About Dina Wallin, MD

ALiEM Series Editor, The Leader's Library
Assistant Medical Director of Pediatric Emergency Medicine
Zuckerberg San Francisco General Hospital;
Assistant Clinical Professor of Emergency Medicine and Pediatrics
University of California San Francisco

PEM Pearls: Chest Radiographs for Shortness of Breath

chest radiograph

Figure 1: Photo by Tim Bish on Unsplash

Paramedics bring in a 5-month-old boy in respiratory distress. He’s crying furiously and has normal tone and color. Thick, copious secretions are coming from his nose. He is tachypneic with diffuse wheezes, crackles, retractions, and nasal flaring. His respiratory rate is 70 and his oxygen saturation is 88% on room air. Would you order a chest radiograph (CXR) for this child?

CXRs are routinely obtained in adults with respiratory symptoms. Children, however, are more sensitive to radiation and can have multiple respiratory infections every year. CXRs can increase cost, length of stay, and may not always be necessary.

This post presents some guidelines on when (and when not) to get a CXR in pediatric patients.

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By |2020-05-02T11:46:09-07:00May 27, 2020|PEM Pearls, Pulmonary, Radiology|

The Leader’s Library: The Coffee Bean – Open call for participants

The coffee bean the leader's library book clubLife recently has been, to say the least, a hair stressful. The global pandemic, with all the resultant lifestyle upheaval, has seized a commanding presence in every minute of every day, personal and professional, and many of us are feeling the heat. There’s never been a more appropriate time then to cultivate effective coping strategies as a community, and ALiEM is here to help, with the third installment of The Leader’s Library, covering The Coffee Bean: A Simple Lesson to Create Positive Change by Jon Gordon and Damon West.

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By |2020-05-06T16:12:42-07:00May 8, 2020|Book Club, Leaders Library|

I’m an Emergency Medicine Physician With COVID-19, Now What?

COVID-19 physicianA 35-year-old female emergency medicine physician presents for evaluation for severe myalgias, headache, fatigue, mild nasal congestion, profound anosmia, cough, and subjective fevers and chills. She has no measured temperature above 100.4°F, but has been taking anti-inflammatories around the clock. The day previously, she called occupational health and received testing for the novel coronavirus. The next day, her test returns positive. What happens next? We are here to share our personal experiences with COVID-19 and provide some resources to best support yourselves, your families, your learners, and your colleagues throughout this uncertain and ever-changing situation.

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By |2020-04-10T23:25:40-07:00Apr 10, 2020|COVID19, Life|

The Leader’s Library: Radical Candor | Curated Summary of the Discussion

radical candor

Welcome back to The Leader’s Library! In our second installment, throughout the week of October 14, 2019, a group of selected learners across the globe tackled Radical Candor by Kim Scott [ALiEM book summary], and generated another fascinating asynchronous dialogue on Slack. This go-round, we had 3 days of discussion with days for reflection in between. Below are the main points that emerged from our robust conversation.

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By |2019-11-10T23:10:07-08:00Nov 18, 2019|Book Club, Leaders Library|

Measles 2019 Updates: The Comeback Kid

Measles

The child with a fever and rash in your Emergency Department (ED) may actually have measles. This year, there have been 1,182 cases of measles in the U.S., and counting. This is the highest rate in the past 27 years [1]. Globally, measles kills over a hundred thousand children [2]. In the U.S., one child dies for about every 1,000 cases [3]. Emergency providers must be able to quickly detect short-term complications that can lead to death and distinguish measles from mimics like Kawasaki Disease. It’s no coincidence that this year’s outbreak is in the setting of lower vaccination rates. The CDC now has new vaccine recommendations, and it’s imperative that ED providers join forces with public health providers to prevent future measles cases and deaths (photo credit).

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By |2019-10-31T12:57:05-07:00Oct 28, 2019|Dermatology, Infectious Disease, Pediatrics|

The Leader’s Library | Radical Candor: Be a Kick-Ass Boss Without Losing Your Humanity

radical candor

We proudly announce the second installment of ALiEM’s career development book club, The Leader’s Library, with Kim Scott’s bestseller Radical Candor [Amazon link].

Your colleague and friend plops down next to you at a meeting. She’s extra excited because she’s going to give an important presentation to hospital administration about her new quality improvement project, and beams a bright smile at you. She has a huge chunk of spinach between her teeth. What do you do? You could shout, “Hey, loser, get that spinach outta your teeth!” in front of the whole group… or you could encourage her to go ahead and give the presentation, telling her she’s going to do a great job… or you could avoid eye contact altogether… or you could just TELL her discreetly, empowering her to do the best job she can.

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The Leader’s Library: Dare To Lead | Curated Summary of the Discussion

Dare to Lead summary | The Leader's Library - a professional development book clubIn April 2019, a group of intrepid readers embarked on an adventure together: the debut session of The Leader’s Library, ALiEM’s new career development book club. Learners and instructors from around the world read and discussed Dr. Brené Brown’s newest book, Dare to Lead, on a 5 day journey via Slack. Each day had its own theme (Rumbling with Vulnerability, Values, Empathy and Shame, Learning to Rise, and Toolkit), and the asynchronous discussion was robust. A day-by-day breakdown of our conversation, along with tangible takeaways and recommendations for further reading, is summarized below.

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