PV Card: Elbow Injuries

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

Elbow injuries are a common presentation to the Emergency Department. This pocket card reviews some the imaging, acute management, and some pearls for the following injuries: elbow dislocation, radial head subluxation, supracondylar fractures (such as the xray on the right), radial head fracture, epicondylitis, condyle fractures, and olecranon fracture. Thanks to Dr. Jonathon Hancock (Doctor's Hospital orthopedist) for the expert peer review. PV Card: Elbow Injuries View other PV Cards.  

AIR Series: Infectious Disease Module (2016)

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

Welcome to the Infectious Disease 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 18 highest quality blog posts within the past 12 months (as of August 2016) related to Infectious Disease emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 2 AIRs and 16 Honorable Mentions. We recommend programs give 6 hours (about 20 minutes per article) of III credit for this module. [+]

Ultrasound For The Win! Case – 40F with Fever, Chest Pain, Shortness of Breath

By |Categories: Cardiovascular, 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 40-year-old woman presents with a fever, chest pain, shortness of breath, cough, and generalized weakness. [+]

PV Card: LVAD Complications

By |Categories: ALiEM Cards, Cardiovascular, Critical Care/ Resus, Expert Peer Reviewed (Clinical)|

Patients with left ventricular assist devices (LVAD) often cause much anxiety amongst providers in the emergency department. This is understandable with all of the hardware, diminished or absent peripheral pulses at baseline, and potential for complications. To add to the already helpful reviews about LVADs at REBELEM and emDocs, this is a PV card set providing a methodical approach to troubleshooting LVAD complications, including a reproduction of an algorithm for managing the LVAD patient with altered mental status from EMCrit.1–3  [Download PDF] John Greenwood, MD Assistant Professor Department of Emergency Medicine Department of Anesthesiology and Critical Care Hospital of the University [+]

PV Card: Knee Injuries | Quick Reference Guide

By |Categories: ALiEM Cards, Orthopedic|

Orthopedic injuries are commonly managed in the emergency department. Often a quick bedside reference card is needed to remind the clinician about the acute management decisions. This is the third of a series of orthopedic quick reference cards written by a team from the 2015-16 ALiEM Chief Resident Incubator. The first two were on ankle and hindfoot fractures and hip injuries. This card set covers knee injuries, specifically patella fractures, patella dislocation, and knee dislocation. These cards were expert reviewed by Dr. Scott Sherman, co-editor of the Emergency Orthopedics textbook (Amazon), and illustrations were created by Dr. Mary Haas. [+]

ED Charting and Coding: Medical Decision Making (MDM)

By |Categories: Administrative|

Editor’s Note (Jan 13, 2023):  The new AMA CPT 2023 Documentation Guidelines have been published and the coding elements within the medical decision making section have been revamped. See the ACEP FAQ page on the 2023 Emergency Department Evaluation and Management (E/M) Guidelines. In this ED Charting and Coding Series, we have covered Introduction to ED Charting and Coding (PV Card); the History of Present Illness & Past Medical, Family, Social History; the Review of Systems; and the Physical Exam. At last we arrive at the crux of the chart: Medical Decision Making (MDM). In this final section, you show [+]

PV Card: Hip Injuries | Quick Reference Guide

By |Categories: ALiEM Cards, Orthopedic|

Orthopedic injuries are commonly managed in the emergency department. Often a quick bedside reference card is needed to remind the clinician about the acute management decisions. This is the second of a series of orthopedic quick reference cards written by a team from the 2015-16 ALiEM Chief Resident Incubator. The first was on ankle and hindfoot fractures, and this card set covers hip injuries, such as hip dislocations and femur fractures. These cards were expert reviewed by Dr. Scott Sherman, co-editor of the Emergency Orthopedics textbook (Amazon), and illustrations were created by Dr. Mary Haas. [+]

ED Charting and Coding: Physical Exam (PE)

By |Categories: Administrative|

Editor’s Note (Jan 13, 2023): The new AMA CPT 2023 Documentation Guidelines have been published and the prior physical elements are no longer incorporated into the billing and coding guidelines. See the ACEP FAQ page on the 2023 Emergency Department Evaluation and Management (E/M) Guidelines. “What do I see, hear, and smell when I walk into the room?” While the oral boards challenge you to perform the physical exam in a certain way, the day to day examination of patients can vary dramatically. Centers for Medicare and Medicaid Services (CMS), however, has physical exam guidelines for billing that conform [+]

PV Card: Algorithm for acute bronchiolitis management

By |Categories: ALiEM Cards, Expert Peer Reviewed (Clinical), Pediatrics, Pulmonary|Tags: |

Bronchiolitis is a common lower respiratory tract infection in children less than 2 years old, and especially in those 3-6 months old. In a collaboration with the American Academy of Pediatrics’ (AAP) Section on Emergency Medicine Committee on Quality Transformation, we present a PV card summarizing the Section’s “Clinical Algorithm for Bronchiolitis in the Emergency Department Setting” (reproduced with permission).1 Dr. Shabnam Jain sums it up best in her expert peer review below: “In bronchiolitis, less is more.” [+]

ED Charting and Coding: Review of Systems

By |Categories: Administrative|

Editor’s Note (Jan 13, 2023):  The new AMA CPT 2023 Documentation Guidelines have been published and the prior Review of Systems section is no longer incorporated into the billing and coding guidelines. See the ACEP FAQ page on the 2023 Emergency Department Evaluation and Management (E/M) Guidelines. The Review of Systems (ROS) was the most frustrating aspect of charting as an intern. Documenting at least 10 elements from systems seemingly unrelated to the chief complaint took as long as a physical exam and was much harder to remember. For efficiency, many of us include any pertinent positives and negatives [+]

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