Effective ED management of status epilepticus includes an algorithmic approach to termination of seizures as well as management of the underlying cause: acute, nonacute, or chronic. Includes 4 AMA PRA Category 1 Credits™. CME expires on 09/01/2025

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the latest guidelines on managing patients with difficult airways in the ED, the components of a successful difficult airway program, and how to implement a difficult airway response program in a community hospital setting. 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 08/15/2028.

Early diagnosis and treatment of sepsis is key to survival, and the evolution of definitions, guidelines, and treatment protocols continues to influence ED management. This issue reviews the latest evidence on the diagnosis and treatment of sepsis in the ED. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Infectious Disease and 2 Pharmacology CME credits, subject to your state and institutional approval. CME expires on 08/01/2025

Hand and wrist injuries can result in significant morbidity and disability if not managed promptly in the ED, with timely follow-up and specialist referral. This issue reviews common injuries and discusses appropriate disposition of patients with hand injuries. Includes 4 AMA PRA Category 1 Credits™. CME expires on 07/01/2025

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

ED management of patients with the chronic neurologic diseases, Parkinson, myasthenia gravis, and multiple sclerosis, requires targeted management strategies based on patient history and disease course. 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 05/01/2028

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.

For patients with knee pain, ruling out dangerous causes with appropriate testing and follow-up can contribute to increased patient comfort as well as healthcare cost savings. Includes 4 AMA PRA Category 1 Credits™. CME expires on 03/01/2028

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the latest evidence on managing mild traumatic brain injury, or concussion, in the ED. 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 02/15/2028..

This issue reviews the evidence on the diagnosis and treatment of patients with suspected traumatic intracranial hemorrhage. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits, subject to your state and institutional approval. CME expires on 02/01/2028

Patients with alkali caustic exposure require prompt evaluation for classification of their injuries to determine the need for imaging, intubation, or surgical intervention. Includes 4 AMA PRA Category 1 Credits™. CME expires on 01/01/2028

Mesenteric ischemia, a potentially deadly cause of abdominal pain, can present as 1 of 4 different subtypes, requiring swift ED resuscitation and referral. Includes 4 AMA PRA Category 1 Credits™. CME expires on 12/01/2027

Low back pain is usually due to benign causes, but emergency clinicians must be able to identify red flag causes of pain in order to avoid patient morbidity, disability, and mortality. Includes 4 AMA PRA Category 1 Credits™. CME expires on 11/01/2027

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the latest evidence on managing maxillofacial trauma in the ED. 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 10/15/2027.

Appendicitis and diverticulitis are frequent causes of abdominal pain in the ED. This issue reviews the latest evidence on imaging, antibiotics, and disposition of these common conditions. Includes 4 AMA PRA Category 1 Credits™. CME expires on 10/01/2027

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the evaluation and management of stroke in the setting of drug intoxication and substance use disorder. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke credits, 2 Substance Use credits, and 1 Controlled Substances credit. CME expires on 09/15/2027.

This issue focuses on best practices for quick recognition and reporting of suspected abuse or neglect of elderly ED patients. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Domestic Violence CME credits and 4 Geriatrics CME credits, subject to your state and institutional approval. CME expires on 09/01/2027

Patients with sickle cell disease require prompt ED management for pain crises and potentially life-threatening complications. Includes 4 AMA PRA Category 1 Credits™. CME expires on 08/01/2027.

This issue reviews best practice management of hemodialysis and peritoneal dialysis patients presenting to the ED with complications of dialysis as well as conditions related to their end-stage renal disease. Includes 4 AMA PRA Category 1 Credits™. CME expires on 07/01/2027.

This issue provides guidance on managing ED patients with opioid overdose and withdrawal, best-practice recommendations on assessing patient readiness for medication for opioid use disorder (MOUD), and initiation strategies for MOUD. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Substance Use Disorders CME credits, subject to your state and institutional approval. CME expires on 06/01/2027. This CME activity is eligible for 4 credit hours toward the United States Department Justice Drug Enforcement Administration Medication Access and Training Expansion (MATE) requirements.

