PECARN Study: Accuracy of Urinalysis for Febrile Infants ≤60 Days Old

The reported accuracy of the urinalysis (UA) for diagnosing urinary tract infections (UTI) is febrile infants ≤ 60 days has been widely variable. Some guidelines specifically exclude these patients due to this variability or recommend urine culture as the primary test.¹

Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger, published in Pediatrics in February of 2018, addressed this topic head-on.² The authors sought to evaluate the accuracy of the UA by analyzing data in a planned secondary analysis of a prospectively collected data set, as part of the Pediatric Emergency Care Applied Research Network (PECARN). We review this publication and present a behind-the-scenes podcast interview with lead author Dr. Leah Tzimenatos.
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By Jason Woods, MD|2021-07-01T21:07:41-07:00Sep 27, 2018|Infectious Disease, Pediatrics|

4 New Podcasts on the Opioid Initiative | ACEP E-QUAL Series

The American College of Emergency Physicians (ACEP) features 3 quality improvement targets within their Emergency Quality Network (E-QUAL) initiative: sepsis, imaging, and chest pain. Most recently, they added a fourth new focus on the opioid epidemic. This opioid initiative covers best-practice approaches and strategies for managing opioid-related complications. In collaboration with ACEP E-QUAL, we have remixed and distilled 5 of their webinars into 4 podcasts.

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By Michelle Lin, MD|2026-06-16T16:13:44-07:00Sep 24, 2018|Podcasts, Tox & Medications|

ALiEMU AIR Obstetrics and Gynecology Module

Welcome to the Obstetrics and Gynecology (Ob/Gyn) 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 Ob/Gyn emergencies. 10 blog posts within the past 12 months (as of July 2018) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 2 AIR and 8 Honorable Mentions. We recommend programs give 4 hours (about 25 minutes per article) of III credit for this module.

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By Chris Belcher, MD|2020-09-04T10:57:45-07:00Sep 13, 2018|ALiEMU, Approved Instructional Resources (AIR series), Ob/Gyn|

Ultrasound guided peripheral IV: It’s time to clean up our act

Have you ever performed a procedure, when suddenly, you are overcome by a sinking feeling that something just is not right? A mix of fear, guilt, and anger: Fear that you endangered a patient, guilt that you missed an important step in the procedure, and anger at yourself for being careless. The oath we take as physicians echoes loudly: Primum non nocere. First, do no harm.

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By Daniel Mirsch, DO|2026-06-16T16:13:37-07:00Sep 11, 2018|Infectious Disease, Ultrasound|

EM Fellowship Match Advice: Ultrasound Fellowship

The EM Residency Match Advice Series is back with its latest installment! We put the focus on emergency ultrasound fellowships, and our sage panel walks us through some of the changes to this year’s application cycle. For the first time, Ultrasound Fellowship Programs will participate in the NRMP match program. The Society for Clinical Ultrasound Fellowships (SCUF) provides the fellowship application service (similar to the role of ERAS, but shorter!) for the residency match. Hosted by Drs. Michael Gisondi and Michelle Lin, watch the video or listen to the podcast to learn about important changes to the application process and hear tips from our experts on what to consider when pursuing a career in emergency ultrasound.

Podcast

Ultrasound Fellowship Program Director Panel

Dr. Jeremy Boyd (Vanderbilt University)
Dr. Matt Fields (Kaiser Permanente San Diego)
Dr. Arthur Au (Thomas Jefferson University)

Listen to all the episodes of the EM Match Advice Series

By Michael Gisondi, MD|2021-07-01T10:18:11-07:00Sep 10, 2018|EM Match Advice, Podcasts, Ultrasound|

Resuscitation of a Drowning Victim: A Literature Review

Drowning cases peak this time of year and represent a leading cause of mortality in children. For example, drowning represents the leading cause of death in boys ages 5-14 years old, and worldwide, there are 500,000 annual deaths from drowning.¹ Hypoxic injury and subsequent respiratory failure represent the primary causes of morbidity and mortality. Although providers are typically taught to be aware of possible trauma (e.g. cervical spine fracture) when evaluating a drowning case, less than 0.5% of drownings are traumatic.² The duration of immersion, volume of aspirated fluid, and water temperature dictate clinical outcomes.¹ We review the presentation, pathophysiology, and management of drowning to raise awareness about this important public health issue.
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By Evan Kuhl, MD|2021-05-13T09:19:37-07:00Sep 3, 2018|Critical Care/ Resus, Environmental, Trauma|

ACMT Toxicology Visual Pearls: Toxic Mouth Pain

A middle-aged Asian female presents to the emergency department complaining of 2-3 days of mouth pain. She has chewed betel nut for a number of years. Which of the following is true regarding her presentation and management?

Debridement should be avoided.
Metronidazole is contraindicated due to the potential of a disulfiram-like reaction.
Oral secretagogues should be used due to the anticholinergic effects.
The patient is at increased risk of oral cancer.

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By Heather A. Borek, MD|2019-11-12T19:05:57-08:00Aug 30, 2018|ACMT Visual Pearls, ENT, Tox & Medications|