MEdIC: Case of the Night Shift Stimulants – Expert Review and Curated Community Commentary

By |Categories: MEdIC series, Tox & Medications|

Our fifth case of season 5, The Case of the Night Shift Stimulants, presented the scenario of a junior emergency medicine (EM) resident who witnesses her attending physician taking stimulants in order to function during his night shift. The MEdIC team (Drs. Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, Alkarim Velji, and Brent Thoma), hosted an online discussion around the case over the last 2 weeks with insights from the ALiEM community. We are proud to present to you the curated commentary and our expert opinions. Thank-you to all participants for contributing to the very rich discussions surrounding [...]

SplintER Series: Complications & Discharge Care Plans | Splint Principles 103

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

The SplintER Series is back with its third installment! In this series, we review splinting fundamentals, introduce advanced concepts, and highlight ways to implement these into your next shift. In SplintER 102, we reviewed the materials used in splinting and a general approach to applying a splint. Today’s post puts the spotlight on some of the potential complications of splinting, discharge care plans, and pharmacological adjuncts to aid in recovery. […]

Renal Colic & Pulmonary Embolism CT | Reducing Imaging: ACEP E-QUAL Network Podcast

By |Categories: Genitourinary, Pulmonary, Radiology|

Computed tomography (CT) is increasingly available across U.S. Emergency Departments and has changed the practice of medicine. However, it is coupled with potential side-effects from radiation and contrast media. Emergency Medicine is beginning to make a concerted effort to identify clinical scenarios in which CT may be unnecessary, producing outcomes research and validated clinical decision rules. Renal colic and pulmonary embolism, in particular, seem amenable to this area of investigation. The ACEP E-QUAL Network podcast, a partnership with ALiEM to promote clinical practice improvements, reviewed this topic with experts Dr. Chris Moore (Emory University) and Dr. Jeffrey Kline (Indiana University). We present highlights [...]

ALiEM AIR Series: Environmental Module

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

Welcome to the Environmental 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 environmental emergencies. 3 blog posts within the past 12 months (as of December 2017) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 0 AIR and 3 Honorable Mentions. We recommend programs give 1 hour (about 20 minutes per article) of III credit for this module. […]

Intravenous lidocaine for renal colic

By |Categories: Tox & Medications|

Pain management in the ED has become a balancing act. EPs must continually balance adequate pain management with the risks of opioids prescribing. As providers reach into their pain management toolbox it is always nice to have as many options as possible because one size does not fit all. Specifically for the management of acute renal colic, IV preservative-free (cardiac) lidocaine has been gaining popularity as a potential alternative when opioids are unable to get job done or are contraindicated due to co-morbidities or a history of addiction. Is it safe? Does it work? […]

Ultrasound For The Win! Case – 64M with Fever and Scrotal Pain #US4TW

By |Categories: Genitourinary, Infectious Disease, Ultrasound, Ultrasound for the Win|

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this series, we focus on a real clinical case where point-of-care ultrasound changed the management or aided in the diagnosis. In this case, a 64-year-old man presents with acute onset scrotal pain and fever. […]

Troubleshooting the Crashing Patient with a Tracheostomy

By |Categories: Critical Care/ Resus, Pulmonary|Tags: |

Patients presenting to the ED with respiratory distress and a tracheostomy can unnerve almost any provider, and management is often fraught with preventable errors.1,2 This recognition has led to the development of treatment algorithms from groups including the U.K. National Tracheostomy Safety Project to improve the safety and quality of care for patients with tracheostomies.3 Use the ABC-Ts mnemonic to help you perform a focused tracheostomy evaluation and troubleshoot in a stepwise, systematic manner while waiting for your ENT consultant to arrive. […]

ALiEMCards: The Red and Painful Eye

By |Categories: ALiEM Cards, Ophthalmology|

There is significant overlap among conditions that cause a red, painful, or red AND painful eye. Having trouble keeping them all straight? Need a refresher before heading in to see a patient with a new eye complaint? Check out our brief, practical ALiEM Cards on the topic: The Painful Eye (Author: Puja Gopal, MD) The Red Eye (Author: Michelle Lin, MD) Eye Differential Diagnoses (Author: Puja Gopal, MD) […]