ALiEMCards.com

ALiEM Cards is point-of-care reference library of narrowly focused, easily digestible cards for the practicing emergency physician or learner (formerly known as PV Cards). As of July 2017 led by the team of Dr. Jeremy Voros and Derek Sifford, we have rebranded these into “ALiEM Cards” and moved away from the index-card templated PDF files. Check it out.

ALiEM Cards website screenshot

ALiEM Cards home page

Why transition to a new ALiEM Cards site?

We have always tried to keep the user and learner in mind. From a readability, design, and content delivery perspective, our index card look was becoming outdated.

  1. The limited text space negatively impacted our ability to easily convey the content in a clear fashion.
  2. The topics and keywords within each card were not searchable. You just had to know where things were.
  3. PDFs are often large-sized files and not easy to read on mobile devices.
  4. The new ALiEM Cards site incorporates the use of GitHub, which allows for better version control. We can more transparently update and incorporate crowdsourced feedback and peer review. This was not possible with the older PV Cards system.

What will we be stopping?

As part of this transition period, we are announcing the following:

  1. No more new content will be written in the PDF format.
  2. We are closing out the Evernote and Dropbox shared account options.

Index of Topics

Topic PDF Major Subject Minor Subject Blog page Date
Abdominal pain, diagnostic studies PDF Surgery, trauma Diagnostics Blog 2011/07/22
Abdominal trauma, blunt (likelihood ratios) PDF Surgery, trauma Bayes Blog 2012/04/20
Abdominal trauma, penetrating PDF Surgery, trauma Blog 2010/07/09
ABG interpretation PDF Pulmonary, critical care Diagnostics Blog 2010/04/02
Acetaminophen toxicity PDF Toxicology, pharmacology Blog 2011/11/04
Acute limb ischemia PDF Cardiovascular Blog 2010/08/13
Acute vestibular syndrome and HINTS exam PDF Neurology Blog 2011/12/02
Alcohol: Ethylene glycol PDF Toxicology, pharmacology Blog 2012/06/08
Alcohol: Isopropyl alcohol PDF Toxicology, pharmacology Blog 2012/06/22
Alcohol: Methanol PDF Toxicology, pharmacology Blog 2012/06/15
Anaphylaxis PDF Allergy, Immunology Blog 2012/02/24
Angioedema PDF Allergy, Immunology Blog 2010/03/26
Ankle and Hindfoot Fractures PDF Orthopedics Blog 2016/06/06
Ankle fractures PDF Orthopedics Blog 2010/02/18
Anticoagulation for atrial fibrillation PDF Cardiovascular Blog 2010/04/09
Aortic dissection (IRAD) PDF Cardiovascular Blog 2011/05/20
Appendicitis: ACEP clinical policy PDF Surgery, trauma Blog 2010/06/18
Asthma NIH classifications PDF Pulmonary, critical care Blog 2011/04/29
Bayes nomogram PDF Bayes 2012/05/17
Bell’s Palsy: Treatment PDF Neurology Blog 2013/02/21
Blood culture indications PDF Infectious disease Bayes Blog 2012/08/17
Blunt cardiac injury PDF Surgery, trauma Blog 2012/06/29
Brugada syndrome PDF Cardiovascular Blog 2011/05/06
Burns PDF Surgery, trauma Blog 2016/04/22 update (original 7/2/2010)
C1-C2 fractures PDF Orthopedics Blog 2010/09/24
C3-C7 fractures PDF Orthopedics Blog 2010/10/01
Cardiac tamponade PDF Cardiovascular Bayes Blog 2011/07/08
Cerebrovascular injury, blunt PDF Surgery, trauma Blog 2011/07/01
Cervical spine rules PDF Surgery, trauma Blog 2010/12/10
Cervical spine, distracting injury PDF Surgery, trauma Blog 2011/09/09
Charting and Coding PDF Administrative Blog 2016/08/15
Chemical sedation PDF Toxicology, pharmacology Blog 2011/03/25
Chest pain, low risk ACS PDF Cardiovascular Blog 2010/01/29
CHF likelihood ratios PDF Cardiovascular Bayes Blog 2012/08/24
Cholecystitis tests PDF Surgery, trauma Bayes Blog 2011/03/18
Clostridium difficile PDF Infectious disease Blog 2011/06/24