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the use of ultrasound in acute stroke, with a focus on applications of interest to emergency clinicians. 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 05/15/2027.

Ketamine has many established uses in the ED, including procedural sedation, analgesia, and intubation. This issue reviews current evidence for these uses, plus emerging uses for depression, asthma, status epilepticus, and alcohol use disorder. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Pharmacology CME credits and 1 Pain Management CME credit, subject to your state and institutional approval. CME expires on 05/01/2027.

Although ear pain is typically benign, a systematic approach to its evaluation and management will enable identification of serious causes, while ensuring appropriate treatment. Includes 4 AMA PRA Category 1 Credits™. CME expires on 04/01/2027.

Constipation is an increasingly common complaint in the ED, and though it is typically benign, serious causes and complications must be ruled out, and patients seeking relief can be given options for treatment and self-care. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Palliative Care CME credit, subject to your state and institutional approval. CME expires on 03/01/2027.

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the latest evidence on managing snake envenomations in the ED. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma credits and 1 Pharmacology credits. CME expires on 02/15/2027.

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.

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the risk factors and management recommendations for stroke in pregnant and postpartum patients. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke credits and 1 Pharmacology credits. CME expires on 12/15/2026.

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.

Patients presenting to the ED with symptoms of methamphetamine use are at risk for rhabdomyolysis, acute kidney injury, and cardiovascular complications if timely treatment is not initiated. 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 11/01/2026.

This issue reviews the latest evidence on ED headache medications, nerve blocks, and therapies to prevent rebound headache and medication overuse headache. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credits and 1 Pain Management credit, subject to your state and institutional approval. CME expires on 10/01/2026.

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews evidence-based recommendations for the diagnosis, treatment, and disposition of patients with traumatic ocular injuries. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma credits. CME expires on 10/01/2026.

Rectal bleeding is a common, though distressing, complaint that may be benign or may be caused by a life-threatening condition. Determining the source of the bleeding is imperative to ensure prompt, appropriate treatment. Includes 4 AMA PRA Category 1 Credits™. 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.

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews evidence-based recommendations for the ED evaluation and management of patients with acute intracerebral hemorrhage. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Stroke and .5 Pharmacology CME credits, subject to your state and institutional approval. CME expires on 07/20/2026.

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.

Foreign body ingestion is a common ED presentation, and it is essential to know what type of imaging is most helpful, when emergent intervention is required, and when watchful waiting is appropriate. Includes 4 AMA PRA Category 1 Credits™. CME expires on 05/01/2026.

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews evidence-based recommendations for the evaluation and management of patients who have experienced intimate partner violence. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma, 4 Domestic Violence, and 4 Ethics CME credits. CME expires on 4/20/2026.

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.

Managing patients injured in a blast event requires rapid assessment of the mechanism of blast and the likely injury patterns in order to diagnose and treat life-threatening injury. 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 02/01/2026.

ED patients experiencing trauma or serious medical events may be at risk for PTSD. This issue presents strategies for screening, referral, and psychological first aid. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 2 Trauma CME credits and 4 Behavioral Health CME credits. CME expires on 01/01/2026.

With evolving research on the causes of pelvic inflammatory disease, emergency clinicians must recognize and treat PID according to the latest evidence and guidelines. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Infectious Disease CME credits and 2 Pharmacology CME credits. CME expires on 12/01/2025.

Patients with tracheostomies and laryngectomies can present with complications including bleeding, dislodgment, obstruction, and infection, requiring quick intervention in the ED. Includes 4 AMA PRA Category 1 Credits™. CME expires on 11/01/2025.

Angioedema can cause life-threatening airway compromise, and determining the cause is essential to timely management. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Pharmacology CME credits. CME expires on 10/01/2025.

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. No CME for this activity

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. No CME for this activity

Quickly differentiating anaphylaxis from lower-risk allergic reactions in the ED is essential for patient safety and comfort. No CME for this activity

Procedural sedation and analgesia are essential in emergency medicine. This issue reviews how to choose the optimal agents and procedures, individualized for each patient. No CME for this activity.

