There are a number of personal attributes characterizing the professional identity of “physician.” We are dedicated to patients, committed to lifelong learning, and responsible for a variety of other professional obligations. Each requires physicians to be highly accountable – obligated or willing to accept responsibility for one’s actions. In this post we present examples of how we’ve adopted peer accountability as a strategy to help us with the myriad responsibilities and obligations at the heart of our profession. Just in time for the New Year – we challenge each of our readers to consider finding an “accountability partner” in 2020!
After receiving numerous high-quality submissions, we are proud to announce the winners of the 2019 Essentials of Emergency Medicine (EEM) Education Fellowship contest! Dr. Tim Montrief from the Jackson Memorial/University of Miami Emergency Medicine residency program has won the blog post competition. A blinded EEM voting panel with input from ALiEM selected his winning post: Trick of the Trade: Bubble Study for Confirmation of Central Line Placement. We are thrilled to feature it today on the blog and look forward to meeting him in Las Vegas in May at the 3-day event. This weekend, we will also feature 2 other excellent submissions from runners-up Dr. Sarah Sanders (Northwestern University) and Dr. Jennifer Rabjohns (George Washington University). Thank you to everyone who submitted their work!
Dr. Tim Montrief
Emergency Medicine Resident
Jackson Memorial/University of Miami
The 2019 Essentials of Emergency Medicine (EEM) conference is in May, but opportunities start NOW. This conference is one of the largest live EM educational conferences in the world with over 2,000 attendees. The conference organizers, led by Dr. Paul Jhun, are again offering an amazing opportunity for EM residents anywhere in the world to serve as an EEM Fellow for the next EEM conference May 14-16, 2019.
Most protocols for managing pediatric patients with diabetic ketoacidosis (DKA) are based on a theoretical association between fluid resuscitation and subsequent neurological decline. Although the evidence for an association between IV fluids and cerebral edema comes from retrospective reviews, for over 20 years, it is an accepted teaching principle of pediatric DKA.
Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis, published just days ago in the New England Journal of Medicine, challenges this teaching with the first randomized controlled trial designed to investigate the relationship between IV fluids and cerebral edema. We review this publication and present a behind-the-scenes podcast interview with lead authors Dr. Nathan Kuppermann and Dr. Nicole Glaser from the Pediatric Emergency Care Applied Research Network (PECARN). (more…)
Podcast Follow-up: Interview with Dr. Debbie Yi Madhok, Co-Author of “Update on the ED Management of Intracranial Hemorrhage”
Intracranial hemorrhage (ICH) is associated with significant disability and mortality. Although evidence-based guidelines exist, many hospitals have their own institutional practice patterns, which can make it difficult to care for these patients in the ED. Dr. Debbie Yi Madhok, an emergency physician and neurointensivist, sat down with Dr. Derek Monette, the ALiEM Deputy Editor in Chief, to discuss updates in the management of ICH. This interview follows up her original popular 2017 ALiEM post on dilemmas in ICH management, and takes a deeper dive into the nuances of seizure prophylaxis, blood pressure control, and platelet transfusions. We present the podcast and key learning points.
Computed tomography (CT) is increasingly available across U.S. Emergency Departments and has changed the practice of medicine. However, it is coupled with potential side-effects from radiation and contrast media. Emergency Medicine is beginning to make a concerted effort to identify clinical scenarios in which CT may be unnecessary, producing outcomes research and validated clinical decision rules. Renal colic and pulmonary embolism, in particular, seem amenable to this area of investigation. The ACEP E-QUAL Network podcast, a partnership with ALiEM to promote clinical practice improvements, reviewed this topic with experts Dr. Chris Moore (Emory University) and Dr. Jeffrey Kline (Indiana University). We present highlights from their discussion with Dr. Jason Woods.
After receiving numerous high-quality submissions, we are proud to announce the winners of the 2018 Essentials of Emergency Medicine (EEM) Education Fellowship Contests! Dr. Puja Gopal from the University of Illinois at Chicago has won the blog post competition. Her winning post, selected by a blinded EEM voting panel, highlights a mnemonic for taking care of patients with tracheostomies, and is featured on the blog today! Dr. Liz Fierro and Dr. Natasha Li have co-won the visual design competition for their submission, Pocket PEM. They were among 4 worthy semifinalist submissions selected by a blinded EEM voting panel, and the winners were ultimately selected by 2,687 ALiEM readers. We look forward to meeting these fellows in Las Vegas in May 2018 at the 3-day event. Thank you to everyone who submitted their work!