• segond fracture xray

SplintER Series: A Case of Knee Pain

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

A 45-year-old male presents with right knee pain after he pivoted and felt a “pop” while making a move playing pickup basketball. You obtain knee x-rays and see a lateral irregularity in the AP view (photo courtesy of Dr. Gerry Gardner at Radiopaedia.org). What is the most likely diagnosis, commonly associated injury, and appropriate management plan? […]

Procedural Sedation Guide

By |Categories: Expert Peer Reviewed (Clinical), Tox & Medications|

Mastering procedural sedation can make your shifts safer, more efficient, and more comfortable for your patients. But what defines a sedation? What and who do I need? Does my patient need to be fasting? How should I choose and dose my medications? Below is a brief guide to help you be more confident in your definitions, preparation, and medications. Included is a guide card you can print out and clip behind your badge! Read on and be a pro for your next on-shift sedation.  […]

Trick of the Trade: Save the Ultrasound Probe Cable

By |Categories: Tricks of the Trade, Ultrasound|

You need to perform an ultrasound on your patient. You walk up to the ultrasound and upon grabbing the machine, you notice it’s stuck! You look down and realize the ultrasound probe cable (particularly the linear probe) is impeding the wheel from rolling. You push the machine back, pick the cable up off the floor and off you go to scan to find that the probe is not working. As you try to figure out why it’s not working, you realize that the cable is exposed after repeated damage from the countless times the wheels on the machine rolled over [...]

SAEM Clinical Image Series: Seeing Stars

By |Categories: Ophthalmology, SAEM Clinical Images|

[Click for larger view] Chief complaint: Left eye pain, redness, and foreign body sensation History of Present Illness: 39 year old man presents after metal grinding without protective eyewear three days prior. He had felt something strike his left eye. He developed “burning” pain, tearing, and redness. Pain worsens with extraocular movements. He notes that vision in his right eye has always been worse than the left. Denies any other visual complaints. […]

Beyond the Abstract | Resident Motivations and Experiences in Listening to Educational Podcasts

By |Categories: Beyond the Abstract, Research, Social Media & Tech|

Podcasts are all the rage these days, and it is not surprising that some residents spend more time with podcasts than any other educational resource.​1–3​ But why? And how do podcasts fit with other forms of learning, like lectures, textbooks, and clinical teaching? In our recent article published in Academic Medicine, we explored these questions. Using qualitative interviews and analysis, we identified 3 overarching themes that shed light on residents’ podcast listening behaviors and the tensions with which listeners wrestled.​4​ […]

SAEM Clinical Image Series: A Page Turner

By |Categories: SAEM Clinical Images, Trauma|

[Click for larger view] Chief complaint: Abdominal pain History of Present Illness: A 36-year-old male with a history of alcohol abuse, hypertension, hyperlipidemia, and myocardial infarction with a subsequent stent on ticagrelor and aspirin presents with abdominal pain. He reports 3 days of epigastric and periumbilical pain and multiple episodes of non-bloody, non-bilious emesis. He denies fever, diarrhea, blood in his stool, and urinary symptoms. He endorses bruising to his bilateral flanks and multiple falls recently while drinking. […]

  • Y junction access

Techniques for Ultrasound-Guided IV Placement

By |Categories: Ultrasound|

Imagine a busy evening shift interrupted by the news that the unstable dialysis patient still has no access. Begrudgingly, you drag the ultrasound into the patient’s room. Buried beneath a layer of muscle, a tiny vein lurks below an intimidating artery with a nerve nestled close by. Making matters worse, the patient is becoming increasingly more frustrated. “This always happens. I told them not to remove my last PICC line,” he notes. The use of ultrasound-guided IV improves successful cannulation and decreases complications, but cases like this have caused many emergency providers to resent, even fear, this basic procedure.​1–4​ Below, [...]

  • lateral elbow fat pads

EMRad: Can’t Miss Elbow Injuries

By |Categories: Orthopedic, Radiology, Trauma|

Have you ever been working a shift at 3 am and wondered, “Am I missing something? I’ll just splint and instruct the patient to follow up with their PCP in 1 week.” This is a reasonable approach, especially if you’re concerned there could be a fracture. But we can do better. Enter the “Can’t Miss” series: a series organized by body part that will help identify injuries that ideally should not be missed. This list is not meant to be comprehensive review of each body part, but rather to highlight and improve your sensitivity for these potentially catastrophic injuries. To begin: “Can’t [...]