Holiday Gift Guide for ALiEM Readers: Top 7 Favorite Level-Up Gear

By |Nov 18, 2021|Categories: Academic, Life|

The difference between a great shift in the Emergency Department and a frustrating one can sometimes be attributable to having the right gear or peri-shift routine. Listed are the top 6 "level-up" tools, recommended by our team. We have a very limited supply of custom ALiEM socks available at $20 per medium-sized pair. These socks have been rumored to quell the blackest of black clouds in the Emergency Department. It may be because of the "Stomping Out Disease" mantra on the socks. You'll have to try for yourself. We have orange (with the COVID-19 graphic) and lime green socks. These [+]

Holiday Gift Guide for ALiEM Readers: Top 7 Favorite Books

By |Nov 17, 2021|Categories: Academic, Life|Tags: |

With the holiday season rapidly approaching, we polled the ALiEM team on favorite books to buy for yourself or a fellow healthcare provider. Many of us try to make time to read in our busy schedules to learn, be entertained, understand, process, and grow. As Truman stated, “Not all readers are leaders, but all leaders are readers.” View our top 7 recommendations below. 1. Tricks of the Trade in Emergency Medicine We are biased, but we believe that the Tricks of the Trade book would make a lovely coffee table gift for you or your colleague. The hardbound, color print [+]

How I Work Smarter: Mark Ramzy, DO EMT-P

By |Nov 12, 2021|Categories: How I Work Smarter, Medical Education|

One word that best describes how you work? Focused Current mobile device Samsung Galaxy S20 Computer Samsung Notebook 9 What is something you are working on now? Ultrasound Teaching Curriculum (both image review and interpretation) that can be made virtual and in very small group sessions with focused teaching and infographics. How did you come up with this Idea/Project? We performed a needs assessment in ultrasound learning across different divisions and specialties (IM, Anesthesia, etc) within the hospital. This didn't just include medical students and residents/fellows, but also included attendings and faculty members with a longitudinal component to teaching. [+]

SAEM Clinical Image Series: Pediatric Rash

By |Nov 8, 2021|Categories: COVID19, Dermatology, Infectious Disease, SAEM Clinical Images|

A previously healthy 8-year-old female presents to the pediatric emergency department due to a rash. Her symptoms started three days prior to presentation with a painful rash on her lower extremities. The rash subsequently spread to the buttocks and upper extremities, and she developed intermittent diffuse abdominal pain, a nonproductive cough, and pharyngitis. The patient denies subjective fever. Known sick contacts include the patient’s mother, who tested positive for COVID-19 two and a half weeks prior.   Vitals: T 98.5°F; HR 93; BP 115/68; RR 16; O2 sat 100% on room air Constitutional: Well-developed and in no [+]

SAEM Clinical Image Series: A Young Woman with Chest Pain

By |Nov 1, 2021|Categories: Cardiovascular, ECG, SAEM Clinical Images|

A 35-year-old female with a history of intermittent palpitations who is three months post-partum presented to the emergency department (ED) with three days of sharp, substernal chest pain radiating down her left arm. She reportedly had a normal electrocardiogram (ECG) at an outside hospital on the first day of symptoms. The pain returned and was associated with one episode of vomiting the night prior to presenting to our ED. Initial ECG on arrival is shown. Vitals: Tachycardic; afebrile; normotensive; no tachypnea or hypoxemia on room air General: Mild distress, appears uncomfortable Cardiovascular: Tachycardic to 100s, regular [+]

Trick of Trade: Large-Bore Endotracheal Tube To Suction the Occluded Airway

By |Oct 31, 2021|Categories: Critical Care/ Resus, Tricks of the Trade|

The paramedics just arrived with a new patient to the resuscitation room. You find an altered patient actively vomiting bloody vomitus and food particles. You prepare for a difficult airway. You prepare 2 Yankauer suction catheters, but you are still worried that the food particles may clog up the catheters. Is there a better alternative? Background Up to 44% of emergent intubations are complicated by blood, vomit, or food particles in the airway. It has been shown that contaminated airways may lead to multiple intubation attempts and are associated with poor outcomes, such as peri-intubation cardiac arrest [1, 2]. The [+]

EM Match Advice: Where did all the jobs go, and did the applicants follow?

By |Oct 30, 2021|Categories: EM Match Advice, Podcasts|Tags: |

In this episode of EM Match Advice, our panel takes on the tough issues of 2021. Specifically we discuss the American College of Emergency Physicians (ACEP) Workforce Study [1] that projects fewer jobs for emergency physicians and the hot-off-the-press ERAS data showing a drop in the number of EM residency applicants, compared to 2 years ago. Did one cause the other? In this podcast, Dr. Mike Gisondi and Dr. Michelle Lin host an esteemed panel of 3 program directors, Dr. Cassandra Bradby (East Carolina University), Dr. Adam Kellogg (Baystate Health), and Dr. Craig Krausz (Saint Louis University). The Numbers The [+]

The 1440 Doctor: 3 Tips for Combating Distractions while Working From Home

By |Oct 22, 2021|Categories: 1440 Doctor, Academic, Life|

We have all been there. You sit down to write your next masterpiece that you know any journal would be lucky to accept and “ding” your phone goes off. You check it, you type a few words on the google document, you hear some yelling in the other room (A kid? Your neighbor's kid?). You try to focus and tell yourself not to worry about it. You need to get this section of the paper written today. The doorbell rings, you hop up to see what it is. Amazon has arrived. Sound familiar? Our brains are hardwired for distraction. Back in [+]

Trick of the Trade: Persistent Paracentesis Leakage 2.0

By |Oct 20, 2021|Categories: Gastrointestinal, Tricks of the Trade|Tags: |

You’re seeing a patient returning to the ED after a recent diagnostic paracentesis. The patient is complaining of persistent peritoneal fluid leakage. They’ve tried putting pressure with no success. You tried applying a medical adhesive glue and noticed it was unsuccessful, based on the patient’s gown continuing to get wet with ascites fluid. Now what? Trick of the Trade: Pressure Gauze and Transparent Film Dressing   The medical adhesive glue trick was proposed in the Trick of the Trade 1.0 version by Dr. Borloz and Dr. Lin in November 2012.  Materials Needed MaterialQuantityBenzoin tincture1Gauze 2" x 2"1-2Transparent Film Dressing (Tegaderm) [+]

SAEM Clinical Image Series: A Rapidly Spreading Rash

By |Oct 18, 2021|Categories: Dermatology, ENT, Infectious Disease, SAEM Clinical Images|

A 40-year-old male with a past medical history of HIV presented for evaluation of a non-pruritic rash. Six days ago, he suddenly felt a stinging sensation at the back of his head and neck similar to a bug bite. He then noticed bumps were starting to form and developed a shock-like pain in the area. Three days ago, the rash spread from the back of his head towards his chest. Yesterday, the rash spread further and now extends medially and upwards covering most of his left neck and ear. The pain continued to worsen, at which point the patient [+]