CNS infections PDF Neurology Blog 2009/12/29
Continuous end tidal CO2 monitoring in cardiac arrest PDF Pulmonary, Critical Care Blog 2015/10/20
Continuous infusions PDF Toxicology, pharmacology Blog 2012/03/09
Croup PDF Pediatrics Blog 2010/08/20
CT cancer risk PDF Radiology Blog 2011/06/10
Cystitis/Pyelonephritis Women Antibiotics PDF Genitourinary Blog 2011/09/02
D-dimer PDF Hematology, oncology Diagnostics Blog 2012/07/12
Delayed sequence intubation PDF Airway, pulmonary Blog 2012/08/31
Dental infections PDF ENT Blog 2011/04/22
Dental trauma PDF ENT Blog 2011/04/15
Dermatomes and myotomes PDF Neurology Anatomy Blog 2010/05/28
Diabetic foot osteomyelitis PDF Orthopedics Bayes Blog 2011/09/23
Diverticulitis outpatient PDF Surgery, trauma Blog 2011/05/27
Drug Card Emergency Department PDF Toxicology, pharmacology Blog 2013/09/11
DVT Diagnostic Guidelines (ACCP) PDF Cardiovascular Blog 2013/01/24
Dysphagia PDF ENT Blog 2010/02/03
Early goal directed therapy in sepsis PDF Infectious disease Blog 2010/04/16
ECG: Early repolarization vs STEMI PDF Cardiovascular Blog 2013/05/16
ECG: Electrolyte imbalance PDF Cardiovascular, Endocrine Blog 2012/09/21
ECG: Geography of AMI PDF Cardiovascular Diagnostic Blog 2011/04/08
ECG: Lead aVR PDF Cardiovascular Diagnostic Blog 2011/11/18
ECG: Right and posterior leads PDF Cardiovascular Diagnostic Blog 2011/03/11
Ectopic Pregnancy PDF Obstetrics/gynecology Bayes Blog 2013/05/09
EMTALA rules in the transfer of ED patients PDF Administrative Blog 2012/09/14
Genital ulcers PDF Genitourinary Blog 2012/05/04
GRACE score PDF Cardiovascular Blog 2012/04/13
Head CT before LP PDF Neurology Blog 2010/04/23
Head CT in trauma: Decision rules PDF Surgery, trauma Blog 2011/05/13
Hyperkalemia PDF Endocrine, metabolic Blog 2010/03/12
Hypertension: First line treatment PDF Cardiovascular Blog 2011/02/11
Hypothermia, accidental PDF Environmental Blog 2011/02/04
Influenza treatment PDF Infectious disease Blog 2011/10/28
Intimate partner violence PDF Trauma Blog 2013/07/31
Intraosseous lab interpretation PDF Hematology, oncology Diagnostics Blog 2012/01/13
IV fluid composition and Chloride-restrictive fluids in ICU PDF Endocrine, metabolic Blog 2012/01/03
Kawasaki disease PDF Pediatrics Blog 2012/03/23
Knee exam PDF Orthopedics Blog 2010/03/19
Laceration repair and sutures PDF Trauma Blog 2017/03/06
Legionnaires disease PDF Pulmonary, critical care Blog 2011/09/16
Local anesthetic toxicity PDF Toxicology, pharmacology Blog 2014/06/13
Metacarpal fracture PDF Orthopedics Blog 2013/12/13
Methotrexate and ectopic pregnancy PDF Gynecology, obstetrics Blog 2011/11/11
Murmurs and need for echocardiography PDF Cardiovascular Blog 2010/09/17
Neutropenic fever and cancer PDF Infectious disease Blog 2011/10/07
NSAID bleeding risk PDF Toxicology, pharmacology Blog 2011/07/15
One minute preceptor: NERDS mnemonic PDF Education Blog 2015/08/01
Open fractures and antibiotics PDF Orthopedics Blog 2012/01/20
Osmolal gap PDF Toxicology, pharmacology Blog 2012/06/01
Ottawa knee, ankle, foot rules PDF Orthopedics Blog 2010/05/07
Overanticoagulation and supratherapeutic INR PDF Hematology, oncology Blog 2012/08/10
Pain medications: Initial options in the ED PDF Toxicology Blog 2015/10/23
Palliative Care Screening in the ED PDF Palliative Care Blog 2015/07/27
Paracentesis and ascites assessment PDF Gastroenterology Blog 2010/06/25
PE clinical decision rules PDF Pulmonary, critical care Blog 2011/06/03
PE indications for fibrinolysis PDF Pulmonary, critical care Blog 2011/07/29
Pediatric assessment triangle PDF Pediatrics Blog 2013/05/30
Pediatric fever (1-3 months old) PDF Infectious disease Pediatrics Blog 2012/02/02
