SplintER Series: Case of a First Metacarpal Fracture



first metacarpal fracture

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A 22 year-old male was playing football when he fell, landing on his outstretched left arm with his thumb flexed. He now has pain at the base of his thumb. This AP view of the hand best demonstrates the injury (photo credit).

What is this fracture, what additional imaging is needed, and what should be the management plan?

 

 

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2019-05-09T18:07:02-07:00

ALiEM AIR | Neurology 2019 Module

Welcome to the Neurology Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to neurological emergencies. 6 blog posts within the past 12 months (as of January 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 1 AIR and 5 Honorable Mentions. We recommend programs give 3 hours (about 30 minutes per article) of III credit for this module. (more…)

DIY Ultrasound Model Compendium in Emergency Medicine

As the use of point-of-care ultrasound expands in emergency medicine, phantoms offer an attractive training solution for new learners and continuing education. Unfortunately, commercially available products are expensive and likely cost-prohibitive for individual practitioners to purchase. Luckily, there are a number of quality, low cost do-it-yourself (DIY) models published in journals and on the Internet. To help you navigate your options, I have created a compendium of DIY ultrasound models relevant to emergency medicine. The models are divided by system or application with a cost estimate for each model, if provided, as well as a list of materials and a short description. Links are provided for further reading.

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2019-04-26T15:26:28-07:00

Guideline Review: ACEP 2018 – ED Procedural Sedation with Propofol

ed procedural sedation with Propofol

The last American College of Emergency Physicians (ACEP) guideline recommendations regarding the use of propofol for ED procedural sedation was in 2007. Much research has since demonstrated its safety in adults and children. Furthermore, many clinicians are co-administering ketamine or fentanyl in conjunction. This 2018 ACEP update​1​ addresses these issues and much more. The following infographic summarizes the key points.

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2019-04-17T02:11:12-07:00

Health Insurance 101 for the Emergency Physician

A 28 year-old single man with type I diabetes mellitus presents to your busy Texas emergency department in diabetic ketoacidosis (DKA). This is his third hospitalization for DKA in 5 months. When you ask the patient about his current medication regimen, he admits that he frequently skips doses as a cost-savings measure. He shares that he works 45 hours a week at a small local grocery store, makes minimum wage ($15,660 pretax), and has no health insurance. His prescribed insulin regimen, consisting of Lantus at bedtime and Humalog with meals, costs approximately $600 a month. This cost estimate is based on 25 units of nightly Lantus and 25 total units of Humalog daily from GoodRx advertised list prices for the San Antonio area.

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2019-04-10T23:14:19-07:00

SplintER Series: 2-Minute Knee Exam | Leg Day #3 | MSK Exam Series

Knee Pain

Welcome to Leg Day #3 of the SplintER Series! Performing a fast and focused history and physical examination of a patient with an acute knee injury is an important skill that has the potential to be overlooked in our busy Emergency Departments. Our hope is that after reviewing this post and with enough practice you will be able to complete your exam within 2 minutes! These are can’t-miss points and expert tips on the knee exam for your next shift in the ED.

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2019-06-28T16:40:51-07:00

ALiEM AIR | Stroke Module

Welcome to the Stroke Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the AIR Team is proud to present the highest quality online content related to Stroke emergencies. 7 blog posts within the past 12 months (as of October 2018) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 0 AIR and 7 Honorable Mentions. We recommend programs give 3.5 hours (about 30 minutes per article) of III credit for this module.

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