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10 08, 2018

Replace dolutegravir (Tivicay) with raltegravir (Isentress) for post-exposure prophylaxis

2018-08-10T04:08:00+00:00

raltegravirPost-exposure prophylaxis (PEP) of patients who may have been exposed to HIV includes a combination HIV nucleoside analog reverse transcriptase inhibitor emtricitabine/tenofovir (Truvada) plus an integrase inhibitor. The CDC initially recommended the integrase inhibitor dolutegravir (Tivicay). However on May 18, 2018, the CDC placed an alert about the neural tube defect risk with dolutegravir.1 How does this change our ED practice?
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8 08, 2018

ALiEM Cards: Maternal Cardiac Arrest

2018-08-08T10:46:09+00:00

pregnancy anatomy maternal cardiac arrestMaternal cardiac arrest is a low-frequency, high-risk pregnancy complication with 2 lives at stake. Incidence is approximately 1 in 12,000 to 50,000 pregnancies with a greater than 40% mortality rate. Understanding physiologic changes of pregnancy and how to perform a perimortem cesarean section (resuscitative hysterotomy) are critical aspects of caring for maternal cardiac arrest. ALiEM Cards: Maternal Cardiac Arrest, written by Drs. Jeffrey Sakamoto, Collin Michels, Nikita Joshi, and Rebecca Bavolek, reviews the causes, management pearls, and summarizes the perimortem cesarean delivery.

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7 08, 2018

From One Medical Student to Another: 5 Tips for Research Success

One of the most challenging aspects of medical school is the sheer volume of information that must be absorbed in a short period. This can pose a problem for those interested in developing research skills and pursuing an independent project. As colleagues, we know that our inherent curiosity is satisfied by discovering new information as much as it is by learning clinical content. We believe that it is important to showcase our hard work through a formal research project, but there are systematic barriers to finding a research mentor and team. Although there are many resources to guide you on “how” to publish, in this post we give some basic tips and tricks, from one medical student to another, on how to get involved in research and find a project that best fits your goals.

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30 07, 2018

ALiEMU AIR Peripheral Vascular Disease Module

AIR peripheral vascular diseaseWelcome to the Peripheral Vascular Disease (PVD) Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to PVD emergencies. 2 blog posts within the past 12 months (as of May 2018) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 0 AIR and 2 Honorable Mentions. We recommend programs give 1 hour (about 30 minutes per article) of III credit for this module.

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23 07, 2018

Approaching Wellness in the ED: A Conversation with Wellness Expert Dr. Shahina Braganza

2018-07-22T21:17:15+00:00

The Wellness Think Tank created a podcast with wellness expert Dr. Shahina Braganza from the Gold Coast in Australia. Facilitated by Dr. Annahieta “AK” Kalantari and joined by EM residents Dr. Alecia Gende and Dr. Adrienne Taren, the conversation covers a broad range of topics including the concepts behind Emotional Contagion, Dr. Braganza’s published “oneED” program1, and the challenges of adopting wellness initiatives in the ED. We present the podcast and highlights below.

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20 07, 2018

MEdIC Series: The Case of the Medication Mishap – Expert Review and Curated Community Commentary

2018-08-06T20:48:15+00:00

Our last case of season 5, The Case of the Medication Mishap, presented the scenario of a senior resident, Tim, who inadvertently administers an incorrect medication dose that leads to a serious adverse event. He then struggles with how to handle this situation as we often aren’t coached on the approach to physician errors and disclosing adverse events throughout our medical training. Physicians aren’t allowed to make mistakes, right? If you haven’t had a chance yet, we urge you to check out the case and share your thoughts on this important topic!

The MEdIC team (Drs. Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, Alkarim Velji, and Brent Thoma) hosted an online discussion around the case over the last 2 weeks with insights from the ALiEM community. We are proud to present to you the curated commentary and our expert reviews. Thank you to all participants for contributing to the rich discussions surrounding this case!

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11 07, 2018

Can’t Miss ECG Findings for the Emergency Medicine Provider

2018-07-21T16:00:04+00:00

high-risk ECGSudden cardiac death accounts for almost 400,000 deaths per year in the United States, and EM providers must be adept at discerning subtle, high-risk ECG findings. With the advent of triage ECG protocols, one of the most common interruptions in the ED is a request to “sign off” on an ECG. We present a reference of some of the most important high-risk ECG findings, intended to help ED providers systematically screen patients in triage and the waiting room.
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