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
Latest [+]
EM Match Advice 48: Transitioning from ERAS to ResidencyCAS – Platform Features and Essential Resources
In this episode of EM Match Advice, Dr. Sara Krzyzaniak (Stanford University EM Program Director) speaks with Dr. Liza Smith (Clerkship Director/Associate Program Director at UMass Baystate and past Chair of the CORD Application Process Improvement Committee, and Dr. Tim Fallon (Associate Program Director at Maine Medical Center and the committee's current Chair), about the historic transition from ERAS to ResidencyCAS for EM residency applications. This marks the first year that EM is using ResidencyCAS as an application service, moving away from the ERAS platform used in previous years. The discussion focuses on essential resources and new platform features [+]
PEM POCUS Series: Pediatric Cardiac
Read this tutorial on the use of point of care ultrasonography (POCUS) for pediatric cardiac evaluation. Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit. Take the ALiEMU PEM POCUS: Pediatric Cardiac Module Goals List the indications and limitations of pediatric cardiac point-of-care ultrasound (POCUS) Describe the technique for performing cardiac POCUS Identify anatomical landmarks accurately on cardiac POCUS Interpret abnormal findings on cardiac POCUS Describe the basic literature behind pediatric cardiac POCUS Case Introduction: Child with respiratory distress You are in [+]
SAEM Clinical Images Series: Pain and Swelling in a Roofer’s Right Wrist
A 27-year-old male with no significant past medical history presented to the ED due to right hand pain and swelling. The patient reported that he works as a roofer and felt severe, sharp pain in his right hand immediately after using a nail gun this morning. The pain was followed by gradual swelling of the right wrist and hand. There was no loss of sensation or bleeding from the injury site. He additionally denied any injury from the nail itself. The patient was in moderate pain but hemodynamically stable while in the ED. [+]
SAEM Clinical Images Series: Painful Great Toe
A 63-year-old-male with a past history of hypertension, renal failure with dialysis three times per week, and prior infective endocarditis appropriately treated with a regimen that ended four weeks ago presented with left great toe pain that started three weeks ago. The toe began swelling two weeks ago with continued pain and tenderness, becoming discolored approximately one week ago. He noted subjective fever and chills, but had no other complaints. Vitals: Heart Rate 104, BP 111/69 mmHg, Temperature oral 38.1°C, Respiratory Rate 16; SpO2: 99% on room air Skin: The plantar [+]
EM Match Advice 47: 2025 EM Match By The Numbers
The Emergency Medicine (EM) Match process continues to evolve, with the specialty experiencing significant shifts in recent years. In this 47th installment of the EM Match Advice podcast series, Dr. Sara Krzyzaniak (Stanford EM PD) hosts the annual program director reflection on the Match with Dr. Abra Fant (Northwestern EM PD), who returns for her fourth consecutive year to share insights on the NRMP Match trends and data. Podcast Episode: EM Match by the Numbers Tables: EM Match by the Numbers Key 2025 Match Statistics: A Clear Improvement Significant Reduction in Unfilled Positions The most notable [+]