AIR Series: Toxicology Module (2017)

By |Categories: Approved Instructional Resources (AIR series), Tox & Medications|

Welcome to the Toxicology 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 6 highest quality blog posts within the past 12 months (as of January 2017) related to Toxicologic emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 0 AIRs and 6 Honorable Mentions. We recommend programs give 2 hours (about 20 minutes per article) of III credit for this module. As of June 2017, the AIR [...]

Envenomations: Initial Management of Common U.S. Snakebites

By |Categories: Environmental|

Nothing says “emergency” like a bite from a venomous reptile. If you work in an area populated by snakes, which covers most of the United States and the world, then chances are good that you will see a patient with a snake bite in the Emergency Department (ED). The severity of the symptoms and the treatment vary greatly with different snakes. In this post, we will outline the ED approach to and management of common U.S. snake envenomation. […]

EM Pharmacotherapy Guidelines and Position Statements: Resource for ED Rotations

By |Categories: Tox & Medications|

Several years ago I created a resource for my ED rotation that I share with pharmacy students, pharmacy residents, and EM physician residents. It contains most of the guidelines and position statements on EM drug therapy that I utilize most often and is updated as new iterations are published. We’d like to share this tool with you to be used/modified to meet your rotation needs. Last updated: February 22, 2018 […]

Little Patients, Big Medicine Podcast: Lactate in Pediatric Sepsis

By |Categories: Infectious Disease, Pediatrics|Tags: |

The first recording from Little Patients, Big Medicine: the Pediatric Emergency Medicine (PEM) Podcast. This is an exciting interview with Dr. Halden Scott, a PEM physician at Children’s Hospital Colorado, about the use of lactate measurement in pediatric sepsis. Dr. Scott is one of the premier pediatric sepsis researchers, with a specific focus on the use of lactate measurement in the ED. We talk about the Sepsis-3 definitions and whether pediatrics will eventually follow them, Dr. Scott’s previous work on lactate use in the pediatric ED, and her new article published in March of 2017 on the association between elevated [...]

Trick: Linear Ultrasound Transducers in Intrauterine Pregnancy Evaluation

By |Categories: Ob/Gyn, Tricks of the Trade, Ultrasound|

The volume of women presenting to the emergency department (ED) with newly diagnosed first-trimester pregnancies and suspected ectopic pregnancies sometimes seems like an infinitely growing number. As ED physicians, proper identification of an intrauterine pregnancy (IUP) in these patients is of paramount importance and the initial imaging test of choice for many has become bedside point-of-care ultrasound (POCUS). […]

Beyond the Abstract | Shared Decision-Making in the ED: 3 Factors That Matter

By |Categories: Beyond the Abstract|

Shared decision-making seems to be more popular than Snapchat these days. Everyone in emergency medicine is talking about it… but who is actually doing it properly? In our recent concepts piece published in Annals of Emergency Medicine, we describe 3 key factors that must be present for shared decision-making (SDM) to be appropriate in the emergency department (ED). […]

Traumatic Bleeding in Anticoagulated Patients: 5 Other Sources Beyond the Brain

By |Categories: Heme-Oncology, Trauma|

When a patient is started on anticoagulant therapy, the purpose is to prevent clot formation or propagation. Anticoagulants can improve morbidity and mortality by maintaining cardiac stent patency, reducing the propagation of pulmonary emboli, or preventing formation of intra-cardiac thrombi.1,2 Unfortunately even after minor trauma, these medications can cause major problems. When a patient on clopidogrel is in a motor vehicle collision (MVC) or an elderly patient on warfarin falls out of their bed, the once life-improving therapy becomes potentially life-threatening. It is important for emergency care providers to maintain a high index of suspicion for life-threatening bleeds in all patients on [...]

60 Second Soapbox: Shared Decision Making, Backboards, and Caring for the Family

By |Categories: 60-Second Soapbox|

Its’ time for another installment of 60 Second Soapbox! Each episode, one lucky individual gets exactly 1 minute to present their rant-of-choice to the world. Any topic is on the table – clinical, academic, economic, or whatever else may interest an EM-centric audience. We carefully remix your audio to add an extra splash of drama and excitement. Even more exciting, participants get to challenge 3 of their peers to stand on a soapbox of their own!  […]

Ultrasound For The Win! – 20F with First Trimester Vaginal Bleeding #US4TW

By |Categories: Ob/Gyn, 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 20-year-old woman presents with first-trimester vaginal bleeding. […]

PEM Pearls: Search & Rescue of Ear Foreign Bodies – Picking the Right Tool

By |Categories: ENT, Pediatrics, PEM Pearls|

While ear foreign bodies can happen at any age, the majority occur in children less than 7 years of age.1 The younger the patient, the less likely they are cooperative with the exam and, therefore, the less chance of successful foreign body removal. The first attempt at removal is the best, so it is important to make it count. Similarly, different types of foreign bodies call for different “tools” for removal. It is important to understand when to attempt removal in the emergency department (ED) and what tools are available. This blog post will help you optimize your first pass success at foreign body removal by [...]