Case of a Lethargic Child: Developing a Differential Diagnosis
A 2-year-old previously healthy boy presents to the emergency department (ED) acting sleepier than usual. Yesterday, he was in his usual state of health, but this morning he didn’t wake up at his usual time of 6 am. When his father went to his room at 7 am, the child was lying in bed. He opened his eyes to look at his father, but did not get out of bed. The mother and father deny any trauma, fever, or seizure activity. [+]
ALiEMU Capsules Module 11: Acute Agitation
We are proud to present Capsules Module 11: Acute Agitation, now published on ALiEMU. We present a summary of the module with key points from a stellar module by PharmDs Jenny Koehl, Kyle DeWitt, Gabrielle Procopio, and Zlatan Coralic. When you’re finished, head over to the Capsules page for even more practical pharmacology for the EM provider. [+]
Use of Point-of-care Ultrasound in Tibial Plateau Fractures | Case Presentation
A 70-year-old female with no past medical history was hit by a motor vehicle while crossing the street. She experienced no head strike or loss of consciousness, however she was unable to ambulate at the scene, and upon arrival to the ED, complained of left knee pain. The emergency physician noted moderate swelling on exam with intact skin and distal pulses. She was tender to palpation over the proximal tibia. Portable 2-view radiographs were obtained and interpreted as “no acute fracture.” On repeat examination, however, the patient continued to have pain and was now unable to bear weight on the [+]
SAEM is teaming up with us and exclusively sponsoring the AIR Series
The Society of Academic Emergency Medicine (SAEM) is now the exclusive, multi-year sponsor of the Approved Instructional Resources (AIR) Series! This series has curated and graded open-access blog posts and podcasts in the field of EM since 2014 to identify and provide high quality, social media-based, educational resources for EM residents. It is one the most used resources for Individualized Interactive Instruction (III) credit, and plus it is free! We look forward to working more with SAEM, who shares our grand vision for medical education. This aligns perfectly with our recently re-launched ALiEMU "be free to learn" learning management platform, [+]
Reversing Anticoagulation to Administer Systemic Fibrinolytics for Ischemic Stroke: Pump the Brakes
Care of acute ischemic stroke patients is a complex and time-sensitive team effort. There is a potentially dangerous trend in the medical literature over the past few years that seems to be increasing as of late: reversing anticoagulation in order to administer systemic thrombolytic therapy. The purpose of this post is to highlight the available literature on this topic, specifically related to the direct acting oral anticoagulants (DOACs), and discuss why we should not support this practice (at least as of today). [+]
PECARN Study: Accuracy of Urinalysis for Febrile Infants ≤60 Days Old
The reported accuracy of the urinalysis (UA) for diagnosing urinary tract infections (UTI) is febrile infants ≤ 60 days has been widely variable. Some guidelines specifically exclude these patients due to this variability or recommend urine culture as the primary test.1 Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger, published in Pediatrics in February of 2018, addressed this topic head-on.2 The authors sought to evaluate the accuracy of the UA by analyzing data in a planned secondary analysis of a prospectively collected data set, as part of the Pediatric Emergency Care Applied Research [+]
4 New Podcasts on the Opioid Initiative | ACEP E-QUAL Series
The American College of Emergency Physicians (ACEP) features 3 quality improvement targets within their Emergency Quality Network (E-QUAL) initiative: sepsis, imaging, and chest pain. Most recently, they added a fourth new focus on the opioid epidemic. This opioid initiative covers best-practice approaches and strategies for managing opioid-related complications. In collaboration with ACEP E-QUAL, we have remixed and distilled 5 of their webinars into 4 podcasts. [+]
ALiEMU AIR Obstetrics and Gynecology Module
Welcome to the Obstetrics and Gynecology (Ob/Gyn) 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 Ob/Gyn emergencies. 10 blog posts within the past 12 months (as of July 2018) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 2 AIR and 8 Honorable Mentions. We recommend programs give 4 hours (about 25 minutes per article) of III credit for this module. [+]
Ultrasound guided peripheral IV: It’s time to clean up our act
Have you ever performed a procedure, when suddenly, you are overcome by a sinking feeling that something just is not right? A mix of fear, guilt, and anger: Fear that you endangered a patient, guilt that you missed an important step in the procedure, and anger at yourself for being careless. The oath we take as physicians echoes loudly: Primum non nocere. First, do no harm. [+]
EM Fellowship Match Advice: Ultrasound Fellowship
The EM Residency Match Advice Series is back with its latest installment! We put the focus on emergency ultrasound fellowships, and our sage panel walks us through some of the changes to this year's application cycle. For the first time, Ultrasound Fellowship Programs will participate in the NRMP match program. The Society for Clinical Ultrasound Fellowships (SCUF) provides the fellowship application service (similar to the role of ERAS, but shorter!) for the residency match. Hosted by Drs. Michael Gisondi and Michelle Lin, watch the video or listen to the podcast to learn about important changes to the application process and [+]
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)
- The Discharge Severity Index: Early Research on ED Readmission Risk Assessment - August 14, 2025
- Suboxone and the Emergency Physician: Get Waivered Training - August 12, 2022
- A Tale of Two Epidemics: COVID-19 and the Opioid Crisis - April 23, 2020