PEM Pearls: 5 Tips to Demystify Amoxicillin in Pediatric Infections

Amoxicillin is a penicillin derivative antibiotic against susceptible gram positive and gram negative bacteria. It has reasonable coverage for most upper respiratory infections and is used as prophylaxis for asplenia and bacterial endocarditis. This post aims to demystify amoxicillin treatment for common pediatric infections.

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2019-09-05T17:59:37-07:00

Fascia iliaca nerve block: A hip fracture best-practice

fascia iliaca nerve block hip fracture

An 82-year-old woman presents with left hip pain after a mechanical fall while cleaning the kitchen floor. When EMS arrived, the left leg was foreshortened and externally rotated. The paramedics administered 10 mg of IV morphine, but she is still writhing in pain on arrival. The AP pelvic x-ray demonstrates a left femoral neck fracture (arrow). You consider performing a fascia iliaca nerve block for better pain control.

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2019-09-09T13:55:18-07:00

SAEM Clinical Image Series: Facial Swelling in a 2 Year Old

Facial swelling


[Click for larger view]

Chief complaint: Left-sided facial swelling

History of Present Illness: A 2-year-old male presents to the emergency department in January after waking up with left-sided facial swelling. Mother states her son has had cough and congestion for the past 4 days for which she has been giving Tylenol and a children’s cough medication. The patient went to bed, awoke the following morning with facial swelling, and was brought to the emergency department.

He has no allergies, history of trauma to the area, or bug bites. The patient is fully vaccinated including the influenza vaccine.

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2019-08-22T08:42:23-07:00

EM Match Advice: Program Directors Reflect on the 2019 Residency Match

em residency match 2019

The National Residency Matching Program® (NRMP) annually publishes data for the Residency Match. In this EM Match Advice episode, program directors reflect on the 2019 data for EM [PDF]. How competitive was emergency medicine (EM), especially given the transition period of having a single-accreditation system? Because it seems that EM remains modestly competitive, how many programs should one apply to and interview at? The below table outlines the data trends for 2011-2019.

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2019-08-18T11:38:49-07:00

ACMT Toxicology Visual Pearls: Mushroom Mania

mushroom poisoning amanita muscariaAfter eating the mushroom pictured, a 15-year-old patient arrives to the emergency department agitated, diaphoretic, and hallucinating, and then acutely becomes more somnolent and less responsive. Which neurotransmitter systems are affected by the toxins contained in this mushroom?

  1. Acetylcholine and histamine
  2. Dopamine and norepinephrine
  3. Gamma-aminobutyric acid (GABA) and N-methyl-D-aspartate (NMDA)
  4. Glycine and serotonin

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2019-08-28T20:03:57-07:00

ALiEM 2019 Gram Rounds Winner

Last month, ALiEM launched a one-of-a-kind social media contest on Instagram to find the most innovative emergency medicine residency education program. Dozens of residency programs from around the country shared incredible didactic, simulation and wellness initiatives. At the end of our contest period, one residency program stood out from the rest.

Join us in congratulating the winner of ALiEM ‘Gram’ Rounds 2019: Loma Linda Emergency Medicine

We were impressed with Loma Linda’s novel approach to simulation and ability to disseminate practical clinical pearls. Be sure to visit our Instagram page @aliemteam, and check out story highlights to see all contest submissions. To learn more about the magic behind Loma Linda’s EM program, see our highlight below.

2019-09-05T08:58:44-07:00

SAEM Clinical Image Series: Corneal Foreign Body

corneal foreign body eye

[Click for larger view]

Chief complaint: Eye pain

History of Present Illness: A 41-year-old man presents with pain and a foreign body sensation in the right eye since welding 4 days ago. The patient wore eye protective gear; however, he explains that he only wore sunglasses. A spark flew in from above his glasses and hit him in the right eye. The pain has been steady since. He complains of irritation exacerbated by blinking, but vision has remained unchanged. He has no other injury and no other physical complaint.

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2019-08-12T06:54:40-07:00