PECARN Study: Accuracy of Urinalysis for Febrile Infants ≤60 Days Old
The reported accuracy of the urinalysis (UA) for diagnosing urinary tract infections (UTI) is febrile infants ≤ 60 days has been widely variable. Some guidelines specifically exclude these patients due to this variability or recommend urine culture as the primary test.1 Accuracy of the Urinalysis for Urinary Tract Infections in Febrile Infants 60 Days and Younger, published in Pediatrics in February of 2018, addressed this topic head-on.2 The authors sought to evaluate the accuracy of the UA by analyzing data in a planned secondary analysis of a prospectively collected data set, as part of the Pediatric Emergency Care Applied Research [+]
4 New Podcasts on the Opioid Initiative | ACEP E-QUAL Series
The American College of Emergency Physicians (ACEP) features 3 quality improvement targets within their Emergency Quality Network (E-QUAL) initiative: sepsis, imaging, and chest pain. Most recently, they added a fourth new focus on the opioid epidemic. This opioid initiative covers best-practice approaches and strategies for managing opioid-related complications. In collaboration with ACEP E-QUAL, we have remixed and distilled 5 of their webinars into 4 podcasts. [+]
ALiEMU AIR Obstetrics and Gynecology Module
Welcome to the Obstetrics and Gynecology (Ob/Gyn) 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 Ob/Gyn emergencies. 10 blog posts within the past 12 months (as of July 2018) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 2 AIR and 8 Honorable Mentions. We recommend programs give 4 hours (about 25 minutes per article) of III credit for this module. [+]
Ultrasound guided peripheral IV: It’s time to clean up our act
Have you ever performed a procedure, when suddenly, you are overcome by a sinking feeling that something just is not right? A mix of fear, guilt, and anger: Fear that you endangered a patient, guilt that you missed an important step in the procedure, and anger at yourself for being careless. The oath we take as physicians echoes loudly: Primum non nocere. First, do no harm. [+]
EM Fellowship Match Advice: Ultrasound Fellowship
The EM Residency Match Advice Series is back with its latest installment! We put the focus on emergency ultrasound fellowships, and our sage panel walks us through some of the changes to this year's application cycle. For the first time, Ultrasound Fellowship Programs will participate in the NRMP match program. The Society for Clinical Ultrasound Fellowships (SCUF) provides the fellowship application service (similar to the role of ERAS, but shorter!) for the residency match. Hosted by Drs. Michael Gisondi and Michelle Lin, watch the video or listen to the podcast to learn about important changes to the application process and [+]
5 Tips to Developing the Daily Habit of Writing in Academia
As newly-minted education fellows, we are expected to be productive writers, and we wanted to share what we’ve learned so far about developing the daily habit – yes, habit! – of writing. For some people, writing seems easy. But not everyone can write non-stop, like they’re running out of time. Writing productively is an important skill to learn, especially if you have your sights set on an academic career. Here are 5 tips to get you started! [+]
Trick of the Trade: Hair tourniquet removal using depilatory cream
A hair tourniquet occurs when a strand of hair coils around a patient’s appendage. It can cause damage to the skin, nerves, or affect blood supply. It is more common in infants as their skin appendages are small which allows for hair or thread to trap inside. Because in some cases these pediatric patients can present with inconsolable crying, it is important to perform a thorough physical examination to evaluate for the presence of such a hair tourniquet. We present a simple trick for removing a hair tourniquet using depilatory cream! [+]
Resuscitation of a Drowning Victim: A Literature Review
Drowning cases peak this time of year and represent a leading cause of mortality in children. For example, drowning represents the leading cause of death in boys ages 5-14 years old, and worldwide, there are 500,000 annual deaths from drowning.1 Hypoxic injury and subsequent respiratory failure represent the primary causes of morbidity and mortality. Although providers are typically taught to be aware of possible trauma (e.g. cervical spine fracture) when evaluating a drowning case, less than 0.5% of drownings are traumatic.2 The duration of immersion, volume of aspirated fluid, and water temperature dictate clinical outcomes.1 We review the presentation, pathophysiology, [+]
I am Dr. Craig Newgard, EM Physician and Researcher: How I Stay Healthy in EM
Dr. Craig Newgard is an emergency physician from Portland, Oregon. When he is not in the ED, Dr. Newgard can be found on his mountain bike, conquering the unpredictable trails of his community. Although it can be challenging to incorporate a routine schedule into life as an emergency physician, he has found that it helps him achieve balance and avoid burnout. Here’s how he stays healthy in EM! [+]
ACMT Toxicology Visual Pearls: Toxic Mouth Pain
A middle-aged Asian female presents to the emergency department complaining of 2-3 days of mouth pain. She has chewed betel nut for a number of years. Which of the following is true regarding her presentation and management? Debridement should be avoided. Metronidazole is contraindicated due to the potential of a disulfiram-like reaction. Oral secretagogues should be used due to the anticholinergic effects. The patient is at increased risk of oral cancer. [+]