PRoMPT BOLUS: A Landmark PECARN Trial Defining Fluid Choice in Pediatric Sepsis
Article reviewed: Balamuth F, Weiss SL, Long E, et al; PRoMPT BOLUS Investigators of the PECARN, PERC, and PREDICT Networks. Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock. N Engl J Med. Published online April 24, 2026 DOI: 10.1056/NEJMoa2601969 | PubMed: PMID 42028918 For years, clinicians and researchers have debated a fundamental question in pediatric emergency care: does the type of fluid used in pediatric sepsis resuscitation matter? The PRoMPT BOLUS trial was designed to answer this question. Conducted across 47 international sites in 5 countries and enrolling more than 9,000 children, this large, pragmatic randomized [+]
ACMT Toxicology Visual Pearl: Delayed Skin Burn
What type of burn may not develop findings shown until days to weeks after the exposure? Chemical Electrical Radiation Thermal [Image generated via Google Gemini] [+]
Kevin Black, DDS, MD
Carolinas Medical Center
Latest posts by Kevin Black, DDS, [+]
ALiEM AIR Series | Non-ACS Cardiology Module (2026)
Welcome to the AIR Non-ACS Cardiology Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to non-ACS cardiology emergencies in the Emergency Department. 9 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 6 AIR and 3 Honorable Mentions. We recommend programs give 5 hours of III credit for this module. AIR Stamp [+]
ACMT Toxicology Visual Pearl – Big Spider, Small Risk
What is the spider pictured below? Atrax robustus (Sydney funnel-web spider) Phoneutria nigriventer (Brazilian wandering spider) Trichonephila clavata (Joro Spider) Trichonephila clavipes (Golden Silk Orb-Weaver) [Author’s own image] [+]
Fernando Tejeda-Castro, DO
Jefferson Einstein Hospital of Philadelphia
EM Match Advice 51: 2026 EM Match by the Numbers
The Emergency Medicine (EM) Match process continues to evolve, with 2026 bringing a mix of growth, new variables, and some familiar uncertainties. In this 51st installment of the EM Match Advice podcast series, Dr. Sara Krzyzaniak (Stanford EM PD) hosts the annual program director reflection on the Match with Dr. Abra Fant (Northwestern EM PD), now returning for her sixth consecutive year to share insights on the NRMP match trends and data. Podcast Episode: EM Match by the Numbers EM Match by the Numbers Key 2026 Match Statistics: A Mixed Picture Growth in Programs and Positions 11 new [+]
ACMT Toxicology Visual Pearl: Breathtaking Emergencies
What toxic gas is created by mixing these two household products? Chloramine gas Chlorine gas Chloroform Peracetic acid [Author’s own image] [+]
Teresa Crow, MD
Carolinas Medical Center, Charlotte, NC
Latest posts by Teresa Crow, MD (see all)
Who Gets Mistriaged? Disparities in Pediatric Behavioral Health ED Triage | A PECARN multicenter analysis
A 14-year-old Hispanic girl presents to the Emergency Department with her mother for suicidal ideation after a conflict at home. The girl is quiet and cooperative. Her mother, who speaks primarily Spanish, is trying to explain the situation. The nurse assigns an ESI level 2, the same score given to nearly every child who walks through the door with a behavioral health complaint. But does that score accurately capture this patient's needs? A new multicenter PECARN study published this week in JAMA Network Open takes a close look at triage accuracy for pediatric behavioral health ED visits. The findings: [+]
Dump the Myths, Not the Milk: Medication and Imaging Considerations for Lactating Patients in the Emergency Department
The challenges in lactation are often compounded by outdated beliefs held by clinicians. Most of the medications we administer in the emergency department (ED) do not warrant any interruption in expression or feeding of breastmilk. Most imaging we perform in the ED is safe in the lactating patient and likewise does not need interruption. Let us convince you to trash the phrase, “Pump and Dump” in the ED. Most medications commonly given in the ED are safe in lactation Evidence suggests medication transfer through breast milk is frequently overestimated, with actual infant exposure typically minimal for most medications commonly [+]
ACMT Toxicology Visual Pearl: Blue to the Rescue
The medication shown in the image is used to treat which type of toxic exposure? Beryllium Cadmium Cesium Iron [Image from Saalebaer via Wikimedia Commons] [+]
Victoria Soewarna, MD
Carolinas Medical Center, Charlotte, NC
Latest posts by Victoria Soewarna, MD (see [+]
SAEM Clinical Images Series: Painful Red Eye
The patient is a 60-year-old male with a history of insulin-dependent diabetes, hypertension, and hyperlipidemia who presents to the Emergency Department after one day of sudden onset right eye pain associated with nausea and vomiting. He notes progressively blurring vision and vision loss in his right eye since the onset of the pain. His wife noted redness of his sclera and urged him to go the emergency department. He can now only sense light and shadows with his right eye. He denies traumatic injury or any history of serious ophthalmological pathology. [+]