SAEM Clinical Image Series: Left Shoulder Pain
[Click for larger view] Chief complaint: Arm pain History of Present Illness: A 30-year-old obese male presents to the ED after a ground level fall onto his left arm with immediate isolated left shoulder pain. He did not lose consciousness and denies dyspnea, numbness, weakness, vomiting, and chest pain. [+]
Sean Murray, MD
Techniques for Ultrasound-Guided IV Placement
Imagine a busy evening shift interrupted by the news that the unstable dialysis patient still has no access. Begrudgingly, you drag the ultrasound into the patient’s room. Buried beneath a layer of muscle, a tiny vein lurks below an intimidating artery with a nerve nestled close by. Making matters worse, the patient is becoming increasingly more frustrated. “This always happens. I told them not to remove my last PICC line,” he notes. The use of ultrasound-guided IV improves successful cannulation and decreases complications, but cases like this have caused many emergency providers to resent, even fear, this basic procedure.1–4 Below, [+]
National Physician Suicide Awareness Day 2019
To address the growing issue of physician suicide, the Council of Emergency Medicine Residency Directors (CORD), in collaboration with AAEM, ACEP, ACOEP, EMRA, RSA, RSO and SAEM, annually join forces to help highlight the issues and drive change. At ALiEM Wellness Think Tank, we tackle resident issues such as preventing suicide and burnout, enhancing resilience, and promoting overall quality of life. Suicide is an important topic that affects our physicians and the future of our specialty. We advocate a culture of support, transparency and openness. If you, or someone you know is exhibiting signs of depression or suicidal ideation, please [+]
EMRad: Can’t Miss Elbow Injuries
Have you ever been working a shift at 3 am and wondered, “Am I missing something? I’ll just splint and instruct the patient to follow up with their PCP in 1 week.” This is a reasonable approach, especially if you’re concerned there could be a fracture. But we can do better. Enter the “Can’t Miss” series: a series organized by body part that will help identify injuries that ideally should not be missed. This list is not meant to be comprehensive review of each body part, but rather to highlight and improve your sensitivity for these potentially catastrophic injuries. To begin: “Can’t [+]
EMRad: Radiologic Approach to the Traumatic Elbow
Radiology teaching during medical school is variable, ranging from informal teaching to required clerkships.1 Many of us likely received an approach to a chest x-ray, but approaches to other studies may or may not have not been taught. We can do better! Enter EMRad, a series aimed at providing approaches and improving interpretation of commonly ordered radiology studies in the emergency department. When applicable, it will provide pertinent measurements specific to management, and offer a framework for when to get an additional view, if appropriate. To begin: the elbow. [+]
Peering into Peer Review: How can you participate in peer review?
As part of the ALiEM Faculty Incubator Program, Dr. Anthony Artino, Deputy Editor of the Journal of Graduate Medical Education (JGME) and Assistant Editor for Academic Medicine participated in a Google Hangout with Drs. Antonia Quinn and Teresa Chan where he provided expert insights into the peer review process. His advice and best practices are summarized below. In this interview, the discussion provides an insider perspective to the peer review process and peer reviewer development. This post is the first half of a longer interview with Dr. Artino with the second half discussing addressing peer review comments. [+]
Building Equipment Kits for Streamlined Care
In the setting of emergent care, the ability to access equipment rapidly and reliably can be a deciding factor in patient outcome. Poor stocking, inconsistent organization, and dispersal of equipment throughout a large geographic area are realities of practice as well as barriers to rapid and effective patient care. Equipment kits are a great way to ensure rapid access to a select set of tools to deal with emergent scenarios. They result in both decreased time to arrival and decreased time to successful completion of procedure.1,2 Scenarios that can benefit from organized and well provisioned kits include central or peripheral [+]
SAEM Clinical Image Series: Hip Pain
[Click for larger view] Chief complaint: Left hip pain History of Present Illness: A healthy right leg-dominant 13-year-old male athlete presents with left hip pain after kicking a soccer ball. He states that he kicked the ball awkwardly and experienced hip pain immediately afterwards. He did not feel a pop or cracking sensation but could not stand after the kick and fell to the ground. He can ambulate but only with significant pain. He now has 8/10 sharp, non-radiating left hip pain that is worse with movement, weight-bearing and palpation. [+]
The Leader’s Library | Radical Candor: Be a Kick-Ass Boss Without Losing Your Humanity
We proudly announce the second installment of ALiEM’s career development book club, The Leader’s Library, with Kim Scott’s bestseller Radical Candor [Amazon link]. Your colleague and friend plops down next to you at a meeting. She’s extra excited because she’s going to give an important presentation to hospital administration about her new quality improvement project, and beams a bright smile at you. She has a huge chunk of spinach between her teeth. What do you do? You could shout, “Hey, loser, get that spinach outta your teeth!” in front of the whole group… or you could encourage her to go ahead and [+]
ALiEM AIR | Procedures 2019 Module
Welcome to the AIR Procedures 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 emergency procedures. 10 blog posts within the past 12 months (as of April 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 9 Honorable Mentions. We recommend programs give 5 hours (about 30 minutes per article) of III credit for this module. [+]