Can’t Miss ECG Findings for the Emergency Medicine Provider

Sudden 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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2019-02-19T18:37:40-07:00

July 11th, 2018 | ECG

By: Christian Rose, MD and Robert Goodnough, MD

Trick of the Trade: Ocular ultrasound for the swollen traumatic eye

You are caring for a patient with an incredibly swollen eye – like a scene out of almost any Rocky film. This patient is likely going to the CT scanner, but regardless of the finding (retrobulbar hematoma, orbital wall fracture, etc.) you still need to evaluate for extraocular muscle entrapment and loss of pupillary response. There’s only one problem: you can’t see the eye. The old standards like getting the patient to retract their lid using paperclips or a cotton swab may help; but sometimes there is just too much swelling, and those techniques are just not enough. Without brute force – and potentially causing more trauma – you likely won’t be able to examine this patient’s eye.

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2018-10-28T21:25:34-07:00

August 9th, 2016 | Ophthalmology, Tricks of the Trade, Ultrasound

By: Christian Rose, MD, Melanie Watts, MD and Nate Teismann, MD

A Starter’s Roadmap to EM Resources: Books, Websites, and Apps

With the start of the year, we welcomed a new group of faces into our respective residency programs. We can all still remember how daunting it was to tackle learning the immense volume of material to be a great emergency medicine physician. We have so many amazing resources, but no road maps for where to start. The purpose of this list is to help guide the new interns as well as to highlight some resources that even the more seasoned clinician may find useful.

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2019-04-07T01:31:19-07:00

August 3rd, 2016 | Medical Education, Social Media & Tech

By: E. Liang Liu, MD, Christian Rose, MD and Sean Dyer, MD |Editors: Fareen Zaver, MD; Adaira Chou, MD

Top 5 FOAM Radiology Resources: ALiEM Chief Resident Incubator Recommendations

There is no shortage of free open access medical education (FOAM) resources available to the current emergency medicine (EM) learner. It seems that no matter what the concept, FOAM has it covered. And radiology is no different. However, with a specialty as vast as radiology, finding educational material pertinent to the emergency practitioner can be overwhelming. The 2016-2017 ALiEM Chief Resident (CRincubator) class also encountered this when attempting to create an organized FOAM radiology curriculum for EM residents. To tackle this challenge, the chief residents have brought together the best online resources to help EM practitioners gain expertise in the field of radiology.

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2019-02-19T18:45:13-07:00

June 9th, 2016 | Incubators, Radiology, Social Media & Tech

By: Christian Rose, MD and Alec Weir, MD

Trick of the Trade: Ultrasound for Pedal Pulse Identification and ABI

The Problem: A patient is rolled in to your ED by EMS with extremity trauma. You’re rightfully concerned about possible vascular injury to an upper or lower extremity, but you can’t palpate a dorsalis pedis (DP) or posterior tibialis (PT) pulse! You spend minutes, whisking the doppler probe, attempting to hear a waveform in a busy ED. Unfortunately you can’t seem to hear the “whoosh,” making accurate it nearly impossible for you to measure ankle-brachial indices (ABI). ^1–3