How I Work Smarter: Luz Silverio, MD

By |Nov 20, 2020|Categories: Medical Education|

One word that best describes how you work? Fitfully and obsessively Current mobile device Two: an iPhone 8 supplied by my job for clinical work, and an iPhone 10 for home. Computer A very old MacBook Air that constantly pings me, requesting "more space." I keep putting it in larger rooms, but... What is something you are working on now? I've been working on a series of 5-10 minute talks to be given prior to shifts that I call "Journal Watch Pictionary." I read journal articles and then illustrate their key points using my own medium-poor quality cartoon illustrations. It's [+]

ALiEM AIR Series | Immunology 2020 Module

By |Nov 18, 2020|Categories: Approved Instructional Resources (AIR series), Infectious Disease|Tags: |

Welcome to the AIR Immunology 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 immunology in the Emergency Department. 5 blog posts within the past 12 months (as of September 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 [+]

SAEM Clinical Image Series: Strange Eyes

By |Nov 16, 2020|Categories: Academic, Emergency Medicine, SAEM Clinical Images|

A 3-month-old boy, born full-term via normal spontaneous vaginal delivery to a gravida 2 para 1 mom with negative prenatal labs, presents with abnormal eye movement and position. His parents report 2 days of an increase in bulging of the soft spot, head size, and abnormal eye movement. He has not been able to look at his mother “like he used to.” This is associated with an increase in fussiness, poor feeding, and non-bilious, non-bloody vomiting. He also had increased sleepiness and difficulty waking up for feedings overnight. The patient has normal urination with no [+]

SAEM Clinical Image Series: An Incidental Finding

By |Nov 16, 2020|Categories: Academic, Emergency Medicine, HEENT, SAEM Clinical Images, Trauma|

A middle-aged man presented after a motor vehicle collision with a logging truck at 55 miles per hour with low back pain. A computed tomography scan (CT) of the abdomen and pelvis at an outside facility showed a burst fracture of the third lumbar vertebra (L3). The patient had no other complaints. Given the fracture, additional CT imaging was done and the above finding was discovered. After the incidental finding was found, the patient reported a nail gun accident three years prior where he thought it had just recoiled and struck him in the lip [+]

Ultrasound for the Win! 18M with Acute Shoulder Injury #US4TW

By |Nov 11, 2020|Categories: Orthopedic, Ultrasound, Ultrasound for the Win|

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series, where bedside ultrasound changed the management or aided in a diagnosis. In this case, an 18-year-old man presents with acute shoulder pain after an injury. Learning Objectives List the differential diagnosis for a patient presenting with shoulder pain.Discuss the role of the shoulder point-of-care ultrasound (POCUS) and how to correctly perform the scan using a posterior approach.  Discuss the prevalence, diagnostic approach, sonographic findings, ED management, and disposition of a shoulder subluxation.Discuss recent literature regarding shoulder POCUS and its utility and value in the ED, particularly [+]

ACMT Toxicology Visual Pearls: Case of a Toxic Tea

By |Nov 9, 2020|Categories: ACMT Visual Pearls, Emergency Medicine, Tox & Medications|

The plant pictured is used as a tea, powder, or capsule by individuals looking to self-treat pain or opioid use disorder.  Patients may develop nausea, vomiting, hallucinations, or other serious clinical effects after ingestion.  What compound is contained in this plant? Arecoline from Areca catechu Kava lactone from Piper methysticum Mitragynine from Mitragyna speciosa Salvinorin from Salvia divinorum Answer 3 – Mitragynine from Mitragyna speciosa also known as Kratom What is Kratom? [1-6] Kratom is an herbal product that derives from the tree Mitragyna speciosa, native to Southeast Asia, where it has been historically used as a stimulant. [+]

Education Theory Made Practical (Volume 3): An ALiEM Faculty Incubator eBook Project

By |Nov 6, 2020|Categories: Academic, Book Club|

The ALiEM Team is delighted to announce another eBook publication: the third volume in the Education Theory Made Practical series. This book was a labor of love written by the 2018-19 Faculty Incubator class. We are very proud of all our Faculty Incubator alumni who made this happen. Their hard work has been compiled in this FREE, peer-reviewed eBook. We sincerely feel that it will be useful for all the educators out there, wrestling with the issue of integrating theory into practice. Special shout-out to the incredible Dr. David Sklar (former Editor-in-Chief of Academic Medicine) for providing us a thought-provoking foreword. [+]

  • X ray boxer's fracture

SplintER Series: Punched a Wall

By |Nov 4, 2020|Categories: Expert Peer Reviewed (Clinical), Orthopedic, SplintER|Tags: |

A 27-year-old male presents to the ED with left hand pain after punching a wall. He has pain and swelling on the ulnar side of the dorsal hand. The above hand radiographs were obtained (image courtesy of Mark Hopkins). This patient has a fracture of the 5th metacarpal neck, otherwise known as a Boxer’s fracture. It is so named because a majority of these fractures come from punching an object [1]. Pearl: Unlike most hand and wrist fractures, metacarpal fractures are more likely to occur from axial loading than from a fall onto an outstretched hand (FOOSH) [1]. [+]

SAEM Clinical Image Series: Eye Injury

By |Nov 2, 2020|Categories: Academic, Emergency Medicine, Ophthalmology, SAEM Clinical Images|

An 11-year-old male presented to a pediatric trauma center following a motor vehicle collision (MVC). He was the restrained front-seat passenger when his vehicle was struck head-on, causing frontal airbag deployment. His primary complaint was pain around his right eye with associated blurry vision. He denied diplopia, pain with extraocular movements, flashers, floaters, or curtains in his vision. [+]

How I Stay Healthy in EM: Keith Henry

By |Oct 30, 2020|Categories: Healthy in EM, Life|

Image 1: Prepping for a shift! This month on our “How I stay Healthy” series, we’re featuring Dr. Keith Henry, director of medical student education at Regions Hospital in St. Paul, Minnesota. Dr. Henry tells us about his pre-shift rituals, his on-shift prioritization schema, and his new favorite exercise tool! [+]