SAEM Clinical Images Series: Caught by the Cuff
A 74-year-old male with a history of hypertension and moderate alcohol use presented to the Emergency Department with generalized weakness. He was started on low dose furosemide once a day for mild ankle swelling 3 days prior. He reported good oral intake but noted that he had been urinating more than usual. He denied any fever, chest pain, shortness of breath, or any other problems but due to worsening weakness he came in for evaluation. Vitals: BP 185/94; HR 90; R 18; T 97.4°F; O2 sat 98% [+]
ACMT Visual Pearl: Basal Ganglia Hemorrhage
Which toxic alcohol can cause a basal ganglia hemorrhage? Ethanol Isopropanol Methanol Propylene glycol [Left image from Wikimedia Commons] [+]
Fernanda Calienes-Cerpa, MD
Wake Forest Emergency Providers
Latest posts by Fernanda Calienes-Cerpa, MD (see all)
SAEM Clinical Images Series: Mind the Gap
A 25-year-old right-handed female with a longstanding history of right wrist pain presents with wrist pain. Her chronic pain had worsened over the past 2-3 weeks. She did not recall a specific recent injury, but did recall that she had a painful injury to the same wrist in the past when she fell on her outstretched hand. She was seen several weeks prior for the injury, but did not seek follow-up care after her initial evaluation. She had pain with any movement and complained of tenderness around the wrist, but denied [+]
SAEM Clinical Images Series: Strawberry Tongue
A 7-year-old male with no significant past medical history presented to the Emergency Department complaining of a sore throat. The parents stated that he had been running fevers for two days along with a worsening sore throat. The patient had been able to swallow, but had decreased oral intake secondary to pain. There are no other complaints at the time. Vitals: BP 110/70; HR 111; R 17; T 101°F; O2 sat: 99% on room air. General: Well appearing, no acute distress, normal voice. HEENT: There is no [+]
SAEM Clinical Images Series: Leg Rash
A 42-year-old male with no significant medical problems presented to the Emergency Department with a 5-week history of abdominal pain and bloody diarrhea. He also reported painful intraoral blisters and ulcerative lesions on the bilateral lower extremities and scrotum. The patient had been self-managing his symptoms with over-the-counter antidiarrheal medications and has unsuccessfully attempted to establish care with a gastroenterologist. He denied any history of intravenous drug use, cutaneous injections, or previous skin infections and has no other complaints at this time. Vitals: BP 125/85; HR 97; [+]
ACMT Visual Pearl: Necrosis in the Name of Anticoagulation
What anticoagulant medication can cause these skin changes? Apixaban Heparin Rivaroxaban Warfarin [Image courtesy of Herbert Fred, MD and Hendrik van Dijk via Wikimedia Commons] [+]
Natalie M. Rall, MD
Carolinas Medical Center
Latest posts by Natalie M. Rall, MD [+]
ALiEM AIR Series | OBGYN Module (2025)
Welcome to the AIR OBGYN Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to OBGYN emergencies in the Emergency Department. 3 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 1 AIR and 2 Honorable Mentions. We recommend programs give 1.5 hours of III credit for this module. AIR Stamp of Approval and Honorable [+]
SAEM Clinical Images Series: Tangled in the Toilet
An otherwise healthy 46-year-old male presented to the Emergency Department with 18 months of diarrhea and intermittent abdominal cramping that has acutely worsened in the past week. On the morning of presentation, he noticed a worm-like object in his stool, which he brought to the ED (See images), prompting his visit. Throughout these 18 months, he experienced 4-10 loose bowel movements per day. He tried dietary modifications, including the removal of dairy, gluten, and soy, all without relief. The patient frequently travels [+]
The Most Dangerous 10 Minutes of Your Shift: Mastering the ED Hand-Off
Handoffs are everywhere, from shift changes to trauma transfers. Each one is a chance for error. A standardized, structured sign-out protects patients, supports teamwork, and makes you a safer, more effective emergency physician. Why Sign-Outs Matter In emergency medicine, handoffs are constant and high-risk. Nearly a third of healthcare workers report an adverse event tied to a poor handoff. When communication falters, patients suffer: delayed results, missed diagnoses, duplicated work, or forgotten tasks. The stakes are higher in the ED, where the pace is quick, interruptions are constant, and boarding patients stretch the system thin. But there is good [+]
SAEM Clinical Images Series: A Case of Sudden Right Arm Pain and Deformity
A 73-year-old male presented to the Emergency Department with acute pain in his upper right arm. The pain began suddenly upon attempting to lift a 30-lb box that had been delivered to his house. He stated that as he began to lift the box, he felt a sudden pop coupled with the acute onset of pain. Since the injury, he had difficulty with flexion of his right upper extremity. He denied any other complaints. [+]