Review the most current information on ED management of skin and soft-tissue infection, including dangerous necrotizing infections. No CME for this activity.

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) addresses emergency department management of traumatic pneumothorax. No CME for this activity.

When a patient presents to the ED and meningitis or encephalitis are suspected, prompt, evidence-based testing and treatment are required. No CME for this activity.

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 Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) covers emergency department management of spontaneous subarachnoid hemorrhage. No CME for this activity

This issue reviews the latest evidence on standard therapies for managing ED patients with acute asthma exacerbations, as well as newer diagnostic, treatment, and ventilation strategies. No CME for this activity

Although acute joint pain in the ED can have a benign source, septic arthritis, gout, and postinfectious reactive causes must be ruled out. This issue reviews current recommendations on diagnosis and treatment of arthritis. No CME for this activity

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the current evidence for the evaluation, cleansing, and repair of wounds and lacerations in the ED. 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

When rib fractures are suspected following blunt thoracic trauma, initiating multimodal pain control and choosing imaging based on patient risk factors is critical. No CME for this activity

This summary and analysis of the international literature on vaccine effectiveness, breakthrough infection, waning immunity, and emergence of variants will help inform the decisions of physicians and institutions regarding vaccination boosters and nonpharmaceutical interventions. Two personal views of the controversies are also included.

Cervical spine injuries can have devastating consequences, and initial ED management is critical in determining the type of injury or fracture and choosing immobilization, imaging, and referral. No CME for this activity

High-altitude illness is a spectrum of respiratory and neurologic effects resulting from hypobaric hypoxia. Swift intervention can manage these life-threatening disorders, and pretravel planning and counseling can prevent them. No CME for this activity

Abnormal uterine bleeding can be a sign of serious and life-threatening conditions as well as being distressing and inconvenient. There are now effective diagnostic and management strategies that emergency clinicians can offer. No CME for this activity

ED management of HIV patients now includes management of age-related concerns, side effects of antiretroviral therapies, and PEP and PrEP regimens. No CME for this activity

This Stroke EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews the evaluation and management of patients with stroke who present to the ED after 3 hours. 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 Trauma EXTRA supplement (free to Emergency Medicine Practice subscribers) reviews the evaluation and management of patients with neck trauma. No CME for this activity.

This white paper outlines essential elements of planning and preparedness for emergency department pandemic surge response, based on lessons learned from the 2020 COVID-19 pandemic experience in New York City

Before or after mammalian bites or exposures, rabies is completely preventable, but ED management must be timely and administered correctly. No CME for this activity

This Pharmacology EXTRA supplement (free to Emergency Medicine Practice subscribers) reviews the management of alcohol withdrawal syndrome. No CME for this activity

While men, women, and children who present with urinary retention require fast, effective, and comfortable relief, it is essential to investigate the cause - structural, toxicologic, neurologic, or infectious - to prevent life-threatening sequelae. No CME for this activity

Interdisciplinary teams at Mount Sinai Health Systems in New York developed protocols for management of COVID-19 patients. This February 2021 update of the protocols is based on the latest published literature and current practice.

Recommendations on risk stratification, imaging, testing, and drug therapies for CAP are evolving continuously. This issue reviews the latest evidence on managing CAP in the ED. 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

This Stroke EXTRA supplement (free to Emergency Medicine Practice subscribers) provides an evidence-based overview of the recognition and management in the emergency department management of blunt cerebrovascular injuries, and focuses on the appropriate diagnostic studies and stroke prevention. No CME for this activity

Rhabdomyolysis is a complex pathological process that requires prompt treatment to prevent potentially life-threatening sequelae. This issue reviews the broad differential and presents evidence-based recommendations for the management of rhabdomyolysis. No CME for this activity

Managing ED patients with hemorrhagic shock requires swift coordination of ED resources and protocols. This issue reviews the latest evidence on hemostatic devices and medications, testing, and massive transfusion. No CME for this activity

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) reviews emergency department management of the pregnant trauma patient. CME expired on 10/01/2023. 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

This Trauma EXTRA CME supplement (free to Emergency Medicine Practice subscribers) provides an evidence-based overview of considerations for radiation exposure in trauma imaging as well as strategies for resuscitation in trauma. CME expired on 08/01/2023. 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

When a patient must be placed on a ventilator in the ED, clinicians choose the mode and initial settings based on institutional protocols and presentation, but the patient’s clinical scenario and respiratory response will dictate strategies for further management. CME expired on 07/01/2023. No CME for this activity

Summary and review of the results of a survey of 65 pediatric emergency department leaders in the U.S. and Canada.

