PV Card: Acute Salicylate Toxicity
Patients with acute salicylate toxicity can rapidly decompensate and require clinicians to understand the pathophysiology of what is going on. First a respiratory alkalosis occurs with non-specific symptoms of vomiting and dizziness. Then an anion-gap metabolic acidosis also occurs with headache, tinnitus, and confusion. Below lists the core set of labs to obtain and treatment strategies by our stellar ALiEM-CORD Social Media and Digital Scholarship Fellow, Dr. Sam Shaikh. [+]
Ultrasound For The Win Case – 46F with Abdominal Pain #US4TW
Welcome to another ultrasound-based case, part of the “Ultrasound For The Win” (#US4TW) Case Series. In this peer-reviewed case series, we focus on real clinical cases where bedside ultrasound changed management or aided in diagnoses. In this case, a 46-year-old woman presents with history of right-sided abdominal pain and vomiting. [+]
I am Dr. Zafrina Poonja: How I Stay Healthy In EM
Staying healthy should not be an option. As emergency physicians, it should be our mandate to stay healthy so that we can promote healthy living, optimize our ability to care for our patients, extend our careers, and be there for our families. However, modern life can be hectic and unpredictable. While we all desire an active and healthy lifestyle, maintaining one in practice can be difficult for physicians despite our extensive education and resources. 1 As emergency physicians we face the additional challenge of working a schedule that has been shown to have negative health implications. 2 [+]
MEdIC Series | The Case of the Financial Fiasco – Expert Review and Curated Commentary
The Case of the Financial Fiasco has stimulated interesting discussion over the past week. We are now proud 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. [+]
Lipid Rescue: Why Aren’t We Using It?
Though lipid rescue sounds like something from a junk food detox regimen, it’s one of the most exciting developments in emergency management of drug overdose in the last 20 years. Unlike charcoal which can lead to aspiration and has relatively little data showing improved outcomes, or dialysis which relies on convincing your nephrologist to come in at 3 am, lipid rescue is a readily available, cheap, safe therapeutic that we’ve been using in TPN for adults and children for decades. And it seems to work, but why aren’t we using it? [+]
Geriatric Emergency Medicine for Students, Residents, and Physicians
We all know the population of the United States is aging. We know emergency physicians need to be prepared and trained to care for older adults. But how can you dive into the world of geriatric EM to learn more, to research, to gain additional training? In this post, we have gathered the wisdom of leaders in geriatric EM across the country, to share their recommendations, inspiration, and motivation. [+]
Adenosine in reactive airway disease
A 44-year old woman presents via EMS with a chief complaint of a racing heartbeat. She is placed on a cardiac monitor, which displays a heart rate of 192, and a subsequent EKG reveals she is in SVT. She also complains of chest discomfort and shortness of breath. Her blood pressure is stable, and you decide to treat her with adenosine. As you take a more thorough past medical history, you learn your patient has a history of asthma. One of the EM residents mentions that he thought adenosine should not be given to patients with reactive airway disease. [+]
How I Work Smarter – Mapping It Out
How I Work Smarter Nominations (Jul 17, 2014-Mar 22, 2015) Today we are taking a break from our regularly schedule program and going meta. FOAM clearly helps break down borders, but sometimes, a look at a map really brings it home. These connections were launched when Dr. Michelle Lin tagged 3 people for their “How I Work Smarter” perspectives, who then each tagged 3 people, and so forth. We have had enough responders (37!) to keep this going for many months. This has cascaded and created a broad virtual international community of smart-working clinicians. Below are more close-up views of the US, [+]
MEdIC Series | The Case of the Financial Fiasco
Many residents and medical students are making career decisions that will last a lifetime. Some are aware of the financial considerations while others avoid discussing the topic for fear of being seen as shallow. This month’s ALiEM MEdIC series case considers how we might help a learners as they consider money in medicine. Please join us in discussing the case this month, we would love your thoughts and advice. [+]
Diagnose on Sight: Swollen gums
Case: A 19 year old male with no past medical history presented with 4 days of painful oral lesions, swollen gums that bled easily, and fever. His temperature was 38.5C. Which of the following is true regarding this patient’s diagnosis? [+]