SAEM Clinical Images Series: There’s a Bird Stuck in Your Throat
The patient is a 61-year-old female with a past medical history of hypertension who presents to the Emergency Department for dysphagia. She states that for the past couple of months, she has experienced some discomfort in her chest as well as progressively worsening pain with swallowing. She was initially able to swallow thoroughly macerated solids and liquids, however over the past several days, she has been unable to tolerate either. She states whenever she eats or drinks something, she feels like the food gets [+]
SAEM Clinical Images Series: Tropical Rash
The patient is a 30-year-old female with no past medical history who presents to the Emergency Department with 2 months of non-healing ulcers on multiple parts of her body. She reports getting bitten by flies while traveling in wooded trails from Venezuela through Mexico. She reports the bites started as small scabs that have since enlarged, but they are non-painful or pruritic. She has ulcerative lesions on her left hand, right arm, back, and gluteal areas. She has taken multiple antibiotics from a doctor in Mexico including clindamycin, ceftriaxone, nitrofurantoin, flagyl, [+]
SAEM Clinical Images Series: When in Doubt, Swab It Out
A 26-year-old female with a history of atopic dermatitis presents with one week of rash that began on her lower lip but spread over her face, eyelids, and neck, plus one day of fevers and headache. She was seen at an urgent care and referred to the emergency department for evaluation and management of “impetigo.” On presentation, she endorsed nausea, headache, and mild neck pain. Vitals: Temp 100.7° F; BP 134/85; HR 121; SpO2: 100% General: Uncomfortable appearing. Cardiovascular: Tachycardia Neurological: AOx3. CN II-XII grossly intact. Moves all extremities [+]
ALiEM ACMT Toxicology Visual Pearl: Cookie Monster
What is most likely contained in this edible product that can cause somnolence and vomiting in a child? Lysergic acid diethylamide (LSD) Methamphetamines Psilocybin Tetrahydrocannabinol (THC) [Authors own image] [+]
Chloe Doris, MD
Carolinas Medical Center, Charlotte, NC
Latest posts by Chloe Doris, [+]
ACMT Toxicology Visual Pearl: Danger in the Shallows
In addition to local pain and dermal injury, stings from this marine animal can result in what systemic symptoms? Acute liver injury Hypotension, arrhythmia, and cardiac arrest Nausea, vomiting, and respiratory arrest Numbness, tingling, and muscle paralysis [Image courtesy of Guido Gautsch, Wikimedia Commons] [+]
Samuel Kerans, MD
Carolinas Medical Center
Charlotte, NC
The Discharge Severity Index: Early Research on ED Readmission Risk Assessment
From Triage to Discharge: As an emergency medicine clinician, you've likely become comfortable using the Emergency Severity Index (ESI), a critical tool helping triage patients entering the ED. But what happens when these patients leave your care? How can we anticipate who might need extra support to avoid readmission? Let’s discuss why ED discharge risk stratification matters, the landscape of existing tools, and introduce a new effort called the Discharge Severity Index (DSI), in the context of this evolving conversation. History of Emergency Severity Index (ESI) As emergency medicine clinicians, we’ve all become comfortable with using the ESI. It’s [+]
ACMT Toxicology Visual Pearl – Lead it Be?
Which retained ballistic fragment(s) would be expected to result in elevated blood lead levels in a patient? Fragments in or near a joint space Fragments with an associated fracture Multiple fragments Soft tissue fragments All of the above [Author’s own image] [+]
Madison Watts, MD
Atrium Health Carolinas Medical Center
ALiEM AIR Series | Vascular Module (2025)
Welcome to the AIR Vascular 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 HEENT emergencies in the Emergency Department. 8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 3 AIR and 5 Honorable Mentions. We recommend programs give 4 hours of III credit for this module. AIR Stamp of Approval and Honorable [+]
When Research Meets Social Media Expertise: Lessons from the PECARN-ALiEM Partnership
From Pipe Dream to Proven Strategy: How a 4-year partnership between PECARN and ALiEM created a replicable framework for evidence-based research dissemination Sometimes the best collaborations begin with simple questions. Following Dr. Nathan Kuppermann's grand rounds presentation in 2018, I had the opportunity to discuss an idea with him as PECARN's Steering Committee Chair: might there be untapped potential in using social media platforms like Twitter to amplify PECARN's research impact? Five years later, that initial conversation has grown into a reality with a systematic approach and measurable outcomes. Social media is not just about fads and marketing. In [+]
ACMT Toxicology Visual Pearl: Not Very A-peel-ing
Which of the following chemicals, commonly used in chemical peels, can cause severe, gray colored skin burns upon direct contact? Acetone Hydrogen peroxide Phenol Salicylic acid [Author’s own image] [+]
Emma Lindemann, MD
Corewell Health West - Butterworth Hospital
Grand Rapids, MI