This is EMRad, a series aimed at providing “just in time” approaches to commonly ordered radiology studies in the emergency department [1]. When applicable, it will provide pertinent measurements specific to management, and offer a framework for when to get an additional view, if appropriate. We have already covered the elbow, the wrist, and the foot and ankle. Next up: the shoulder.
A child presents with tachypnea, tachycardia, and drooling after ingesting the sweet smelling contents of the pictured household item. What toxin could explain this presentation?
Our organization has always been a champion and fan of the Pediatric Emergency Care Applied Research Network (PECARN) research collaborative. We jointly worked on designing their official Head Injury Decision Tool found printed in various emergency departments around the country, featured several PECARN authors on our ALiEM podcast, and provide summaries of their 147-and-growing list of publications in our P3 app. So it follows that we are incredibly honored and thrilled to announce our Twitter collaboration. We will be helping to run their Twitter account. Join @PECARNteam and keep current on their growing list of publications, their clinical take-home points, and even insights from the authors themselves.
Welcome to the AIR Toxicology 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 toxicology emergencies. 11 blog posts within the past 12 months (as of March 2020) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 1 AIR and 10 Honorable Mentions. We recommend programs give 5.5 hours (about 30 minutes per article) of III credit for this module.
Foreign bodies in the ear or the nose can be extremely challenging to remove, especially considering that a majority of them occur in children less than 7 years old who are likely to be uncooperative with exam [1]. In a previous post, we emphasized the need to pick the best tool for the job in order to minimize complications. What happens when you find yourself in an austere environment and the usual tools are not available?
While HIV medications receive much attention for the treatment of HIV infection, less attention has focused on the prophylaxis indications. In 2017, the Center for Disease Control and Prevention (CDC) updated their guidelines on the indications for the HIV medications tenofovir disoproxil fumarate (TDF) and emtricitabine (2′,3′-dideoxy-5-fluoro-3′-thiacytidine, FTC) for pre-exposure prophylaxis (PrEP). The trade name for the combination medication is Truvada. These daily medications are taken by people at risk for HIV to prevent HIV. This Guideline Review succinctly summarizes the 77-page CDC document into the key pearls for emergency physicians.
Education in emergency response to trauma is a global health priority [1]. Mortality rates are nearly twice as high in patients with trauma in low-income as compared to high-income countries [2]. With uncontrolled bleeding as the number one cause of death from trauma, tourniquet application has been the focus of training programs, like the “Stop the Bleed” campaign in the United States [3]. Although understanding how to apply a tourniquet is a life-saving intervention, use of a windlass tourniquet may not be intuitive [4]. The windlass tourniquet in its simplest form is the “stick-and-rope.” Winding the stick in the tourniquet creates a mechanical advantage for providing compression. Simulation of the windlass technique can be used to teach management of uncontrolled bleeding. Here we describe a low-cost simulation model that combines low- and high-fidelity techniques to train healthcare personnel on windlass tourniquet application.