ALiEM AIR | Respiratory 2019 Module

By |Categories: ALiEMU, Approved Instructional Resources (AIR series), Pulmonary|

Welcome to the AIR Respiratory 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 respiratory emergencies. 8 blog posts within the past 12 months (as of November 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 2 AIR and 6 Honorable Mentions. We recommend programs give 4 hours (about 30 minutes per article) of III credit for this module. […]

SAEM Clinical Image Series: Tick Bite

By |Categories: Environmental, Infectious Disease, Pediatrics, SAEM Clinical Images|

A 14 year old girl presenting from Mexicali with altered mental status. Her mother reports a rash about a week ago following a tick bite. She had been going to school until 4 days ago when she became very fatigued with associated vomiting, diarrhea, tactile fevers, and headache. She subsequently collapsed at home today and was difficult to arouse which prompted EMS activation. Her mother denies any prior complaint of neck stiffness, shortness of breath, cough, hematemesis, or hematochezia. […]

  • Bankart Lesion

SplintER Series: The Recurrent Shoulder Dislocation

By |Categories: Expert Peer Reviewed (Clinical), Orthopedic, SplintER|Tags: , , |

  A 17 year-old football player with prior shoulder dislocation presents to the emergency department reporting shoulder pain after fall. You obtain shoulder x-rays and see the following injury (Image courtesy of Richard Hopkins, MD). What is your diagnosis? Are there any associated lesions you could expect to find? What is your emergency department management? […]

Trick of the Trade: Directed Saline Irrigation for Nasal Suctioning

By |Categories: Emergency Medicine, Pediatrics, Tricks of the Trade|

You are just starting out your mid-January evening shift, and you go to the room of an 8-month old male with nasal congestion. He is afebrile, and mildly tachycardic, but his lung exam is fairly benign and he’s breathing easily without retractions. You can clearly see he has congestion. You instruct the parents to use saline irrigation and then nasal suctioning to clear the congestion as needed, and they say, “How can we do this if our child struggles? Won’t we just end up with a wet, angry, and congested child?” […]

  • rash fever

SAEM Clinical Image Series: Fever and Aches

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

A 62 year old female with no past medical history presented to the ED with fevers, generalized weakness, severe muscle aches, and a rash. She had returned home from the Philippines 3 days prior to evaluation. Twenty-four hours prior to arrival, the patient noticed a rash on her shins. She denied any nausea, vomiting, diarrhea, abdominal pain, chest pain, shortness of breath, cough, sore throat, dysuria, urinary frequency, headache, and neck pain. The patient was in the Philippines for a family funeral and was indoors for most of the trip. She was unsure if she [...]

  • lateral elbow fat pads

EMRad: Can’t Miss Adult Wrist Injuries

By |Categories: EMRad, Orthopedic, Radiology, Trauma|

Have you ever been working a shift at 3 AM and wondered, “Am I missing something? I’ll just splint and instruct the patient to follow up with their PCP in 1 week.” This is a reasonable approach, especially if you’re concerned there could be a fracture. But we can do better. Enter the “Can’t Miss” series: a series organized by body part that will help identify common and catastrophic injuries. This list is not meant to be a comprehensive review of each body part, but rather to highlight and improve your sensitivity for these potentially [...]

  • AP wrist radiograph

EMRad: Radiologic Approach to the Traumatic Wrist

By |Categories: EMRad, Orthopedic, Radiology, Trauma|

This is EMRad, a series aimed at providing “just in time” approaches to commonly ordered radiology studies in the emergency department. When applicable, it will provide pertinent measurements specific to management, and offer a framework for when to get an additional view, if appropriate. Last post, we focused on the elbow. Now: the wrist. […]

PECARN: Its relevance and importance in pediatric emergency care

By |Categories: Pediatrics|Tags: , |

Did you know that many of the landmark pediatric emergency medicine (EM) studies come from the Pediatric Emergency Care Applied Research Network (PECARN) collaborative? It works to address the challenging pediatric questions that only multicenter studies can. In this blog post, we highlight PECARN’s goal to translate, disseminate, and implement evidence to all providers of emergent and urgent care for pediatric patients. […]