SAEM Clinical Image Series: Fishing in Papua New Guinea

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Chief Complaint: Right lower extremity injury while spear fishing

History of Present Illness: A 33-year-old male went river fishing with a homemade spear and diving mask in Papua New Guinea. He felt sudden pain and tugging to the right lower extremity. He was near shore and grabbed a tree root. He held on for dear life as he was being pulled back into the water. It felt as if his foot had been torn off. He did not let go of the tree root and eventually the pulling force ceased. He got out of the water and walked 2 miles unassisted before finding help and hospital transport.

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By Michael Parsa, MD|2019-07-28T21:31:42-07:00Jul 8, 2019|SAEM Clinical Images, Trauma|

SplintER Series: A Case of Traumatic Wrist Pain After Fall on Outstretched Hand

A 46 year-old male presents with wrist pain after sustaining a mechanical fall and catching himself on his outstretched hand. An anteroposterior (left) and lateral (right) plain films of the wrist are obtained (photo credit).

What is the diagnosis (hint – there are 2 findings), injury classification system, associated findings, and the recommended management plan?

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By Tabitha Ford, MD|2019-09-10T14:00:40-07:00Jul 3, 2019|Expert Peer Reviewed (Clinical), Orthopedic, SplintER|

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Chief Complaint: Abdominal distention

History of Present Illness: A 36-year-old male with a history of cerebral palsy, gastrointestinal dysmotility, epilepsy, hypertension, gastroesophageal reflux disease, and insomnia presents to the ED after referral by his family physician for a 3-day history of abdominal distention. Due to the patient’s neurological disorder, he is unable to communicate but is accompanied by his mother who provides his medical history. The patient’s mother states that he had a loose bowel movement this morning, which is normal for him. He has had a history of bowel problems since the age of 14. Two months previously the patient was admitted for abdominal distention and had a rectal tube placed which relieved his symptoms. The patient has not experienced nausea, vomiting, or changes in bowel movements.

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By Benjamin Gibson|2019-07-28T21:32:13-07:00Jul 1, 2019|Gastrointestinal, SAEM Clinical Images|

Rash with blood pressure cuff inflation - petechiae

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Chief Complaint: Possible seizure, Left arm rash

History of Present Illness: A 29-year-old with a history of migraine headaches, thalassemia of unknown phenotype, and no history of hypertension or epilepsy arrived to the emergency department via ambulance after possible seizure. The patient had nausea and vomiting the morning after a night of heavy drinking. After several rounds of vomiting, she felt shaky, lightheaded and experienced paresthesia in both of her hands and feet. There was no loss of consciousness, confusion or incontinence. EMS reported hypertension and tremors with upper extremity spasms. The patient developed a left upper extremity rash distal to the blood pressure cuff after paramedics did the first blood pressure measurement.

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By Mallory Hawksworth|2019-07-28T21:32:30-07:00Jul 1, 2019|Dermatology, Heme-Oncology, SAEM Clinical Images|

Our ALiEMU learning management system, which currently houses the AIR series, Capsules series, and In-Training Exam Prep courses, is ready to slowly open the doors to welcome external authors with high quality content. We are thrilled to welcome a UCSF-sponsored pediatric emergency medicine (EM) point of care ultrasonography (POCUS) series, led by Dr. Margaret Lin. The first course is on the intussusception scan, filled with multiple ultrasound scans showing normal variants and two different types of intussusception.

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By Michelle Lin, MD|2019-11-10T21:51:53-08:00Jun 28, 2019|ALiEMU, Gastrointestinal, Pediatrics, Radiology, Ultrasound|

ACMT Toxicology Visual Pearls: Abnormal ECG

This abnormal ECG would be typical following an overdose on which of the following medications?

Amitriptyline
Buspirone
Citalopram
Haloperidol (more…)

By Colin O'Neill, MD|2019-11-12T19:02:16-08:00Jun 26, 2019|ACMT Visual Pearls, ECG, Tox & Medications|

Welcome to the AIR Cutaneous 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 cutaneous emergencies. 6 blog posts within the past 12 months (as of February 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 3 AIR and 3 Honorable Mentions. We recommend programs give 3 hours (about 30 minutes per article) of III credit for this module.

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By Chris Belcher, MD|2020-09-04T11:11:06-07:00Jun 20, 2019|ALiEMU, Approved Instructional Resources (AIR series), Dermatology|