AIR Series: Peripheral Vascular Disease Module 2014

Welcome to the fourth ALiEM Approved Instructional Resources (AIR) Module! In an effort to reward our residents for the reading and learning they are already doing online, we have created an Individual Interactive Instruction (III) opportunity utilizing FOAM resources for U.S. Emergency Medicine residents. For each module, the AIR board curates and scores a list of blogs and podcasts. A quiz is available to complete after each module to obtain residency conference credit. Once completed, your name and institution will be logged into our private database, which participating residency program directors can access to provide proof of completion.

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PV Card: Focused Abdominal Aorta Ultrasound

UltrasoundIn this next ultrasound installment in the PV Card series, Drs. Victoria Koskenoja, Heidi Kimberly, and Mike Stone succinctly summarize the focused abdominal aorta ultrasound to assess for an abdominal aortic aneurysm (AAA). These can serve as key reference cards when you do your next AAA scan. Don’t miss the last card with tips on optimizing the view and common pitfalls.

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By |2017-08-03T00:21:42-07:00Sep 13, 2014|ALiEM Cards, Cardiovascular|

Beta Blockers vs Calcium Channel Blockers for Atrial Fibrillation Rate Control: Thinking Beyond the ED

AFibIntravenous beta blockers and non-dihydropyridine calcium channel blockers are recommended first-line for atrial fibrillation (AF) with rapid ventricular rate (RVR) [1]. In a previous post, Bryan Hayes (@PharmERToxGuy) provided an overview of the data comparing beta blockers to calcium channel blockers for atrial fibrillation rate control in the ED. Here is part 2 of our two-part AF series. (more…)

By |2016-11-16T09:41:30-08:00Sep 8, 2014|Cardiovascular, Tox & Medications|

Diagnose on Sight: Swollen Upper Extremity in a Patient with End Stage Renal Disease

AV fistula pseudoaneurysmCase: A 45 year old female with end-stage renal disease presents with 2 days of worsening pain, swelling, and color change of her left upper extremity.  The symptoms began after her left arm arteriovenous (AV) fistula was accessed for hemodialysis. The skin is tense and a bruit is present. What is your diagnosis for this swollen upper extremity? Click on the image for a larger view.

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By |2016-12-22T20:07:29-08:00Sep 2, 2014|Cardiovascular, Diagnose on Sight, Ultrasound|

ADJUST-PE Study: ALiEM-Annals of EM Journal Club

ALiEM-AnnalsEM-SquareWe are very excited this month to bring you our fourth ALiEM-Annals of EM Global Journal Club on the use of age-adjusted D-dimer levels to help exclude the diagnosis of pulmonary embolism (PE). We hope you will participate in an online discussion of the four posted questions below from now until August 29th. Respond by commenting below or tweeting (#ALiEMJC). Mark your calendars: On Thursday, August 28th at 16:30 CST (17:30 EST), we will be hosting a 30-minute live Google Hangout with Drs. Jeff Kline and Jonathan Kirschner, the authors of the Annals of Emergency Medicine Journal Club for the ADJUST-PE Trial, that is informed by the discussion. Later this year, a summary of this journal club will hopefully be published in Annals of EM.

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By |2017-03-05T14:18:40-08:00Aug 25, 2014|Cardiovascular, Journal Club, Pulmonary|

Atrial Fibrillation Rate Control in the ED: Calcium Channel Blockers or Beta Blockers?

Screen Shot 2014-05-27 at 2.26.48 AMRate control with IV medications is recommended for atrial fibrillation in the acute setting in patients without preexcitation. This was a Class 1 recommendation (Level of Evidence B) per the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation [1]. What does the evidence say? Are calcium channel blockers or beta blockers better?

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Deep Vein Thrombosis (DVT): Wells criteria and D-dimers happy together

DVTYou are evaluating a 45-year-old male who is complaining of calf pain. He has a history of cancer however he has never had a clot in the past.   The leg is neither swollen nor warm but he notes a cramping sensation in the posterior portion of his calf.  You are concerned for a deep vein thrombosis (DVT) and consider the multiple means to reliable exclude the diagnosis: Wells score, D-dimers, ultrasound? What works?

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By |2016-11-11T19:46:08-08:00Apr 24, 2014|Cardiovascular|