ACMT Toxicology Visual Pearl: Household Plant Gone Wrong
What toxic substance found in common houseplants (such as this one pictured) causes intense irritation of skin and mucous membranes? Calcium oxalate Lycorine Oxalic acid Terpene [Left image from Dr. Bryant Allen, MD, and right image from AJ West -Wikimedia Commons] [+]
Deryan Smith, MD
Carolinas Medical Center, Charlotte, NC
ACMT Toxicology Visual Pearl: Skin Lesions
Which of the following chronic exposures could produce lesions such as this on the hands, feet, and trunk? Inorganic arsenic Iron Lead Mercury [Image from Wikimedia Commons] [+]
ACMT Toxicology Visual Pearl – Along Comes a Spider
What is this pictured spider that can inflict a deadly bite? Black Widow Spider (Latrodectus mactans) Brown Recluse Spider (Loxosceles reclusa) Redback Spider (Latrodectus hasselti) Sydney Funnel Web Spider (Atrax robustus) [Image from thebeachcomber, CC BY 4.0 https://creativecommons.org/licenses/by/4.0, via Wikimedia] [+]
Doug Maslowski MD
Department of Emergency Medicine
Carolinas Medical Center
EM Match Advice 44: Approaching your EM sub-internship clerkship – “Just gotta roll with it”
Dr. Sara Krzyzaniak (podcast host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Jessica Bod (Yale University Clerkship Director and 2024 CDEM Clerkship Director of the Year award winner) in this episode to discuss how one might approach their emergency medicine sub-internship. Dr. Bod shares her her wealth of experience and wisdom to provide not only general advice but also answers more detailed questions like: What are some things NOT to do on a rotation? How do I judge my own competitiveness in the residency application process? What if I have decided late [+]
Trick of the Trade: Ultrarapid adenosine push for SVT with a pressure bag
With some things in life, speed is everything. Adenosine is one of those things. With an ultrafast half-life estimated to be between 0.6 to 10 seconds [1], parenterally administered adenosine needs to reach the cells of the AV-node and cardiac pacemaker cells in an expedited fashion to facilitate the termination of supraventricular tachycardias (SVTs). Known Techniques of Adenosine Administration Currently, there are 2-syringe and 1-syringe methods that are widely accepted for the administration of adenosine. Recent data suggests that they are non-inferior to each other [2]. Classic 2-syringe method: Benefit = undiluted adenosine to the heart; Limitation = [+]
PEM Pearls: Approach to Spontaneous Intracranial Hemorrhage in Pediatric Patients
Case: A 6-year-old female with a past medical history of immune thrombocytopenia presents to the Emergency Department (ED) for concerns of dysarthria that started the day prior to arrival. The patient’s mother denies any recent trauma, including head injury. Vitals and Physical Exam Blood pressure 109/80 Pulse 121 beats/minute Respiratory rate 22 breaths/minute Oxygen saturation 100% on room air Temperature 36.8ºC Her physical exam is remarkable for a mild right-sided facial droop with forehead sparing and dysarthria. Initial Work-Up The patient’s ED workup shows the following: Point-of-care glucose: Normal Platelet count: 0 platelets/liter Hemoglobin: 9.8 g/dL Head CT: Frontal [+]
From Collision to Clarity: PECARN cervical spine injury prediction rule for injured children
For years, adult literature has provided clear guidelines for cervical spine imaging through the NEXUS and Canadian C-spine Rule (CCR) tools. These have been invaluable in helping clinicians decide when to image the neck in trauma patients. Similarly, the Pediatric Emergency Care Applied Research Network (PECARN) has developed robust tools for assessing blunt head trauma in children. However, until now, there has been a gap in guidance for clinicians managing pediatric patients at risk for cervical spine injuries. Case Scenario: What would you do? A 10-year-old boy presents to the emergency department (ED) after a high-speed motor vehicle collision. [+]
ACMT Toxicology Visual Pearls: Lye to the Eye
What caustic exposure from the pictured item can lead to ocular injury? Acetic Acid Hydrofluoric Acid Potassium Hydroxide Sodium Hydroxide [Image from Istockphoto] [+]
Hannah Corral, MD
Carolinas Medical Center, Charlotte, NC
Latest posts by Hannah Corral, MD (see all)
ACMT Visual Pearl: Watt – Ever is that Foreign Body?
Which type of foreign body should be suspected in a child who is drooling and has the following x-ray? Button battery Coin Magnet Marble [+]
Carrie Bissell, MD
Carolinas Medical Center, Charlotte, NC
Latest posts by Carrie Bissell, MD (see all)
PEM POCUS Series: Soft Tissue Ultrasound
Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric soft tissue ultrasonography. Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit. Take the ALiEMU PEM POCUS: Soft Tissue Quiz Case Goals List the indications of performing a pediatric soft tissue point-of-care ultrasound (POCUS). Describe the technique for performing soft tissue POCUS. Interpret signs of cellulitis, abscess, and soft tissue foreign body on POCUS. Describe the limitations of soft tissue POCUS. Differentiate abscess from other soft tissue pathologies [+]