IDEA Series: Just-in-Time Training for Diagnostic Paracentesis
According to the National Health And Nutrition Examination Survey, approximately 630,000 adults in the United States have cirrhosis of the liver, 69% of which are reportedly unaware of having liver disease. A diagnostic paracentesis is a simple procedure for identifying spontaneous bacterial peritonitis in cirrhotic patients with ascites. A just-in-time training (JITT) model incorporating low-fidelity equipment readily available in the ED can facilitate procedural teaching of the diagnostic paracentesis. [+]
SAEM Clinical Image Series: Uncommon Cause of Right Groin Pain
A 48-year-old male presents with 2 weeks of severe right lower quadrant abdominal pain and inguinal pain. The patient had similar pain 2 weeks ago, was referred to a surgery clinic, but was lost to follow up. The pain has been progressively worsening over the last 2 days. It’s now severe, associated with nausea and vomiting, does not radiate, and it is worsened with coughing and sneezing. He also endorses polyuria for an unknown length of time. His last bowel movement was 3 days ago. He denies diarrhea, constipation, hematochezia, melena, dysuria, hematuria, or recent [+]
SAEM Clinical Image Series: A Case of a Painful Facial Rash
A 65-year-old female without any significant past medical history presented to the emergency department with left eye pain and redness. She also reported a developing rash to left side of her face over the last 24 hours. [+]
Jonathan Chan
Latest [+]
ALiEM AIR | Infectious Disease 2019 Module
Welcome to the AIR Infectious Disease 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 online content related to infectious disease emergencies. 9 blog posts within the past 12 months (as of September 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 1 AIR and 8 Honorable Mentions. We recommend programs give 4.5 hours (about 30 minutes per article) of III credit for this module. [+]
Trick of Trade: Topical lidocaine jelly takes the tears out of skin tears and road rash
Skin tears are a common injury treated in the elderly in the emergency department (ED). Often the skin is paper thin, and the area involved can have a large flap. By the time the patient has arrived, the may blood have dried with a retracted and rolled-in skin flap. Often the surface area is too big and skin to thin to inject local anesthesia around the entire site. [+]
Syncope as Easy as 1-2-3
A 66-year-old otherwise healthy man presents by Emergency Medical Services (EMS) after being found unconscious on the ground. On arrival to your emergency department, he is back to his baseline normal mental status and without complaints. His vital signs are within normal limits and his physical exam is unremarkable. Is it a syncope? What are the key features of his history and physical exam that should affect your medical decision making? What should this patient’s work-up entail? [+]
Ultrasound for the Win! 3-year-old with abdominal pain #US4TW
A 3-year-old Hispanic female with no significant past medical or surgical history presents to the Emergency Department with her mother for a 3 day history of crampy abdominal pain, intermittent bloody diarrhea and fever. There has been no recent travel, admissions, or antibiotic use. Her older sister reports similar symptoms, which have resolved. The patient saw her pediatrician the day prior, who recommended supportive care including oral rehydration. [+]
SAEM Clinical Image Series: Rash and Headache in Acute Myeloid Leukemia
A 25 year old male with a history of acute myeloid leukemia (AML) after an allogeneic stem cell transplant, which has been in remission for 6 years. He presents with a headache and rash. 4 days ago the patient noticed a rash on the abdomen that was itchy, but not painful. Today, he noticed a similar rash on his face. The headache started yesterday, waking him up from sleep. It is now slowly getting worse. He endorses chills, nausea, neck stiffness, neck pain, myalgias, and photophobia. He denies fevers, vomiting and phonophobia. He does have [+]
SplintER Series: Salter-Harris Fractures
A 6 year-old boy presents with left wrist pain after he fell off the monkey bars onto an outstretched hand. You obtain wrist x-rays and see an abnormality. What is the most likely diagnosis, differential diagnosis, and management plan? [+]
Mark Hopkins, MD
SAEM Clinical Image Series: Bellybutton Mass
A 4 week-old female infant presents due to yellow discharge from her umbilicus and mom noticing a red mass coming from the umbilical area after changing her diaper today. She is a healthy infant born at 40 weeks by vaginal delivery without complications and weighed 6 lbs 1 oz at birth. She is feeding 4 oz of formula every 3-4 hours. She received immunizations at birth and has an established pediatrician. [+]
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General Hospital;
Chief Scientific Officer, Conductscience.com
Latest posts by Shuhan He, MD (see all)
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