Skip to content
25 09, 2014

High risk back pain: Spinal Epidural Abscess

2016-11-12T09:28:24+00:00

epidural-abscess-282x300-modifiedSpinal epidural abscess (SEA) is a rare but potentially catastrophic cause of back pain. Classically these patients are described as having back pain, fever, and clear neurologic deficits. In reality, patients often present with less obvious symptoms which often leads to a delay in diagnosis. Missed cases of SEA are a source of significant risk to both the patient and the provider. To improve outcomes and minimize risk, providers must identify and promptly evaluate patients who are at increased risk of developing a SEA.

(more…)

16 07, 2014

AIR Series: Infectious Disease, Hematology, Oncology 2014

Welcome to the first ALiEM Approved Instructional Resources (AIR) Module! In an effort to reward our readers for the reading and learning they are already doing online, we have created an Individual Interactive Instruction (III) opportunity utilizing FOAM resources for US Emergency Medicine residents. For each module, the 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 Google Drive database, which participating residency program directors can access to provide access.

(more…)

14 04, 2014

Neuraminidase Inhibitors for Influenza – The Truth, The Whole Truth, and Nothing But the Truth Finally

2016-11-11T19:20:05+00:00

InfluenzaOver the last 5 years, the use of neuraminidase inhibitors for the treatment of influenza has skyrocketed. Emergency physicians have been pushed to prescribe these medications under the belief that they reduced symptoms, the risk of complications, hospitalizations, and transmission. However, the recommendation for the use of these drugs has never sat on firm evidence-based ground. So what did we know then, and what do we know now?

(more…)

1 04, 2014

Cellulitis: Do Not Get Blood Cultures

BloodCultureBottleYou are treating a patient with left lower leg cellulitis. The nurse is going to establish IV access, draw blood work, and give analgesia and antibiotics. Before walking into the room, the nurse asks, “Do you need me to grab a set of blood cultures?” Additionally the hospitalist had asked you to order a “set of cultures” on your most recent cellulitis admission. Should you proceed?

(more…)

18 03, 2014

ProCESS Study: Identify sepsis early and treat aggressively

2016-11-11T19:19:47+00:00

sepsismanagementchartToday, the New England Journal of Medicine just released a landmark paper by the ProCESS (Protocolized Care for Early Septic Shock) trial investigators. There has already been much buzz about this on various blogs and websites, including St. Emlyn’s, MedPageToday, and MDAware. I received an email from my colleague Dr. Michael Callaham, who shared some direct comments and pearls from Dr. Donald Yealy, (professor and chair of emergency medicine from the University of Pittsburgh Medical Center) who was the first author of this writing team. Thank you to Dr. Yealy for allowing me to share your team’s comments with the ALiEM readership.

(more…)

10 03, 2014

Trick of the Trade: Fist Bump to Reduce Pathogen Transmission

2016-11-11T19:19:34+00:00

Fist BumpHandshaking has been practiced as far back as the 5th century BC and used today as a common way of greeting others. In the hospital setting this occurs multiple times throughout the day. Many alternatives to the handshake have been developed and utilized, but they have failed to replace the handshake as a form of greeting. Nosocomial infections have been identified as a major preventable complication of inpatient care and one of the most important initiatives to reduce this is hand hygiene. The authors of this study propose the fist bump as a safe and effective way to avoid hand-to-hand contact and therefore reduce transmission of infection. 1 (more…)