4 Pitfalls of Bedside Ultrasonography During First Trimester Pregnancy

By |Categories: Expert Peer Reviewed (Clinical), Ob/Gyn, Ultrasound|Tags: |

One of the more common indications for the use of bedside ultrasound (US) is to evaluate patients who present to the emergency department (ED) with pain or bleeding during the first trimester of pregnancy. When performing this study, providers should be aware of several potential pitfalls that pose significant risk to both the patient and the provider. [+]

Brian Bauerband, MD

Brian Bauerband, MD

PGY-2 EM [+]

Announcing the ALiEM-AgileMD Educational Design Fellowship

By |Categories: ALiEM Cards, Social Media & Tech|

Based on the successes of our 2014-15 ALiEM-EMRA (for medical students), ALiEM-CORD (for residents), and ALiEM-AAEM Young Physicians fellowships, we are thrilled to be launching the 2015 ALiEM-AgileMD Educational Design Fellowship! The application process for this virtual fellowship is now open. [+]

PV Card: Acute Salicylate Toxicity

By |Categories: Tox & Medications|

Patients with acute salicylate toxicity can rapidly decompensate and require clinicians to understand the pathophysiology of what is going on. First a respiratory alkalosis occurs with non-specific symptoms of vomiting and dizziness. Then an anion-gap metabolic acidosis also occurs with headache, tinnitus, and confusion. Below lists the core set of labs to obtain and treatment strategies by our stellar ALiEM-CORD Social Media and Digital Scholarship Fellow, Dr. Sam Shaikh. [+]

Ultrasound For The Win Case – 46F with 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 peer-reviewed case series, we focus on real clinical cases where bedside ultrasound changed management or aided in diagnoses. In this case, a 46-year-old woman presents with history of right-sided abdominal pain and vomiting. [+]

Lipid Rescue: Why Aren’t We Using It?

By |Categories: Tox & Medications|

Though lipid rescue sounds like something from a junk food detox regimen, it’s one of the most exciting developments in emergency management of drug overdose in the last 20 years. Unlike charcoal which can lead to aspiration and has relatively little data showing improved outcomes, or dialysis which relies on convincing your nephrologist to come in at 3 am, lipid rescue is a readily available, cheap, safe therapeutic that we’ve been using in TPN for adults and children for decades. And it seems to work, but why aren’t we using it? [+]

    Geriatric Emergency Medicine for Students, Residents, and Physicians

    By |Categories: Geriatrics, Medical Education|

    We all know the population of the United States is aging. We know emergency physicians need to be prepared and trained to care for older adults. But how can you dive into the world of geriatric EM to learn more, to research, to gain additional training? In this post, we have gathered the wisdom of leaders in geriatric EM across the country, to share their recommendations, inspiration, and motivation. [+]

    Adenosine in reactive airway disease

    By |Categories: Expert Peer Reviewed (Clinical), Pulmonary, Tox & Medications|

    A 44-year old woman presents via EMS with a chief complaint of a racing heartbeat. She is placed on a cardiac monitor, which displays a heart rate of 192, and a subsequent EKG reveals she is in SVT. She also complains of chest discomfort and shortness of breath. Her blood pressure is stable, and you decide to treat her with adenosine. As you take a more thorough past medical history, you learn your patient has a history of asthma. One of the EM residents mentions that he thought adenosine should not be given to patients with reactive airway disease. [+]

    Author Insight: Ultrasonography versus CT for suspected nephrolithiasis | NEJM

    By |Categories: Genitourinary, Radiology, Ultrasound|Tags: |

    Are you getting a CT or bedside ultrasound as your first-line diagnostic approach to patients with undifferentiated abdominal or flank pain in whom you suspect kidney stones? In a landmark 15-center, multidisciplinary study published in the New England Journal of Medicine in September 2014, Dr. Rebecca Smith-Bindman (UCSF Department of Radiology) and her research team looked at exactly this question for emergency department patients. In the paper, “Ultrasonography versus CT for suspected nephrolithiasis,” Dr. Smith-Bindman and Dr. Ralph Wang (UCSF Department of Emergency Medicine) kindly joined us on a quick discussion about her paper. [+]

    AIR Series: Ob/Gyn Module 2015

    By |Categories: Approved Instructional Resources (AIR series), Ob/Gyn|

    Welcome to the seventh ALiEM Approved Instructional Resources (AIR) Module! In an effort to reward our residents for the reading and learning they are already doing online we have created an Individual Interactive Instruction (III) opportunity utilizing FOAM resources for U.S. Emergency Medicine residents. For each module, the AIR board curates and scores a list of blogs and podcasts. A quiz is available to complete after each module to obtain residency conference credit. Once completed, your name and institution will be logged into our private database, which participating residency program directors can access to provide proof of completion. [+]

    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