This Pediatric EXTRA supplement describes the epidemiology, reviews presenting features, and offers management recommendations for COVID-19 in pediatric patients. It includes a discussion of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, as well as other aspects of the COVID-19 pandemic that are affecting children and families. (No CME)

Life-threatening secondary headache can be due to vascular disorders or trauma, and they can present with sudden, severe onset. This course presents the red flag signs for the most dangerous causes of life-threatening headaches, with recommendations on swift imaging and treatment. No CME for this activity.

Acid-base disturbances signal many disorders and diseases, and interpretation of testing results can be difficult. Using descriptive methodologies, comparing various approaches, and following a diagnostic algorithm will improve diagnosis and treatment. CME expired on 06/01/2023. No CME for this activity

The novel coronavirus, COVID-19, has raised serious concerns worldwide, particularly for emergency clinicians. This overview reviews and links the most authoritative early research and provides all the contacts and resources that can keep you continuously updated on this outbreak. This article and related resources are free for everyone.

Abnormal vision in ED patients can be caused by abnormalities in visual structures (cornea, lens, vitreous, and retina) as well as neurologic, toxicologic, and psychogenic etiologies. High-value history, physical examination, and imaging can provide important clues for management. CME expired on 04/15/2023. No CME for this activity

Acute gastroenteritis is common in the ED, but what is the evidence on whether testing, antibiotics, and antiemetics are useful and necessary? CME expired on 03/01/2023. No CME for this activity

Influenza can present with a wide range of nonspecific clinical signs and symptoms, making ED management challenging. This issue reviews the latest evidence on recognizing influenza in the ED, performing rapid testing and initiating antiviral treatment, and how to manage complications in high-risk patient groups. CME expired on 02/01/2023. No CME for this activity

Follow a systematic approach for managing patients with DKA and HHS in the ED: volume repletion, correction of hyperglycemia, and electrolyte replacement. Includes 4 AMA PRA Category 1 Credits™. CME expired on 02/15/2023. 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

This EXTRA Stroke CME supplement (free to Emergency Medicine Practice subscribers) provides evidence-based recommendations for common causes of ischemic stroke and hemorrhagic stroke in children, offers guidance for differentiating stroke from its mimics, discusses indications for diagnostic studies, and provides recommendations for treatment of pediatric stroke in the emergency department. CME expired on 12/01/2022. No CME for this activity

Acute dizziness is a common presentation in the ED. Quickly differentiate the benign from the deadly with the timing-and-triggers approach to evaluation. CME expired on 12/01/2022. No CME for this activity

Many options exist to effectively manage pain without opioids. This issue provides the latest evidence what to use and when. CME expired on 11/01/2022. No CME for this activity

Altered mental status is a common presentation in the ED, and time is of the essence in diagnosing NCSE and halting seizure activity. CME expired on 10/01/2022. No CME for this activity

This EXTRA Trauma CME supplement (free to Emergency Medicine Practice subscribers) provides evidence-based recommendations for concussion management in the ED and reviews consensus-based guidelines for the evaluation and management of sport-related concussion and mTBI. CME expired on 09/15/2022. No CME for this activity

When a medical emergency occurs onboard a commercial aircraft and you raise your hand to help, what are the resources and risks in volunteering? CME expired on 09/01/2022. 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

As bariatric surgery for weight loss becomes increasingly common, more patients are presenting to the ED with complications. This issue reviews the most common types of surgery, their early and late complications, and diagnostic and management options. CME expired on 07/01/2022. No CME for this activity

