PV Card: Laceration Repair and Sutures – A cheat sheet guide

By |Categories: ALiEM Cards, Orthopedic, Trauma|

Laceration repair and suturing are foundational skills for the Emergency Department. This pocket card serves as a quick reference guide for clinicians, and provides a much-needed update and design upgrade from the 2011 PV card on Sutures. This card covers suture/staple removal times, suture sizes, suture material characteristics, special laceration considerations, and suture techniques. […]

PEM Pearls: Pediatric Sepsis Management – Understanding the Basics

By |Categories: Infectious Disease, Pediatrics, PEM Pearls|

Just as in adults, pediatric sepsis is a complex topic with continued research. In the United States, there are an estimated 75,000 cases per year of pediatric severe sepsis with an in-hospital mortality of 5-10%.1,2 This is one of the deadliest conditions treated in children. In addition, after the Rory Staunton case, New York State passed regulations requiring all hospitals to have pediatric specific recognition, treatment, and data reporting systems. Several other states have adopted, or are considering, similar requirements. Thus it is critical that emergency physicians understand at least the basics of pediatric sepsis management. […]

60 Second Soapbox: Messman (Vertigo), Dolcourt (Charcoal), Stiell (C-spine Rules)

By |Categories: 60-Second Soapbox|

After a bit of a hiatus we are back with another round 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!  […]

Epistaxis Management in the Emergency Department: A Helpful Mnemonic

By |Categories: ENT|

Epistaxis is a common presentation to the emergency department (ED)1 that can be challenging and time consuming. Knowledge of the pearls, pitfalls, and troubleshooting tips around managing nosebleeds often can be the difference between a frustrating versus straightforward ED stay for patients. Use the EPISTAXIS mnemonic to help you remember these points. […]

Trick of the Trade: Rapid Insertion of Orogastric Tube

By |Categories: Critical Care/ Resus, Tricks of the Trade|

We have all been in the situation: an intubated patient needs an orogastric (OG) tube and no one has been able to place it successfully. Unfortunately, we typically find out about this situation after several failed attempts, when the patient is bleeding and/or the anatomy is distorted. It may coil in the mouth or esophagus. Here I present a novel technique to rapidly place an OG tube within seconds. […]

Ultrasound For The Win! – 46M with Diffuse Abdominal Pain #US4TW

By |Categories: Gastrointestinal, 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 46-year-old man with a history of alcohol abuse presents with diffuse abdominal pain. […]

PEM Pearls: Calming techniques while repairing a laceration

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

Most children who come into the Emergency Department present with pain or experience pain during their ED stay.1,2,3 Pain and distress during a procedure can leave a lasting impact on a child and contribute to mistrust of the medical system and compliance with future procedures.1 ,4,5 Children who use active forms of coping report less pain and distress during a procedure.3 To help with coping, when feasible, involve parents or family, nursing and a child life specialist. If the parents are willing, try to get them involved in all parts of the medical procedure.2,3 This includes positioning the patient with a parent in [...]

AIR Series: Respiratory Module (2017)

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

Welcome to the Respiratory 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 procedure content. Below we have listed our selection of the 12 highest quality blog posts within the past 12 months (as of August 2016) related to Respiratory emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 4 AIRs and 8 Honorable Mentions. We recommend programs give 4 hours (about 20 minutes per article) of III credit for this module. […]

PEM Pearls: Brief Resolved Unexplained Events (BRUE)

By |Categories: Pediatrics, PEM Pearls|

A 2-month old boy was brought in by his mother after an episode of the child’s face turning blue and a pause in breathing. Mom reports this lasted a few seconds. The mother was terrified, so she brought the baby to the ED. Sometimes infants briefly stop breathing or go limp. How do we determine if an infant is low-risk for serious illness? Earlier last year, the American Academy of Pediatrics (AAP) released guidelines on the evaluation and management of Brief Resolved Unexplained Events (BRUE, replacing a 30-year old label “apparent life-threatening event” or ALTEs).1 […]

Introducing In-Line Expert Peer Review: Advancing the State of Academic Blogging

By |Categories: Expert Peer Reviewed (Clinical), Social Media & Tech|Tags: |

A peer review process, in one form or another, has long been the de facto standard for academic publishing. In 2013, ALiEM was the first FOAM resource to initiate an attributed peer review process for all submitted content–effectively bringing a traditional standard to a new frontier of medical education.1 Since our expert peer review (EPR) program inception, reviewers have published critical appraisals alongside 114 ALiEM posts to date. […]