SplintER Series: A Case of Severe Shoulder Pain

By |Categories: Orthopedic, SplintER|

A 45 year old woman presents with several days of gradually worsening right shoulder pain and stiffness. Her shoulder is very warm to the touch but not erythematous. You obtain shoulder x-rays and see a linear density in the AP view (photo credit). What is the most likely diagnosis, the differential diagnosis, and management plan?   [+]

  • warm ultrasound gel

Ultrasound Gel Warmers in the Emergency Department?

By |Categories: Infectious Disease, Ultrasound|

How many times have you told a patient “The gel will be cold?” How many times have you watched a patient retract from the transducer because of the cold gel? How about a pediatric patient? Could warm gel improve your rate of clinically successful scans? It seems easy enough to install gel warmers alongside our ultrasound machines. But, should we do this? Read more

SplintER Series: Case of a First Metacarpal Fracture

By |Categories: Orthopedic, SplintER|

Click image to enlarge view A 22 year-old male was playing football when he fell, landing on his outstretched left arm with his thumb flexed. He now has pain at the base of his thumb. This AP view of the hand best demonstrates the injury (photo credit). What is this fracture, what additional imaging is needed, and what should be the management plan?     [+]

ALiEM AIR | Neurology 2019 Module

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

Welcome to the Neurology 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 neurological emergencies. 6 blog posts within the past 12 months (as of January 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 5 Honorable Mentions. We recommend programs give 3 hours (about 30 minutes per article) of III credit for this module. [+]

DIY Ultrasound Model Compendium in Emergency Medicine

By |Categories: Ultrasound|

As the use of point-of-care ultrasound expands in emergency medicine, phantoms offer an attractive training solution for new learners and continuing education. Unfortunately, commercially available products are expensive and likely cost-prohibitive for individual practitioners to purchase. Luckily, there are a number of quality, low cost do-it-yourself (DIY) models published in journals and on the Internet. To help you navigate your options, I have created a compendium of DIY ultrasound models relevant to emergency medicine. The models are divided by system or application with a cost estimate for each model, if provided, as well as a list of materials and a [+]

Guideline Review: ACEP 2018 – ED Procedural Sedation with Propofol

By |Categories: Guideline Review, Tox & Medications|Tags: , |

The last American College of Emergency Physicians (ACEP) guideline recommendations regarding the use of propofol for ED procedural sedation was in 2007. Much research has since demonstrated its safety in adults and children. Furthermore, many clinicians are co-administering ketamine or fentanyl in conjunction. This 2018 ACEP update​1​ addresses these issues and much more. The following infographic summarizes the key points. [+]

Health Insurance 101 for the Emergency Physician

By |Categories: Public Health, Public Policy|

A 28 year-old single man with type I diabetes mellitus presents to your busy Texas emergency department in diabetic ketoacidosis (DKA). This is his third hospitalization for DKA in 5 months. When you ask the patient about his current medication regimen, he admits that he frequently skips doses as a cost-savings measure. He shares that he works 45 hours a week at a small local grocery store, makes minimum wage ($15,660 pretax), and has no health insurance. His prescribed insulin regimen, consisting of Lantus at bedtime and Humalog with meals, costs approximately $600 a month. [+]

  • Knee Pain

SplintER Series: 2-Minute Knee Exam | Leg Day #3 | MSK Exam Series

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

Welcome to Leg Day #3 of the SplintER Series! Performing a fast and focused history and physical examination of a patient with an acute knee injury is an important skill that has the potential to be overlooked in our busy Emergency Departments. Our hope is that after reviewing this post and with enough practice you will be able to complete your exam within 2 minutes! These are can't-miss points and expert tips on the knee exam for your next shift in the ED. Read more

ALiEM AIR | Stroke Module

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

Welcome to the Stroke Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the AIR Team is proud to present the highest quality online content related to Stroke emergencies. 7 blog posts within the past 12 months (as of October 2018) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 0 AIR and 7 Honorable Mentions. We recommend programs give 3.5 hours (about 30 minutes per article) of III credit for this module. [+]

Beyond the Abstract: A Return to Work Policy for New Resident Parents

By |Categories: Beyond the Abstract, Wellness|

More women than men entered medical school in the United States for the first time in 2017. Will this generation also set new trends in parenting during their training? One study suggests that 40% of female residents plan to have a child while in residency.1 Can our graduate medical education system withstand even a modest increase in the number of resident parents? Can your hospital? [+]

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