• sodium bicarbonate

Hydroxychloroquine Toxicity

By |May 28, 2020|Categories: Tox & Medications|

As the COVID-19 pandemic continues to unravel, the role of hydroxychloroquine (HCQ) in the treatment of patients with this disease has been a major focus of discussion on the news and social media. Despite the lack of good data supporting its use in the clinical setting, there have been numerous reports of individual consumption of HCQ resulting in accidental overdose and even death. It is therefore important to recognize and manage patients who may present with HCQ toxicity. […]

PEM Pearls: Chest Radiographs for Shortness of Breath

By |May 27, 2020|Categories: PEM Pearls, Pulmonary, Radiology|

Figure 1: Photo by Tim Bish on Unsplash Paramedics bring in a 5-month-old boy in respiratory distress. He’s crying furiously and has normal tone and color. Thick, copious secretions are coming from his nose. He is tachypneic with diffuse wheezes, crackles, retractions, and nasal flaring. His respiratory rate is 70 and his oxygen saturation is 88% on room air. Would you order a chest radiograph (CXR) for this child? CXRs are routinely obtained in adults with respiratory symptoms. Children, however, are more sensitive to radiation and can have multiple respiratory infections every year. [...]

  • rapid code status

The rapid code status conversation guide for seriously ill older adults in acute respiratory failure

By |May 25, 2020|Categories: Palliative Care|

You are working a regular shift in your emergency department (ED) when a 85 year old female presents with a complaint of altered mental status. She comes from an extended care facility, where paramedics are able to tell you “they called us to come get her”, you are handed a stack of paperwork, given some vital signs and you notice the patient is altered beyond being helpful to you. You dig a little in the paperwork and note a history of dementia, as well as a long list of other medical problems, you notice no known advanced directive and a [...]

Work Grief: A Primer for Emergency Medicine Providers

By |May 22, 2020|Categories: Palliative Care, Wellness|

Heartbreaking patient situations are the backbone of Emergency Medicine. Whether it’s a new cancer diagnosis, telling a family member that their loved one has died, or the creeping dread that a mistake that we’ve made will negatively impact one of our patients, we all experience extraordinary stress in our day-to-day clinical practice. Most clinicians are not tasked with routinely sharing news about the violent, unexpected, and horrific life-changing situations that occur in the emergency department, and yet we are given so few tools to help us manage this firehose of grief. This article is intended to share some of the [...]

  • genitourinary FOAM

Beyond the Abstract: Systemic Online Academic Resources Review: Renal and Genitourinary

By |May 20, 2020|Categories: Genitourinary, Renal|

Production and use of free open access medical education resources (FOAM) has had a meteoric rise over the last decade.​1–4​ ALiEM works hard to produce content, disseminate knowledge, and consolidate resources in a democratic and accessible way. However, we recognize that FOAM comes with its own limitations: Blogs are distinct, individual, and decentralized. How can we search for topic-specific content? FOAM doesn’t often have peer review. How can we assess quality and accuracy?  FOAM is produced on an as-needed basis. How do we achieve curricular comprehensiveness? […]

Tricks of the Trade Book: Pre-order release of first 500 copies

By |May 18, 2020|Categories: Tricks of the Trade|Tags: |

Will there be a return to book publishing in this era of digital information chaos and overload? We believe so. We are proud to announce “Tricks of the Trade in Emergency Medicine: Where Experience, Ingenuity, and Evidence Intersect.” Being our own publishers (ALiEM Publishing) and selling through a print-on-demand bookstore has allowed us to design the book with full creative license. In stark contrast to our blog and other digital-based projects, we aimed to create a hardback, full-color book that you can read on a lazy Sunday afternoon, give as a graduation gift, or look delightful on your coffee table. [...]

9-Minute Workout for the Frontline Provider

By |May 15, 2020|Categories: Life, Wellness|

Providing medical care for patients at the frontline can be physically demanding. Exercise is an important part of a routine that can help mitigate the physiologic stressors that come with providing care at the frontline, but in the setting of decreased time and space, providers may have difficulty developing new routines. We worked with a physiotherapist to create an exercise regimen for frontline providers that requires little space, little time, and can still help keep us healthy in the face of an ever more challenging work environment. […]

  • Clue pediatric rash game

IDEA Series: Use of gamification through Clue: Pediatric Rash Edition

By |May 13, 2020|Categories: Dermatology, IDEA series, Pediatrics|

Emergency Medicine (EM) physicians care for anyone, with anything, at any time. This includes pediatric patients as well as adults. For those without advanced pediatric training, “sick kids” can be quite intimidating. Rashes in the pediatric population are often benign, but in rare cases they portend significant illness. Rashes are also frequent chief complaints; In 2015, there were 1,452,300 pediatric ED visits for “skin and subcutaneous tissue disorders” [1]. We sought to improve the teaching of pediatric rashes in our residency curriculum. […]

ACMT Toxicology Visual Pearls: The Doom from Down Under

By |May 11, 2020|Categories: ACMT Visual Pearls, Tox & Medications|

Inadvertent contact with this aquatic species causes excruciating pain and an overwhelming sense of impending doom.  What is this? Box Jellyfish (Chironex fleckeri) Irukandji Jellyfish (Carukia barnesi) Lion’s Mane Jellyfish (Cyanea capillata) Portuguese Man o’ War (Physalia physalis) […]

ALiEMU New Course: Pediatric Ultrasound-Guided Peripheral IV Access

By |May 10, 2020|Categories: ALiEMU, Pediatrics, Ultrasound|

Did you know that the ALiEMU learning management platform has courses in addition to the AIR Series? We just published the third installment of the pediatric point-of-care ultrasound (POCUS) series, which focuses on peripheral IV access using ultrasonography. Do you use the traditional transverse, transverse with dynamic needle tip visualization, or longitudinal ultrasound technique? […]