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 [...]

ACMT Toxicology Visual Pearls: Exotic Viper Envenomation

By |Categories: ACMT Visual Pearls, Tox & Medications|Tags: |

A man was bitten twice on the dorsal radial aspect of his right hand while feeding his pet West African Bush Viper. The patient immediately tied multiple tourniquets around his right arm before presenting to the emergency department. During examination he is complaining of swelling and severe pain in his right upper extremity, but has no other complaints. What are the appropriate next steps in managing this patient? Apply ice to the bites Measure compartment pressures in the right arm and forearm Perform a fasciotomy Remove the tourniquets and order hematologic studies Use a venom extractor to reduce venom burden [...]

AIR-Pro: Gastroenterology

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

Welcome to the Gastroenterology AIR-Pro Module. Below we have listed our selection of the 10 highest quality blog posts related to 4 advanced level questions on toxicology topics posed, curated, and approved for residency training by the AIR-Pro Series Board. The blogs relate to the following questions: Cirrhosis and variceal bleeding Food impaction Management of diverticulitis Airway management in the gastrointestinal bleed In this module, we have 8 AIR-Pro’s and 2 Honorable Mentions. To strive for comprehensiveness, we selected from a broad spectrum of blogs identified through FOAMSearch.net and FOAMSearcher. […]

The Post-ROSC Checklist

By |Categories: Cardiovascular|

In emergency medicine, we are so heavily trained in resuscitation that any senior resident could recite the ACLS algorithm to you after being woken up at 3 am. However, the real work begins after the pulse return. Up to two-thirds of patients with return of spontaneous circulation (ROSC) will not survive to discharge.1,2 This approach, modeled after the 2015 American Heart Association Guidelines3 and an excellent review article by Dr. Jacob Jentzer et al,4 can help guide you through the chaos to stabilize your next post-ROSC patient. […]

Trick of the Trade: Sphenopalatine Ganglion Block for Treatment of Primary Headaches

By |Categories: Neurology, Tricks of the Trade|

It is thought that the autonomic nervous system is likely involved in migraines and other primary headache disorders given commonly associated symptoms such as nausea, lacrimation, emesis, and rhinorrhea. The sphenopalatine ganglion (SPG) is an extracranial parasympathetic ganglion with both sensory and autonomic fibers. It has therefore been hypothesized that blockade of the sphenopalatine ganglion may produce relief from primary headaches by modulating the autonomic fibers involved in headache disorders.1 While in our anecdotal experience with SPG blocks has been overall very positive, thus far there have been only a few small studies that have investigated it’s use in the [...]

PEM Pearls: 2017 AAP Section of EM’s Guide to Pediatric Community Acquired Pneumonia

By |Categories: Pediatrics, PEM Pearls, Pulmonary|Tags: |

Pediatric community-acquired pneumonia (CAP) is an acute, common, and potentially serious infection of the pulmonary parenchyma in children. In November 2010, the American Academy of Pediatrics endorsed “The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.” [PDF]1Based on this guideline, the American Academy of Pediatrics (AAP) Section on Emergency Medicine’s Committee on Quality Transformation developed a clinical algorithm for CAP in the ED setting. […]