ACMT Toxicology Visual Pearl: Making Rash Decisions

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

Which of the following best describes the pictured rash occurring 4 weeks after starting minocycline? Anaphylaxis Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Erythema multiforme Serum sickness Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN) [+]

Destiny D. Folk, MD

Destiny D. Folk, MD

Emergency Medicine Resident
Carolinas Medical Center
Destiny D. Folk, MD

Latest [+]

SAEM Clinical Images Series: Wolf in Sheep’s Clothing

By |Categories: Cardiovascular, ECG, SAEM Clinical Images|

A 55-year-old female with a history of hyperlipidemia presents after a syncopal episode. She had mild nausea and diarrhea on the morning of presentation but otherwise had no prodromal symptoms before suddenly losing consciousness in a grocery store. Of note, she recalls a similar syncopal episode in the remote past, also preceded by gastrointestinal symptoms at that time. At present, she is symptom-free. Vitals: BP 135/71; HR 52; Temp 98°F; RR 18; SpO2 100% on room air General: Tired appearing CV: 2+ peripheral pulses. Regular rate and rhythm, no murmurs, rubs, or [+]

ALiEM AIR Series | Trauma 2023 Module

By |Categories: Approved Instructional Resources (AIR series), Expert Peer Reviewed (Clinical), Trauma|

Welcome to the AIR Trauma Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to trauma in the Emergency Department. 8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 3 AIR and 5 Honorable Mentions. We recommend programs give 4 hours of III credit for this module. AIR Stamp of Approval and Honorable Mentions [+]

  • test tube of different color urine

ACMT Toxicology Visual Pearl: Who Doesn’t Like a Nice Rosé?

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

What clinical presentation and medication is associated with this urinary discoloration? Critical illness requiring intubation and propofol sedation Cyanide toxicity requiring sodium thiosulfate Iron toxicity treated with deferoxamine Refractory vasoplegic shock treated with methylene blue Septic shock treated with vancomycin and cefepime [+]

Allison Frazure, MD

Allison Frazure, MD

Emergency Medicine Resident
Carolinas Medical Center
Allison Frazure, MD

SAEM Clinical Images Series: Intracranial Abnormality

By |Categories: Neurology, SAEM Clinical Images|

A 26-year-old male with no significant past medical history presented to the ED after slipping on wet pavement and hitting his head on the ground three hours prior. He endorsed a constant, achy 7/10 headache accompanied by nausea and photophobia. He denied vomiting, dizziness, diplopia, loss of consciousness, or seizures. Nothing made it better or worse.   Vitals: BP 101/63; HR 76; RR 14; T 36.7°C General: Alert and oriented, no acute distress HEENT: Normocephalic, atraumatic, tenderness elicited over right occipital bone, PERRLA, + photophobia Neurologic: WNL with no focal motor or [+]

SAEM Clinical Images Series: Dangerous Eye Drainage

By |Categories: HEENT, Ophthalmology, SAEM Clinical Images|

A 32-year-old man with a history of traumatic globe rupture from a stab wound two months ago, status post repair, presented to the emergency department for worsening right eye pain and green malodorous drainage for the past three days. These symptoms started when he got a fleck of sawdust in the right eye about four days prior to presentation, which he was able to brush out with his finger. He described the pain as severe, throbbing, constant, and non-radiating. He had been unable to open the right eyelid for three days, both due to pain [+]

SAEM Clinical Images Series: A Case of Painful Skin Lesions

By |Categories: Dermatology, Endocrine-Metabolic, SAEM Clinical Images|

A 50-year-old Caucasian female with a history of hypertension, coronary artery disease, and insulin-dependent diabetes mellitus presents to the emergency department with a complaint of painful sores on the top of her left foot. She notes that ulcerations have formed over the past two weeks and reports a history of multiple recurrent usually non-tender skin lesions to her lower extremities, forearms, and hands over the past twenty years. She is homeless and medically non-compliant secondary to financial issues. Vitals: T 37.2°C; BP 149/77; HR 94; RR 20 Skin: Multiple yellow-brown and violaceous [+]

SAEM Clinical Images Series: A Serious Pain in the Neck

By |Categories: HEENT, Infectious Disease, SAEM Clinical Images|

An otherwise healthy 34-year-old male presented to the Emergency Department with two weeks of anterior neck pain. Symptoms began with several days of pain in his mandibular molars, progressing to pain and swelling in the neck. In the last several days, the patient developed warmth and redness in the chest wall associated with subjective fever and chills. Additionally, the patient reports difficulty swallowing solid foods secondary to odynophagia associated with intermittent globus sensation. He has no history of immunocompromise and denies any drug or alcohol use. Of note, he has not seen a dentist in [+]

ALiEM AIR Series | Respiratory 2023 Module

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

Welcome to the AIR Respiratory Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to respiratory diseases in the Emergency Department. 6 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 3 AIR and 3 Honorable Mentions. We recommend programs give 3 hours of III credit for this module. AIR Stamp of Approval and Honorable [+]

  • pufferfish tetrodotoxin

ACMT Toxicology Visual Pearls: A Meal Worth Dying For

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

What is the most common primary cause of death from ingesting the pictured marine animal? Acute liver failure Acute renal failure Coagulopathy and DIC Respiratory failure Status epilepticus [Image from Canstockphoto] [+]

Faith Meyers, MD

Faith Meyers, MD

Emergency Medicine Resident
Department of Emergency Medicine
Carolinas Medical Center
Faith Meyers, MD

Latest posts by Faith Meyers, [+]

Shuhan He, MD
ALiEM Senior Systems Engineer;
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General Hospital;
Chief Scientific Officer, Conductscience.com
Shuhan He, MD