• posterior elbow dislocation xray

SplintER Series: Elbow Injury

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

A 70-year-old female presents with left elbow pain and deformity after falling on an outstretched hand. You obtain shoulder x-rays and see the above images. What is the most likely diagnosis, likely mechanism of injury, expected physical exam findings, and management plan?  (Image 1: AP and lateral views of the left elbow. Author’s own images) […]

  • Non-contrast CT

SAEM Clinical Image Series: Found Down with Altered Mental Status

By |Categories: Emergency Medicine, Infectious Disease, Neurology, SAEM Clinical Images|

A forty-nine-year-old male with a history of polysubstance abuse, including methamphetamine and intravenous (IV) drug use, rectal cancer, and human immunodeficiency virus (HIV) was brought into the emergency department by emergency medical services (EMS) after he was found down at the bottom of a flight of stairs by his roommate. In the emergency room, he was found to have a Glasgow Coma Scale (GCS) score of 7 and was intubated for airway protection. Non-contrast head CT was performed. Per the roommate, the patient had been “not himself,” exhibiting strange behavior and weight loss. History and [...]

ALiEM AIR | Renal/Genitourinary 2020 Module

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

Welcome to the AIR Renal/Genitourinary 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 renal and genitourinary emergencies. 6 blog posts within the past 12 months (as of May 2020) 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. AIR Stamp of [...]

  • posterior shoulder dislocation xray

SplintER Series: Finger pain

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

A 45-year-old male presents to the emergency department (ED) with right hand pain after an e-bike accident. Physical exam shows deformity and tenderness at the 5th proximal phalanx. Radiographs are shown above (Image 1: Plain radiography of right hand with AP and oblique views. Author’s own images). What is the most likely diagnosis? What are the important aspects of the associated physical examination? What is the management in ED, including pain management? When do you consult orthopedics? […]

IDEA Series: Big Screen Ultrasound in Resuscitation Bays

By |Categories: IDEA series, Medical Education, Ultrasound|

Bedside ultrasound (US) often plays a crucial role in medical and trauma resuscitations in the emergency department (ED) [1]. Performing and interpreting bedside US studies such as the Extended Focused Assessment with Sonography for Trauma (E-FAST) during traumas or echocardiography during medical resuscitations are key skills for emergency medicine residents to learn during their training and adopt into clinical practice [2]. During trauma resuscitations timely and efficient dissemination of critical information is paramount. Information obtained via bedside US can be critical in determining further clinical actions (need for urgent thoracostomy for a pneumothorax, need for urgent exploratory laparotomy in a [...]

  • normal pediatric elbow

SplintER Series: Pediatric Elbow Pain

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

A 9-year-old male presents with right elbow pain after a fall onto the elbow. What is your diagnosis? What common pediatric elbow findings are you looking for? What is your management and disposition in the ED? (Image 1: Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 47354) […]

PEM Pearls: Intranasal Medications in the Pediatric ER

By |Categories: PEM Pearls, Tox & Medications|

Fiona is a 6 year old female who presents to your emergency department after falling onto her left hand while racing on the playground. X-ray of the left upper extremity reveals a distal radius fracture with minimal displacement and angulation. You plan to place her arm in a splint and arrange for close orthopedic follow-up. The only problem: Fiona is in a lot of pain, especially with any manipulation of her arm, and Dad is worried that she will not be able to tolerate having a splint placed. You consider reaching for an intranasal medication to help Fiona feel more [...]

IDEA Series: Toxicology Virtual Escape Room during COVID-19

By |Categories: IDEA series, Medical Education, Tox & Medications|

In order to enhance emergency medicine (EM) residents’ knowledge of toxicology core content, we previously created an immersive escape room experience complete with team-based puzzle solving in a geographical maze to find an antidote. The subsequent COVID-19 pandemic and physical distancing guidelines resulted in canceled in-person EM conferences, thereby requiring a rapid adaptation to virtual formats [1-4]. Our toxicology division sought a novel method of engaging learners with toxicology core content remotely.  […]