Pediatric fever (3 mo- 3 yrs old) PDF Infectious disease Pediatrics Blog 2012/02/09
Pediatric fever (neonate) PDF Infectious disease Pediatrics Blog 2012/01/27
Pediatric head trauma (PECARN) PDF Surgery, trauma Pediatrics Blog 2010/02/04
Pediatric ingestion dose thresholds for ED referral PDF Toxicology, pharmacology Pediatrics Blog 2014/07/09
Pediatric pertussis algorithm PDF Pulmonary, critical care Pediatrics Blog 2010/10/29
Pediatric sizes and doses PDF Pediatrics Blog 2010/10/23
Pericarditis PDF Cardiovascular Blog 2015/02/05
Pertussis PDF Pulmonary, critical care Bayes Blog 2010/09/03
PESI score for pulmonary embolism PDF Pulmonary, critical care Blog 2012/11/17
Pneumonia scores PDF Pulmonary, critical care Blog 2011/02/25
Post-exposure prophylaxis, non-occup PDF Infectious disease Blog 2011/04/01
Procedural sedation PDF Toxicology, pharmacology Blog 2010/08/06
Rapid sequence intubation PDF Toxicology, pharmacology Blog 2010/07/16
Rashes, approach to PDF Dermatology Blog 2011/08/26
Red eye PDF Ophthalmology Blog 2010/01/22
Salicylate toxicity PDF Toxicology, pharmacology Blog 2015/06/15
Scaphoid fracture PDF Orthopedics Blog 2016/02/01
Seizure, first time PDF Neurology Blog 2011/01/13
Seizure, status epilepticus PDF Neurology Blog 2011/01/20
Septic arthritis PDF Orthopedics Bayes Blog 2010/06/11
Serotonin syndrome PDF Toxicology, pharmacology Blog 2012/01/06
Sgarbossa criteria for LBBB PDF Cardiovascular Bayes Blog 2010/11/05
Shift feedback card PDF Education Blog 2011/12/09
Shock and RUSH protocol PDF Cardiovascular Blog 2009/12/22
Shock, vasopressors and inotropes PDF Cardiovascular Blog 2010/04/30
Shoulder exam PDF Orthopedics Blog 2011/01/28
Spinal epidural abscess PDF Neurology Blog 2011/08/05
Streptococcal pharyngitis PDF ENT Blog 2010/07/30
Stroke scale NIH PDF Neurology Blog 2010/02/26
Stroke: Contraindications for Thrombolytics PDF Neurology Blog 2013/05/23
Subarachnoid hemorrhage, atraumatic PDF Neurology Blog 2010/03/05
Subarachnoid hemorrhage, high risk PDF Neurology Blog 2010/12/17
Suicide risk stratification PDF Psychiatry Blog 2011/02/18
Supraventricular Tachycardia (SVT) Aberrancy vs Ventricular Tachycardia (VT): Brugada Criteria PDF Cardiovascular Blog 2013/02/27
Suture materials PDF Surgery, trauma Blog 2011/01/07
Tachycardia, approach to PDF Cardiovascular Blog 2011/08/19
TIMI score PDF Cardiovascular Blog 2010/08/27
Toxidromes and vital signs PDF Toxicology, pharmacology Blog 2010/11/19
Transient ischemic attack (TIA) PDF Neurology Blog 2010/01/05
Ultrasound: 1st Trimester Pregnancy (Transabdominal) PDF Gynceology, obstetrics Blog 2015/02/25
Ultrasound: 1st Trimester Pregnancy (Transvaginal) PDF Gynceology, obstetrics Blog 2015/03/04
Ultrasound: Abdominal Aorta PDF Radiology Blog 2014/09/13
Ultrasound: Biliary Exam PDF Gastroenterology Blog 2015/01/01
Ultrasound: Deep Vein Thrombosis (DVT) PDF Cardiovascular Blog 2015/02/18
Ultrasound: FAST PDF Radiology Blog 2014/09/14
Ultrasound: Focused Echocardiography PDF Cardiovascular Blog 2015/02/11
Ultrasound: Lung Exam PDF Pulmonary, critical care Blog 2015/02/04
Ultrasound Measurements: Normal Values PDF Radiology Ultrasound Blog 2015/10/15
Ultrasound: Ocular Exam PDF Ophthalmology Blog 2015/01/28
Ultrasound: Skin and Soft Tissue PDF Dermatology Blog 2015/01/07
Ultrasound: Testicular Exam PDF Genitourinary Blog 2015/01/21
Upper GI bleed PDF Gastroenterology Bayes Blog 2011/06/17
Urine toxicology PDF Toxicology, pharmacology Diagnostic Blog 2010/07/22
UTI, cystitis PDF Genitourinary Blog 2010/02/11
VBG versus ABG PDF Pulmonary, critical care Blog 2013/01/31
Ventilator settings: Lung protection PDF Pulmonary, critical care Blog 2011/10/14
Ventilator settings: Obstructive disease PDF Pulmonary, critical care Blog 2011/10/21




