Trick of the Trade: Naloxone Dilution for Opioid Overdose
Traditional teaching recommends naloxone doses of at least 0.4 mg IV to reverse opioid toxicity. Drs. Lewis Nelson (@LNelsonMD) and Mary Ann Howland (@Howland_Ann) co-authored the opioid antagonist chapter in Goldfrank’s Toxicologic Emergencies.1 They write: “However, this dose [0.4 mg] in an opioid-dependent patient usually produces withdrawal, which should be avoided if possible. The goal is to produce a spontaneously and adequately ventilating patient without precipitating significant or abrupt opioid withdrawal. Therefore, 0.04 mg is a practical starting dose in most patients, increasing to 0.4 mg, 2 mg, and finally 10 mg.” [+]
EM Match Advice: Post Interview Communications
With interview season now in full swing this winter season, we gathered a few more of our favorite program directors to discuss the hot topic of making the post-interview communication etiquette. We feature Dr. Jim Colletti (Mayo Clinic), Dr. Jessica Smith (Brown University), and Dr. Jeff Schneider (Boston Medical Center). Thanks again to Dr. Mike Gisondi (Northwestern) for spearheading this innovative and helpful EM Match Advice series for medical students. [+]
ALiEM-Annals of EM Journal Club: Spontaneous pneumothorax, pigtail catheters, and outpatient management
We are very excited this month to bring you another installment of the ALiEM-Annals of EM Global Journal Club. The highlighted article is Voison et al. on the “Ambulatory Management of Large Spontaneous Pneumothorax With Pigtail Catheters.” We hope you will participate in an online discussion based on the clinical vignette and questions below from now until Nov 17, 2014. Respond by commenting below or tweeting using the hashtag #ALiEMJC. In a few months, a summary of this journal club will be published in Annals of EM. On Fri, Nov 14, 2014, we hosted a live Google Hangout with Dr. Stéphane Jouneau, the senior author of [+]
I am Dr. Teresa Chan, ALiEM Associate Editor/BoringEM Managing Editor: How I Work Smarter
In her original post for the “How I Work Smarter” series, Editor-in-Chief Michelle Lin (@M_Lin) called out Dr. Esther Choo (@choo_ek), who then called out Dr. Lainie Yarris (@lainieyarris) from OHSU… and in an unexpected turn of events, Lainie then somehow decided to tag me. How odd… Lainie is a mentor of one of my friends, and she’s been kinda a hero to me, so I find that this is both flattering and somewhat flabbergasting… There is no way I fit within the ranks of those others’ whom have been tagged in this wonderful game of academic “you’re it…”, but as the [+]
AIR Series: Peripheral Vascular Disease Module 2014
Welcome to the fourth 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. [+]
Trick of the Trade: Mix Ceftriaxone IM with Lidocaine for Less Pain
Ceftriaxone is a broad-spectrum antibiotic that is frequently administered intramuscularly (IM) in emergency medicine. However, these injections hurt — A LOT! Can we do anything to minimize the pain? [+]
Director of Growth, Strategic Alliance Initiative, [+]
Mythbusting the Banana Bag
We’re all pretty familiar with the banana bag: intravenous (IV) fluids with the addition of thiamine, folic acid, multivitamins, and sometimes magnesium. Banana bags are commonly utilized in patients at risk for alcohol withdrawal symptoms or those who present to the emergency department (ED) acutely intoxicated. [+]
I am Rob Rogers, Course Director for The Teaching Course & Innovative Educator: How I Work Smarter
I have known thought-leader and star speaker Dr. Rob Rogers from the University of Maryland for many years now as we have often crossed paths on the national lecture circuits. He has launched many successful innovative educational endeavors such as the EM:RAP Educators Edition podcast series (way before podcasts were cool). Now Rob is leading the charge as the Course Director for The Teaching Course, a premiere conference to mentor today’s and tomorrow’s leaders in medical education. Nominated for this Working Smarter series by Ken Milne, Rob has kindly sent in his secrets to world domination. [+]
MEdIC Series: The Case of the Debriefing Debacle – Expert Review and Curated Commentary
The Case of the Debriefing Debacle brought us into the world of Melanie the medical student who experienced her first cardiac arrest. Join us as we explore the issues around debriefing and how best to incorporate it into your clinical and teaching practices. This week demonstrated that the MEdIC community is dedicated to engaging in thoughtful, reflective discussion. [+]
US4TW Case: 30M with Blunt Abdominal Trauma
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 today’s case, a 30-year-old male is brought in after blunt trauma from a high-speed MVC. [+]