SAEM Clinical Images Series: A Rare Gastrointestinal Complication of an Endocrine Emergency
A 54-year-old woman with a history of hypothyroidism, diabetes mellitus type II, COPD, asthma, anxiety, and depression presented to the emergency department via EMS with three days of fatigue, weakness, chills, and shortness of breath without chest pain or cough. Symptoms had been progressively worsening, and she stated she felt as if she could not move her body on presentation. She also noted diarrhea without abdominal pain, melena, or hematochezia. Just prior to arrival the patient’s daughter thought she looked paler and shorter of breath and called EMS after a near syncopal episode. EMS reported [+]
ACMT Toxicology Visual Pearl: Where There’s Air, There’s Fire
What chemical substance is used to produce this smoke screen? Cesium Polyvinyl Chloride White Phosphorous Wood Ash [Image from the National Museum of the U.S. Air Force, Wikimedia Commons] [+]
Aaron Fox, MD
Atrium Health’s Carolinas Medical Center, Charlotte, NC
Latest posts by [+]
ALiEM AIR Series | GI Module (2024)
Welcome to the AIR GI 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 related to GI emergencies in the Emergency Department. 11 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 3 AIR and 8 Honorable Mentions. We recommend programs give 6 hours of III credit for this module. AIR Stamp of Approval and Honorable [+]
ACMT Visual Pearl: Seabather’s Eruption: The unexpected beach burn
What organism causes seabather’s eruption? Jellyfish Nematodes Portuguese man-of-war Stonefish [Author’s own image] [+]
Lila Nanagas
Villanova University
Latest posts by Lila Nanagas (see all)
- ACMT Visual Pearl: Seabather’s Eruption: The unexpected beach burn - February 12, 2025
SAEM Clinical Images Series: Male Weightlifter with Chest Pain
An otherwise healthy 45-year-old male presented to the emergency department (ED) with substernal chest pain radiating down his left arm over the previous two days. On the first day of symptoms, his pain began several hours after using a new pre-workout supplement and weightlifting. The symptoms lasted for a few hours and self-resolved. The pain returned the following day under the same conditions, although this time persistent, which brought him in for evaluation. Associated symptoms included shortness of breath, nausea, and one episode of emesis. He denied pleuritic pain, lower extremity edema, hemoptysis, syncope, cough, [+]
ACMT Toxicology Visual Pearl: Hiss-teria Averted
What is the predominant clinical effect of envenomation by this snake? Acute hepatic failure leading to coagulopathy Direct cardiotoxicity leading to arrhythmias Profound neuromuscular paralysis Rapid onset of shock and multisystem organ failure [Image courtesy of iStock. ID: 1311554579] [+]
Sean Flannigan, MD
Atrian Health Carolinas Medical Center
SAEM Clinical Images Series: Snake it Off
A 35-year-old male with no past medical history presented to the Emergency Department with eye redness. Two days prior, the patient reported he was cutting brush with a chainsaw when he felt something “spray” into his face. After inspecting the area, the patient found the remnants of a dead rattlesnake that unfortunately got in the way of his chainsaw. He subsequently developed bilateral eye redness without pain or vision changes, as well as a painless, pruritic facial rash. The patient denied any additional trauma, [+]
SAEM Clinical Images Series: Unusual Presentation of an Exophytic Tumor
A 60-year-old African American female without a past medical history presented to the emergency department with a complaint of a "hard, yellowish brown, growth" on her right upper abdomen. The patient reported that it had been present and slowly enlarging over a two-year period and was now causing pain when it "snags on clothing". Skin: 9.5 cm, firm, curved, exophytic, keratotic, tumor protruding from the right upper abdominal wall. Non-contributory Histopathology confirmed a diagnosis of a benign Cutaneous Horn a.k.a. Cornu Cutaneum (latin). Cutaneous horns are yellow or white [+]
EM Match Advice 46 | Program Directors Share Match Season Insights
As interview season wraps up, medical students across the country are preparing their rank lists for the upcoming Match. EM Match Advice podcast host, Dr. Sara Krzyzaniak (Stanford EM Program Director) recently sat down with Dr. Melissa Parsons (University of Florida College of Medicine - Jacksonville EM Program Director), to discuss the match process from both program and applicant perspectives. Podcast: Match Season Insights Podcast Sound Engineer: Dr. Kaitlin Bowers What's Happening on the Program Side? Programs are busy finalizing their rank lists through comprehensive meetings with their teams. Many programs, including UF Jacksonville, are intentionally completing their rank [+]
SAEM Clinical Images Series: Bilateral Periorbital Edema
A 20-year-old previously healthy student-athlete female presented with a 2-week history of bilateral periorbital swelling unresponsive to steroids and anti-histamines prescribed by her PCP. The edema had been worsening, and there was a new development of throat tightening and discomfort. She denied rash, allergies, fever, URI symptoms, urinary symptoms, or new medications. General: No acute distress. HEENT: Significant bilateral periorbital edema with an otherwise normal eye exam. 2+ bilateral tonsillar swelling and erythema, no exudates. No uvula swelling or deviation. No oral mucosal lesions. Neck: Anterior and posterior cervical lymphadenopathy. Respiratory: [+]