SplintER Series: My Arm Is Stuck Like This
A 70-year-old female presents with right shoulder pain and the inability to adduct her arm after she fell on the sidewalk. You obtain shoulder x-rays and see the following images (Image 1: AP, scapular Y, and axillary views of the right shoulder. Author’s own images). [+]
EM Match Advice Series: Advice for the Non-EM Resident Applying To EM
Match season came to a close last month – and with that, some 17,000 U.S. medical school seniors earned a PGY-1 position. Most will go on to complete these programs and have happy, successful [+]
ACMT Toxicology Visual Pearls: Suicide plant
The seeds of the Suicide Plant, when ingested, may result in significant toxicity, including the ECG findings shown. Which kind of toxicity does it cause? Anticholinergic poisoning Cardiac glycoside poisoning Cardiac sodium channel [+]
MEdIC Series: The Case of the Lazy Learners
Welcome to season 4, episode 6 of the ALiEM Medical Education in Cases (MEdIC) series! Our team (Drs. Tamara McColl, Teresa Chan, John Eicken, Sarah Luckett-Gatopoulos, Eve Purdy, Alkarim Velji and Brent Thoma) is pleased to welcome you to [+]
One-Time Vancomycin Doses in the Emergency Department
Background A previous ALiEM post from 2013 by an EM pharmacist colleague argued the case against one-time vancomycin doses in the ED prior to discharge. The take-home points from this post were: No evidence that a one-time vancomycin has any benefit This practice is not recommended by the Infectious Diseases Society of America (IDSA) May extend the patient’s ED stay by at least an hour for the IV infusion, depending on the dose Increases the [+]
Cyclobenzaprine vs TCA Toxicity
Should we treat a cyclobenzaprine (Flexeril) overdose similar to a tricyclic antidepressant (TCA) overdose? With the only difference between the commonly prescribed muscle relaxant, cyclobenzaprine, and the TCA amitriptyline consisting of a single [+]
When the PERC Rule Fails
Kline et al developed a clinical decision tool based on parameters that could be obtained from a brief initial assessment to reasonably exclude the diagnosis of pulmonary embolism (PE) without the use of [+]
AMA: 2 high risk myths and misconceptions
Patients who leave the emergency department against medical advice (AMA) are at an increased risk of having a bad medical outcome, and can be a source of significant medicolegal risk to providers. Earlier [+]
ALiEM Book Club | Show and Tell by Dan Roam
“Its all about the audience” is a nice sentiment, but only half true” ― Dan Roam, author of “Show and Tell” book Public speaking and presentation building skills are critical aspects of medical education and academic careers. Despite how important it is to develop these skills, many educators often “wing it” or copy the same boring format they have seen in the past. Show and Tell: How Everybody Can Make Extraordinary Presentations by Dan Roam is a worthy investment for [+]
Social Media Index: Controversy and Evolution
The Social Media Index was moved from BoringEM to ALiEM on the morning of Thursday, November 21st. The increased exposure for my previously obscure little prototype got it a lot of attention. By that afternoon Dr. Scott Weingart (@EMCrit) had weighed in with an audio response critical of the index and requested that EMCrit be removed. This set off a lively discussion on Twitter as a good chunk of the FOAM community got in on [+]
