60-Second Soapbox: New podcast series featuring Drs. Lin, Riddell, Shaikh

We are excited to announce our new podcast series, 60-Second Soapbox! Each episode, one lucky individual gets exactly 1 whole minute to present their rant-of-choice to the world. Any topic is on the table – clinical, academic, economic, or whatever else may interest an EM-centric audience. Don’t worry if your are microphone-shy. We will carefully remix your audio to add an extra splash of drama and excitement. Even more exciting, participants get to challenge 3 of their peers to stand on a soapbox of their own!

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By Sam Shaikh, DO|2020-04-20T19:40:02-07:00Jul 29, 2015|60-Second Soapbox, Genitourinary, Infectious Disease, Medical Education, Podcasts, Trauma|

AIR Series: Respiratory Part 2 (2015)

We found an enormous amount of respiratory content and thus have divided the respiratory module into two modules. While the first module focused on general respiratory issues, this second module is focused on airway and pulmonary embolism. Below we have listed our selection of the 15 highest quality blog posts within the past 12 months (current as of March 2015) related to respiratory, curated and approved for residency training by the AIR Series Board. In this module we have 4 AIRs and 11 Honorable Mentions. We strive for comprehensiveness by selecting from a broad spectrum of blogs from the top 50 listing per the Social Media Index.

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By Andrew Grock, MD|2017-03-05T14:18:42-08:00Jul 28, 2015|Approved Instructional Resources (AIR series), Pulmonary|

Assessing and Managing Delirium in Older Adults

Every day in the Emergency Department we see older adults with dementia who have developed delirium and are brought in because of worsening agitation, combativeness, or confusion. In order to care for them, we have to consider what the underlying cause of their agitation may be, but we also have to protect the patient and staff in case of violent outbursts. Older adults experience a phenomenon termed ‘homeostenosis’ in which their physiologic reserve and the degree to which they can compensate for stressors is narrowed, putting them at risk for delirium. This post will outline ways to prevent and de-escalate agitation in a patient with delirium, and how to treat it pharmacologically in a cautious manner to minimize side effects.

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By Christina Shenvi, MD, PhD, MBA|2024-04-25T11:36:22-07:00Jul 27, 2015|Geriatrics, Neurology|

Poll : How do you use the PV cards?

In our effort to take the Paucis verbis (PV) card series to the next level, we are interested in knowing how YOU use the cards. We would appreciate your answers to the following 4 questions. Also if you have any comments/suggestions regarding the PV cards and how we can make them better please, use the Comments section.

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By Catherine Patocka, MD MHPE|2017-03-05T14:14:37-08:00Jul 24, 2015|ALiEM Cards|

EMS Fellowship: 10 Questions I Wish Applicants Would Ask the Fellowship Director

Well, it is EMS fellowship interview season again, and every year after the lovely encounter with very well qualified candidates, I am left wondering if they have achieved a good return on their investment of time and money coming to visit us. Did they really get a good idea of the important aspects of our program, or will they just have to make an educated guess about whether they would be happy spending a year or more with us?

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By John Brown, MD|2016-11-11T19:39:27-08:00Jul 23, 2015|EMS, Medical Education|

Considering a Medical Toxicology Fellowship?

Every year, EM residents ponder whether to do a fellowship. In the ALiEM Chief Resident Incubator, a handful are very interested in a medical toxicology fellowship, but I woefully am unqualified to provide any advice. So in a “phone a friend” moment, I boldly sent out an email requesting advice and insights. I received two amazing replies from Dr. Lewis Nelson (NYU) from a fellowship director’s perspective and Dr. Annie Arens (UCSF) from a fellow’s perspective.

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By Lewis Nelson, MD|2016-11-11T19:37:19-08:00Jul 23, 2015|Medical Education, Tox & Medications|

Trick of the Trade: Squeeze test for confirmation of IO placement

Venipuncture is the most common invasive procedure performed in the emergency department ¹ , likely due to the fact that the vast majority of our laboratory evaluations require blood and many of our life saving interventions require access to the patient’s systemic circulation. Most of the time emergency department staff are able to perform this procedure easily, but occasionally you find that your patient is the dreaded “difficult stick”. Literature suggests that the landmark technique is successful on the initial venipuncture 74-77% of the time. ^2–5 Success rates rise after multiple attempts, but what happens when you don’t have the luxury of time? What happens when your patient will die if you don’t get life saving medications into their circulation promptly? There are a few options when you can’t get IV access through traditional means, among them external jugular vein cannulation, central line, ultrasound-guided IV, and the intraosseous lines (IO).⁶ However, when managing the crashing patient, a wise decision is to use the quickest option, which is often the IO.

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By Jailyn Avila, MD, RDMS (She/Her)|2020-01-15T23:56:42-08:00Jul 22, 2015|Cardiovascular, Critical Care/ Resus, Tricks of the Trade|

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