Child Whisperer Series: Just Breathe

Just breathe….

Early in my career as a Child Life Specialist, I was working with a 4 year old girl who needed her port catheter accessed. She was beginning to panic with rapid breathing and moving around. She was clearly on the verge of screaming at any moment. Her panic made everyone in the room feel anxious. I knew I had to do something, so I got on one knee, looked her in the eye and said, “Just breathe.” Without missing a beat, she leaned in closer to me and said, “I am!”… Touché my little friend.

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By Kristen Beckler, CTRS, CCLS|2017-03-05T14:18:37-08:00Nov 6, 2013|Pediatrics, Tricks of the Trade|

Discussing Annals EM article: Social Media and Physician Learning

I was delighted to see the News and Perspectives piece in this month’s Annals of Emergency Medicine about “Social Media and Physician Learning” (free PDF). I had totally forgotten that Jan Greene, the author, had called to talk with me several months ago. In the piece, she discusses many of the issues with which I struggle:

Is peer review good or bad?
What is the role of blog and podcast sites in the future of medical education?
With the ease of how anyone can be “published” on blogs, how can one decide on the trustworthiness of open educational resources such as FOAM?
Can or should social media education practices be held up to the rigorous scientific standards of original research?

Here are some noteworthy quotes:

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By Michelle Lin, MD|2019-01-28T21:52:47-08:00Nov 5, 2013|Expert Peer Reviewed (Clinical), Medical Education, Social Media & Tech|

5 Tips in Managing Acute Salicylate Poisoning

Salicylate is among the top 25 substances that cause the greatest number of overdose fatalities in the United States. ¹ Patients can present with a wide variety of complaints including tinnitus, dyspnea, vomiting, confusion, and coma. Significant toxicity occurs when a large amount of salicylate saturates the body’s protein-binding capacity and leaves free salicylate in the serum. ² The American College of Medical Toxicology (ACMT) recently published a guidance document on management priorities in salicylate toxicity, and it’s definitely worth a read. ³ While not an official clinical guideline, it highlights some important concepts to consider when working up and treating patients after a significant salicylate exposure, and we’ll review five major concepts here and hopefully answer some questions that may cross your mind on shift.

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By Kristin Fontes, MD|2026-06-16T16:04:20-07:00Nov 4, 2013|Expert Peer Reviewed (Clinical), Tox & Medications|

Patwari Academy videos: Testicular torsion and acute scrotal pain

There are several causes for the acutely painful scrotum. In the follow two short tutorial videos, Dr. Rahul Patwari reviews common causes, which include testicular torsion, epididymitis, orchitis, torsion of the testicular appendix, and testicular masses.

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By Michelle Lin, MD|2019-01-28T21:53:01-08:00Nov 3, 2013|Genitourinary, Patwari Videos|

Putting an Older Patient Under: Tips for Geriatric Procedural Sedation

An 84-year old woman presents to your ED with a traumatic, left-sided posterior hip dislocation. You need to reduce the hip. But how should you sedate her? Procedural sedation is an important component of ED care. It allows us to more comfortably perform otherwise painful procedures such as fracture or dislocation reductions, endoscopies, large laceration repairs, and I&Ds. How safe is procedural sedation in older adults?

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By Christina Shenvi, MD, PhD, MBA|2017-03-05T14:18:37-08:00Oct 31, 2013|Expert Peer Reviewed (Clinical), Geriatrics, Tox & Medications|

Introducing REBEL in EM and IM

As a physician and newcomer to FOAM, I am finding that I have learned a lot of myths and pearls that are not true as I matriculated through school. This has taught me that learning from textbooks may be great for board exams, but more importantly it is not optimal for patient care and has made me question a lot of different practices. We all want to know clinically relevant information that is evidence based and up to date that will make a difference in our care of patients. The purpose and goal of REBEL is to create a sustained change in beliefs, attitudes, and behavior through review of the best evidence available.

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By Salim Rezaie, MD|2019-09-10T13:33:39-07:00Oct 30, 2013|Cardiovascular, ECG|

Epinephrine Dosing for Anaphylaxis in Patients on Beta-Blockers

I love when complex medication questions come across my desk from folks like Drs. Amal Mattu, Rob Orman, Mike Winters, and Haney Mallemat (just to name a few). This week I received one from Dr. Scott Weingart that someone had sent to him. This paramedic was reviewing his anaphylaxis protocol with some new medics and providers. They asked a challenging question regarding a “pearl” they learned in which half-dose epinephrine should be administered in anaphylactic patients on beta-blockers. Patients on beta-blockers do have an increased risk for anaphylaxis, so there is a chance you’ll see a case just like this at some point.

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By Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP|2016-11-16T09:38:02-08:00Oct 29, 2013|Tox & Medications|