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30 08, 2018

ACMT Toxicology Visual Pearls: Toxic Mouth Pain

2018-08-28T12:41:01+00:00

betel nut mouthA middle-aged Asian female presents to the emergency department complaining of 2-3 days of mouth pain. She has chewed betel nut for a number of years. Which of the following is true regarding her presentation and management?

  1. Debridement should be avoided.
  2. Metronidazole is contraindicated due to the potential of a disulfiram-like reaction.
  3. Oral secretagogues should be used due to the anticholinergic effects.
  4. The patient is at increased risk of oral cancer.

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26 05, 2018

ALiEMCards: Tranexamic Acid

2018-05-26T21:29:25+00:00

Tranexamic acid (TXA) is a synthetic form of the amino acid lysine that binds to receptors on plasmin and prevents it from breaking down fibrin clots. Numerous studies have investigated its utility in preventing or treating traumatic hemorrhage, and the World Health Organization now includes TXA on its list of Essential Medicines. In addition to trauma, TXA may be effective in other clinical scenarios relevant to Emergency Medicine, including gynecological hemorrhage and epistaxis. ALiEM Cards: TXA, written by Dr. Sam Ashoo, reviews the dosing and potential indications for TXA use in the ED.

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12 04, 2018

ALiEM AIR Series: Ear, Nose, and Throat (ENT) Module

2018-04-13T10:04:19+00:00

air series traumaWelcome to the Ear, Nose, and Throat (ENT) 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 ENT emergencies. 8 blog posts within the past 12 months (as of December 2017) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 1 AIR and Honorable Mentions. We recommend programs give 3 hours (about 20 minutes per article) of III credit for this module.
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22 01, 2018

PEM Pearls: Regional Facial Nerve Blocks

2018-01-21T21:11:01+00:00

facial nerve blocksRegional nerve blocks of the face and ear can be a wonderful choice of analgesia in a child, particularly for wounds that need to be repaired. The benefits include fewer local injections, improved cosmesis due to less wound margin distortion, and improved analgesia within the nerve region.1,2 The following blog post and brief video tutorial review the key elements of this technique.

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8 05, 2017

PEM Pearls: Search & Rescue of Ear Foreign Bodies – Picking the Right Tool

2017-10-26T14:32:51+00:00

baby otoscope ear foreign bodiesWhile ear foreign bodies can happen at any age, the majority occur in children less than 7 years of age.1 The younger the patient, the less likely they are cooperative with the exam and, therefore, the less chance of successful foreign body removal. The first attempt at removal is the best, so it is important to make it count. Similarly, different types of foreign bodies call for different “tools” for removal. It is important to understand when to attempt removal in the emergency department (ED) and what tools are available. This blog post will help you optimize your first pass success at foreign body removal by understanding what tools are at your disposal.

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15 02, 2017

Epistaxis Management in the Emergency Department: A Helpful Mnemonic

2017-02-08T03:22:05+00:00

epistaxisEpistaxis is a common presentation to the emergency department (ED)1 that can be challenging and time consuming. Knowledge of the pearls, pitfalls, and troubleshooting tips around managing nosebleeds often can be the difference between a frustrating versus straightforward ED stay for patients. Use the EPISTAXIS mnemonic to help you remember these points.

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29 12, 2016

Trick of the Trade: A cleaner way to apply dental cement for a tooth fracture

2017-01-09T10:15:20+00:00

dental cement for tooth fracture The management of a dental fracture is a core skill of the emergency physician.1 When the enamel is violated and the underlying dentin is exposed (i.e. Ellis Class II or greater), the dental pulp becomes at risk.2 Protecting the exposed dentin in a timely manner, therefore, is paramount. This is best accomplished through the use of dental cements.

The application of dental cement to a fractured tooth, while a relatively rare procedure, is one often fraught with difficulties. With many of the formulations requiring the rapid application of a fast-drying cement, time for accurate and clean application is limited. This often clumsy, haphazard spackling of the patient’s tooth with cement rarely feels smooth or confidence-instilling. Isn’t there a better way?
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