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12 12, 2018

Accidental Hypothermia and Cardiac Arrest: Physiology, Protocol Deviations, and ECMO


accidental hypothermia and cardiac arrestAccidental hypothermia is a life threatening condition that can lead to a challenging resuscitation. The very young, old, and intoxicated patient are at high risk to developing hypothermia, even in temperate climates. The pathophysiologic changes from hypothermia make the standard ACLS approach insufficient to care for the hypothermic patient. This article will discuss the physiology of hypothermia and how you should alter your approach in the hypothermic patient, including early consideration of extracorporeal membrane oxygenation (ECMO).


3 09, 2018

Resuscitation of a Drowning Victim: A Review


Drowning cases peak this time of year and represent a leading cause of mortality in children. For example, drowning represents the leading cause of death in boys ages 5-14 years old, and worldwide, there are 500,000 annual deaths from drowning.1 Hypoxic injury and subsequent respiratory failure represent the primary causes of morbidity and mortality. Although providers are typically taught to be aware of possible trauma (e.g. cervical spine fracture) when evaluating a drowning case, less than 0.5% of drownings are traumatic.2 The duration of immersion, volume of aspirated fluid, and water temperature dictate clinical outcomes.1 We review the presentation, pathophysiology, and management of drowning to raise awareness about this important public health issue.

15 05, 2018

Climate Change and Emergency Medicine: A Specialty on the Frontline


Emergency medicine (EM) is on the frontlines of climate change, which the Lancet Commission declared “the biggest global health threat of the 21st century” with “potentially catastrophic risk to human health.”1,2 Climate change is having broad and profound negative impacts on the health of our patients, especially for the vulnerable populations. It is also affecting our healthcare systems and mandating the creation of climate-resilient emergency departments (ED) with robust disaster preparedness. EM needs to engage climate change advocacy efforts for 2 key reasons. It has a profound impact on our specialty, and it is built into the moral fiber of our practice. As this threat continues to grow, EM is perfectly situated to lead the charge.

26 02, 2018

ALiEM AIR Series: Environmental Module


air series traumaWelcome to the Environmental 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 environmental emergencies. 3 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 0 AIR and 3 Honorable Mentions. We recommend programs give 1 hour (about 20 minutes per article) of III credit for this module.

23 06, 2017

Envenomations: Initial Management of Common U.S. Snakebites


Nothing says “emergency” like a bite from a venomous reptile. If you work in an area populated by snakes, which covers most of the United States and the world, then chances are good that you will see a patient with a snake bite in the Emergency Department (ED). The severity of the symptoms and the treatment vary greatly with different snakes. In this post, we will outline the ED approach to and management of common U.S. snake envenomation.