Beyond the Abstract: Patient video testimonials improve physician interpretation of advance directives and POLST

By |Categories: Beyond the Abstract, Geriatrics, Palliative Care|

Over 1,300 physicians across the U.S. were asked to interpret patient preferences for end-of-life care in theoretical cases. Physicians rarely reached consensus about patient preferences when they were given only living wills and POLST documents to interpret. The addition of a patient video testimonial helped physicians make better care decisions that reflected their patients’ wishes. Will video become the new national standard for advance care planning? [+]

AIR Series: Trauma Module (2017)

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

Welcome to the Trauma 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 procedure content. Below we have listed our selection of the 21 highest quality blog posts within the past 12 months (as of September 2016) related to Trauma emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 5 AIRs and 16 Honorable Mentions. We recommend programs give 7 hours (about 20 minutes per article) of III credit for this module. [+]

PV Card: Laceration Repair and Sutures – A cheat sheet guide

By |Categories: ALiEM Cards, Orthopedic, Trauma|

Laceration repair and suturing are foundational skills for the Emergency Department. This pocket card serves as a quick reference guide for clinicians, and provides a much-needed update and design upgrade from the 2011 PV card on Sutures. This card covers suture/staple removal times, suture sizes, suture material characteristics, special laceration considerations, and suture techniques. [+]

PEM Pearls: Pediatric Sepsis Management – Understanding the Basics

By |Categories: Infectious Disease, Pediatrics, PEM Pearls|

Just as in adults, pediatric sepsis is a complex topic with continued research. In the United States, there are an estimated 75,000 cases per year of pediatric severe sepsis with an in-hospital mortality of 5-10%.1,2 This is one of the deadliest conditions treated in children. In addition, after the Rory Staunton case, New York State passed regulations requiring all hospitals to have pediatric specific recognition, treatment, and data reporting systems. Several other states have adopted, or are considering, similar requirements. Thus it is critical that emergency physicians understand at least the basics of pediatric sepsis management. [+]

    60 Second Soapbox: Messman (Vertigo), Dolcourt (Charcoal), Stiell (C-spine Rules)

    By |Categories: 60-Second Soapbox|

    After a bit of a hiatus we are back with another round of 60-Second Soapbox! Each episode, one lucky individual gets exactly 1 minute to present their rant-of-choice to the world. Any topic is on the table – clinical, academic, economic, or whatever else may interest an EM-centric audience. We carefully remix your audio to add an extra splash of drama and excitement. Even more exciting, participants get to challenge 3 of their peers to stand on a soapbox of their own!  [+]

    Epistaxis Management in the Emergency Department: A Helpful Mnemonic

    By |Categories: ENT|

    Epistaxis is a common presentation to the emergency department (ED)1 that can be challenging and time consuming. Knowledge of the pearls, pitfalls, and troubleshooting tips around managing nosebleeds often can be the difference between a frustrating versus straightforward ED stay for patients. Use the EPISTAXIS mnemonic to help you remember these points. [+]

    Trick of the Trade: Rapid Insertion of Orogastric Tube

    By |Categories: Critical Care/ Resus, Tricks of the Trade|

    We have all been in the situation: an intubated patient needs an orogastric (OG) tube and no one has been able to place it successfully. Unfortunately, we typically find out about this situation after several failed attempts, when the patient is bleeding and/or the anatomy is distorted. It may coil in the mouth or esophagus. Here I present a novel technique to rapidly place an OG tube within seconds. [+]

    Ultrasound For The Win! – 46M with Diffuse Abdominal Pain #US4TW

    By |Categories: Gastrointestinal, Ultrasound, Ultrasound for the Win|

    Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where point-of-care ultrasound changed the management of a patient’s care or aided in the diagnosis. In this case, a 46-year-old man with a history of alcohol abuse presents with diffuse abdominal pain. [+]

    PEM Pearls: Calming techniques while repairing a laceration

    By |Categories: Pediatrics, PEM Pearls, Trauma, Tricks of the Trade|Tags: |

    Most children who come into the Emergency Department present with pain or experience pain during their ED stay.1,2,3 Pain and distress during a procedure can leave a lasting impact on a child and contribute to mistrust of the medical system and compliance with future procedures.1 ,4,5 Children who use active forms of coping report less pain and distress during a procedure.3 To help with coping, when feasible, involve parents or family, nursing and a child life specialist. If the parents are willing, try to get them involved in all parts of the medical procedure.2,3 This includes positioning the patient with a parent in [+]

    AIR Series: Respiratory Module (2017)

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

    Welcome to the Respiratory 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 procedure content. Below we have listed our selection of the 12 highest quality blog posts within the past 12 months (as of August 2016) related to Respiratory emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 4 AIRs and 8 Honorable Mentions. We recommend programs give 4 hours (about 20 minutes per article) of III credit for this module. [+]

    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