SAEM Clinical Image Series: Eye Pain After Assault

By |Nov 30, 2020|Categories: Academic, Emergency Medicine, Ophthalmology, SAEM Clinical Images, Trauma|0 Comments

A 33-year-old male presents with intermittent blurry vision and left eye pain for 3 months, and a left-sided orbital headache for 1 day. He reports getting punched in the left side of the head during an altercation a few months ago. The eye pain is worse with ocular movements and is associated with bilateral conjunctival injection and white/green discharge from the left eye. The patient was seen at another emergency department 3 months prior for the same symptoms. He was then found to have left-sided proptosis, visual acuity 20/60 in the left eye, no fluorescein [...]

SAEM Clinical Image Series: Surfing Sting

By |Nov 30, 2020|Categories: Academic, Emergency Medicine, SAEM Clinical Images, Tox & Medications|0 Comments

A 38-year-old male presents 8 days after being stung in the left foot while surfing. He reports the sudden onset of sharp pain while walking in the ocean. He was seen initially in the emergency department. The puncture wound on his left foot was anesthetized, explored, and irrigated. No X-ray was obtained, no foreign body was discovered, and he was discharged home. Two days ago, he noticed worsening heat, itchiness, swelling, and skin changes (red bumps and patches extending from the foot up to the lower calf) in his left foot. His current pain is [...]

SAEM Clinical Images: Man vs Snow Blower

By |Nov 23, 2020|Categories: Academic, Emergency Medicine, Orthopedic, SAEM Clinical Images, Trauma|0 Comments

A 28-year-old man presents to the emergency department after a snow blower accident while at work. The patient was performing maintenance and he placed his hand into a clogged snow blower while the machine was still on. His hand subsequently got jammed in the snow blower, catching his second and third digits. The patient has an obvious amputation of the right third digit with the stump still connected to the hand via the flexor tendon, which is attached to the distal phalanx. He has pain in the right hand and lack of sensation to the [...]

How I Work Smarter: Luz Silverio, MD

By |Nov 20, 2020|Categories: Medical Education|0 Comments

One word that best describes how you work? Fitfully and obsessively Current mobile device Two: an iPhone 8 supplied by my job for clinical work, and an iPhone 10 for home. Computer A very old MacBook Air that constantly pings me, requesting "more space." I keep putting it in larger rooms, but... What is something you are working on now? I've been working on a series of 5-10 minute talks to be given prior to shifts that I call "Journal Watch Pictionary." I read journal articles and then illustrate their key points using my own medium-poor quality cartoon illustrations. It's [...]

SAEM Clinical Image Series: Strange Eyes

By |Nov 16, 2020|Categories: Academic, Emergency Medicine, SAEM Clinical Images|0 Comments

A 3-month-old boy, born full-term via normal spontaneous vaginal delivery to a gravida 2 para 1 mom with negative prenatal labs, presents with abnormal eye movement and position. His parents report 2 days of an increase in bulging of the soft spot, head size, and abnormal eye movement. He has not been able to look at his mother “like he used to.” This is associated with an increase in fussiness, poor feeding, and non-bilious, non-bloody vomiting. He also had increased sleepiness and difficulty waking up for feedings overnight. The patient has normal urination with no [...]

SAEM Clinical Image Series: An Incidental Finding

By |Nov 16, 2020|Categories: Academic, Emergency Medicine, HEENT, SAEM Clinical Images, Trauma|0 Comments

A middle-aged man presented after a motor vehicle collision with a logging truck at 55 miles per hour with low back pain. A computed tomography scan (CT) of the abdomen and pelvis at an outside facility showed a burst fracture of the third lumbar vertebra (L3). The patient had no other complaints. Given the fracture, additional CT imaging was done and the above finding was discovered. After the incidental finding was found, the patient reported a nail gun accident three years prior where he thought it had just recoiled and struck him in the lip [...]

Education Theory Made Practical (Volume 3): An ALiEM Faculty Incubator eBook Project

By |Nov 6, 2020|Categories: Academic, Book Club|0 Comments

The ALiEM Team is delighted to announce another eBook publication: the third volume in the Education Theory Made Practical series. This book was a labor of love written by the 2018-19 Faculty Incubator class. We are very proud of all our Faculty Incubator alumni who made this happen. Their hard work has been compiled in this FREE, peer-reviewed eBook. We sincerely feel that it will be useful for all the educators out there, wrestling with the issue of integrating theory into practice. Special shout-out to the incredible Dr. David Sklar (former Editor-in-Chief of Academic Medicine) for providing us a thought-provoking foreword. [...]

SAEM Clinical Image Series: Eye Injury

By |Nov 2, 2020|Categories: Academic, Emergency Medicine, Ophthalmology, SAEM Clinical Images|0 Comments

An 11-year-old male presented to a pediatric trauma center following a motor vehicle collision (MVC). He was the restrained front-seat passenger when his vehicle was struck head-on, causing frontal airbag deployment. His primary complaint was pain around his right eye with associated blurry vision. He denied diplopia, pain with extraocular movements, flashers, floaters, or curtains in his vision. […]

IDEA Series: Virtual “Faux-tation” Rotation for 4th Year Medical Students Interested in Emergency Medicine

By |Oct 26, 2020|Categories: clerkships, IDEA series, Medical Education, Medical Student|0 Comments

Visiting clerkships have traditionally offered the opportunity for extended contact among medical student applicants and residency program representatives, allowing for enhanced assessment of mutual compatibility. Accordingly, visiting clerkships are consistently rated as an essential consideration among residency program leadership when reviewing applications, and among medical students, as they determine “fit” [1,2]. The COVID-19 pandemic has resulted in institutional restrictions on visiting clerkships. Despite the now limited opportunities for medical students to see residency programs of interest in-person, demand for these experiences remains high. Opportunities that allow for increased interaction among medical student applicants and residency programs that maintain compliance with [...]

Treating Blood Pressure in Intracranial Hemorrhage

By |Oct 23, 2020|Categories: Academic, Emergency Medicine, Neurology|0 Comments

Blood pressure control in the setting of ischemic stroke has a clearly recognized benefit in patient outcomes. The impact of blood pressure control in hemorrhagic stroke is not as well understood. The ACEP E-QUAL Network podcast, a partnership with ALiEM to promote clinical practice improvements, reviewed this topic with Dr. Latha Ganti (University of Central Florida College of Medicine). Dr. Ganti addressed the evidence behind recommended blood pressure targets and the available medications to achieve control. We present highlights from this discussion with Dr. Jason Woods.    What is the goal of blood pressure control in hemorrhagic stroke? Management of [...]