ACMT Toxicology Visual Pearl: The Bark with Some Bite
Which medication can be derived from the bark of the pictured tree? Aspirin Atropine Colchicine Quinine [+]
Ivan Ivanov, DO
Emergency Medicine
South Brooklyn Health
Latest posts by Ivan Ivanov, DO (see all)
SAEM Clinical Images Series: Two Pupils for the Price of One
A 24-year-old female with no pertinent PMHx presents to the ED with a chief complaint of eye pain. She reported a 10-day history of worsening right eye pain following being punched in that eye. She had been managing her pain with ice and had not taken any OTC medications. Her mom convinced her to go to the ED and she first went to an outside hospital, but was referred to come to our institution. She endorsed photophobia and blurry vision but denied double vision. She further noted occasional left-sided headaches. Vitals: [+]
SAEM Clinical Images Series: Neonatal Rash
An 18-day-old male presented for a rash on his face for two days. The patient was born via spontaneous vaginal delivery full term without complications to a mom who has a history of genital HSV but without active lesions at delivery and on acyclovir. The patient presented with a vesicular rash on his face including around his eyes. He had conjunctival discharge noted by mom. Otherwise, he was well-appearing, acting normally, and eating/voiding/stooling normally. General: Well appearing, acting appropriately for age HEENT: Scalp normal. Anterior fontanelle soft and flat. Vesicular appearing [+]
ACMT Toxicology Visual Pearl: Salt, not Shock
What agent would most likely be responsible for these ECG findings? Cyclobenzaprine Digoxin Flecainide Sotalol [+]
Timothy Harmon, MD
Inova Fairfax Medical Campus, George Washington University
Latest posts by Timothy Harmon, MD (see all)
SAEM Clinical Images Series: An Ultrasonographic Rabbit Hole
An 86-year-old man with a past medical history of coronary artery disease, hypertension, hyperlipidemia, chronic kidney disease, COPD, choledocholithiasis requiring ERCP and sphincterotomy 2 years ago presented with five days of feeling unwell. History was limited due to cognitive impairment. His daughter had reported to staff he had been feeling unwell for five days, intermittently having nausea and generalized abdominal pain, subjective fevers, chest pain, and shortness of breath. His daughter also reported a history of intermittent lower abdominal cramping which was chronic for him. He denied changes to urination or bowel movements. [+]
SAEM Clinical Images Series: One Month of Vaginal Bleeding
A 28-year-old female G3P2002 presented to the emergency department for one month of vaginal bleeding. The patient was seen in the emergency department one month earlier for vaginal bleeding in the first trimester of pregnancy. Her estimated gestational age was six weeks by last menstrual period. At the time her beta-hCG was 7225 mlU/mL with no intrauterine pregnancy demonstrated on transvaginal ultrasound. Three days later, the patient had declining b-hCG and transvaginal ultrasound again with no intrauterine pregnancy. The patient was discharged home with a diagnosis of miscarriage. Since discharge, she endorsed an initial slowing [+]
High sensitivity cardiac troponins for ED chest pain evaluation (2022 ACC pathway)
How do we best use high-sensitivity cardiac troponin (hs-cTn) to risk stratify patients with symptoms concerning for an acute myocardial infarction (AMI)? The 2022 American College of Cardiology (ACC) pathway provides timely guidance [1]. We help you translate this to your clinical practice, by illustrating with a case. Time to know your hs-cTn better. Take-to-work points When interpreting the hs-cTn, you can use either of the following pathways to optimize both accuracy and patient throughput: European Society of Cardiology (ESC) 2020 0/1 hour or 0/2 hour pathway High-Sensitivity Troponin in the Evaluation of Patients With Acute Coronary Syndrome (High-STEACS) [+]
ALiEM AIR Series | Toxicology Module
Welcome to the AIR Toxicology Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to toxicology in the Emergency Department. 8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 3 AIR and 5 Honorable Mentions. We recommend programs give 4 hours of III credit for this module. AIR Stamp of Approval and Honorable [+]
SAEM Clinical Images Series: Back Lesion
An 18-year-old-female with no known past medical history presented with a lesion on her back that had been present and enlarging for five months. It was not painful unless she touched it, and then only mildly tender. She denied any known cause, wound, prior rash, or other lesions. Her review of systems and past medical history were negative. Vitals: Normal Skin: An erythematous lenticular, or biconvex, lesion with distinct borders is noted at the left posterior [+]
SAEM Clinical Images Series: Retrobulbar Spot Sign
A 59-year-old male with no known past medical history other than an incidental abdominal aortic aneurysm presented with sudden onset, painless vision loss in his left eye. The patient was watching TV two days prior when he saw a “brightness” in his left eye and then progressive blurriness until his vision faded away, all occurring within the span of a minute. At the time of presentation, he only sees a speck of light from that eye. He denied associated pain, flashes, floaters, jaw claudication, the sensation of a “curtain falling”, prior vision problems, or a [+]
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General Hospital;
Chief Scientific Officer, Conductscience.com
Latest posts by Shuhan He, MD (see all)
- The Discharge Severity Index: Early Research on ED Readmission Risk Assessment - August 14, 2025
- Suboxone and the Emergency Physician: Get Waivered Training - August 12, 2022
- A Tale of Two Epidemics: COVID-19 and the Opioid Crisis - April 23, 2020