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SAEM Clinical Image Series: Distended Abdomen after ROSC

distended abdomen

A 64-year-old female presented to the emergency department (ED) in cardiac arrest. Her family members heard her fall in the bathroom and started CPR. EMS intubated the patient and 20 minutes of CPR was done en route. Return of spontaneous circulation (ROSC) was achieved after fifteen minutes of resuscitation in the ED.

At baseline, the patient ambulated with her walker and was conversant. She was having abdominal pain and nausea for the past three days after recently being diagnosed with a urinary tract infection. On arrival to the ED, the patient was pulseless with ventricular fibrillation. The patient received ten doses of epinephrine, two doses of sodium bicarbonate, calcium, amiodarone, magnesium, and one dose of naloxone during the resuscitation. One defibrillatory shock was administered. She was started on a norepinephrine drip and an amiodarone drip.

Computed tomography (CT) of the head was negative. CT of the chest was significant for left pneumothorax and left-sided subcutaneous emphysema. A pigtail chest tube was placed. After a few hours, she developed worsening abdominal distension. An abdominal CT scan revealed the images shown.

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By |2020-09-18T20:43:44-07:00Sep 21, 2020|Critical Care/ Resus, Gastrointestinal, SAEM Clinical Images, Uncategorized|
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IDEA Series: 3D-printed pediatric lumbar puncture trainer

Pediatric lumbar puncture trainers are less available than adult trainers; most are the newborn size and quite expensive. Due to age-based practice patterns for fever diagnostic testing, most pediatric lumbar punctures are performed on young infants, and residents have fewer opportunities to perform lumbar punctures on older children.1 Adult lumbar puncture trainers have been created using a 3D-printed spine and ballistics gel, which allows for ultrasound guidance.2 No previous model has been described for pediatric lumbar puncture.

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By |2024-04-09T14:18:42-07:00Sep 16, 2020|IDEA series, Medical Education, Neurology, Pediatrics, Simulation|
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Announcing ALiEMU SplintER Course: Approach to Splinting

ALiEMU Course Approach to Splinting badge

We are so thrilled to announce that we created an ALiEMU Course on the Approach to Splinting, using one of our most popular series, the SplintER Series, as the learning foundation. We have created a custom quiz assessing the learning objectives. Are you a medical student getting ready for your EM rotation or internship? Or an EM resident needing to brush up on your splinting knowledge? Take this free course for 2 hours of ALiEMU course credit, and receive your “Approach to Splinting” badge.

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By |2020-11-05T18:30:58-08:00Sep 9, 2020|ALiEMU, Orthopedic, SplintER|
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SAEM Clinical Image Series: Atraumatic Proptosis

An 85-year-old female with a past history of hypertension presents with acute right-eye pain, redness, and proptosis/bulging for the past two months that has been worsening over the past two days. She endorses blurry vision that began two days prior. She does not use contacts or glasses. No trauma, headache, or loss of consciousness are reported. She reports a “whooshing” sound in her right ear for two to three months.

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By |2020-09-08T14:58:05-07:00Sep 7, 2020|Emergency Medicine, HEENT, Ophthalmology, SAEM Clinical Images|
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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.

Take the AIR Psychosocial Quiz on ALiEMU

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.

 

By |2020-09-04T11:08:46-07:00Sep 4, 2020|ALiEMU, Approved Instructional Resources (AIR series), Psychiatry|
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