SplintER Series: Ankle Dislocation | Leg Day #4
Welcome to Leg Day #4 of the SplintER Series! Ankle dislocations are an emergent condition in the Emergency Department (ED) that requires expert-level examination and management. We review the pertinent and subtle sports medicine examination and management techniques that will help you feel in control from time of presentation to disposition. [+]
Summer [+]
SAEM Clinical Image Series: Fishing in Papua New Guinea
[Click for larger view] Chief Complaint: Right lower extremity injury while spear fishing History of Present Illness: A 33-year-old male went river fishing with a homemade spear and diving mask in Papua New Guinea. He felt sudden pain and tugging to the right lower extremity. He was near shore and grabbed a tree root. He held on for dear life as he was being pulled back into the water. It felt as if his foot had been torn off. He did not let go of the tree root and eventually the pulling force ceased. He [+]
SplintER Series: A Case of Traumatic Wrist Pain After Fall on Outstretched Hand
A 46 year-old male presents with wrist pain after sustaining a mechanical fall and catching himself on his outstretched hand. An anteroposterior (left) and lateral (right) plain films of the wrist are obtained (photo credit). What is the diagnosis (hint – there are 2 findings), injury classification system, associated findings, and the recommended management plan? [+]
SAEM Clinical Image Series: Distended Bowels
[Click for larger view] Chief Complaint: Abdominal distention History of Present Illness: A 36-year-old male with a history of cerebral palsy, gastrointestinal dysmotility, epilepsy, hypertension, gastroesophageal reflux disease, and insomnia presents to the ED after referral by his family physician for a 3-day history of abdominal distention. Due to the patient’s neurological disorder, he is unable to communicate but is accompanied by his mother who provides his medical history. The patient’s mother states that he had a loose bowel movement this morning, which is normal for him. He has had a history of bowel problems [+]
SAEM Clinical Image Series: Rash with Blood Pressure Cuff Inflation
[Click for larger view] Chief Complaint: Possible seizure, Left arm rash History of Present Illness: A 29-year-old with a history of migraine headaches, thalassemia of unknown phenotype, and no history of hypertension or epilepsy arrived to the emergency department via ambulance after possible seizure. The patient had nausea and vomiting the morning after a night of heavy drinking. After several rounds of vomiting, she felt shaky, lightheaded and experienced paresthesia in both of her hands and feet. There was no loss of consciousness, confusion or incontinence. EMS reported hypertension and tremors with upper extremity spasms. [+]
Pediatric Point of Care Ultrasonography ALiEMU Course on Intussusception
Our ALiEMU learning management system, which currently houses the AIR series, Capsules series, and In-Training Exam Prep courses, is ready to slowly open the doors to welcome external authors with high quality content. We are thrilled to welcome a UCSF-sponsored pediatric emergency medicine (EM) point of care ultrasonography (POCUS) series, led by Dr. Margaret Lin. The first course is on the intussusception scan, filled with multiple ultrasound scans showing normal variants and two different types of intussusception. [+]
ACMT Toxicology Visual Pearls: Abnormal ECG
This abnormal ECG would be typical following an overdose on which of the following medications? Amitriptyline Buspirone Citalopram Haloperidol [+]
Colin O'Neill, MD
Carolinas Medical Center, Charlotte, NC
Latest posts by Colin O'Neill, MD (see all)
- ACMT Toxicology Visual Pearls: Abnormal ECG - June 26, 2019 [+]
ALiEM “Gram” Rounds | Contest Announcement!
In January of 2019, ALiEM was able to continue leveraging the power of social media by delivering high quality educational content to Instagram. We love your enthusiasm for our weekly #TrickoftheTradeTuesday posts and hope you check out our content if you haven’t visited yet. It has been inspiring to follow the many residency programs who have a presence on Instagram, and so we’ve come up with a way to try and help you disseminate all of your hard work. Read on to learn more about the ALiEM “Gram” Rounds! [+]
ALiEM AIR | Cutaneous 2019 Module
Welcome to the AIR Cutaneous 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 cutaneous emergencies. 6 blog posts within the past 12 months (as of February 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 3 AIR and 3 Honorable Mentions. We recommend programs give 3 hours (about 30 minutes per article) of III credit for this module. [+]
New PECARN Febrile Infant Rule: A 3-Variable Approach for Ages 29-60 Days | Interview with Dr. Kuppermann
The diagnosis and risk stratification of febrile young infants continues to present a clinical challenge. Serious bacterial infection (SBI) rates in infants ≤60 days have continued to be reported between 8-13%. Despite several different classification rules and pathways, we continue to struggle to accurately delineate which infants have SBI and which do not. A paper titled “A Clinical Prediction Rule to Identify Febrile Infants 60 days and Younger at Low Risk for Serious Bacterial Infections” was published in JAMA Pediatrics in February of 2019.1 The authors sought to derive a new clinical prediction rule for infants with fever. The research [+]