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. [+]
SAEM Clinical Image Series: Tick Bite
A 14 year old girl presenting from Mexicali with altered mental status. Her mother reports a rash about a week ago following a tick bite. She had been going to school until 4 days ago when she became very fatigued with associated vomiting, diarrhea, tactile fevers, and headache. She subsequently collapsed at home today and was difficult to arouse which prompted EMS activation. Her mother denies any prior complaint of neck stiffness, shortness of breath, cough, hematemesis, or hematochezia. [+]
Should the Trainee be Trusted? A User’s Guide to Assessment with EPAs
You are an attending working with a fourth-year medical student on their emergency medicine clerkship. The student sees a patient with the chief complaint of dizziness. After an initial assessment, the student says that there are no red flags in the history and the patient has a normal neurological exam. In the back of your mind you are thinking, “Does this student know the risk factors, comorbidities, and red flags? Was a thorough neurological exam performed?” How do you know the trainee should be trusted? [+]
SplintER Series: The Recurrent Shoulder Dislocation
A 17 year-old football player with prior shoulder dislocation presents to the emergency department reporting shoulder pain after fall. You obtain shoulder x-rays and see the following injury (Image courtesy of Richard Hopkins, MD). What is your diagnosis? Are there any associated lesions you could expect to find? What is your emergency department management? [+]
ACMT Toxicology Visual Pearls – Look, Don’t Touch
What toxin is responsible for the most serious clinical effects experienced by patients bitten by the creature in this photo? latrotoxin Conotoxin Helothermine Tetrodotoxin Verrucotoxin [+]
Ashley Mazo, MD
Department of Emergency Medicine
Carolinas Medical Center, Charlotte, NC
Latest posts by Ashley Mazo, MD [+]
Introducing the 2020-2021 ALiEM Faculty Incubator Cohort!
We put the call out, and *wow* did the MedEd community respond! We were beyond excited this year about the quality of our applicants for the 2020-2021 ALiEM Faculty Incubator. This next cohort will include educators from across the globe and from all arenas of medicine including pre-clinical educators and our first nurse practitioner! [+]
Trick of the Trade: Directed Saline Irrigation for Nasal Suctioning
You are just starting out your mid-January evening shift, and you go to the room of an 8-month old male with nasal congestion. He is afebrile, and mildly tachycardic, but his lung exam is fairly benign and he’s breathing easily without retractions. You can clearly see he has congestion. You instruct the parents to use saline irrigation and then nasal suctioning to clear the congestion as needed, and they say, “How can we do this if our child struggles? Won’t we just end up with a wet, angry, and congested child?” [+]
SAEM Clinical Image Series: Fever and Aches
A 62 year old female with no past medical history presented to the ED with fevers, generalized weakness, severe muscle aches, and a rash. She had returned home from the Philippines 3 days prior to evaluation. Twenty-four hours prior to arrival, the patient noticed a rash on her shins. She denied any nausea, vomiting, diarrhea, abdominal pain, chest pain, shortness of breath, cough, sore throat, dysuria, urinary frequency, headache, and neck pain. The patient was in the Philippines for a family funeral and was indoors for most of the trip. She was unsure if she [+]