About Christina Shenvi, MD PhD

ALiEM Associate Editor
Assistant Professor
Assistant Residency Director
University of North Carolina

Rib Fractures in Older Adults – What’s the Big Deal?

Fall Risk Bracelet And Wooden CaneBlunt chest trauma from falls or motor vehicle collisions are a common reason for ED visits and a common source of rib fractures. While many patients with rib fractures can be discharged home with oral analgesics and an incentive spirometer, certain patients are at much higher risk for morbidity and mortality. This post will look at which patients are at risk, what factors predict increased mortality, and inpatient interventions that can reduce mortality, with a focus on the risks in older adults.


By |2016-11-11T19:37:08-08:00Jun 3, 2015|Geriatrics, Trauma|

Geriatric Emergency Medicine for Students, Residents, and Physicians

geriatricsWe all know the population of the United States is aging. We know emergency physicians need to be prepared and trained to care for older adults. But how can you dive into the world of geriatric EM to learn more, to research, to gain additional training? In this post, we have gathered the wisdom of leaders in geriatric EM across the country, to share their recommendations, inspiration, and motivation.


By |2019-02-19T18:25:22-08:00Mar 31, 2015|Geriatrics, Medical Education|

Sepsis in Older Adults: The Presentation May Be Subtle

sepsis260% of patients in the United States who develop severe sepsis are older adults (age 65 and over) [1], and the mortality of severe sepsis increases steadily with age to nearly 40% in those over 85 [2]. There are many factors that make older adults more susceptible to sepsis, and that can also make sepsis more difficult to detect. Here are some tips to help explain why this is, and how you can identify it sooner.


By |2017-07-21T09:52:48-07:00Feb 5, 2015|Geriatrics, Infectious Disease|

Palliative Care in the ED – The Time is Now

hospice“Don’t delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit.” This statement was one of ACEPs 2013 Choosing Wisely recommendations. How palliative care can be effectively and practically integrated into the ED, and which patients are likely to benefit from it is still being worked out at many institutions.1–4 However, it is clear that the time for palliative care in the ED has come.


By |2019-07-23T00:18:26-07:00Dec 8, 2014|Geriatrics|

Carbon Monoxide Poisoning – It’s That Time of Year Again

Screen Shot 2014-09-24 at 9.29.50 PMCarbon monoxide (CO) poisoning may be the most common cause of fatal poisonings worldwide. 1 The majority of poisonings occur in the Fall and Winter. It is that time of year when heaters that have lain dormant all summer are flicked on, sometimes in enclosed areas, introducing CO fumes into homes. The pathophysiology is complex, and not fully understood, but all ED physicians should be aware of the signs and symptoms of CO toxicity, and know how to treat it.


By |2016-11-11T19:22:45-08:00Oct 8, 2014|Tox & Medications|

10 Tips on Writing Your First Grant

writing your first grantIf you are a junior faculty looking to do research in an academic setting the question will inevitably arise: How do you get funding? You may have a fantastic research idea, but without money to back it, it is hard to get anywhere. Funding is becoming more difficult and more competitive to obtain. This guide will present 10 tips to help you through the daunting task of applying for and writing your first grant.


By |2018-01-30T02:35:49-08:00Aug 7, 2014|Academic|

Transitions of Care: Top 10 things admitting providers wish we did for older adults

connection“Transitions of care” has become a hot topic in the care of older adults. It is usually applied to the transition from the hospital to home or the hospital to a nursing facility. But what about the transition from the ED to an inpatient service? It turns out there are plenty of things we could be doing (or not doing) to help smooth that transition and improve patient care. Here are some thoughts from admitting physicians with geriatrics training.


By |2016-11-11T19:21:04-08:00Jun 2, 2014|Geriatrics|
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