SplintER Series: The 2 minute ankle exam | Leg Day #5
Welcome to Leg Day #5 of the SplintER Series. The focused history and physical ankle exam of the patient with an acute ankle injury is a crucial tool often overlooked in the Emergency Department (ED). Our hope is that after enough practice, you will be able to complete your ankle exam within 2 minutes! The key is to practice, practice, and practice some more. [+]
SAEM Clinical Image Series: A Multifactorial Skin Eruption
A 9-year-old male with no past medical history, brought in by his mother to the ER with a new rash on his face and torso. The rash began 10 days ago. On the day he developed the rash, the patient noted swimming in a newly chlorinated outdoor pool. That same day he also played with freshly picked oranges and limes outdoors with his friends, having squeezed the juices onto his head and body. He developed a non-painful, non-pruritic, hyper-pigmented rash on his left cheek. Over the course of 3 days, the patient and his family [+]
TLDR Book Review: The Culture Code – The Secrets of Highly Successful Groups
Have you had shifts or worked on committees where everything went smoothly? Closed loop communication happened, there was mutual respect among all the team members, and each individual felt empowered to give input even if it differed from what had already been said or done? You’ve probably also worked on shifts, in meetings, or participated in projects where it seemed like the team was falling apart, communicating on different wavelengths, and failing to have a shared understanding. You may feel like a great leader one day and a failure the next. The difference, according to The Culture Code, has everything [+]
IDEA Series: Just-in-Time Training for Diagnostic Paracentesis
According to the National Health And Nutrition Examination Survey, approximately 630,000 adults in the United States have cirrhosis of the liver, 69% of which are reportedly unaware of having liver disease. A diagnostic paracentesis is a simple procedure for identifying spontaneous bacterial peritonitis in cirrhotic patients with ascites. A just-in-time training (JITT) model incorporating low-fidelity equipment readily available in the ED can facilitate procedural teaching of the diagnostic paracentesis. [+]
SAEM Clinical Image Series: Uncommon Cause of Right Groin Pain
A 48-year-old male presents with 2 weeks of severe right lower quadrant abdominal pain and inguinal pain. The patient had similar pain 2 weeks ago, was referred to a surgery clinic, but was lost to follow up. The pain has been progressively worsening over the last 2 days. It’s now severe, associated with nausea and vomiting, does not radiate, and it is worsened with coughing and sneezing. He also endorses polyuria for an unknown length of time. His last bowel movement was 3 days ago. He denies diarrhea, constipation, hematochezia, melena, dysuria, hematuria, or recent [+]
SAEM Clinical Image Series: A Case of a Painful Facial Rash
A 65-year-old female without any significant past medical history presented to the emergency department with left eye pain and redness. She also reported a developing rash to left side of her face over the last 24 hours. [+]
Jonathan Chan
Latest [+]
ALiEM AIR | Infectious Disease 2019 Module
Welcome to the AIR Infectious Disease 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 infectious disease emergencies. 9 blog posts within the past 12 months (as of September 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 1 AIR and 8 Honorable Mentions. We recommend programs give 4.5 hours (about 30 minutes per article) of III credit for this module. [+]
Trick of Trade: Topical lidocaine jelly takes the tears out of skin tears and road rash
Skin tears are a common injury treated in the elderly in the emergency department (ED). Often the skin is paper thin, and the area involved can have a large flap. By the time the patient has arrived, the may blood have dried with a retracted and rolled-in skin flap. Often the surface area is too big and skin to thin to inject local anesthesia around the entire site. [+]
Syncope as Easy as 1-2-3
A 66-year-old otherwise healthy man presents by Emergency Medical Services (EMS) after being found unconscious on the ground. On arrival to your emergency department, he is back to his baseline normal mental status and without complaints. His vital signs are within normal limits and his physical exam is unremarkable. Is it a syncope? What are the key features of his history and physical exam that should affect your medical decision making? What should this patient’s work-up entail? [+]
EM Match Advice: Deep Dive into the SLOE
A high-stakes component in a medical student's application for an emergency medicine (EM) residency is the Standard Letter of Evaluation, or SLOE. This is a standardized templated letter, written by an group (e.g. department) or faculty from an EM-residency program. This episode of EM Match Advice gives a behind-the-scenes peek into what letter writers are thinking and a deeper dive into the mechanics of the SLOE. Panelists Dr. Abra Fant (Northwestern University) Dr. David Gordon (Duke University) Dr. Michael Takacs (University of Iowa) Listen to all the episodes of the EM Match Advice Series Resources FAQ on SLOE for medical [+]