I am Dr. Gillian Schmitz, Associate Program Director, UT San Antonio: How I Work Smarter
Today we feature another young star in our field. Dr. Gillian Schmitz (@GillianMD1) is part of the next generation of emergency medicine leaders. In her young career she has already been decorated with several teaching awards, including the Academy for Women in Academic Emergency Medicine Early Career Faculty Award. An active member of EMRA as a resident, she continues her societal involvement as the chair of the ACEP Academic Affairs Committee. In a recent move to UT San Antonio, she helped launch a new residency program and currently serves as the associate program director. Dr. Schmitz kindly shares her pearls [+]
I am Dr. Ryan Tam, Emergency Medicine Resident: How I Stay Healthy in EM
Finishing up his first year as an emergency medicine resident, Dr. Ryan Tam has strived to integrate wellness into his normal routine. Maintaining his love for cooking and photography has helped provide him with balance over the past year. Being a foodie, he’s got great tips to eating well and hitting all of the essential food groups. Believe it or not, the food still tastes great! He hopes that his small changes in day to day routine, will become permanent habits of wellness. Here’s how he stays healthy in EM! [+]
ALiEM Bookclub: How Not to Be Wrong – The Power of Mathematical Thinking
“Math is like an atomic powered prosthesis that you attach to your common sense, vastly multiplying its reach and strength.” – Jordan Ellenberg “If you don’t get elementary probability in your repertoire, you’re like a one-legged man in an ass-kicking contest.” – Charlie Munger When your grade school teachers told you that you’d be doing math every day of your life, you scoffed. In adulthood, you likely took perverse pride in noting their predictions to be wrong. Enter Jordan Ellenberg (@JSEllenberg) to show you that math is nothing less than a method of thinking and reasoning, and it pervades your everyday decisions. [+]
Tricks of the Trade: Fluorescein application techniques for the eye
Application of fluorescein is a vital part of the workup of ocular complaints. Despite some studies showing questionable support, the typical cited clinical concern for stored fluorescein solutions is contimination with Pseudomonas and risk for iatrogenic infection with associated ulcer formation. 1–4 Subsequently, single dose sterile strips have become the standard agent stocked in most EDs. Many patients, especially children, can be apprehensive of the application of the physical strip directly to the eye, and are more comfortable with the concept of eye drops. In this post, we review multiple technique to create fluorescein solutions and additional tips for utilization [+]
Trick of the Trade: Eye pH
Your patient presents with an ocular burn after accidentally splashing an industrial acid on his face. You, however, can not seem to find the ever elusive eye pH paper to track her initial and serial pH’s during copious ocular irrigation. Now what? [+]
Diagnose on Sight: Diffuse Desquamating Dermatitis
Case: An 84 year old female presents with five days of a diffuse rash. She had a seizure and was started on phenytoin 2 weeks ago. Her mouth, labia, and medial canthi are involved. There are scattered areas of desquamation comprising less than a tenth of her total body surface area. She is tachycardic and febrile. Her complete blood count differential is normal. What is the diagnosis? [+]
MEdIC Series | The Case of the Flirtatious Patient – Expert Review and Curated Commentary
The Case of the Flirtatious Patient has been sparse in volume of comments but we’ve still had a really interesting set of comments over the past week. We are now happy to present to you the Curated Community Commentary and our two expert opinions. Thank-you again to all our experts and participants for contributing again this week to the ALiEM MEdIC series. [+]
Methemoglobinemia: Not the Usual Blue Man With Low SpO2
On a Friday night shift, an ambulance brings you a 52 year-old man who had an episode of syncope at a local club. EMS found him confused and hypoxic with poor skin color. The patient was placed on oxygen via face mask en route to your ED without clinical improvement. On exam, you note a blue discoloration of his extremities, and his chest x-ray and ECG are unremarkable. You draw blood, which appears very dark, and an ABG demonstrates pH 7.39, PCO2 41, and PO2 176. Figure 1. Blue foot Figure 2. Dark arterial blood You suspect [+]
Rib Fractures in Older Adults – What’s the Big Deal?
Blunt chest trauma from falls or motor vehicle collisions are a common reason for ED visits and a common source of rib fractures. While many patients with rib fractures can be discharged home with oral analgesics and an incentive spirometer, certain patients are at much higher risk for morbidity and mortality. This post will look at which patients are at risk, what factors predict increased mortality, and inpatient interventions that can reduce mortality, with a focus on the risks in older adults. [+]
The McMAP Project | #FOAMed Assessment Resources
For all you medical education folks out there, you will know that learner assessment is a really hot topic these days. Competency-based medical education (CBME), entrustable professional activities (EPAs), milestones… These are all the fancy new terms that are floating out of most residency educator’s mouths. Herein we present our McMaster Modular Assessment Program (McMAP) in e-book form, courtesy of ALiEM Press. [+]