ALiEM AIR | Orthopedics Upper Extremity 2019 Module
Welcome to the AIR Orthopedics Upper Extremity 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 orthopedics upper extremity emergencies. 5 blog posts within the past 12 months (as of March 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 0 AIR and 5 Honorable Mentions. We recommend programs give 2.5 hours (about 30 minutes per article) of III credit for this module. [+]
Revise and Resubmit: Responding to peer reviewer comments about your journal manuscript
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 in which he provided expert advice for responding to editor and peer reviewer comments on your journal manuscript submission. This was the focus of the second half of the webinar panel discussion starting at the 28-minute mark. His advice and best practices are summarized below. [+]
What is palliative emergency medicine and why now?
The skilled and rapid resuscitation of critically ill patients is a central premise in the specialty of emergency medicine (EM). A paradox for providers often arises when in the midst of resuscitating a patient with advanced chronic illness, the question of risks versus benefits arises. For this patient, we may successfully stabilize vital signs, but at what cost? Will this patient return to a quality of life they deem acceptable? What are the patient’s goals of treatments given his/her underlying disease? These questions illustrate the need for emergency physicians to be more aware of and comfortable with palliative care practices. [+]
SAEM Clinical Image Series: Rash After a Sore Throat and Ibuprofen Use
[Click for larger view] Chief complaint: Rash History of Present Illness: The patient is an 18 year-old male who presents with a rash that appeared 7 days ago. The rash is located on his torso, back, and lower lip. It is pruritic. Three days prior to the appearance of the rash, he had a sore throat and intermittently took ibuprofen over the ensuing 3 days. He stopped taking ibuprofen 4 days after his sore throat abated. He denies any fever, nausea, vomiting, shortness of breath, chest pain, abdominal pain, diarrhea, extended travel in the [+]
New free P3 app: PECARN Publication Prospectus
One of the gold standard for building and sustaining collaborative, multi-institutional research networks in medicine is the Pediatric Emergency Care Applied Research Network (PECARN) organization. Their efforts on studying pediatric emergency care has resulted some of our specialty's landmark papers in Lancet, New England Journal of Medicine, JAMA Pediatrics, and Annals of Emergency Medicine. Although we are not officially affiliated with them, we fully support their efforts and wanted to help disseminate their evidence-based findings with an educations. Thus was born the PECARN Publication Prospectus (P3) app project [download free P3 app]. The P3 Project and Team As with many [+]
SAEM Clinical Image Series: Another Heart Attack?
[Figure 1: Click for larger view] Chief Complaint: Chest pain History of Present Illness: An 89-year-old female with a past medical history of coronary artery disease and with recent admission for myocardial infarction that was medically managed, presented with chest pain and shortness of breath. She reports worsening midsternal chest pain that occasionally radiates to her back and right arm since discharge. [+]
SAEM Clinical Image Series: Flu-like symptoms, oral ulcers, and rash
[Click for larger view] Chief Complaint: Flu-like symptoms, lip pain/swelling, mouth pain, eye redness, and rash History of Present Illness: Patient is a 35-year-old transgender male with a history of bipolar disorder (taking seroquel/lamotrigine) who presents with 2 days of: Flu-like symptoms Progressive lip pain/swelling Mouth pain Oral ulcers Eye redness New erythematous rash involving the palms/soles and lower extremities The patient initially noted myalgias, fever, and malaise 2 days ago. Yesterday, the patient woke up with bilateral eye redness and itching, and he developed lip swelling/discoloration and mouth pain throughout the day. He presented [+]
Trick of Trade: Topical lidocaine jelly to make constipation relief less painful
Severe constipation, requiring fecal disimpaction and rectal enemas, can be excruciatingly painful for patients. Administering sedatives and opioids to help alleviate this pain poses a challenge, because many of the patients are elderly and tend to be more sensitive to these medications. Furthermore, there may be increased vagal tone when straining, leading to hypotension and bradycardia and which can result in defecation-related syncope. 1 Also, opioids can exacerbate constipation. Herein we present 2 cases and tricks on achieving better pain control. [+]
Strep Pharyngitis in Children: Review of the 2012 IDSA Guidelines
Sore throat accounts for a whopping 7.3 million outpatient pediatric visits. Group A Streptococcus (GAS) accounts for 20-30% of pharyngitis cases with the rest being primarily viral in etiology. However, clinically differentiating viral versus bacterial causes of pharyngitis is difficult and we, as providers, often don’t get it right. In addition, antimicrobial resistance is increasing.. So who do we test and when do we treat for strep throat? The 2012 Infectious Diseases Society of America (IDSA) guideline on GAS pharyngitis helps answer these questions. [+]
IDEA Series | “Saving Society” Podcast Series Teaches Residents Reflective Practice Through Debriefing
The Problem Emergency physicians (EPs) experience professional burnout more than 3 times that of the average physician.1 In a recent study, the prevalence of burnout among emergency medicine residents was found to be an astounding 76.1%, suggesting that burnout begins as early as residency training.2 The emotional impact of witnessing suffering and death and the high-stakes, stressful environment of the ED likely contribute to burnout among trainees. One potential protective factor against burnout is the strategic use of debriefing to mitigate work-related stress. Debriefing involves taking the opportunity to discuss and reflect upon a recent experience with a group of [+]