AIR Series Psychobehavioral 2017

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

Welcome to the Psychobehavioral 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 toxicology content. Below we have listed our selection of the 2 highest quality blog posts within the past 12 months (as of June 2017) related to psychology emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 0 AIRs and 2 Honorable Mentions. We recommend programs give 1 hour (about 30 minutes per article) of III credit for this module. As of June [...]

AIR Series: Renal/Genitourinary (2017)

By |Categories: Approved Instructional Resources (AIR series), Genitourinary, Renal|

Welcome to the Renal/GU 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 Renal/GU content. Below we have listed our selection of the 13 highest quality blog posts within the past 12 months (as of May 2017) related to Renal/GU emergencies, curated and approved for residency training by the AIR Series Board. We identified 3 AIRs and 10 Honorable Mentions. We recommend programs give 4 hours (about 20 minutes per article) of III credit for this module. As of June 2017, over 125 residency programs [...]

Team-Focused CPR: Bringing Pre-hospital Success to the ED

By |Categories: Cardiovascular, Critical Care/ Resus, Expert Peer Reviewed (Clinical)|

High-quality chest compressions and early defibrillation are the cornerstones of effective cardiac arrest care.1 When implemented correctly these two interventions enhance patient outcomes and improve overall survival.2 However, despite simplified advanced cardiac life support (ACLS) algorithms and extensive training of providers, cardiac arrest scenarios in the emergency department (ED) are still high-stress and mortality rates remain high.3,4  […]

Announcing the new ALiEM Cards website

By |Categories: ALiEM Cards|

The PV Cards are getting a new name and their own website! Beginning today you can find the complete point-of-care reference library on its own standalone, mobile-enabled website: ALiEM Cards at www.aliemcards.com. The PV Cards have been in various formats whether they be apps and websites. Hopefully building a single repository, accessible on any device, will make the PV Cards easier to access and use when you need them at the bedside, after a shift, or in impromptu teaching sessions. […]

Trick of the Trade: DIY Squirt Bottle Wound Irrigation

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

Wound irrigation is arguably one of the most important steps in closing a laceration, because all lacerations should be considered to be contaminated. Irrigation is considered the foundation in preventing infection. A common way to cleanse a wound is to irrigate a wound using a 20 cc syringe, angiocatheter, and splash protector. To achieve 500 cc of irrigation, however, it would require 25 syringe refills! Is there a better, cost-effective alternative? […]

Trick of the Trade: Gaze Testing Using “Selfie Mode” on Your Smartphone Camera

By |Categories: Neurology, Tricks of the Trade|Tags: |

The NIH Stroke Scale is used to assess the severity of a suspected stroke. It includes 11 neurologic exam components that can be quickly performed at the bedside. The second component of the NIH Stroke Scale is testing of voluntary horizontal eye movements, a.k.a., “best gaze”.1 Gaze is usually tested by instructing the patient to follow the examiner’s hand or pointer finger in a horizontal plane from side to side. This assessment assumes that the patient can comprehend instructions and actively participate in the physical exam. But… how do you test gaze if your patient is aphasic or unable to [...]

ALiEM’s Greatest Hits for Interns: A Curated Collection of High-Yield Topics

By |Categories: Cardiovascular, Critical Care/ Resus, Gastrointestinal, Medical Education, Neurology, Ophthalmology, Pediatrics, Tox & Medications, Ultrasound for the Win|

Congratulations, you’ve made it! On July 1, thousands of medical students across the country made the transition to becoming Emergency Medicine residents. It was a particularly competitive year for Emergency Medicine, with 99.7% of first-year spots filled despite a whopping 2,047 positions being offered in 2017 (up by 152 spots compared to last year).1 Now begins the most crucial 3 or 4 years of your medical training that will prepare you for the rest of your career in Emergency Medicine. […]

Management of Major Pelvic Trauma

By |Categories: Orthopedic, Trauma|

Pelvic trauma frequently is associated with other injuries from the high force required to break the pelvis. Management is focused on stabilizing the pelvis and stopping the bleeding. Due to other injuries requiring emergent surgical stabilization, pelvic trauma is primarily managed surgically with pre-peritoneal packing and external fixation, followed by angioembolization for continued bleeding. Emergency physicians must quickly resuscitate patients while gathering vital information to direct the correct definitive bleeding control strategy. New endovascular techniques such as REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) may change future emergency department strategies and improve mortality in severe pelvic trauma.  […]

ED Charting and Coding: Critical Care Time

By |Categories: Administrative, Critical Care/ Resus|

After a STEMI activation from the field on Monday morning, the cardiac catheterization team scoops the patient away shortly after the paramedics arrive in the Emergency Department (ED). “Well that was a smooth and seamless resuscitation. The patient was barely in the ED for more than 15 minutes,” you think to yourself. You diligently complete your critical care documentation, noting 20 minutes of critical care time, before seeing your next patient. A few weeks later the chart is bounced back and noted as an erroneous documentation of critical care time. The coding department notifies you that the case will be [...]

Ultrasound for the Win! 53M with Right Index Finger Swelling #US4TW

By |Categories: 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 case series, we focus on a real clinical case where point-of-care ultrasound changed the management of a patient’s care or aided in the diagnosis. In this case, a 53-year-old man with history of diabetes mellitus presents with right index finger swelling. […]