• Normal-shoulder series

EMRad: Can’t Miss Adult Shoulder Injuries

By |May 6, 2020|Categories: EMRad, Orthopedic, Radiology, Trauma|

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 primary doctor 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 a comprehensive review of each body part, but rather aims to highlight and improve [...]

  • Normal-shoulder series

EMRad: Radiologic Approach to the Traumatic Shoulder

By |May 6, 2020|Categories: EMRad, Orthopedic, Radiology, Trauma|

This is EMRad, a series aimed at providing “just in time” approaches to commonly ordered radiology studies in the emergency department [1]. When applicable, it will provide pertinent measurements specific  to management, and offer a framework for when to get an additional view, if appropriate. We have already covered the elbow, the wrist, and the foot and ankle. Next up: the shoulder. […]

Welcoming PECARN to Twitter

By |May 1, 2020|Categories: Pediatrics, Social Media & Tech|

Our organization has always been a champion and fan of the Pediatric Emergency Care Applied Research Network (PECARN) research collaborative. We jointly worked on designing their official Head Injury Decision Tool found printed in various emergency departments around the country, featured several PECARN authors on our ALiEM podcast, and provide summaries of their 147-and-growing list of publications in our P3 app. So it follows that we are incredibly honored and thrilled to announce our Twitter collaboration. We will be helping to run their Twitter account. Join @PECARNteam and keep current on their growing list of publications, their clinical take-home points, [...]

ALiEM AIR | Toxicology 2020 Module

By |Apr 30, 2020|Categories: ALiEMU, Approved Instructional Resources (AIR series), Tox & Medications|Tags: , , , |

  Welcome to the AIR Toxicology 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 toxicology emergencies. 11 blog posts within the past 12 months (as of March 2020) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 1 AIR and 10 Honorable Mentions. We recommend programs give 5.5 hours (about 30 minutes per article) of III credit for this module. […]

Trick of the Trade: An Improvised Foreign Body Removal Device

By |Apr 29, 2020|Categories: HEENT, Tricks of the Trade|

Foreign bodies in the ear or the nose can be extremely challenging to remove, especially considering that a majority of them occur in children less than 7 years old who are likely to be uncooperative with exam [1]. In a previous post, we emphasized the need to pick the best tool for the job in order to minimize complications. What happens when you find yourself in an austere environment and the usual tools are not available? […]

Guideline Review: Pre-exposure prophylaxis (PrEP) for HIV prevention

By |Apr 27, 2020|Categories: Guideline Review, Infectious Disease, Tox & Medications|

While HIV medications receive much attention for the treatment of HIV infection, less attention has focused on the prophylaxis indications. In 2017, the Center for Disease Control and Prevention (CDC) updated their guidelines on the indications for the HIV medications tenofovir disoproxil fumarate (TDF) and emtricitabine (2′,3′-dideoxy-5-fluoro-3′-thiacytidine, FTC) for pre-exposure prophylaxis (PrEP). The trade name for the combination medication is Truvada. These daily medications are taken by people at risk for HIV to prevent HIV. This Guideline Review succinctly summarizes the 77-page CDC document into the key pearls for emergency physicians. […]

  • Tourniquet simulation

IDEA series: The Bleeding Arm Tourniquet Simulation

By |Apr 24, 2020|Categories: IDEA series, Medical Education, Simulation, Trauma|

Education in emergency response to trauma is a global health priority [1]. Mortality rates are nearly twice as high in patients with trauma in low-income as compared to high-income countries [2]. With uncontrolled bleeding as the number one cause of death from trauma, tourniquet application has been the focus of training programs, like the “Stop the Bleed” campaign in the United States [3]. Although understanding how to apply a tourniquet is a life-saving intervention, use of a windlass tourniquet may not be intuitive [4].  The windlass tourniquet in its simplest form is the “stick-and-rope.” Winding the stick in the tourniquet [...]

A Tale of Two Epidemics: COVID-19 and the Opioid Crisis

By |Apr 23, 2020|Categories: Creative, Emergency Medicine, Tox & Medications, Treatoud|

The United States is currently dealing with 2 deadly, concurrent epidemics: COVID-19 and the opioid crisis. Both need viable solutions. The better we are equipped to address one, the more effective we can be at treating the other. Counterintuitively, now is actually the best time to get waivered. It’s imperative that we do so for 3 reasons: […]

Diagnose on Sight: Scrotal Swelling

By |Apr 22, 2020|Categories: Diagnose on Sight, Gastrointestinal, Genitourinary|Tags: , , , |

Case: A 58-year-old male with no past medical history presents to the emergency department for evaluation of right lower quadrant abdominal pain associated with right scrotal swelling. The patient reports that he had a colonoscopy the day before to remove a 20 mm polyp, which had been seen on an outpatient CT scan. He states that he noticed that his right scrotum appeared slightly swollen immediately away after the procedure, but since then the swelling had increased and he developed mild right lower quadrant abdominal pain. Physical examination reveals mild tenderness to the right lower quadrant and swelling of the [...]