This EXTRA Stroke CME supplement (free to Emergency Medicine Practice subscribers) reviews the latest evidence and recommendations for two essential treatments for patients with acute ischemic stroke: IV thrombolysis with rt-PA and endovascular thrombectomy with stentriever. CME expired on 06/15/2022. No CME for this activity

Improve ED assessment of patients with abdominal pain by using strategies that emphasize safe disposition over diagnosis. Recognize high-risk patients and dangerous mimics and choose testing, imaging, and consultation that will improve outcomes. CME expired on 06/01/2022. No CME for this activity

The ED is a critical intervention point for patients in mental health crisis. Emerging evidence shows it is possible and feasible to screen all ED patients for depression and suicidal ideation. Novel tools and strategies can help reduce the risk of suicide. CME expired on 05/01/2022.

Sexually transmitted diseases are a significant and growing public health threat that can cause lasting danger to the health of men, women, and unborn babies. Swift diagnosis and effective treatment strategies can lessen the public health consequences. CME expired on 04/01/2022.

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

Life-threatening secondary headache can be due to vascular disorders or trauma, and can present with sudden, severe onset. This issue presents the red flag signs for the most dangerous causes, with recommendations on swift imaging and treatment. CME expired on 02/01/2022

Common first-trimester ED presentations include miscarriage, ectopic pregnancy, nausea and vomiting, urinary tract infections, and potential appendicitis. This issue reviews the evidence on these common conditions to ensure swift and safe management. CME expired 01/01/2022. 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).

This issue reviews the pathophysiology and clinical findings associated with cannabinoid use, including acute intoxication, the recent emergence of cannabinoid hyperemesis syndrome, and novel treatments for its symptoms. CME expired on 8/1/2021 - No CME for this activity

Dyspnea is a distressing symptom in the dying process, but it can be managed in the ED to keep patients comfortable, alleviate patient and family anxieties, and honor the patient's goals of care. CME expired 07/01/2021 - No CME for this activity

Determining the source of shoulder pain - fracture, dislocation, or overuse - is an essential part of management. This issue offers information about effective strategies in diagnostic techniques, pain management, and indications for surgical referral for patients presenting to the ED with shoulder injuries and pain. CME expires on 06/01/2021 - No CME for this activity

For ED patients with signs and symptoms of infectious disease - including fever, rash, joint pain, and headache - obtaining a travel history is essential in order to quickly identify emerging (or re-emerging) infections. This issue reviews diagnostic and management best practices for three infections: Middle East respiratory syndrome, chikungunya virus infection, and Zika virus infection. CME expired on 05/01/2021 - No CME for this activity

This issue reviews the critical steps that should be taken to manage a patient who presents with jaundice, including the history and physical examination, necessary laboratory testing, imaging, and treatment. Management of neonates, pregnant patients, and transplant patients are also reviewed. (No CME for this activity).

This issue reviews the diagnosis and management of airway compromise that can result from fire, smoke, and heat injury, as well as carbon monoxide and cyanide toxicity. Although a standardized diagnostic protocol is lacking, the evidence on best-practice diagnostic tools, airway management, and medical adjuncts are presented. (No CME for this activity).

Optimal management of a burn patient begins with accurately classifying and measuring the extent of the burns. Every treatment decision that follows - from IV fluid management, wound care, escharotomy, and criteria for referral - depends on it. This issue reviews the best evidence on managing patients with burns, from prehospital management to disposition. (No CME for this activity).

This issue reviews 3 of the more common presentations of oncology patients to the emergency department: metastatic spinal cord compression, tumor lysis syndrome, and febrile neutropenia. (No CME for this activity).

This review presents an algorithmic approach to management that ensures that pain relief, imaging, reduction, vascular monitoring, and emergent orthopedic consultation are carried out in a timely fashion. (No CME for this activity).

This issue reviews the literature on management of IBD flares in the emergency department, including laboratory testing, imaging, and identification of surgical emergencies, emphasizing the importance of coordination of care with specialists on treatment plans and offering patients resources for ongoing support. (No CME for this activity).

