Magnesium for Rapid Atrial Fibrillation Rate-Control in the ED

By |Categories: Cardiovascular, Tox & Medications|

We love magnesium in the Emergency Department. It’s been said that magnesium is second-line for everything (kind of like doxycycline). But what about rate/rhythm control in atrial fibrillation (AF)? The 2014 AHA/ACC/HRS guideline for the management of patients with AF doesn’t mention magnesium at all.1 Dr. Josh Farkas (@PulmCrit) wrote about magnesium infusions for atrial fibrillation and torsade last year. His post looked at its use for cardioversion, rhythm-control, and rate-control in critically-ill patients. Our post will focus specifically on the IV magnesium data for rate-control in ED-related settings. [+]

52 Articles in 52 Weeks (2nd edition, 2016)

By |Categories: Emergency Medicine, Medical Education|

Maintaining lifelong learning is challenging, especially when trying to keep up with all of the journal publications in emergency medicine (EM). In 2013, we published a compilation of 52 journal articles, which interns could read over a 52-week period, at an average pace of 1 journal article per week. In the list below, we present an updated compilation for the “52 Articles in 52 Weeks” initiative. [+]

Whipped Cream Charger Abuse: The Toxicologist Mindset

By |Categories: Tox & Medications|Tags: |

The Toxicologist Mindset series features real-life cases from the San Francisco Division of the California Poison Control System. Case: A 39-year-old man, with no significant past medical history, was brought to the emergency department by family members, over three consecutive days, for anxiety, confusion, and ataxia. In the first two visits, his laboratory work-up, including complete blood cell count, chemistry panel, liver function tests, urine drug screen, and non-contrast head CT, were unremarkable. On his third visit, he was profoundly encephalopathic with confusion and poor concentration. He had bilateral lower extremity weakness and ataxia. He was admitted to the neurology [+]

Introducing CME for ALiEM via FOAMbase

By |Categories: CME, Medical Education, Social Media & Tech|

Ever wish you could get Continuing Medical Education (CME) credit for the Free Open Access Meducation (FOAM) you already consume? We are excited to announce that 10 ALiEM articles are now available for AMA PRA Category 1 CME. This is a pilot program in collaboration with FOAMbase and EB Medicine. There is great content on trauma, geriatrics, pediatrics, critical care, and more. We think CME for FOAM is going to be a great way to increase sustainability for FOAM authors while keeping FOAM 100% free and open access.   [+]

ALiEMU CAPSULES Module 7: Emergency Thyroid Disorders

By |Categories: Capsules, Endocrine-Metabolic, Tox & Medications|

We are proud to present CAPSULES module 7: Emergency Thyroid Disorders, now published on ALiEMU. Here is a summary of the key points from this outstanding module by Drs. Craig Cocchio and Colleen Martin. [+]

Shuhan He, MD
ALiEM Senior Systems Engineer;
Director of Growth, Strategic [+]

AIR-Pro: Toxicology (Part 1)

By |Categories: Approved Instructional Resources PRO (AIR-Pro Series), Tox & Medications|

Welcome to the Toxicology (Part 1) AIR-Pro Module. Below we have listed our selection of the 10 highest quality blog posts related to 5 advanced level questions on toxicology topics posed, curated, and approved for residency training by the AIR-Pro Series Board. The blogs relate to the following questions: Flumazenil in benzodiazepine overdose Acetaminophen – drawing and timing of levels Opioid overdoses Acetaminophen toxicity related to liver transplant Salicylates and hemodialysis In this module, we have 6 AIR-Pro’s and 4 Honorable Mentions. To strive for comprehensiveness, we selected from a broad spectrum of blogs identified through FOAMSearch.net and FOAMSearcher.We have a brand new chief resident team and want to thank the [+]

Ultrasound for the Win! Emergency Medicine Cases: Volume 1 Book

By |Categories: Medical Education, Ultrasound, Ultrasound for the Win|

The Ultrasound for the Win! book, available now on Amazon and coming soon to the Apple iBooks Store, is a compilation of real ultrasound cases that have been featured on the blog’s Ultrasound for the Win! Series. [+]

PEM Pearls: Perfecting your pediatric lumbar puncture using ultrasound

By |Categories: CME, Pediatrics, PEM Pearls, Ultrasound|

A lumbar  puncture (LP) is a common procedure that every emergency physician must master. Pediatric LPs can be challenging for even the most experienced clinician due to small anatomy, difficulty with patient cooperation, and lack of frequency performed. A successful procedure is defined by obtaining cerebrospinal fluid and/or performing a non-traumatic lumbar puncture. There are multiple variables that lead to a successful pediatric lumbar puncture including provider experience, use of anesthesia, and patient positioning. Success rates for pediatric lumbar punctures are variable, with a large range from 34%-75%.1 [+]

AIR Series: Procedures Module (2016)

By |Categories: Approved Instructional Resources (AIR series), Critical Care/ Resus|

Welcome to the Procedures 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 13 highest quality blog posts within the past 12 months (as of June 2016) related to procedure emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 3 AIRs and 10 Honorable Mentions. We recommend programs give 4 hours (about 20 minutes per article) of III credit for this module. [+]

ED Charting and Coding: History of Present Illness & Past Medical, Family, Social History

By |Categories: Administrative|Tags: |

Editor's Note (Jan 13, 2023):  The new AMA CPT 2023 Documentation Guidelines have been published and the prior history and 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. Remember the “OPQRST” mnemonic? It stands for Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, Timing. Not only can it guide your history taking, but charting these descriptors also ensures you can code at an appropriate level. The patient’s history is the first example of the balance between essential information and over-documentation. It should be comprehensive, [+]

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