The last American College of Emergency Physicians (ACEP) guideline recommendations regarding the use of propofol for ED procedural sedation was in 2007. Much research has since demonstrated its safety in adults and children. Furthermore, many clinicians are co-administering ketamine or fentanyl in conjunction. This 2018 ACEP update1 addresses these issues and much more. The following infographic summarizes the key points.(more…)
The ALiEM Faculty Incubator reviewed stellar applications from around the globe for the 2019-2020 Faculty Incubator cohort and we are thrilled to announce our latest group of 30 medical educators! We are beyond excited to see what kinds of amazing things come out of this group (spoiler alert: it’s going to be epic!). A warm congratulations to this group and thank you to everyone who applied to be part of our virtual community of education scholars.
A 28 year-old single man with type I diabetes mellitus presents to your busy Texas emergency department in diabetic ketoacidosis (DKA). This is his third hospitalization for DKA in 5 months. When you ask the patient about his current medication regimen, he admits that he frequently skips doses as a cost-savings measure. He shares that he works 45 hours a week at a small local grocery store, makes minimum wage ($15,660 pretax), and has no health insurance. His prescribed insulin regimen, consisting of Lantus at bedtime and Humalog with meals, costs approximately $600 a month. This cost estimate is based on 25 units of nightly Lantus and 25 total units of Humalog daily from GoodRx advertised list prices for the San Antonio area.
We proudly introduce ALiEM’s newest series, The Leader’s Library, with Dr. Brené Brown’s newest book, Dare to Lead!
Have you ever gotten to work with someone who just “got it?” Someone who inspires greatness in all people with whom s/he worked, seemingly effortlessly, all the while maintaining humility and approachability? What about the converse– have you ever worked with someone who just seems out of touch with the rest of the team, failing to unite the group under a common goal, leaving the team members feeling unheard and voiceless? Unfortunately, we’ve all probably worked more with folks from the latter category than the former, and this can lead us to believe that good leadership is a mysterious, innate quality that some people are lucky enough to have, while the rest of us are stuck bumbling through our days, just trying to avoid catastrophic mistakes.
Welcome to Leg Day #3 of the SplintER Series! Performing a fast and focused history and physical examination of a patient with an acute knee injury is an important skill that has the potential to be overlooked in our busy Emergency Departments. Our hope is that after reviewing this post and with enough practice you will be able to complete your exam within 2 minutes! These are can’t-miss points and expert tips on the knee exam for your next shift in the ED.
Many of you are asked to take a leadership role in leading a team, whether it’s for research, administration, or even clinical. It is easy to feel unprepared for these roles, and there are many pitfalls waiting to sabotage your group’s teaming culture. The ALiEM Faculty Incubator has created a series of 10 case-based teaming problems to provide you with evidence-based advice and solutions for tackling some of the more common problems encountered in our professional team experiences.(more…)