This issue presents strategies and algorithms for the early use of evidence-based interventions, including appropriate use of antibiotics, bronchodilators, and corticosteroids, along with noninvasive ventilation with capnography, to minimize morbidity and mortality associated with this disease. (No CME for this activity).

This issue provides recommendations on effective management of patients presenting with adrenal insufficiency, with particular attention to the management of critically ill and septic patients, pregnant patients, and children. (No CME for this activity).

This review provides a best-practice approach to the diagnosis and management of renal and genitourinary injuries, with an emphasis on the systematic approach needed to identify subtle injuries and avoid long-term urinary sequelae such as hypertension, incontinence, erectile dysfunction, chronic kidney disease, and nephrectomy. (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).

This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment. (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).

A review of the pathophysiology, diagnostic decision-making tools, and pharmaceutical treatment options to create a patient-tailored approach to sedative-hypnotic withdrawal.

When noninvasive ventilation is indicated over endotracheal intubation and rapid sequence intubation for patients in respiratory distress. Key contraindications for NIV and signs that positive pressure ventilation has failed. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacotherapy credits. CME expires on 02/01/2020.

Current evidence for immediate emergency room treatment of ischemic priapism, using a stepwise approach starting with aspiration of cavernosal blood, cold saline irrigation, and penile injection with sympathomimetic agents. 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 1/1/2020

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

Reviews common sources of alcohol ingestion, basic mechanisms of toxicity, physical examination and laboratory findings that may guide rapid assessment and management, and indications for treatment. 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 9/1/2019

A detailed framework for the emergency physician to distinguish transient global amnesia (the acute onset of profound anterograde amnesia lasting up to 24 hours) from its most common mimics. Includes 4 AMA PRA Category 1 Credits™. CME expires on 08/01/2019.

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.

Diagnosis and treatment of caustic ingestions and exposures, including staging, pathophysiology, and surgical consult. 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 05/01/2019.

In-depth look at the treatment of human and animal bites, including the timing of wound closure, the use of prophylactic antibiotics, and the latest recommendations for rabies postexposure prophylaxis (PEP). Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME and 0.5 Pharmacology CME credits. CME expires on 4/1/2019

The use and limitations of the FAST examination in patients with blunt pelvic trauma, including the when to perform the exam during the trauma survey and how FAST can be used for abdominal trauma with pelvic injuries. 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 03/01/2019.

2016 review of long-term HIV infection complications seen in the emergency room, especially noninfectious conditions, complications common in the HAART-adherent HIV patient, and side effects from antiretroviral drugs, as well as recognition of life-threatening and rare opportunistic infections. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 3 Pharmacology CME credits. CME expires on 2/1/2019

2016 review of the pathophysiology, differential diagnosis, and emergency room rewarming and treatment of patients with mild, moderate, and severe hypothermia with or without hemodynamic instability. Includes 4 AMA PRA Category 1 Credits™. CME expires on 01/01/2019.

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.

Evidence-based recommendations for diagnosis and treatment of ocular trauma: ocular burn, corneal abrasion, retrobulbar hemorrhage, open glob injury, traumatic hyphema, retinal detachment, vitreous hemorrhage, lens dislocation. Includes 4 AMA PRA Category 1 Credits™. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits and 0.5 Pharmacology CME credits. CME expires on 11/01/2018.

Evaluating for delirium using the Confusion Assessment Method (CAM), targeting underlying etiology, and treatment guidelines including nonpharmacological and means and when to use antipsychotics or benzodiazepines. 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 10/01/2018.

This issue reviews the various international guidelines for pharyngitis and notes controversies in diagnostic and treatment strategies, specifically for management of suspected bacterial, viral, and fungal etiology.

Review of clinical criteria to diagnose anaphylaxis, and treatment guidelines involving the intramuscular administration and dosing of epinephrine, both in and out of the hospital setting. 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 08/01/2018.

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.

Resuscitating and treating adult drowning patients in the emergency department, including pathophysiology of drowning and concerns such as hypothermia, mechanical ventilation, and trauma. 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 05/01/2018.

This issue of Emergency Medicine Practice will focus on the management of patients with upper gastrointestinal bleeding.

