13 08, 2017

Team-Focused CPR: Bringing Prehospital Success to the ED

2017-08-13T21:45:38+00:00

High-quality chest compressions and early defibrillation are the cornerstones of effective cardiac arrest care.1 When implemented correctly these two interventions enhance patient outcomes and improve overall survival.2 However, despite simplified advanced cardiac life support (ACLS) algorithms and extensive training of providers, cardiac arrest scenarios in the emergency department (ED) are still high-stress and mortality rates remain high.3,4 

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4 06, 2017

Trick of the Trade: Using Linear Transducers for Point of Care Ultrasound in Intrauterine Pregnancy Evaluation

Ultrasound Intrauterine PregnancyThe volume of women presenting to the emergency department (ED) with newly diagnosed first-trimester pregnancies and suspected ectopic pregnancies sometimes seems like an infinitely growing number. As ED physicians, proper identification of an intrauterine pregnancy (IUP) in these patients is of paramount importance and the initial imaging test of choice for many has become bedside point-of-care ultrasound (POCUS).

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12 01, 2017

Introducing In-Line Expert Peer Review: Advancing the State of Academic Blogging

2017-01-11T19:57:40+00:00

expert peer reviewA peer review process, in one form or another, has long been the de facto standard for academic publishing. In 2013, ALiEM was the first FOAM resource to initiate an attributed peer review process for all submitted content–effectively bringing a traditional standard to a new frontier of medical education.1 Since our expert peer review (EPR) program inception, reviewers have published critical appraisals alongside 114 ALiEM posts to date.
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12 12, 2016

PV Card: Elbow Injuries

elbow injuries

Elbow injuries are a common presentation to the Emergency Department. This pocket card reviews some the imaging, acute management, and some pearls for the following injuries: elbow dislocation, radial head subluxation, supracondylar fractures (such as the xray on the right), radial head fracture, epicondylitis, condyle fractures, and olecranon fracture. Thanks to Dr. Jonathon Hancock (Doctor’s Hospital orthopedist) for the expert peer review.

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23 11, 2016

PV Card: LVAD Complications

lvad-image-from-mayo

Patients with left ventricular assist devices (LVAD) often cause much anxiety amongst providers in the emergency department. This is understandable with all of the hardware, diminished or absent peripheral pulses at baseline, and potential for complications. To add to the already helpful reviews about LVADs at REBELEM and emDocs, this is a PV card set providing a methodical approach to troubleshooting LVAD complications, including a reproduction of an algorithm for managing the LVAD patient with altered mental status from EMCrit.1–3
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7 11, 2016

PV Card: Algorithm for acute bronchiolitis management

2017-04-19T05:41:36+00:00

baby-cough-canstockphoto5283520Bronchiolitis is a common lower respiratory tract infection in children less than 2 years old, and especially in those 3-6 months old. In a collaboration with the American Academy of Pediatrics’ (AAP) Section on Emergency Medicine Committee on Quality Transformation, we present a PV card summarizing the Section’s “Clinical Algorithm for Bronchiolitis in the Emergency Department Setting” (reproduced with permission).1 Dr. Shabnam Jain sums it up best in her expert peer review below: “In bronchiolitis, less is more.”
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18 08, 2016

Trick of the Trade: Ear Irrigation in the Emergency Department

2016-11-11T19:47:00+00:00

Ear pediatricEar irrigation is an important tool for adult and pediatric patients in the Emergency Department (ED) with ENT complaints. Irrigation can be used to clear ear cerumen, visualize tough-to-see tympanic membranes, and remove foreign bodies. This may reduce the need for subspecialist care and improve the patient’s hearing and quality of life.1 Commercial electronic and mechanical devices are available for irrigation and have been studied. Moulton and Jones presented the improved efficacy of foreign body removal using an electric ear syringe in an (ED) population.2 In this trick of the trade, we present a low cost and effective way of  “ear-rigation” taught to us by one of our veteran nurses using easily available tools in the ED.

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