Annals of Emergency Medicine

Annals of Emergency Medicine Fan page for Annals of Emergency Medicine, the highest cited journal in the general EM category with Any such posting will be removed.

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05/16/2026

Could IV magnesium change how we manage acute headaches in the ED? ⚡️🧠

A major new study published in Annals of Emergency Medicine evaluated over 1,000 patients with acute non-traumatic headache and found that adding IV magnesium sulfate to acetaminophen improved treatment success, reduced rescue analgesia use, and increased patient satisfaction. 💉📉

🔑 Highlights:
✅ Better overall treatment success
✅ Less need for rescue medications
✅ Higher patient satisfaction
⚠️ Mild adverse effects were slightly more common
🤔 Pain score differences, however, may not have reached a clinically meaningful threshold.

As always, studies like this help move the conversation forward in evidence-based headache management and non-opioid analgesia in emergency medicine.

🚨 Most importantly: always read the FULL paper yourself before making clinical judgments or changing your practice. Social media summaries are never a substitute for critically appraising the actual study, methodology, limitations, and patient population.

Be sure to check out Annals for more practice-changing and thought-provoking EM papers.

📖 Full article here:
https://www.annemergmed.com/article/S0196-0644(26)00201-5/fulltext

Reference:
Messous S, Toumia M, Dhaoui R, et al. Intravenous Magnesium Sulfate for Acute Nontraumatic Headache in the Emergency Department. Ann Emerg Med. 2026.

Does residency structure matter for ABEM performance?This program-level analysis found:• No significant difference in me...
05/10/2026

Does residency structure matter for ABEM performance?

This program-level analysis found:
• No significant difference in median board pass rates between 3- and 4-year EM programs
• Earlier-accredited programs had higher median scores
• Privately sponsored programs showed lower median board scores compared to other ownership models

Read more at www.annemergmed.com

What we carry on shift is rarely just what fits in our pockets.This piece captures the humor, exhaustion, improvisation,...
05/09/2026

What we carry on shift is rarely just what fits in our pockets.

This piece captures the humor, exhaustion, improvisation, and invisible weight of emergency medicine in a way that will feel deeply familiar to anyone who’s worked in healthcare.

One of those essays that quietly stays with you.

This month’s Annals Resident Collection features steroids in sepsis, smarter CT use in pediatric blunt trauma, and the r...
05/01/2026

This month’s Annals Resident Collection features steroids in sepsis, smarter CT use in pediatric blunt trauma, and the real risk of deterioration in ED boarders. This is practical evidence to sharpen your clinical judgment where it matters most!

Read more at https://www.annemergmed.com/annals-resident-collection

04/29/2026

In this study Zhou et al found that 39% of patients had multiple health care encounters before cerebral venous thrombosis was diagnosed, with a median time from symptom onset to diagnosis of 4 days. Women had longer times to diagnosis and were more likely to have multiple encounters before diagnosis. The authors note that, in the right clinical context, CVT should remain on the differential, particularly in younger women and in patients with persistent or repeat presentations.

Zhou LW, Dizonno V, Mandzia J, et al. Multiple health care encounters prior to diagnosis of cerebral venous thrombosis. Ann Emerg Med.

Watchful waiting:The Power of Patience: High-Impact Insights on Pediatric Abdominal Trauma Observation 🩺🛡️Can a little e...
04/25/2026

Watchful waiting:
The Power of Patience: High-Impact Insights on Pediatric Abdominal Trauma Observation 🩺🛡️

Can a little extra time in the ED save a child from unnecessary radiation? ⏱️ This massive study of 7,442 children proves that observation is a game-changer for blunt abdominal trauma, but it’s important to understand the full picture,.

💪🏾Why this study is a heavyweight (Strengths):

-Massive Scale: This was a rigorous prospective multicenter cohort study involving children across six level-1 trauma centers,.

-Precision Modeling: Researchers used multivariable logistic regression to adjust for critical factors like age, clinician suspicion, and PECARN risk variables,.

-Proven Safety: The study successfully showed reduced CT use—especially in intermediate-risk cases—without an increase in missed injuries,.

-Standardized Training: Enrolling clinicians underwent standardized training to ensure consistent documentation of clinical findings.

⚠️ Know the fine print (Limitations):

-Setting Matters: The study was conducted in pediatric-specific EDs, so the results might differ in general community hospitals with less pediatric trauma experience.

-Unstructured Observation: There was no set protocol for the observation period; the duration, lab tests, and ultrasound use were left to clinician discretion.

-Older Kids Skew: The study population skewed toward older children, who are often easier to evaluate for abdominal pain and tenderness than younger ones.

-Cost-Effectiveness: No specific cost-effectiveness analysis was conducted for abdominal trauma observation in this study.

🤓The Bottom Line: Choosing to observe rather than scan can safely lower CT utilization with a minimal median increase in ED stay of only 27 minutes.

🔗 Read the full paper here: https://www.annemergmed.com/article/S0196-0644(26)00095-8/abstract



📚Reference: Ishimine P, et al. Emergency Department Observation and Computed Tomography Use in Children With Blunt Abdominal Trauma. Annals of Emergency Medicine. 2026

Migraine in the ED: NSAIDs + fluids… but do the fluids actually matter? 💧This study might make you rethink that reflexiv...
04/17/2026

Migraine in the ED: NSAIDs + fluids… but do the fluids actually matter? 💧
This study might make you rethink that reflexive fluids order.

Read more www.annemergmed.com

04/10/2026

🚨 The overdose you think you’re treating… may not be what it seems.

As emergency and critical care clinicians, we’re trained to recognize opioid toxicity and respond rapidly.
But a new adulterant — medetomidine — is changing that clinical picture.

Patients may initially respond to naloxone… yet remain profoundly sedated.

Hours later, they can develop rapid, severe withdrawal with agitation, hypertension, and delirium — often refractory to standard therapies.

This is not just a variation of opioid toxicity.
It’s a distinct and evolving clinical syndrome that demands awareness at the bedside.

🎧 In this reel, I discuss key insights from a recent review in Annals of Emergency Medicine and share perspectives from one of the authors.

👇🏾For the full review, see:

Lynch MJ, Pizon AF, Yealy DM. Emergence of Medetomidine in the Illicit Drug Supply: Implications for Emergency Care and Withdrawal Management.

📖 Annals of Emergency Medicine (2025)
🔗 https://www.annemergmed.com

04/03/2026

Managing Cannabinoid Hyperemesis Syndrome by Rech, Shalaby, Gage, and Gottlieb in Annals of Emergency Medicine reviews how to recognize CHS in the ED, when to broaden the differential, and which treatments current guidelines support. One of the key takeaways: CHS has no definitive test, droperidol or haloperidol are recommended first-line in current guidelines cited by the authors, and long-term symptom control still centers on cannabis cessation.

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