This issue of Emergency Medicine Practice provides an evidence-based review of the diagnosis and management of adult patients presenting to the emergency department (ED) with seizure and SE, with a focus on the clinical situations most commonly encountered in daily practice.

This review discusses the clinical evaluation and management of high-morbidity hand injuries in the context of the current evidence.

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 examines the physiology, diagnosis, and treatment of exertional, classic, and drug-induced hyperthermia.

A working knowledge of local or at least national susceptibil - ity patterns of the most likely pathogens is essential. A variety of special populations exist that require special management, including pregnant females, patients with anatomic abnormalities, and instrumented patients.

This review evaluates the current strategies for management of diabetic emergencies and offers new information regarding effective diagnostic strategies, selection of fluids for rehydration, correction of potassium, the use of subcutaneous insulin for mild hyperglycemia, and management of metformin-induced lactic acidosis.

This review discusses the diagnosis and treatment of the 3 most common mosquito-borne illnesses seen in the United States: Plasmodium falciparum malaria, dengue, and West Nile virus.

This issue reviews the 4 primary categories of shock as well as special categories, including shock in pregnancy, traumatic shock, septic shock, and cardiogenic shock in myocardial infarction. Adherence to evidence-based care of the specific causes of shock can optimize a patient's chances of surviving this life-threatening condition.

The focus of this issue of Emergency Medicine Practice is the ED evaluation of anemia and, more importantly, its management based on the best available evidence in the literature.

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.

This review explores an evidence-based rationale for the evaluation of the patient with low back pain, and it provides guidance on risk stratification pertaining to laboratory assessment and radiologic imaging in the emergency department. Published guidelines from the American College of Physicians and American Pain Society are reviewed, with emphasis on best evidence for pharmacologic treatments, self-care interventions, and more invasive procedures and surgery in management of low back pain. Utilizing effective and proven strategies will avoid medical errors, provide better care for pa- tients, and help manage healthcare resources and costs.

Traumatic brain injury is the most common cause of death and disability in young people, with an annual financial burden of over $50 billion per year in the United States.

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 evidence-based review summarizes the pathophysiology, historical factors, diagnostic strategies, and demographics that influence the experience of pain and provides recommendations for a variety of treatment options.

This issue outlines and reviews the literature on 4 evolving strategies reflecting developing advancements in the care of acute ischemic stroke and their potential to impact patients in the emergency department setting: (1) the expanding window for intravenous rt-PA, (2) the use of multimodal computed tomographic scanning in emergent diagnostic imaging, (3) endovascular therapies for stroke, and (4) stroke systems of care.

This issue of Emergency Medicine Practice discusses the initial workup and management of patients with primary headache disorders, with special detail to classification and medication options.

This issue of Emergency Medicine Practice reviews the available evidence and consensus guidelines for the management of common infectious diseases presenting to the ED and presents recommendations for treatment.

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.

In this issue of Emergency Medicine Practice, the most current findings in regard to the diagnosis of appendicitis in the emergency department (ED) will be discussed, with particular attention towards elucidating the elements of history, physical examination, and laboratory testing that will most benefit the emergency clinician faced with the dilemma of diagnosing possible appendicitis.

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

In this issue of Emergency Medicine Practice, the current understanding of flank pain associated with urinary stone disease is discussed.

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.

The goal of this review is to provide an analysis of the current literature and recommendations regarding the diagnosis and management of CA-MRSA in the ED based on the best available evidence.

This review will cover 4 common complaints involving the ear: pain (otalgia), hearing loss, tinnitus, and trauma.

This issue of Emergency Medicine Practice focuses on the management of ALF and the acutely symptomatic cirrhotic patient.

This issue of Emergency Medicine Practice focuses on determining which patients will benefit from regional anesthesia and how to perform the most common facial anesthesia procedures.

This issue of Emergency Medicine Practice focuses on hypertensive disorders of pregnancy and vaginal bleeding. More information about complications in early pregnancy, specifically ectopic pregnancies, can be found in the June 2007 issue of Emergency Medicine Practice.

