Trick of the Trade: Topical Treatment of Cannabinoid Hyperemesis Syndrome

By |Categories: Tox & Medications, Tricks of the Trade|

A 23-year-old female with no past medical history presents to the ED for the 4th time this month complaining of severe “10-out-of-10” abdominal pain, nausea, and intractable vomiting. She denies alcohol use, but reports she has smoked at least 1 marijuana “bud” daily for the last 3 years. In an attempt to relieve her symptoms, she has increased her marijuana use, however she has found that her pain is actually increasing, and the only thing that appears to help is taking a hot shower or bath. With this statement, the provider immediately considers cannabinoid hyperemesis syndrome (CHS). […]

Pediatric Trick of the Trade: Finger Immobilization Technique

By |Categories: Orthopedic, PEM Pearls, Trauma, Tricks of the Trade|

A 3 year-old boy presents with a deep laceration of the distal phalanx, through the nail bed, after slamming his fingers in a car door. He is crying, anxious, and uncooperative. How do you make this situation easier to evaluate and repair? Nail bed and finger laceration repairs can be challenging, and even more challenging in young patients. Preparation is key to getting a good outcome. Here we present a pediatric trick of the trade on immobilizing a finger for digit or nail bed procedures. […]

AIR-Pro: Neurology

By |Categories: ALiEMU, Approved Instructional Resources PRO (AIR-Pro Series), Neurology|

Welcome to the Neurology AIR-Pro Module. Below we have listed our selection of the 7 highest quality blog posts related to 4 advanced level questions on neurology topics posed, curated, and approved for residency training by the AIR-Pro Series Board. The blogs relate to the following questions: Intracranial hemorrhage Diagnosis of subarachnoid hemorrhages Management of subarachnoid hemorrhages Vertigo […]

AIR Series: Immunology 2017

By |Categories: ALiEMU, Allergy-Immunology, Approved Instructional Resources (AIR series)|

Welcome to the Immunology 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 immunology content. Below we have listed our selection of the 4 highest quality blog posts within the past 12 months (as of July 2017) related to immunology emergencies. These are curated and approved for residency training by the AIR Series Board. We have identified 0 AIRs and 4 Honorable Mentions. We recommend programs give 1 hour (about 15 minutes per article) of III credit for this module. […]

  • Pills

ALiEMU Capsules Module 9: Hospital Acquired Pneumonia

By |Categories: Capsules, Infectious Disease, Pulmonary|

We are proud to present CAPSULES Module 9: Hospital Acquired Pneumonia (HAP), now published on ALiEMU. Here is a summary of the key points from a stellar module by Drs. Jamie Rosini and Matt Stanton. When you’re finished, head over to the Capsules page for even more practical pharmacology for the EM provider. […]

Atraumatic Low Back Pain: ACEP E-QUAL Network Podcast

By |Categories: Orthopedic, Radiology|

Atraumatic low back pain is a common complaint in the ED. For most patients, a thorough history and physical exam is sufficient to exonerate causes that threaten life or neurological function. For a small subset, however, MRI may be required. ALiEM has partnered with the ACEP E-QUAL Network to promote clinical practice improvements through a series of podcasts. In our first installment, we focus on this common presentation. We review highlights from an interview with Dr. Jonathan Edlow, Vice Chair of Emergency Medicine at Beth Israel Deaconess, about the presentation and evaluation of low back pain. Afterward be sure to check [...]

SplintER Series: Splint Principles 101

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

Why do we splint? Splinting is one of the fundamental procedures of the Emergency Department (ED). How well-versed are we with it? Why do we even splint? By the end of this post, you will know the reason why we splint, when to splint, and just as importantly — when NOT to splint in the ED. […]

SplintER: A New Series on Orthopedic Injuries and Splinting

By |Categories: Incubators, Orthopedic, SplintER|

The purpose of the SplintER series is to teach the fundamentals and introduce advanced concepts of splinting to the Emergency Medicine (EM) professional. Humans have been splinting their injuries since 1300 B.C.1 Although the fundamentals have not changed, splint selection and application require some thoughtful consideration. A 2017 prospective, observational study in the Journal of Pediatric Orthopaedics demonstrated that more than 90% of splints applied in the Emergency Department were inappropriate (30% applied by EM attendings), as evaluated by orthopaedic surgeons.2 While that number may not be representative in your institution, it certainly highlights the inadequacies that many of us feel [...]

  • eye differential

Using Eye Anatomy to Recall Key Diagnoses: The Rule of 2’s

By |Categories: ALiEM Cards, Ophthalmology|

Our latest ALiEM Card introduces the “Rule of 2’s,” a simple method that uses eye anatomy to help you recall some of the major ocular diagnoses! It builds a framework for your physical exam and will help you include or eliminate some of the more common ocular conditions. The Rule of 2’s is easy to remember: 2 eyes, 2 major diagnoses to consider for each ocular layer, as you move anterior to posterior. […]