PEM Pearls: To Scan or Not to Scan? CT Abdomen in Children with Blunt Torso Trauma
An 18-month-old female with no past medical history is brought in by ambulance after a motor vehicle collision (MVC) at highway speed, restrained in an appropriate car seat. Mom was also brought in after delayed extrication with an obvious femur deformity. EMS reports that the patient had emesis on the scene, was fearful but calm, and has been moving all extremities. Vitals per EMS: HR 120, BP 100/60, RR 30, SpO2 99%, Temp 36.5 C Initial Exam: General: crying Neuro: Glasgow Coma Scale (GCS) of 13 (eyes shut unless talked to, crying spontaneously, moving all extremities) MSK: atraumatic chest, erythema [+]
SAEM Clinical Image Series: The Insidious Rash
A 60-year-old African American female with a history of hypertension presents to the emergency department for an itchy, diffuse rash. She first noticed the lesions a few years prior, and they have progressively become larger and more inflamed. The lesions have become severely pruritic over the last couple of months. Steroid creams did not appear to improve symptoms. Currently, the lesions on her arm have become painful with yellow drainage. The patient denies nausea, vomiting, and fever. [+]
EM Match Advice: 2020-21 Interview Season | This is how it started, this is how it’s going
The 2020-21 residency interview season has required rapid innovation and adaptability for both medical student applicants and residency programs, given COVID-19's physical distancing restrictions. Listen to how it started and how it is going thus far with podcast co-hosts Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF). Podcast episode with 2020-21 mid-season update and insights Program director panelists Dr. Camiron Pfennig - Prisma Health University of South Carolina Greenville Dr. Ryan Bodkin - University of Rochester Dr. Michael Kiemeney - Loma Linda University Listen to all the episodes of the EM Match Advice Series Additional resources AAMC open letter [+]
Free eBook Announcement: Emergency Medicine Resident Simulation Curriculum for Pediatrics (EM ReSCu Peds)
The Emergency Medicine Resident Simulation Curriculum for Pediatrics (EM ReSCu Peds) is here! This free ebook contains 16 EM resident-tested, peer reviewed cases covering essential pediatric content identified through a robust modified Delphi process [1] with experts across the United States. Each chapter contains robust supporting materials to help educators prepare, execute, and debrief cases with residents at every level to help supplement the clinical experience. Download the EM ReSCu Peds eBook We request some basic demographic about you and how you plan to use the educational cases in the download form to provide us with necessary insights whether [+]
SAEM Clinical Image Series: What Lies Beneath?
A 35-year-old male with a history of diabetes and pericarditis, status post pericardiectomy 3 years ago, presented with a painful lesion on his anterior chest wall. One month prior, the patient reported a bump at his sternotomy scar base which extruded a piece of suture when squeezed and subsequently healed. Two days ago, the patient developed diffuse right-sided chest pain. During the past 24 hours, an enlarging, erythematous, painful, non-draining lesion developed at the base of his scar. He reports subjective fever. He denies shortness of breath, exertional chest pain, nausea, and vomiting. [+]
SAEM Clinical Image Series: Left Ear Mass
A 25-year-old male who was previously healthy presents to the emergency department with a painful left posterior ear mass. The mass began as a “pimple” and has been increasing in size for the last 6 months. He has an associated headache, dizziness, and malaise. He denies fever, trauma, drainage, known insect bite, dysphagia, dyspnea, trismus, and hearing loss. He emigrated to the United States from Honduras 8 months ago. He was seen in the emergency department 4 months prior for a similar complaint, which was diagnosed as lymphadenopathy by point-of-care ultrasound. [+]
How I Work Smarter: Jaime Hope, MD
One word that best describes how you work? Systematically Current mobile device iPhone 11 Computer Dual-monitor PC What is something you are working on now? An educational product to help elderly adults discover their risk factors for falls and use prevention strategies for fall prevention. How did you come up with this Idea/Project? Falls are the main cause of morbidity and mortality in older adults, we see this daily on shifts. Helping them reduce trip hazards and improve balance, proprioception, and strength can make substantial reductions in falls. What’s your office workspace setup like? Dual monitors (lots of open tabs!!) [+]
SAEM Clinical Image Series: Blisters, Bullae, and Badness
A 3-year-old female with a history of epilepsy presents with a rash that began one day ago. The patient started becoming fussy four days ago, saying, “I don’t feel good,” and not wanting to play outside with her siblings or finish her meals. Family noticed the patient rubbing her eyes frequently and crying when she went to the bathroom. She felt warm so they gave her Tylenol and Motrin at home. Yesterday, they noticed a rash was starting to develop with itchy, painful red spots. This morning, the rash progressed to involve some blisters on the [+]
How I Work Smarter: Drew Kalnow, DO
One word that best describes how you work? Conscientiousness Current mobile device iPhone X Computer MacBook Air What is something you are working on now? InSitu EM Simulation How did you come up with this Idea/Project? Identified the need to improve critical patient care in the ED. This project uses senior residents as resus leaders with the ED critical patient team in one of our ED resus bays. Through this, we improved team communication and understanding of work-flows while also identifying and addressing latent safety threats. What’s your office workspace setup like? Most of my work is done in my [+]
Defying Forgettable Flatness: The Power of Moments | Summary of The Leader’s Library Discussion
In September, ALiEM hosted its fourth iteration of The Leader’s Library, this time discussing The Power of Moments by Chip Heath and Dan Heath [Amazon link to book]. Driven by a purpose “to defy the forgettable flatness of everyday work and life by creating a few precious moments,” 30 participants and 6 facilitators embarked on a 3-day voyage through the book, exploring general themes of CREATE (how do we manipulate our surroundings to create powerful moments?), REFLECT (how have powerful moments influenced our personal and professional lives?), and CAPITALIZE (how can we utilize moments to effect change and progress?). The [+]