EM Match Advice 43: EM Program Directors Reflect on the 2024 Match
Dr. Sara Krzyzaniak (podcast host and Stanford University PD) and Dr. Michelle Lin (ALiEM Founder/UCSF) are joined by Dr. Abra Fant (Northwestern PD) in this discussion reflecting on the 2024 Match results, after last year's shocking number of 500+ unfilled positions. Here are the 2024 relevant numbers for Emergency Medicine, as compared to prior years. In the following podcast, we run down the numbers and what they might mean for the future. Match Fill Rates Across Specialties in 2024 In 2023 Match, the number of unfilled positions was 554 for EM. This has been dramatically reduced to 135 in [+]
ACMT Toxicology Visual Pearls: The Kitchen Cabinet High
What is the primary toxin in the substance above? Solanine Myristicin Lysergic acid amide Phytolacca toxin [+]
Top 3 SOAR Blog Posts on Pediatric Respiratory Infectious Disease
There has been a well-documented growth in the use of FOAM in graduate medical education [1-4]. The decentralized nature of FOAM along with concerns with the lack of peer review make the assessment of the quality of information difficult. Several years ago, a group of physicians set out to solve these problems by modifying the traditional systematic review format, and created the Systematic Online Academic Resource (SOAR) review. The SOAR review aims to “systematically identify online resources by topic…[and] assess the quality of these resources with a validated tool, and collate links.” [5] Our review, "Systematic online academic resource [+]
Pigtail catheter for pleural drainage: Tips to minimize complications
Traditionally large-bore tube thoracostomy has been the standard of care for treating many acute intrathoracic pathologies [1]. However, the advent of less invasive small-bore chest tubes, also known as pigtail catheters, has gradually led to a paradigm shift. Pigtails provide a less invasive and often better tolerated alternative to traditional chest tubes and allow for adequate treatment of pneumothoraces and uncomplicated pleural effusions [1-5]. Unfortunately, these less invasive catheters are not without complications - both unique and similar to traditional chest tubes. Case A 48 year-old male with a history of hypertension and polysubstance abuse presented to the emergency [+]
ACMT Toxicology Visual Pearl: Abdominal Bruising
What could cause this finding three days after ingestion of a concentrated household substance? Duodenal ulcer Gastric perforation Necrotizing enterocolitis Post-corrosive acute pancreatitis [+]
Maha M Farid MBBCh, MSc, PhD
Faculty of Medicine
Helwan University, Egypt
Cocaine for Epistaxis: What was old is new again
Droperidol is back! Routine use of calcium for cardiac arrest is out? TPA is... well, we won’t go there. The landscape of medicine is continuously being reshaped. New research may question the effectiveness of an existing medication or promote the arrival of a novel treatment. Once beloved medications sit dust-laden in the back of a hospital pharmacy. But sometimes, just sometimes, an old medicine arises from that dust. Phenobarbital for alcohol withdrawal comes to mind. Could cocaine hydrochloride be one of those medications to be resurrected? Cocaine is effective in the treatment of epistaxis. Epistaxis is an exceedingly common [+]
SAEM Clinical Images Series: Red Rash on My Legs
A 23-year-old female with no known past medical history presented with a rash concentrated on her legs, with a few areas on her arms and chest. The rash began the day before presentation when she became overheated while wearing sweatpants in 104°F weather. The rash was mildly pruritic but not painful. She denied any prior reaction to her sweatpants that she has had for several months. She denied any new soap or cosmetic use, prior rash, allergy, or medication use. Her review [+]
ACMT Toxicology Visual Pearl: A Bane to Existence
What is the primary cause of death following ingestion of the plant pictured? Acute liver failure Arrhythmia Disseminated intravascular coagulation Status epilepticus [+]
SAEM Clinical Images Series: Seeing Double
A 53-year-old woman with no significant past medical history presented to the emergency department with a 3-day history of double vision on leftward gaze. She initially presented to urgent care with a chief complaint of chest heaviness and concern that her blood pressure was too high, but was sent to the emergency department for further cardiac and neurological evaluation after her urgent care provider noticed abnormal eye movement. She endorsed mild, intermittent headaches associated with diplopia when looking to the left. However, she denied any blurry vision when looking forward. She denied any trauma or [+]
SAEM Clinical Images Series: Purple Finger
A 30-year-old female with a past medical history of Crohn's Disease presented to the ED for evaluation of an acutely bruised right 4th finger. She stated she was typing on a computer keyboard approximately 10 minutes prior to presentation and she noticed a sudden popping sensation at the base of her right ring finger. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger. Shortly after that, the finger turned purple, so she came to the Emergency Department for evaluation. She denied pain in the hand and [+]