Magnesium for Rapid Atrial Fibrillation Rate-Control in the ED

We love magnesium in the Emergency Department. It’s been said that magnesium is second-line for everything (kind of like doxycycline). But what about rate/rhythm control in atrial fibrillation (AF)? The 2014 AHA/ACC/HRS guideline for the management of patients with AF doesn’t mention magnesium at all.¹ Dr. Josh Farkas (@PulmCrit) wrote about magnesium infusions for atrial fibrillation and torsade last year. His post looked at its use for cardioversion, rhythm-control, and rate-control in critically-ill patients. Our post will focus specifically on the IV magnesium data for rate-control in ED-related settings.

(more…)

By Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP|2018-08-22T06:55:46-07:00Oct 26, 2016|Cardiovascular, Tox & Medications|

Whipped Cream Charger Abuse: The Toxicologist Mindset

The Toxicologist Mindset series features real-life cases from the San Francisco Division of the California Poison Control System.

Case: A 39-year-old man, with no significant past medical history, was brought to the emergency department by family members, over three consecutive days, for anxiety, confusion, and ataxia. In the first two visits, his laboratory work-up, including complete blood cell count, chemistry panel, liver function tests, urine drug screen, and non-contrast head CT, were unremarkable. On his third visit, he was profoundly encephalopathic with confusion and poor concentration. He had bilateral lower extremity weakness and ataxia. He was admitted to the neurology service for further work up. Additional history revealed that hundreds of empty canisters of whipped cream chargers were found in his house.

(more…)

By Kathy Vo, MD|2016-11-11T19:47:20-08:00Oct 17, 2016|Tox & Medications|

ALiEMU CAPSULES Module 7: Emergency Thyroid Disorders

We are proud to present CAPSULES module 7: Emergency Thyroid Disorders, now published on ALiEMU. Here is a summary of the key points from this outstanding module by Drs. Craig Cocchio and Colleen Martin.

(more…)

By Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP|2019-02-19T18:24:36-08:00Oct 10, 2016|Capsules, Endocrine-Metabolic, Tox & Medications|

AIR-Pro: Toxicology (Part 1)

Welcome to the Toxicology (Part 1) AIR-Pro Module. Below we have listed our selection of the 10 highest quality blog posts related to 5 advanced level questions on toxicology topics posed, curated, and approved for residency training by the AIR-Pro Series Board. The blogs relate to the following questions:

Flumazenil in benzodiazepine overdose
Acetaminophen – drawing and timing of levels
Opioid overdoses
Acetaminophen toxicity related to liver transplant
Salicylates and hemodialysis

In this module, we have 6 AIR-Pro’s and 4 Honorable Mentions. To strive for comprehensiveness, we selected from a broad spectrum of blogs identified through FOAMSearch.net and FOAMSearcher.We have a brand new chief resident team and want to thank the out-going team for all of their support!

(more…)

By Fareen Zaver, MD|2017-01-20T12:32:53-08:00Sep 26, 2016|Approved Instructional Resources PRO (AIR-Pro Series), Tox & Medications|

Ultrasound for the Win! Emergency Medicine Cases: Volume 1 Book

The Ultrasound for the Win! book, available now on Amazon and coming soon to the Apple iBooks Store, is a compilation of real ultrasound cases that have been featured on the blog’s Ultrasound for the Win! Series.

(more…)

By Jeffrey Shih, MD, RDMS|2017-07-19T00:06:32-07:00Sep 23, 2016|Medical Education, Ultrasound, Ultrasound for the Win|

PEM Pearls: Perfecting your pediatric lumbar puncture using ultrasound

A lumbar puncture (LP) is a common procedure that every emergency physician must master. Pediatric LPs can be challenging for even the most experienced clinician due to small anatomy, difficulty with patient cooperation, and lack of frequency performed. A successful procedure is defined by obtaining cerebrospinal fluid and/or performing a non-traumatic lumbar puncture. There are multiple variables that lead to a successful pediatric lumbar puncture including provider experience, use of anesthesia, and patient positioning. Success rates for pediatric lumbar punctures are variable, with a large range from 34%-75%.¹

(more…)

By Ashley Foster, MD|2026-06-16T16:10:12-07:00Sep 21, 2016|CME, Pediatrics, PEM Pearls, Ultrasound|

AIR Series: Procedures Module (2016)

Welcome to the Procedures 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 procedure content. Below we have listed our selection of the 13 highest quality blog posts within the past 12 months (as of June 2016) related to procedure emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 3 AIRs and 10 Honorable Mentions. We recommend programs give 4 hours (about 20 minutes per article) of III credit for this module.

(more…)

By Andrew Grock, MD|2017-03-05T14:18:45-08:00Sep 12, 2016|Approved Instructional Resources (AIR series), Critical Care/ Resus|