Can’t Miss ECG Findings for the Emergency Medicine Provider
Sudden cardiac death accounts for almost 400,000 deaths per year in the United States, and EM providers must be adept at discerning subtle, high-risk ECG findings. With the advent of triage ECG protocols, one of the most common interruptions in the ED is a request to “sign off” on an ECG. We present a reference of some of the most important high-risk ECG findings, intended to help ED providers systematically screen patients in triage and the waiting room. [+]
SplintER Series: Common ED Splint Techniques 104
The SplintER series is back with its fourth installment! In this series, we review splinting fundamentals, introduce advanced concepts, and highlight ways to implement these into your next shift. In this post, we summarize some of the most commonly deployed splints in the ED. Peer-reviewed by sports medicine experts (Dr. Kori Hudson and Dr. Anna Waterbrook), these injury-splint summary tables provide information on the origin, insertion, and positioning for each splint, along with the recommended number of layers of plaster. [+]
ACMT Toxicology Visual Pearls: Snake Bite
Envenomation by the pictured snake would be expected to produce which clinical effects? Bradycardia and hypotension Bruising and epistaxis Difficulty swallowing and muscle weakness Severe swelling and blistering [+]
Director of Growth, Strategic Alliance Initiative, Center [+]
ALiEM AIR Series: Endocrine Module
Welcome to the Endocrine 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 Endocrine emergencies. 8 blog posts within the past 12 months (as of May 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 6 Honorable Mentions. We recommend programs give 3 hours (about 20 minutes per article) of III credit for this module. [+]
PEM Practice Changing Paper: Clinical Trial of Fluid Infusion Rates for Pediatric DKA
Most protocols for managing pediatric patients with diabetic ketoacidosis (DKA) are based on a theoretical association between fluid resuscitation and subsequent neurological decline. Although the evidence for an association between IV fluids and cerebral edema comes from retrospective reviews, for over 20 years, it is an accepted teaching principle of pediatric DKA. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis, published just days ago in the New England Journal of Medicine, challenges this teaching with the first randomized controlled trial designed to investigate the relationship between IV fluids and cerebral edema. We review this publication and present a behind-the-scenes podcast interview [+]
The Myth of Vasopressors and Ischemia
Despite the widespread clinical use, and their well-documented life-saving properties, vasopressors are often maligned, accused of causing ischemia to fingers, toes, mesentery, kidneys, and so forth. Not only is the evidence that this happens poor, but, a fear of this dreaded complication can unwarrantedly lead good clinicians to limit or withhold potentially life- and organ-saving medications. This article showcases the importance of end-organ perfusion and explains how vasopressors may in fact be one of the most important therapies in an emergency physician’s armamentarium. [+]
IDEA Series: Implementing an Integrative Longitudinal Online Ultrasound Curriculum
The Problem Emergency ultrasound (EUS) has quickly become a fundamental aspect of emergency medicine (EM) residency training. While still relatively novel to the field, there has been a significant focus on curriculum development in accordance with the core ultrasound application guidelines set forth by the American College of Emergency Physicians (ACEP).1 Currently, there is no consensus on the optimal approach to EUS education that will provide learners with true clinical competence post-matriculation. Furthermore, a recent survey demonstrated that there is conflict between what ACEP guidelines consider to be competence in EUS and resident opinion on the matter.2 One potential identified [+]
Trigger Point Injection for Musculoskeletal Pain in the ED
Musculoskeletal pain is a common ED presentation and emergency providers can often manage it with NSAIDs alone.1 On the other hand, when patients present with small localized areas of intense muscle spasm called trigger points, NSAIDs won’t cut it. A trigger point injection (TPI), however, is a safe and easy way to treat the underlying cause of trigger point pain, and requires only basic equipment already available in most the EDs. [+]
Nuclear Attack: What Emergency Physicians Working in the ED Need to Know
Ever wonder what would happen if you were working in the emergency department (ED) when a nuclear attack happens? We’ve all had questions on boards or inservice exams about the long-term effect of radiation exposure, but would you know what to ACTUALLY DO if a nuclear attack happened? What do you do in the first few minutes? First few hours? We know that if you are in the immediate bomb vicinity, there is not much you can do. But what if you are 5 miles away? Or 10 miles? If you look for information regarding nuclear attacks, there are no [+]
ECMO for ARDS: Key Pearls for Emergency Physicians from the EOLIA Trial
The role of extracorporeal membrane oxygenation (ECMO) in the management of acute respiratory distress syndrome (ARDS) has been a source of debate within the critical care community.1 The use of ECMO has steadily increased over the past decade;2 however, evidence to support the widespread adoption of this expensive and invasive technology is limited. As advances in ECMO technology have rapidly outpaced evidence, clinicians have been left to speculate as to ECMO’s true value. Is ECMO a promising tool to advance the care of patients with respiratory failure3 or an expensive distraction that has inappropriately supplanted evidence-based strategies?4 All who care [+]
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