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 [+]
PV Card: Focused Deep Vein Thrombosis (DVT) Ultrasound
Deep vein thrombosis (DVT) is always a consideration when patients with asymmetric lower extremity swelling. Why is one leg. Two-point focused DVT ultrasonography of the femoral and popliteal veins can be incredibly useful in the Emergency Department when trying to narrow the differential diagnosis. Drs. Margaret Greenwood-Ericksen, Joshua Rempell, and Mike Stone provide a clear, image-based clinical reference tool on this ultrasound technique. PV Card: Focused DVT Ultrasound Assessment Adapted from [1, 2] References Kline J, O’Malley P, Tayal V, Snead G, Mitchell A. Emergency clinician-performed compression ultrasonography for deep venous thrombosis of the lower extremity. Ann Emerg Med. 2008;52(4):437-445. [PubMed] Bernardi [+]
Diagnose on Sight: Lower extremity numbness and pain
Case: An 18 year old male presents after a single gunshot wound to his left calf. He complains of pressure-like pain near the wound and sensory numbness below his left knee. On examination, the left leg is tense. He has no dorsalis pedis pulse. Based on the history, exam, and findings in the image, which of the following is true regarding this diagnosis? [+]
I am Dr. Jesse Pines, Professor of Emergency Medicine and Health Policy at George Washington University: How I Work Smarter
This week’s guest on the How I Work Smarter series is a master of efficiency and quality in the Emergency Department. Dr. Jesse Pines (@DrJessePines) is the principal investigator of UrgentMatters.org, a group dedicated to improving emergency care and hospital patient flow. He has the ear of the Center for Medicare and Medicaid Services Innovation Center and the National Quality Forum where, via policy, he’s helping to shape the future landscape of emergency care in the USA. While he has academically published extensively on health policy and workflow, he also takes the time to educate the public at large on the [+]
MEdIC Series |The Case of The Returning Traveller – Expert Review and Curated Commentary
The Case of the Returning traveller generated thoughtful 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. [+]
