Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this peer-reviewed case series, we focus on real clinical cases where bedside ultrasound changed management or aided in diagnoses. In this case, a 38-year-old pregnant woman presents with acute right-sided abdominal pain radiating to her flank.
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Our virtual school doors are open starting today to ALiEM University (ALiEMU), which can best be thought of as our open-access, on-demand, online school of e-courses for anyone practicing Emergency Medicine worldwide. This ambitious venture was made possible by a tremendous team, but primarily led by Chris Gaafary, MD (@CGaafary), ALiEMU’s Chief of Design and Development and an EM chief resident in his free time at the University of Tennessee. Today we are incredibly excited to launch our inaugural longitudinal e-course the ALiEM Capsules Series: A Practical Pharmacology for the EM Practitioner, created and led by Bryan Hayes, PharmD, FAACT (@PharmERToxGuy).
A 26-year-old woman presented to an urban Detroit emergency department complaining of bilateral foot pain after walking outside in the snow for 30 minutes without shoes or socks. She was unable to ambulate secondary to the pain and swelling. Physical examination revealed bilateral pallor, doughy texture, and coolness to the touch. There was generalized tenderness to palpation throughout the digits. The overlying skin was edematous, although without signs of breakdown.
Distal radius fractures are among the most commonly encountered fractures in the emergency department (ED). They have been reported to account for around 25% of pediatric fractures and up to 18% of fractures in the elderly.1 Reducing minimally displaced distal radius fractures is a procedure that can be greatly facilitated by the presence of finger traps, which help hold traction while you reduce the fracture.2 Often While working in small 5-bed, free-standing emergency department (ED), I found myself needing to perform this vital procedure and finger traps were unavailable.
Severe sepsis and septic shock affect millions of patients worldwide and have high rates of morbidity and mortality as well as high resource utilization. The way we manage sepsis has changed quite a bit since the Rivers et al randomized controlled trial of early goal-directed therapy (EGDT) 1 , which had an absolute decrease in mortality from 46% with “usual care” to 31% with EGDT. What we now know is that a proactive approach to septic patients will result in lower mortality rates and better outcomes (i.e. early identification, early intravenous fluids, and early antibiotics). Patients with sepsis are still missed despite the fact that we understand the benefits to morbidity and mortality with early recognition. In this blast from the past study from 2007, Howell et al 2 answered the important question of does elevated lactic acid simply reflect a patient’s hemodynamic status or can it independently predict 28 day in-hospital mortality after controlling for other potential confounders in patients with sepsis. (more…)
We are excited and proud to introduce a new series as part of the recently announced ALiEMU: Capsules: Practical Pharmacology for the EM Practitioner.
The Capsules series’ primary focus is bringing Emergency Medicine pharmacology education to the bedside. Our expert team distills complex pharmacology principles into easy-to-apply concepts. It’s our version of what-you-need-to-know as an EM practitioner. We hope you enjoy it.
We found an enormous amount of posts on respiratory topics and thus have divided the content into two modules. This first module will focus on general respiratory issues with airway and pulmonary embolism covered in the second module. Below we have listed our selection of the 15 highest quality blog posts within the past 12 months (current as of April 2015) related to respiratory, curated and approved for residency training by the AIR Series Board. In this module we have 4 AIRs and 11 Honorable Mentions. We strive for comprehensiveness by selecting from a broad spectrum of blogs from the top 50 listing per the Social Media Index.