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? [+]
Author Insight: Ultrasonography versus CT for suspected nephrolithiasis | NEJM
Are you getting a CT or bedside ultrasound as your first-line diagnostic approach to patients with undifferentiated abdominal or flank pain in whom you suspect kidney stones? In a landmark 15-center, multidisciplinary study published in the New England Journal of Medicine in September 2014, Dr. Rebecca Smith-Bindman (UCSF Department of Radiology) and her research team looked at exactly this question for emergency department patients. In the paper, “Ultrasonography versus CT for suspected nephrolithiasis,” Dr. Smith-Bindman and Dr. Ralph Wang (UCSF Department of Emergency Medicine) kindly joined us on a quick discussion about her paper. [+]
I am Dr. Resa Lewiss, Director of Point-of-Care Ultrasound at University of Colorado: How I Work Smarter
Today we are back with Dr. Resa Lewiss (@ultrasoundREL), ultrasound guru and pioneer. She has championed ultrasound via each of the three pillars of academics. She is a clinical master of ultrasound, has taught its use worldwide, and has published extensively on the topic. To top is all off, she has taken institutional leadership as the past President of the Academy of Emergency Ultrasound of the Society of Academic Emergency Medicine and the current chair for the Ultrasound Section of the American College of Emergency Physicians. Plus, she has a TEDMed talk. Nominated by Dr. John Bailitz, Dr. Lewiss offers [+]
ALiEM BookClub: Being Mortal
“Death, of course, is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things. I knew these truths abstractly, but I didn’t know them concretely – that they could be truths not just for everyone but also for this person right in front of me, for this person I was responsible for.” Atul Gawande, Being Mortal. [+]
AIR Series: Ob/Gyn Module 2015
Welcome to the seventh ALiEM Approved Instructional Resources (AIR) Module! In an effort to reward our residents for the reading and learning they are already doing online we have created an Individual Interactive Instruction (III) opportunity utilizing FOAM resources for U.S. Emergency Medicine residents. For each module, the AIR board curates and scores a list of blogs and podcasts. A quiz is available to complete after each module to obtain residency conference credit. Once completed, your name and institution will be logged into our private database, which participating residency program directors can access to provide proof of completion. [+]
The Art of Syringe Labeling in the ED
The ‘look-alike, sound-alike’ nature of many drug appearances and names is problematic. In high-stress environments such as the Emergency Department (ED), potential disasters can arise if “drug swap” or other medication errors occur. Drug swap is the accidental injection of the wrong drug.1 The anesthesiology literature contains several published reports presenting various ideas on how to properly label syringes used in the operating room to reduce medication errors. Techniques include color-coding the labels,2 labeling of the plunger,3 double-labeling,4,5 and specific placement of the labels on the syringe.6 [+]
I am Dr. Rick Body, Research Director of the Manchester Emergency Medicine & Intensive Care Research Group: How I Work Smarter
This weeks post takes us back across the pond to Manchester, UK, with Dr. Rick Body (@richardbody). Dr. Body is known in the SoMe world for his contributions to the fantastic St. Emlyn’s blog and Best BETs, a great resource which summarizes research into clinically usable information. His academic focus has been on research in cardiovascular medicine and decision-making technology/biomarkers. He’s a National Institute for Health Research Postdoctoral Research Fellow (yup, he has a PhD) and also research director of the Manchester Emergency Medicine & Intensive Care Research Group (aka EMERGING), a 12 person group dedicated to Emergency Medicine and Critical [+]