PV Card: Algorithm for acute bronchiolitis management

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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2019-01-28T21:38:43-07:00

PV Card: Introduction to ED Charting and Coding

ED charting and coding computer-charting-TEXT-canstockphoto17902161What makes a good chart? How do you write a good chart quickly? How about a good, efficient, billable chart? On average, residents and practicing physicians report they did not receive adequate training in charting and coding1–3 and resident charts are more often down-coded due to documentation failures than those of attendings and PAs.4 Thankfully, resident education in charting has improved over the past 15 years,5 and a little learning goes a long way to improve confidence6 and competence.7

In the spirit of #FOAMed, we would like to provide some pearls and pitfalls for EM documentation, starting with a PV card that addresses the basic elements of coding a chart. We hope it’s a handy on-shift reference.

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PV Card: Ankle and Hindfoot Fractures | Quick Reference Guide

Ankle and Hindfoot Fractures Talar Neck Hawkins Classification IVOrthopedic fractures and injuries are commonly managed in the emergency department. Often a quick bedside reference card is needed to remind the clinician about the acute management and follow-up instructions. Thanks to the efforts of a 2015-16 ALiEM Chief Resident Incubator team, we are pleased to announce the first of these reference cards. Ankle and hindfoot fractures covered include ankle malleolar fractures, talus, and calcaneus fractures. These cards were expert reviewed by Dr. Scott Sherman, co-editor of the Emergency Orthopedics textbook and illustrations were created by Dr. Mary Haas.

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PV Card: Adult scaphoid fracture

snuffbox tendernessWhat is the most commonly fractured carpal bone in adults? It’s the scaphoid bone. As a bonus it has the dreaded complication of avascular necrosis. So how good are the physical exam and imaging modalities in diagnosing a fracture? What is the likelihood ratio (LR) that snuffbox tenderness predicts a fracture? Bottom lines: The exam is highly sensitive but poorly specific, such that one can only confidently state that a NON-tender snuffbox and scaphoid tubercle essentially rule out an acute scaphoid fracture. Also negative x-rays for patients with scaphoid tenderness still yield a fracture post-test probability of 25%. This PV card breaks down all the LRs.1

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2017-08-03T00:34:20-07:00

PV Card: Initial Pain Medication Options in the Emergency Department

backpain_pc_400_clr_2144The emergency department (ED) manages acute pain on a daily basis, ranging from non-traumatic back pain to traumatic fractures. Some providers jump immediately to opioids without considering other non-opioid alternatives or start at incorrect doses. In the age of the opioid epidemic (ALiEM-Annals of EM journal club; bookclub discussing Dreamland) and medication errors, choosing the initial right agent(s) and dose(s) are important. Dr. Nick Koch and Dr. Sergey Motov (@PainFreeED) from Maimonides Medical Center present a thoughtful, evidence-based PV reference card on selecting and dosing initial pain medications for ED patients. Also congratulations to Dr. Motov and his team for their recent 2015 Annals of EM publication1 on subdissociative dose ketamine for analgesia.

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2019-01-28T21:42:50-07:00

PV Card: Continuous End Tidal CO2 Monitoring in Cardiac Arrest

capnographyFor many years, end tidal CO2 monitoring initially was helpful in differentiating tracheal versus esophageal intubations. Now with continuous end tidal capnography, providers have access to so much more information during a cardiac arrest resuscitation, as summarized by the recently released 2015 American Heart Association (AHA) recommendations.1 Thanks to Dr. Abdullah Bakhsh from Emory University for a great PV card to help remind us of these key cardiac resuscitation pearls.

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2019-01-28T21:43:05-07:00

PV Card: Normal Values for Ultrasound Measurements

Ultrasound-PV-Card-smAs emergency medicine providers become more proficient in using bedside ultrasonography as a diagnostic tool, it can be difficult to remember all of the normal cutoff values. Is it 3 or 5 mm as the cutoff? Thanks to the team at UCSF (Dr. Maria Beylin, Dr. Scott Fischette, and Dr. Nate Teismann) for creating a succinct PV card listing the key numbers to remember. You can download this PV card into your mobile device as a reference guide, or you can even print and attach to each of your ultrasound machines!

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2019-01-28T21:43:45-07:00