MEdIC: Case of the Night Shift Stimulants – Expert Review and Curated Community Commentary

Our fifth case of season 5, The Case of the Night Shift Stimulants, presented the scenario of a junior emergency medicine (EM) resident who witnesses her attending physician taking stimulants in order to function during his night shift.

The MEdIC team (Drs. Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, Alkarim Velji, and Brent Thoma), hosted an online discussion around the case over the last 2 weeks with insights from the ALiEM community. We are proud to present to you the curated commentary and our expert opinions. Thank-you to all participants for contributing to the very rich discussions surrounding this case!

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By Tamara McColl, MD FRCPC|2019-03-30T22:21:39-07:00Mar 9, 2018|MEdIC series, Tox & Medications|

SplintER Series: Complications & Discharge Care Plans With Splints 103

In this SplintER Series, we review splinting fundamentals, introduce advanced concepts, and highlight ways to implement these into your next shift. In SplintER 102, we reviewed the materials used in splinting and a general approach to applying a splint. Today’s post puts the spotlight on some of the potential complications of splinting, discharge care plans, and pharmacological adjuncts to aid in recovery.
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By Austin Smith, MD|2020-08-08T15:03:05-07:00Mar 7, 2018|Expert Peer Reviewed (Clinical), Orthopedic, SplintER|

Renal Colic & Pulmonary Embolism CT | Reducing Imaging: ACEP E-QUAL Network Podcast

Computed tomography (CT) is increasingly available across U.S. Emergency Departments and has changed the practice of medicine. However, it is coupled with potential side-effects from radiation and contrast media. Emergency Medicine is beginning to make a concerted effort to identify clinical scenarios in which CT may be unnecessary, producing outcomes research and validated clinical decision rules. Renal colic and pulmonary embolism, in particular, seem amenable to this area of investigation. The ACEP E-QUAL Network podcast, a partnership with ALiEM to promote clinical practice improvements, reviewed this topic with experts Dr. Chris Moore (Emory University) and Dr. Jeffrey Kline (Indiana University). We present highlights from their discussion with Dr. Jason Woods.

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By Derek Monette, MD|2026-06-16T16:12:55-07:00Mar 5, 2018|Genitourinary, Podcasts, Pulmonary, Radiology|

ALiEM AIR Series: Environmental Module

Welcome 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.
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By Andrew Grock, MD|2020-09-04T10:58:45-07:00Feb 26, 2018|ALiEMU, Approved Instructional Resources (AIR series), Environmental|

ACMT Toxicology Visual Pearls: Drug-Induced Rash

Two patients with substance-use disorder present to an ED in the United States with a new rash. Which of the following is the most likely exposure?

Krokodil (desomorphine)
Levamisole-adulterated cocaine
Methamphetamine-induced allergic reaction
Wound botulism secondary to heroin use

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By Jennifer S. Love, MD|2019-11-12T19:06:42-08:00Feb 21, 2018|ACMT Visual Pearls, Tox & Medications|

Intravenous lidocaine for renal colic

Pain management in the ED has become a balancing act. EPs must continually balance adequate pain management with the risks of opioids prescribing. As providers reach into their pain management toolbox it is always nice to have as many options as possible because one size does not fit all. Specifically for the management of acute renal colic, IV preservative-free (cardiac) lidocaine has been gaining popularity as a potential alternative when opioids are unable to get job done or are contraindicated due to co-morbidities or a history of addiction. Is it safe? Does it work?

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By Alexis LaPietra, DO|2026-06-16T16:12:50-07:00Feb 14, 2018|Tox & Medications|

PEM Pearls: Pediatric Ultrasound-Guided Peripheral IV Access

Pediatric patients are not just little adults. Placing peripheral IVs in young patients can be challenging and comes with its own set of challenges. Presented are some basic and advanced tips to maximize success in establishing peripheral IV access in pediatric patients using ultrasonography.
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By William White, MA MD|2018-02-05T21:18:43-08:00Feb 7, 2018|Pediatrics, Ultrasound|