Pigtail catheter for pleural drainage: Tips to minimize complications

By |Categories: Pulmonary, Trauma|

Traditionally large-bore tube thoracostomy has been the standard of care for treating many acute intrathoracic pathologies [1]. However, the advent of less invasive small-bore chest tubes, also known as pigtail catheters, has gradually led to a paradigm shift. Pigtails provide a less invasive and often better tolerated alternative to traditional chest tubes and allow for adequate treatment of pneumothoraces and uncomplicated pleural effusions [1-5]. Unfortunately, these less invasive catheters are not without complications - both unique and similar to traditional chest tubes. Case A 48 year-old male with a history of hypertension and polysubstance abuse presented to the emergency [+]

  • Abdominal Bruising

ACMT Toxicology Visual Pearl: Abdominal Bruising

By |Categories: ACMT Visual Pearls, Expert Peer Reviewed (Clinical), Tox & Medications|

What could cause this finding three days after ingestion of a concentrated household substance? Duodenal ulcer Gastric perforation Necrotizing enterocolitis Post-corrosive acute pancreatitis [+]

Maha M Farid MBBCh, MSc, PhD

Maha M Farid MBBCh, MSc, PhD

Lecturer of Forensic Medicine and Clinical Toxicology
Faculty of Medicine
Helwan University, Egypt
  • cocaine for epistaxis

Cocaine for Epistaxis: What was old is new again

By |Categories: ENT, Expert Peer Reviewed (Clinical), Tox & Medications|

Droperidol is back! Routine use of calcium for cardiac arrest is out? TPA is... well, we won’t go there. The landscape of medicine is continuously being reshaped. New research may question the effectiveness of an existing medication or promote the arrival of a novel treatment. Once beloved medications sit dust-laden in the back of a hospital pharmacy. But sometimes, just sometimes, an old medicine arises from that dust. Phenobarbital for alcohol withdrawal comes to mind. Could cocaine hydrochloride be one of those medications to be resurrected? Cocaine is effective in the treatment of epistaxis. Epistaxis is an exceedingly common [+]

SAEM Clinical Images Series: Red Rash on My Legs

By |Categories: Dermatology, SAEM Clinical Images|

A 23-year-old female with no known past medical history presented with a rash concentrated on her legs, with a few areas on her arms and chest. The rash began the day before presentation when she became overheated while wearing sweatpants in 104°F weather. The rash was mildly pruritic but not painful. She denied any prior reaction to her sweatpants that she has had for several months. She denied any new soap or cosmetic use, prior rash, allergy, or medication use. Her review [+]

ACMT Toxicology Visual Pearl: A Bane to Existence

By |Categories: ACMT Visual Pearls, Expert Peer Reviewed (Clinical), Tox & Medications|

What is the primary cause of death following ingestion of the plant pictured? Acute liver failure Arrhythmia Disseminated intravascular coagulation Status epilepticus [+]

Neelou Tabatabai, DO

Neelou Tabatabai, DO

Emergency Medicine Resident
UNC Health Southeastern, Lumberton, NC
Neelou Tabatabai, DO

Latest posts by Neelou Tabatabai, DO (see all)

SAEM Clinical Images Series: Seeing Double

By |Categories: Neurology, Ophthalmology, SAEM Clinical Images|

A 53-year-old woman with no significant past medical history presented to the emergency department with a 3-day history of double vision on leftward gaze. She initially presented to urgent care with a chief complaint of chest heaviness and concern that her blood pressure was too high, but was sent to the emergency department for further cardiac and neurological evaluation after her urgent care provider noticed abnormal eye movement. She endorsed mild, intermittent headaches associated with diplopia when looking to the left. However, she denied any blurry vision when looking forward. She denied any trauma or [+]

SAEM Clinical Images Series: Purple Finger

By |Categories: Orthopedic, SAEM Clinical Images|

A 30-year-old female with a past medical history of Crohn's Disease presented to the ED for evaluation of an acutely bruised right 4th finger. She stated she was typing on a computer keyboard approximately 10 minutes prior to presentation and she noticed a sudden popping sensation at the base of her right ring finger. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger. Shortly after that, the finger turned purple, so she came to the Emergency Department for evaluation. She denied pain in the hand and [+]

SAEM Clinical Images Series: Workout Gone Wrong

By |Categories: Ophthalmology, SAEM Clinical Images|

A 28-year-old male presented to the ED for evaluation of an injury to his right eye. While working out with an exercise band, it snapped back, hitting the patient in the right eye. He experienced blurry vision and excess eye tearing immediately after the incident occurred. The patient also developed gross blood over the front of the eye. Vitals: Temp 98°F, HR 73, BP (135/77), RR 16, SpO2 99% HEENT: Gross blood in the anterior portion of the right eye (grade I). The right pupil is dilated with minimal responsiveness to light. Visual [+]

SAEM Clinical Images Series: Not Your Usual Irritated Eye

By |Categories: Infectious Disease, Ophthalmology, SAEM Clinical Images|

In July 2022, a 32-year-old male with a past medical history of HIV (on antiretroviral therapy, CD4 390, viral load undetectable) presented to the emergency department with constitutional symptoms and a rash for 4-5 days. His symptoms included malaise, body aches, subjective fevers, a sore throat, tender, swollen neck glands, body rash, and irritation of his left eye. He also noticed fluid-filled vesicles on his face, neck, trunk, and extremities. He denied travel outside the U.S. but reported a recent trip to New Orleans. He denied any new sexual partners or known exposure to individuals [+]

  • pediatric ultrasound positioning

PEM POCUS Series: Pediatric Renal and Bladder Ultrasound

By |Categories: Expert Peer Reviewed (Clinical), Genitourinary, Pediatrics, PEM POCUS, Renal|

Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric renal and bladder ultrasonography. Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit. Take the ALiEMU Quiz: Pediatric Renal and Bladder Ultrasound Module Goals List the indications for performing a pediatric renal/bladder point-of-care ultrasound (POCUS) Describe the technique for performing renal/bladder POCUS Identify hydronephrosis and its appearance at different severities List the limitations of renal/bladder POCUS Advanced: Recognize direct and other indirect signs of nephrolithiasis as well as [+]

Shuhan He, MD
ALiEM Senior Systems Engineer;
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General Hospital;
Chief Scientific Officer, Conductscience.com
Shuhan He, MD