IDEA Series: Just-in-Time Training for Diagnostic Paracentesis

According to the National Health And Nutrition Examination Survey, approximately 630,000 adults in the United States have cirrhosis of the liver, 69% of which are reportedly unaware of having liver disease. A diagnostic paracentesis is a simple procedure for identifying spontaneous bacterial peritonitis in cirrhotic patients with ascites. A just-in-time training (JITT) model incorporating low-fidelity equipment readily available in the ED can facilitate procedural teaching of the diagnostic paracentesis.

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By Al'ai Alvarez, MD|2019-12-21T13:00:22-08:00Dec 18, 2019|Academic, Gastrointestinal, IDEA series|

SAEM Clinical Image Series: Uncommon Cause of Right Groin Pain

A 48-year-old male presents with 2 weeks of severe right lower quadrant abdominal pain and inguinal pain. The patient had similar pain 2 weeks ago, was referred to a surgery clinic, but was lost to follow up. The pain has been progressively worsening over the last 2 days. It’s now severe, associated with nausea and vomiting, does not radiate, and it is worsened with coughing and sneezing. He also endorses polyuria for an unknown length of time. His last bowel movement was 3 days ago. He denies diarrhea, constipation, hematochezia, melena, dysuria, hematuria, or recent trauma.

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By Jason Raggi, DO|2019-12-12T21:43:29-08:00Dec 16, 2019|Gastrointestinal, SAEM Clinical Images|

SAEM Clinical Image Series: A Case of a Painful Facial Rash

A 65-year-old female without any significant past medical history presented to the emergency department with left eye pain and redness. She also reported a developing rash to left side of her face over the last 24 hours.

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By Jonathan Chan|2019-12-12T21:57:03-08:00Dec 16, 2019|Dermatology, Ophthalmology, SAEM Clinical Images|

Welcome to the AIR Infectious Disease 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 infectious disease emergencies. 9 blog posts within the past 12 months (as of September 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 1 AIR and 8 Honorable Mentions. We recommend programs give 4.5 hours (about 30 minutes per article) of III credit for this module.

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By Chris Belcher, MD|2020-09-04T11:07:35-07:00Dec 13, 2019|ALiEMU, Approved Instructional Resources (AIR series), Infectious Disease|

Skin tears are a common injury treated in the elderly in the emergency department (ED). Often the skin is paper thin, and the area involved can have a large flap. By the time the patient has arrived, the may blood have dried with a retracted and rolled-in skin flap. Often the surface area is too big and skin to thin to inject local anesthesia around the entire site.

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By Kara Bragg DNP, APRN, FNP-C, ENP-BC|2019-11-30T18:19:15-08:00Dec 11, 2019|Trauma, Tricks of the Trade|

A 66-year-old otherwise healthy man presents by Emergency Medical Services (EMS) after being found unconscious on the ground. On arrival to your emergency department, he is back to his baseline normal mental status and without complaints. His vital signs are within normal limits and his physical exam is unremarkable. Is it a syncope? What are the key features of his history and physical exam that should affect your medical decision making? What should this patient’s work-up entail?

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By Andrew Grock, MD|2019-12-02T08:48:04-08:00Dec 9, 2019|Cardiovascular|

A 3-year-old Hispanic female with no significant past medical or surgical history presents to the Emergency Department with her mother for a 3 day history of crampy abdominal pain, intermittent bloody diarrhea and fever. There has been no recent travel, admissions, or antibiotic use. Her older sister reports similar symptoms, which have resolved. The patient saw her pediatrician the day prior, who recommended supportive care including oral rehydration.

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By Ryan Gibbons, MD|2019-11-19T01:47:58-08:00Dec 4, 2019|Pediatrics, Ultrasound, Ultrasound for the Win|