PEM Pearls: Red Flags for Child Abuse – Case 1
Child abuse is a common cause of pediatric morbidity and mortality. In 2015, over 650,000 children were found to be victims of maltreatment and over 1,500 child deaths occurred due to child abuse or neglect in the United States.1 Children under 1 year of age are at the highest risk of abuse with potential for lifelong sequelae. Emergency department providers are in a unique position to recognize child abuse and take appropriate steps to reduce further injury to children. An understanding of the motor development of young children can aid physicians in the identification of clinical red flags in the [+]
A Can’t Miss ED Diagnosis: Euglycemic DKA
A middle-aged man with a history of diabetes and hypertension presents with nausea, vomiting, and shortness of breath. His laboratory testing is remarkable for a leukocytosis, ketonemia, and an anion gap acidosis (pH of 7.13). The EM resident caring for this patient is surprised to find that the blood glucose is 121 mg/dL. Which home medication is likely responsible for this presentation? Metformin Glipizide Liraglutide Canagliflozin Canagliflozin: An SGLT2 Inhibitor The patient's presentation is consistent with diabetic ketoacidosis (DKA) in the absence of hyperglycemia. This entity is known at euglycemic DKA and it is increasingly recognized for an association with [+]
3rd Annual Emergency Medicine Wellness Week | 2018 Highlights
We are set to wrap-up the 3rd Annual Emergency Medicine Wellness Week. The ALiEM Wellness Think Tank (WTT) collaborated with CanadiEM, ACEP, and the Canadian Association of Emergency Physicians (CAEP) to encourage participation from EDs across North America and around the world. Many of you shared your individual and group successes, which have helped to build collective wellness across the specialty. We are proud to present some of the Wellness Week highlights, and remain hugely motivated to participate in this important movement! When you’re done reading, be sure to welcome today’s newly matched EM interns with the hashtag #WelcometoEM! [+]
Resilience in EM Despite Litigation: An Interview with Dr. Gita Pensa
You have just signed out from one of the best shifts in your career. You feel like you were born to do this! You’re a great EM doctor! Then, you spot him, a man in a dark suit making eye contact as you walk through the lobby towards the exit. He stops and asks, “Are you Dr. About-to-get Sued?” Being named in a malpractice lawsuit is a potentially devastating, frequently unmentioned, and yet rather common event in EM. Providers may find themselves feeling isolated and ashamed, questioning their career choice regardless of the trial outcome. Members of the ALiEM Wellness [+]
Nuts and Bolts of Competency-Based Medical Education: Interviews with Drs. Sherbino, Cooney, Chan, and Hamstra
Are you confused about competency-based medical education (CBME)? Look no further! The Faculty Incubator conducted 2 Google Hangouts with 4 experts on the subject: Dr. Stanley Hamstra, the ACGME Vice-President of Milestones Research and Evaluation, and Drs. Teresa Chan, Robert Cooney, and Jonathan Sherbino. We summarized some of the key points from this robust discussion, which is available to you both in podcast and video formats. Enjoy! [+]
3rd Annual Emergency Medicine Wellness Week | March 11-17, 2018
In 2016, Emergency Medicine led the national charge to promote physical, mental, and emotional health of physicians. The American College of Emergency Physicians (ACEP) promoted the first EM Wellness Week, with the goal of reminding EPs and colleagues to take time to care for themselves. This initiative continues to expand and impact EPs across the country. Last year, The ALiEM Wellness Think Tank joined forces with CanadiEM, ACEP, and Canadian Association of Emergency Physicians (CAEP). This year, we hope to raise the bar. The ALiEM Wellness Think Tank is inviting residents from ALL programs to participate in daily challenges related to wellness, and [+]
I am Dr. Elise Lovell, EM Program Director: How I Stay Healthy in EM
Dr. Elise Lovell is an EP and the EM Residency Program Director at Advocate Christ Medical Center in Chicago. She maintains her wellness by staying active, spending time with her supports, and loving her job. When she isn’t working clinically or leading her residency program, you can find her clearing her mind with a quick run. She’s onto something with her philosophy on work-life integration! Here’s how she stays healthy in EM! [+]
MEdIC: Case of the Night Shift Stimulants – Expert Review and Curated Community Commentary
Our fifth case of season 5, The Case of the Night Shift Stimulants, presented the scenario of a junior emergency medicine (EM) resident who witnesses her attending physician taking stimulants in order to function during his night shift. The MEdIC team (Drs. Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, Alkarim Velji, and Brent Thoma), hosted an online discussion around the case over the last 2 weeks with insights from the ALiEM community. We are proud to present to you the curated commentary and our expert opinions. Thank-you to all participants for contributing to the very rich discussions surrounding [+]
SplintER Series: Complications & Discharge Care Plans With Splints 103
In this SplintER Series, we review splinting fundamentals, introduce advanced concepts, and highlight ways to implement these into your next shift. In SplintER 102, we reviewed the materials used in splinting and a general approach to applying a splint. Today’s post puts the spotlight on some of the potential complications of splinting, discharge care plans, and pharmacological adjuncts to aid in recovery. [+]
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Renal Colic & Pulmonary Embolism CT | Reducing Imaging: ACEP E-QUAL Network Podcast
Computed tomography (CT) is increasingly available across U.S. Emergency Departments and has changed the practice of medicine. However, it is coupled with potential side-effects from radiation and contrast media. Emergency Medicine is beginning to make a concerted effort to identify clinical scenarios in which CT may be unnecessary, producing outcomes research and validated clinical decision rules. Renal colic and pulmonary embolism, in particular, seem amenable to this area of investigation. The ACEP E-QUAL Network podcast, a partnership with ALiEM to promote clinical practice improvements, reviewed this topic with experts Dr. Chris Moore (Emory University) and Dr. Jeffrey Kline (Indiana University). We present highlights [+]