ACMT Toxicology Visual Pearls: Painful Foot
Question: A patient presents with foot pain 4 hours after contact with a chemical in the garage. What chemical exposure likely caused this injury? Ethylene Glycol Hydrofluoric Acid Petroleum Propylene Glycol Sodium Hypochlorite [+]
Ethen Ellington
Carolinas Medical Center
Charlotte, NC ,br>
Latest posts by [+]
Navigating Life After Residency: 10 Lessons I Learned in EMS Fellowship
The transition from residency to your first job or fellowship is an exciting time in any career. New opportunities for professional growth appear, but with them come a new and unique set of challenges. Transitioning from a structured clinical environment to more independent work and self-driven projects can be a difficult transition. For this reason, we wanted to share a few lessons we’ve learned. Although this advice is derived from our experience in EMS fellowship, we expect that it will apply and be helpful to other upcoming fellows and all people stepping away from residency to enter the workforce. [+]
SplintER: Knee pain after the jump
A 15 year-old male presents to the emergency department with left knee pain and swelling after jumping while attempting to dunk a basketball. You obtain a knee x-ray (image 1 courtesy of Mark Hopkins, MD). What is your diagnosis? What patient population is at risk for this injury? What other injuries occur in this anatomical location? What is your emergency department management? [+]
ACMT Toxicology Visual Pearls: The Blood Sample Doesn’t Look Right
Which administered antidote causes this appearance in a blood sample? a) Hydroxocobalamin b) Intravenous Lipid Emulsion (ILE) c) Methylene blue d) N-acetylcysteine [+]
Austin Costa, MD
Carolinas Medical Center
Charlotte, NC
Latest posts by Austin Costa, MD (see all)
Book Club: Forget a Mentor, Find a Sponsor
One of the most common themes in advice for career advancement is “find a mentor.” But we are rarely told HOW to find a mentor, WHY we need mentors, or WHAT ROLE mentors are supposed to play in our careers. In addition to the lack of direction regarding mentorship, when you start to research “what is mentorship,” it becomes clear that there are several limitations to the benefits of this popularized mentor-mentee relationship. To see results, the key may be more than mentorship and the answer is likely sponsorship. [+]
SplintER Series: Two cases of shoulder pain
Two patients present to your emergency department: Patient 1 is a 17 year-old soccer player who fell during a game onto their right side and is now complaining of mild right shoulder pain. You obtain x-rays (Figure 1). Patient 2 is a 21 year-old motorist who lost control and went over the handlebars. They heard a pop and are complaining of left shoulder pain. You obtain shoulder x-rays (Figure 2). For these cases, what are your diagnoses, expected physical examination findings, and emergency department management? [+]
Trick of the Trade: Tracheostomy leak temporization
Patients who are tracheostomy and ventilator dependent are at increased risk for complications the longer they remain in this condition. One common complication is tracheomalacia. Progressive tracheomalacia can lead to air leaks around the tracheostomy cannula balloon. Initially, this can be managed by placing a longer tracheostomy cannula deeper into the trachea, however, these are often unavailable in the emergency department [1]. A second line strategy is to temporarily over-inflate the balloon, however, with chronic overinflation, eventually both the trachea and the neck stoma become too large, leading to an inability to maintain appropriate positive pressure (PEEP) and tidal volume [+]
Gaining the Diagnosis of Vitreous Hemorrhage with Ultrasound
A 54 year-old male presents to the emergency department with an eye complaint. The patient works as a cook and while cleaning the grill several hours ago felt something fly into his eye. He did not immediately feel pain, but notes blurred vision and an increasing pressure-like sensation in his left eye. He describes his left-sided blurred vision as a haziness, like cobwebs over his eye. He has been able to open his eye and keep it open without difficulty. [+]
Winner of the 2020 ALiEM-EEM Fellowship Contest: Dr. Mark Ramzy
After receiving numerous high-quality submissions, we are proud to announce the winners of the 2020 Essentials of Emergency Medicine (EEM) Education Fellowship contest! Dr. Mark Ramzy from the Maimonides Medical Center Emergency Medicine Residency program has won the blog post competition. A blinded ALiEM voting panel selected his winning post after carefully examining all of the excellent entries. We are thrilled to feature it today on the blog and look forward to meeting him in San Francisco in May at the 3-day event. Thank you to everyone who submitted their work! Dr. Mark RamzyEmergency Medicine ResidentMaimonides Medical Center Emergency [+]
ALiEM AIR | Respiratory 2019 Module
Welcome to the AIR Respiratory 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 respiratory emergencies. 8 blog posts within the past 12 months (as of November 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 2 AIR and 6 Honorable Mentions. We recommend programs give 4 hours (about 30 minutes per article) of III credit for this module. [+]