SAEM Clinical Image Series: Atraumatic Proptosis

By |Sep 7, 2020|Categories: Emergency Medicine, HEENT, Ophthalmology, SAEM Clinical Images|

An 85-year-old female with a past history of hypertension presents with acute right-eye pain, redness, and proptosis/bulging for the past two months that has been worsening over the past two days. She endorses blurry vision that began two days prior. She does not use contacts or glasses. No trauma, headache, or loss of consciousness are reported. She reports a “whooshing” sound in her right ear for two to three months. […]

EM Match Advice: Administration Fellowship

By |Sep 6, 2020|Categories: EM Match Advice|Tags: |

    The EM Administration Fellowship serves to train residents desiring to pursue a leadership position in departments and hospital systems. Many graduates become department chairs and medical directors. Hosted by Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF), this podcast features fellowship directors from around the country discussing the who, what, when, and why of the fellowship. […]

ALiEM AIR | Psychosocial 2020 Module

By |Sep 4, 2020|Categories: ALiEMU, Approved Instructional Resources (AIR series), Psychiatry|

Welcome to the AIR Psychosocial Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to psychosocial emergencies. 5 blog posts within the past 12 months (as of July 2020) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 2 AIR and 3 Honorable Mentions. We recommend programs give 3 hours (about 30 minutes per article) of III credit for this module. AIR Stamp of Approval and [...]

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A Recipe for Success: Virtual Alternatives to Residency Pre-Interview Receptions

By |Sep 4, 2020|Categories: Academic, Medical Education|

The COVID-19 pandemic forced sweeping changes to graduate medical education over the last several months, and as we plan for the new academic year, it is clear that residency recruitment will fundamentally change as well. The Association of American Medical Colleges (AAMC) released a position statement encouraging medical school, residency, and faculty interviews to be held virtually [1]. While there is precedent for holding residency and fellowship interviews online [2-4], these new circumstances present significant challenges for applicants and residency programs alike. One important change will be the loss of the pre-interview reception. Information exchange between students and residents over [...]

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SplintER Series: An Easily Missed Shoulder Injury

By |Sep 2, 2020|Categories: Expert Peer Reviewed (Clinical), Orthopedic, SplintER|

A 30-year-old male presents with right shoulder pain after a motorcycle accident. You obtain shoulder x-rays and see the following images (Image 1: AP, scapular Y, and axillary views of the right shoulder. Author’s own images). What is the most likely diagnosis, typical mechanism of injury, expected physical exam findings, appropriate imaging modalities, and management plan? […]

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SAEM Clinical Image Series: An Oropharyngeal Mass

By |Aug 31, 2020|Categories: Emergency Medicine, ENT, Gastrointestinal, SAEM Clinical Images|

A fifty-year-old male presented to the emergency department (ED) unconscious with CPR in progress. Per EMS report, the patient was found down surrounded by emesis with no pulse or respirations. Fifteen minutes of CPR was performed prior to arrival in the ED with a King Tube in place. The King Tube was filled with emesis and increasingly difficult to bag. The King Tube was removed to attempt intubation and maximize oxygenation and ventilation. When the Mac 4 blade was placed in the mouth, a large, pink, fleshy, and vascularized structure was seen in the mouth [...]

The Leader’s Library: The Power of Moments | Sign Up for the Book Club

By |Aug 30, 2020|Categories: Academic, Book Club, Leaders Library|Tags: |

Thus far, 2020 has been a year of catastrophic events, some surprising and others disappointingly predictable, and many people are struggling to navigate the chaos, to grasp at some semblance of a routine in the face of an unpredictable near future. Time has become a blur, a coalescence of unremarkable (yet unprecedented) moments. What if we have the possibility to intentionally create these moments, for ourselves and those around us? What if, by reframing the way we view memory, experience, and time, we could be the powerful author of our own moments? […]

SplintER Series: A Jammed Finger

By |Aug 26, 2020|Categories: Expert Peer Reviewed (Clinical), Orthopedic, SplintER|

A 50-year-old male presents to the emergency department with a new inability to extend his 5th digit of the left hand. He states he was playing a game of pick-up basketball last week when he jammed the finger while attempting to catch a pass from a teammate. An AP and lateral radiograph of the digit is obtained (Image 1 courtesy of Dr Alborz Jahangiri, Radiopaedia.org). What is your diagnosis? What causes this injury? What exam maneuver can help diagnose the underlying injury before the deformity is evident? What is the treatment/management of this injury? What [...]

Unlocking the MIC-KEY: Understanding and Troubleshooting Low-Profile Gastrostomy Tubes

By |Aug 24, 2020|Categories: Emergency Medicine, Gastrointestinal|

You are working an overnight clinical shift at your community emergency department when a worried mother brings in her 15-year-old child with cerebral palsy due to their gastric tube “coming out.” As you begin to obtain a history of the patient’s gastric tube (when it was placed, where it was placed, why is it in place, etc.) you realize you will be the one replacing it tonight, and frankly you haven’t done this before. The following post serves as a refresher on the use, placement, and complications of gastrostomy tubes. […]

How I Stay Healthy in EM: Christian Rose

By |Aug 21, 2020|Categories: Healthy in EM, Life, Wellness|

We would be remiss to not acknowledge the unique challenges we as emergency providers have faced over the last few months. Prevention of burnout and active wellness management is more important now than ever. This month on our “How I stay Healthy” series, we’re featuring Dr. Christian Rose, clinical informatics fellow at Stanford University and staff physician at Kaiser Permanente. He shares some guiding principles when facing difficult clinical decisions, his belief in the power of connection, and his favorite noise machine! […]