ALiEM AIR | Psychosocial 2020 Module

Welcome to the AIR Psychosocial 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 psychosocial emergencies. 5 blog posts within the past 12 months (as of July 2020) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 2 AIR and 3 Honorable Mentions. We recommend programs give 3 hours (about 30 minutes per article) of III credit for this module.

AIR Stamp of Approval and Honorable Mentions

In an effort to truly emphasize the highest quality posts, we have 2 subsets of recommended resources. The AIR stamp of approval is awarded only to posts scoring above a strict scoring cut-off of ≥30 points (out of 35 total), based on our scoring instrument. The other subset is for “Honorable Mention” posts. These posts have been flagged by and agreed upon by AIR Board members as worthwhile, accurate, unbiased, and appropriately referenced despite an average score.

Interested in taking the Psychosocial quiz for fun or asynchronous (Individualized Interactive Instruction) credit? Please go to the above link. You will need to create a free, 1-time login account.

Highlighted Quality Posts: Psychosocial Emergencies

SiteArticleAuthorDateLabel
EMCrit: The Tox and the HoundWe have a MOUD DisorderHoward Greller, MD12/23/2019AIR
RebelEMEvolution of Ketamine for Severe AgitationJeff Riddell, MD7/1/2019AIR
EMCrit: The Tox and the HoundBreastfeeding on BuprenorphineChristine Murphy, MD7/5/2019HM
EMCrit: The Tox and the HoundU(ds) and IHoward Greller, MD5/13/2019HM
EMDocsEM Cases: Pediatric Physical Abuse Recognition and ManagementAnton Helman, MD7/12/2019HM

(AIR = Approved Instructional Resource; HM = Honorable Mention)

If you have any questions or comments on the AIR series, or this AIR psychosocial module, please contact us! More in-depth information regarding the Social Media Index.

Thank you to the Society of Academic Emergency Medicine (SAEM) and the Council of EM Residency Directors (CORD) for jointly sponsoring the AIR Series! We are thrilled to partner with both on shaping the future of medical education.

 

SplintER Series: An Easily Missed Shoulder Injury

posterior shoulder dislocation xray

A 30-year-old male presents with right shoulder pain after a motorcycle accident. You obtain shoulder x-rays and see the following images (Image 1: AP, scapular Y, and axillary views of the right shoulder. Author’s own images). What is the most likely diagnosis, typical mechanism of injury, expected physical exam findings, appropriate imaging modalities, and management plan?

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SAEM Clinical Image Series: An Oropharyngeal Mass

oropharyngeal mass

A fifty-year-old male presented to the emergency department (ED) unconscious with CPR in progress. Per EMS report, the patient was found down surrounded by emesis with no pulse or respirations. Fifteen minutes of CPR was performed prior to arrival in the ED with a King Tube in place. The King Tube was filled with emesis and increasingly difficult to bag. The King Tube was removed to attempt intubation and maximize oxygenation and ventilation.

When the Mac 4 blade was placed in the mouth, a large, pink, fleshy, and vascularized structure was seen in the mouth just anterior to where the uvula should have been located.  Attempts were made to compress the mass into the tongue, separate the tongue from the mass, and sweep the mass out of the way. All attempts failed to expose the epiglottis. An attempt was made to remove the mass, but it appeared to be part of the mouth.  The decision was made to proceed with a cricothyrotomy; a 6.0 tube was successfully placed, and the patient was able to be ventilated. Return of spontaneous circulation was never achieved and the patient expired in the ED.

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SplintER Series: A Jammed Finger

boutonniere deformity boutonniere deformity

A 50-year-old male presents to the emergency department with a new inability to extend his 5th digit of the left hand. He states he was playing a game of pick-up basketball last week when he jammed the finger while attempting to catch a pass from a teammate. An AP and lateral radiograph of the digit is obtained (Image 1 courtesy of Dr Alborz Jahangiri, Radiopaedia.org). What is your diagnosis? What causes this injury? What exam maneuver can help diagnose the underlying injury before the deformity is evident? What is the treatment/management of this injury? What are the surgical indications?

 

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Unlocking the MIC-KEY: Understanding and Troubleshooting Low-Profile Gastrostomy Tubes

You are working an overnight clinical shift at your community emergency department when a worried mother brings in her 15-year-old child with cerebral palsy due to their gastric tube “coming out.” As you begin to obtain a history of the patient’s gastric tube (when it was placed, where it was placed, why is it in place, etc.) you realize you will be the one replacing it tonight, and frankly you haven’t done this before. The following post serves as a refresher on the use, placement, and complications of gastrostomy tubes.

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By |2020-08-23T17:00:00-07:00Aug 24, 2020|Emergency Medicine, Gastrointestinal|

SplintER Series: Hip Pain Following an MVC

A 48-year-old female presents to the emergency department after a high-speed motor vehicle collision (MVC). She is complaining of left hip pain. Her radiographs are shown (Image 1 courtesy of Dr Ayaz Hidayatov, Radiopaedia.org, rID: 52760). What is your diagnosis? What is the likely mechanism of injury? What physical exam findings are expected? What is your management in the emergency department and when should you consult orthopedics?

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SAEM Clinical Image Series: The Cocaine Gut

pneumoperitoneum

A sixty-five-year-old male with a medical history of gastroesophageal reflux disease (GERD), hypertension, alcohol dependence, homelessness, and cocaine abuse presents to the emergency department with abdominal pain for three days. The patient describes his abdominal pain as knife-like, 9/10, located diffusely throughout his abdomen, with associated anorexia and nausea. He reports that he had one episode of coffee ground emesis this morning which provoked him to come to the ED. He reports frequent cocaine use with his last use three days ago. He endorses subjective fevers, chills, and no bowel movement for two days. He has had no sick contacts.

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