This issue of Emergency Medicine Practice addresses cervical spine injuries by providing a systematic approach that optimizes resource utilization and minimizes identification failure.

In this issue of Emergency Medicine Practice, an overview of the technical features of MRI will be presented in order to provide a framework for understanding its limits and potential benefits.

The goal of this issue of Emergency Medicine Practice is to provide a risk management tool and to provide an evidence-based best practice approach to the male complaining of acute scrotal or penile pain.

The goal of this Emergency Medicine Practice issue is to provide an overview of mechanical ventilation in the acute care setting. Basic ventilator technology will be discussed and placed in the context of various disease pathophysiologies with a focus on asthma, emphysema, and acute pulmonary edema.

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.

This issue of Emergency Medicine Practice discusses the general management of cocaine-associated emergencies. Additionally, it will make evidence-based recommendations for the treatment and disposition of these patients.

Emergency physicians are frequently confronted with patients with neurological complaints requiring emergent imaging for diagnosis and treatment. The diversity and variations of imaging modalities may appear confusing, resulting in physician uncertainty about the most appropriate modality to evaluate the presenting complaint. An evidence-based approach, with the modality and technique selected based on patient characteristics and differential diagnosis, is essential. In this review, the evidence supporting the use of computed tomography (CT) and magnetic resonance imaging (MRI) for the diagnosis and treatment of emergency brain disorders will be reviewed. Adjunctive imaging techniques will also be considered, including conventional angiography, plain films, and ultrasound. Clinical decision rules intended to target imaging utilization to high-risk patients will also be discussed.

This issue of Emergency Medicine Practice is designed to provide an evidencebased, algorithmic approach to the management and diagnosis of conditions causing hypotension. Specific attention will be given to the role of ultrasound in the clinical decision making involved in caring for these patients.

This issue of Emergency Medicine Practice provides an overview of the current evidence regarding the benefit of respiratory, hemodynamic, and neurologic monitoring of the critically ill patient.

Toxic exposures present a unique set of issues to clinicians caring for children. Children commonly ingest household products and sometimes are exposed to medications that are taken by others living in the household. The clinician must be quick to recognize potentially dangerous exposures in order to intervene and prevent or mitigate adverse outcomes. Fortunately, the majority of pediatric ingestions involve unintentional exposure to small doses of nontoxic or minimally toxic substances. However, it is those few truly toxic exposures that demonstrate the invaluable role played by a skilled emergency physician. This review will primarily focus on pediatric poison exposures in children ages six years and under.

This issue of Emergency Medicine Practice provides a comprehensive overview of the spectrum of altitude illness with a focus on prevention strategies and life saving interventions in the eventuality for severe disease.

Anyone who works in an emergency department (ED) knows that abdominal pain (or some variation of it) is one of the most frequent presenting complaints evaluated. Although it is difficult to truly quantify, it is estimated that abdominal pain accounts for 5 - 10% of all ED visits and that emergency physicians care for nearly eight million patients with abdominal pain each year.1-3 The sheer volume of potential diagnoses coupled with the lack of evidenced-based standards create a dilemma when determining a diagnostic study choice. The question of which radiological modality and when to utilize it is further complicated by the rapid advances in radiolographic technology. The goal of this Emergency Medicine Practice article is to provide a functional framework for the diagnostic evaluation of the patient with nontraumatic abdominal pain.

This issue of Emergency Medicine Practice provides an overview of thoracic imaging modalities and guidance on the indications for each test in emergency practice.

This issue of Emergency Medicine Practice provides a systematic review of the diseases that present with a chief complaint of "swollen extremity" and provides a costeffective approach to guide in the selection of diagnostic tests to aid in clinical decision-making.

Acute spinal cord injuries (ASCIs) remain a devastating consequence of traumatic injuries around the globe. These injuries cause permanent, profound disabilities and lead to changes in lifestyle ranging from employment to marital status.

This issue of Emergency Medicine Practice will review the current literature, including the potential mechanisms of injury. early signs of these injuries, and the natural course of the problems caused by explosive blasts.

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.