- Krokodil (desomorphine)
- Levamisole-adulterated cocaine
- Methamphetamine-induced allergic reaction
- Wound botulism secondary to heroin use
Pain management in the ED has become a balancing act. EPs must continually balance adequate pain management with the risks of opioids prescribing. As providers reach into their pain management toolbox it is always nice to have as many options as possible because one size does not fit all. Specifically for the management of acute renal colic, IV preservative-free (cardiac) lidocaine has been gaining popularity as a potential alternative when opioids are unable to get job done or are contraindicated due to co-morbidities or a history of addiction. Is it safe? Does it work?
Pediatric patients are not just little adults. Placing peripheral IVs in young patients can be challenging and comes with its own set of challenges. Presented are some basic and advanced tips to maximize success in establishing peripheral IV access in pediatric patients using ultrasonography.
Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this series, we focus on a real clinical case where point-of-care ultrasound changed the management or aided in the diagnosis. In this case, a 64-year-old man presents with acute onset scrotal pain and fever.
Patients presenting to the ED with respiratory distress and a tracheostomy can unnerve almost any provider, and management is often fraught with preventable errors.1,2 This recognition has led to the development of treatment algorithms from groups including the U.K. National Tracheostomy Safety Project to improve the safety and quality of care for patients with tracheostomies.3 Use the ABC-Ts mnemonic to help you perform a focused tracheostomy evaluation and troubleshoot in a stepwise, systematic manner while waiting for your ENT consultant to arrive.
There is significant overlap among conditions that cause a red, painful, or red AND painful eye. Having trouble keeping them all straight? Need a refresher before heading in to see a patient with a new eye complaint? Check out our brief, practical ALiEM Cards on the topic:
- The Painful Eye (Author: Puja Gopal, MD)
- The Red Eye (Author: Michelle Lin, MD)
- Eye Differential Diagnoses (Author: Puja Gopal, MD)
Calcium channel blocker overdose can produce a deadly toxidrome that requires rapid recognition and intervention. Dr. Joshua C. Feblowitz, a PGY-3 EM resident at the Harvard-Affiliated Emergency Medicine Residency at Brigham and Women’s Hospital and Massachusetts General Hospital, created a high-yield infographic on the symptoms and management of this important toxidrome!