PEM Pearls: Intranasal Medications in the Pediatric ER
Fiona is a 6 year old female who presents to your emergency department after falling onto her left hand while racing on the playground. X-ray of the left upper extremity reveals a distal radius fracture with minimal displacement and angulation. You plan to place her arm in a splint and arrange for close orthopedic follow-up. The only problem: Fiona is in a lot of pain, especially with any manipulation of her arm, and Dad is worried that she will not be able to tolerate having a splint placed. You consider reaching for an intranasal medication to help Fiona feel more comfortable and to place the splint in a quick, efficient manner.
IDEA Series: Toxicology Virtual Escape Room during COVID-19

In order to enhance emergency medicine (EM) residents’ knowledge of toxicology core content, we previously created an immersive escape room experience complete with team-based puzzle solving in a geographical maze to find an antidote. The subsequent COVID-19 pandemic and physical distancing guidelines resulted in canceled in-person EM conferences, thereby requiring a rapid adaptation to virtual formats [1-4]. Our toxicology division sought a novel method of engaging learners with toxicology core content remotely.
ACMT Toxicology Visual Pearls: Caterpillar Envenomation
SplintER: Persistent Left Groin Pain
A 24-year-old male presents with progressively worsening left groin pain for six weeks after he began training for a marathon. He states he had x-rays done by his PCP that were negative four weeks ago and was diagnosed with a groin strain. X-rays were obtained and featured to the right.
IDEA Series: Homemade Escharotomy Kit

Although escharotomy is rarely performed by emergency physicians during the initial management of burns, it is a life and limb-sparing skill important to know as a trainee and provider in emergency medicine [1,2]. There are few models made to accommodate procedural training, and the ones available are often cost-prohibitive. It is critical to have a method for learning and practicing this important procedure [3,4].
EMRad: Radiologic Approach to the Traumatic Knee

Radiology teaching during medical school is variable, ranging from informal teaching to required clerkships [1]. Many of us likely received an approach to a chest x-ray, but approaches to other studies may or may not have not been taught. We can do better! Enter EM:Rad, a series aimed at providing “just in time” approaches to commonly ordered radiology studies in the emergency department. When applicable, it will provide pertinent measurements specific to management, and offer a framework for when to get an additional view, if appropriate. We recently covered the elbow, wrist, shoulder, ankle, and foot. Next up: the knee.


