2018 ACEP Clinical Policy for Patients with Suspected Non-ST Elevation ACS

A patient presents to your ED with an all too common complaint – chest pain. After a focused history and physical exam, you have an extremely low clinical suspicion for thoracic aortic dissection, pulmonary embolism, pneumonia, pneumothorax, pericarditis/myocarditis, and Boerhaave’s syndrome. When the labs (including a troponin), an ECG, and chest x-ray yield normal results, questions often arise. Can you discharge her with a single troponin if she is low risk? How do you define low risk? And lastly, does she need urgent provocative testing after discharge?

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By Andrew Grock, MD|2026-06-16T16:13:56-07:00Dec 17, 2018|Cardiovascular, Guideline Review|

Ultrasound For The Win! – 57F with Chest Pain and Dyspnea #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where point-of-care ultrasound changed the management of a patient’s care or aided in the diagnosis. In this case, a 57-year-old woman presents with chest pain and dyspnea.

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By John MacIsaac, BSc. Hons, MD Candidate (2019)|2018-08-26T19:17:12-07:00Aug 27, 2018|Cardiovascular, ECG, Ultrasound, Ultrasound for the Win|

ALiEMU AIR Peripheral Vascular Disease Module

Welcome to the Peripheral Vascular Disease (PVD) 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 PVD emergencies. 2 blog posts within the past 12 months (as of May 2018) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 0 AIR and 2 Honorable Mentions. We recommend programs give 1 hour (about 30 minutes per article) of III credit for this module.

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By Chris Belcher, MD|2020-09-04T10:58:02-07:00Jul 30, 2018|ALiEMU, Approved Instructional Resources (AIR series), Cardiovascular|

Can’t Miss ECG Findings for the Emergency Medicine Provider

Sudden cardiac death accounts for almost 400,000 deaths per year in the United States, and EM providers must be adept at discerning subtle, high-risk ECG findings. With the advent of triage ECG protocols, one of the most common interruptions in the ED is a request to “sign off” on an ECG. We present a reference of some of the most important high-risk ECG findings, intended to help ED providers systematically screen patients in triage and the waiting room.
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By Christian Rose, MD|2026-06-16T16:13:15-07:00Jul 11, 2018|ECG|

Chest Pain and Making the Most of Observation: ACEP-EQUAL Network Podcast

Emergency Medicine has made significant contributions to the proliferation of Observation Medicine, an attractive alternative to admission for patients with low- and moderate-risk chest pain. Selecting the right patient, identifying appropriate interventions, and documenting appropriately are just some of the challenges discussed in the latest ACEP E-QUAL Network podcast, a partnership with ALiEM to promote clinical practice improvements. We review highlights from a podcast with experts Dr. Anwar Osborne (Emory University) and Dr. Michael Granovsky (LogixHealth).

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By Derek Monette, MD|2026-06-16T16:12:26-07:00Dec 11, 2017|Cardiovascular, Podcasts|

Team-Focused CPR: Bringing Pre-hospital Success to the ED

High-quality chest compressions and early defibrillation are the cornerstones of effective cardiac arrest care.¹ When implemented correctly these two interventions enhance patient outcomes and improve overall survival.² However, despite simplified advanced cardiac life support (ACLS) algorithms and extensive training of providers, cardiac arrest scenarios in the emergency department (ED) are still high-stress and mortality rates remain high.^3,4

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By Blake Johnson, MD|2017-09-07T21:23:14-07:00Aug 13, 2017|Cardiovascular, Critical Care/ Resus, Expert Peer Reviewed (Clinical)|

ALiEM’s Greatest Hits for Interns: A Curated Collection of High-Yield Topics

Congratulations, you’ve made it! On July 1, thousands of medical students across the country made the transition to becoming Emergency Medicine residents. It was a particularly competitive year for Emergency Medicine, with 99.7% of first-year spots filled despite a whopping 2,047 positions being offered in 2017 (up by 152 spots compared to last year).¹ Now begins the most crucial 3 or 4 years of your medical training that will prepare you for the rest of your career in Emergency Medicine.

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By Jeffrey Shih, MD, RDMS|2026-06-16T16:11:58-07:00Jul 21, 2017|Cardiovascular, Critical Care/ Resus, Gastrointestinal, Medical Education, Neurology, Ophthalmology, Pediatrics, Tox & Medications, Ultrasound for the Win|