The rapid code status conversation guide for seriously ill older adults in acute respiratory failure
You are working a shift in your emergency department (ED) when an 85 year old female presents with a complaint of altered mental status. She comes from an extended care facility, where paramedics are able to tell you “they called us to come get her,”you are handed a stack of paperwork, given some vital signs, and you notice the patient is altered and unable to provide any further history. You dig a little in the paperwork and note a history of dementia as well as a long list of other medical problems, you notice no known advanced directive, and see [+]
Work Grief: A Primer for Emergency Medicine Providers
Heartbreaking patient situations are the backbone of Emergency Medicine. Whether it’s a new cancer diagnosis, telling a family member that their loved one has died, or the creeping dread that a mistake that we’ve made will negatively impact one of our patients, we all experience extraordinary stress in our day-to-day clinical practice. Most clinicians are not tasked with routinely sharing news about the violent, unexpected, and horrific life-changing situations that occur in the emergency department, and yet we are given so few tools to help us manage this firehose of grief. This article is intended to share some of the [+]
Beyond the Abstract: Systemic Online Academic Resources Review: Renal and Genitourinary
Production and use of free open access medical education resources (FOAM) has had a meteoric rise over the last decade.1–4 ALiEM works hard to produce content, disseminate knowledge, and consolidate resources in a democratic and accessible way. However, we recognize that FOAM comes with its own limitations: Blogs are distinct, individual, and decentralized. How can we search for topic-specific content? FOAM doesn’t often have peer review. How can we assess quality and accuracy? FOAM is produced on an as-needed basis. How do we achieve curricular comprehensiveness? [+]
Tricks of the Trade Book: Pre-order release of first 500 copies
Will there be a return to book publishing in this era of digital information chaos and overload? We believe so. We are proud to announce “Tricks of the Trade in Emergency Medicine: Where Experience, Ingenuity, and Evidence Intersect.” Being our own publishers (ALiEM Publishing) and selling through a print-on-demand bookstore has allowed us to design the book with full creative license. In stark contrast to our blog and other digital-based projects, we aimed to create a hardback, full-color book that you can read on a lazy Sunday afternoon, give as a graduation gift, or look delightful on your coffee table. [+]
IDEA Series: Use of gamification through Clue: Pediatric Rash Edition
Emergency Medicine (EM) physicians care for anyone, with anything, at any time. This includes pediatric patients as well as adults. For those without advanced pediatric training, “sick kids” can be quite intimidating. Rashes in the pediatric population are often benign, but in rare cases they portend significant illness. Rashes are also frequent chief complaints; In 2015, there were 1,452,300 pediatric ED visits for “skin and subcutaneous tissue disorders” [1]. We sought to improve the teaching of pediatric rashes in our residency curriculum. [+]
ACMT Toxicology Visual Pearls: The Doom from Down Under
Inadvertent contact with this aquatic species causes excruciating pain and an overwhelming sense of impending doom. What is this? Box Jellyfish (Chironex fleckeri) Irukandji Jellyfish (Carukia barnesi) Lion’s Mane Jellyfish (Cyanea capillata) Portuguese Man o’ War (Physalia physalis) [+]
Christopher Gardner, MD
Carolinas Medical Center, Charlotte, NC
ALiEMU New Course: Pediatric Ultrasound-Guided Peripheral IV Access
Did you know that the ALiEMU learning management platform has courses in addition to the AIR Series? We just published the third installment of the pediatric point-of-care ultrasound (POCUS) series, which focuses on peripheral IV access using ultrasonography. Do you use the traditional transverse, transverse with dynamic needle tip visualization, or longitudinal ultrasound technique? [+]
EMRad: Can’t Miss Adult Shoulder Injuries
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 primary doctor 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 a comprehensive review of each body part, but rather aims to highlight and improve [+]
EMRad: Radiologic Approach to the Traumatic Shoulder
This is EMRad, a series aimed at providing “just in time” approaches to commonly ordered radiology studies in the emergency department [1]. When applicable, it will provide pertinent measurements specific to management, and offer a framework for when to get an additional view, if appropriate. We have already covered the elbow, the wrist, and the foot and ankle. Next up: the shoulder. [+]
ACMT Toxicology Visual Pearls: Tox Never Smelled So Good
A child presents with tachypnea, tachycardia, and drooling after ingesting the sweet smelling contents of the pictured household item. What toxin could explain this presentation? Camphor Eucalyptus oil Menthol Methyl salicylate/Oil of Wintergreen [+]
Jessica Hoglund, MD
Carolinas Medical Center
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General Hospital;
Chief Scientific Officer, Conductscience.com
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