Sternoclavicular Joint Dislocations: Diagnosis and Treatment
A 16-year-old football player presents to the emergency department directly from a game. He was tackled, falling onto his right shoulder. The patient is complaining of right-sided chest pain. On exam, there is tenderness over the right sternoclavicular joint (SCJ) with a prominent medial clavicle. Range of motion is limited in the right arm. What diagnostic studies need to be performed? What treatment is warranted in the emergency department? [+]
I am Victoria Brazil, Academic Lead for Clinical Skills and Simulation at Bond University: How I Work Smarter
In the first post for the “How I Work Smarter” series, I called out one my favorite, accomplished clinician-educators Dr. Victoria Brazil, because she makes extreme-productivity look easy. Victoria was kind enough to provide her trade secrets, and it is with great pleasure that I share her responses to the questions in this series. [+]
I am Michelle Lin, ALiEM Editor in Chief: How I Work Smarter
In this inaugural post of the series “How I Work Smarter,” I wanted to share my thoughts and efforts towards working smarter and not always necessarily harder. I have been the Editor-in-Chief of ALIEM since 2009 where I first was only managing myself and now I working with an all-star team of very motivated and capable medical educators in EM. Three moving parts rapidly became thirty moving parts with thirty different deadlines. Here are my responses to the series questions. [+]
New Series: How I Work Smarter
We are all busy individuals trying to juggle various projects, a multitude of responsibilities, and balancing work and home life. “Work smarter, not harder” is often heard to remind us that we should be looking to improve our working styles to be more efficient. It is easier said than done. One place that I have drawn inspiration from is in LifeHacker’s “How I Work” series, which highlights the personal working habits of successful entrepreneurs and leaders. [+]
AIR Series: Infectious Disease, Hematology, Oncology 2014
Welcome to the first ALiEM Approved Instructional Resources (AIR) Module! In an effort to reward our readers for the reading and learning they are already doing online, we have created an Individual Interactive Instruction (III) opportunity utilizing FOAM resources for US Emergency Medicine residents. For each module, the 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 Google Drive database, which participating residency program directors can access to provide access. [+]
New AIR Series: ALiEM Approved Instructional Resources
On behalf of the AIR Executive Board, we are excited to introduce the Approved Instructional Resources (AIR) series! The AIR series was conceived to provide a credible method by which an U.S. Emergency Medicine resident can receive academic credit for using Free Open Access Meducation (FOAM) resources. The Executive Board will release a list of high-quality FOAM educational posts and podcasts specially selected by our Executive Board, in parallel with the CORD residency training curriculum. We will have an accompanying quiz for each list and track who completes it. EM residents who complete the quiz can hopefully receive credit for Individualized Interactive Instruction (III) from their EM residency [+]
Most Followed #FOAMed Twitter Users
As the Free Open Access Meducation (FOAM; #FOAMed) movement has continued to flourish over the past few years, Twitter has become a vital method for disseminating/discussing educational and clinical content. We thought it would be interesting to see who is being ‘followed’ on Twitter in the FOAM world. Certainly, the metric of Twitter followers does not necessarily correlate with quality. And, it misses newcomers to the FOAM scene and those with a more focused area of expertise/interest. We are more interested in understanding the landscape such as who is involved, geographic locations, areas of expertise, and association with blogs/podcasts. [+]
ALiEM Bookclub Review: David and Goliath
What is the essence of the underdog? Are they truly disadvantaged? Or occasionally, are they disruptors that provides them with a brilliant new perspective on things? Therein lies the question central to Malcolm Gladwell’s latest New York Times Bestseller. This is the key concept behind the latest book by Malcolm Gladwell’s book, David and Goliath [Amazon link], and the topic of this month’s ALiEM bookclub discussion. [+]
PV Card: Pediatric Ingestion Dose Thresholds for ED Referral
Clinical Toxicology has published guidelines for out-of-hospital management of 16 distinct overdoses and their dose thresholds, above which, pediatric patients should be referred to the Emergency Department for evaluation. Clinical Toxicology is the official journal of the American Academy of Clinical Toxicology (AACT, @AACTinfo), the American Association of Poison Control Centers (AAPCC, @AAPCC), and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT). There are two caveats to be aware of regarding these guidelines. They were developed between 2005 and 2007. New medications have been approved since that time and there may be more recent data available. As with any poisoning, dose is [+]
Intraosseous Rapid Sequence Intubation
Intravenous (IV) rapid sequence intubation (RSI) is by most considered the gold standard practice for securing an airway in the critically ill. There are, however, scenarios where it may not be possible to get rapid IV access in a timely manner (i.e. severe cutaneous burns, hemorrhagic shock, IV drug users, and/or the morbidly obese). It has been reported that intraosseous (IO) drug administration has similar pharmacokinetics to IV administration, but there have only been a handful of cases reported using the IO route for RSI. In this post we will discuss intraosseous rapid sequence intubation and if it is a feasible [+]