaneous circulation and simultaneously attempting to find;and then reverse;the cause of the cardiac arrest.

This issue of Emergency Medicine Practice expands on this review and summarizes the existing and best available literature concerning these EUS applications.

This issue of Emergency Medicine Practice will provide a review of SVTs with a focus on the ECG analysis and the evidence behind the most recent ACLS guidelines.

In this issue of Pediatric Emergency Medicine PRACTICE, we will review an evidence-based approach to the evaluation and management of children with tachyarrhythmias.

This month's issue of Emergency Medicine Practice is the second in a 2-part review of aortic emergencies. The first part focused on the thoracic aorta and emphasized the pivotal role the emergency physician plays in diagnosing and directing care for these patients. This month's issue reviews abdominal aortic aneurysms and aortic trauma. While aortic emergencies are relatively unusual in the total scope of emergency practice, their associated morbidity and mortality is high, making recognition and management a mandatory competency for the emergency physician.

In this issue of Pediatric Emergency Medicine PRACTICE, I will review pediatric out-of-hospital cardiopulmonary arrest and discuss the utility of pediatric PAD programs based on the available evidence.

This review highlights the advances in our understanding of ACS: its pathophysiology, clinical diagnosis, risk stratification, and therapeutics. There is a particular focus on the subgroup of unstable angina (UA) and non-STsegment elevation myocardial infarction (NSTEMI).