ALiEM

MARCH 5, 2024

Further information on the diagnosis and treatment of salicylate toxicity Bedside Pearls Willow tree bark ( Salix genus) contains salicin, which is metabolized in the body to salicylic acid. Willow tree bark supplements are available as tablets, tinctures, powders, or tea. Ingestion of willow bark supplements can cause salicylism.

OR 286

OR 286

High Performance EMS

MARCH 8, 2024

There is plenty of data in the world, the key to improving performance is to discover the right information and make an appropriate decision, based on facts, in time to change outcomes for the better. It is also important that the decision criteria be flexible to adjust quickly to any changes in the business environment.

Public Safety 278

Public Safety OR 278

NVFC

MARCH 12, 2024

Hohon and Captain Jesse Slaughter, the department’s training officer, created a podcast – “It Tastes Like Burning” – to share and discuss information about the volunteer fire service. However, departments that protect fewer than 2,500 people, which are almost all volunteer, have the highest percentage of firefighters over the age of 50 (34%).

OR 116

OR Firefighter NFPA EMT 116

ALiEM

OCTOBER 27, 2023

Author information Sarah Gross Medical Student University of South Alabama College of Medicine | The post SAEM Clinical Images Series: Intracranial Abnormality appeared first on ALiEM. He denied vomiting, dizziness, diplopia, loss of consciousness, or seizures. Nothing made it better or worse. No follow-up or treatment is needed.

OR 278

OR ED 278

ALiEM

APRIL 14, 2023

More in-depth information regarding the Social Media Index. Author information Chris Belcher, MD Editor, ALiEM AIR Series Assistant Professor and Assistant Program Director Department of Emergency Medicine University of Kentucky College of Medicine | Twitter | The post ALiEM AIR Series | Procedures Module appeared first on ALiEM.

EMS 246

EMS Emergency Department ED OR 246

ALiEM

FEBRUARY 28, 2024

Author information Jessica Mason, MD Associate Clinical Professor of Emergency Medicine Medical Education Fellowship Director Vanderbilt University School of Medicine Associate Editor for EM:RAP | The post How to Cite Videos, Podcasts, Apps, Media, and Blogs in a Publication or CV (AMA style 11th edition) appeared first on ALiEM.

OR 130

OR ED 130

Dr. Smith's ECG Blog

OCTOBER 15, 2024

It should be treated as such unless there is more information such as old or serial EKGs that can confirm a benign diagnosis, as BTWI patterns can mimic the South Africa Flag Sign (Compare this EKG to case 4 here: [link] com/2022/05/quiz-post-which- of-these-if-any-are-omi.html ). Still, such dramatic changes cannot be overlooked.

OR 112

OR STEMI Coronary ED 112

ALiEM

MARCH 18, 2024

Author information Cassandra Bradby, MD Residency Program Director East Carolina University | The post SAEM Clinical Images Series: Purple Finger appeared first on ALiEM. Shortly after that, the finger turned purple, so she came to the Emergency Department for evaluation. She denied pain in the hand and has had no problems moving the finger.

Emergency Department 306

Emergency Department ED OR 306

Dr. Smith's ECG Blog

SEPTEMBER 22, 2023

This ECG was texted to me with no other information. I assumed the presentation was consistent with acute MI. What did I say? Activate the cath lab." The T-waves in V2-V6 are diagnostic. It does, in fact, the STE meets STEMI criteria since there is 1 mm of in V4 and V5. There is also some non-diagnostic STE in inferior leads.

OR 129

OR STEMI Coronary 129

EMS 12-Lead

MAY 15, 2024

We will be using redacted information from different cases where paramedics attempted TCP in the field. Details are edited and redacted to preserve patient anonymity. In this call, paramedics arrived on scene to find a patient apneic and pulseless with CPR in progress by first responders (AED had an unknown unshockable rhythm).

Epinephrine 331

Epinephrine Paramedic CPR EMT 331

The Skeptics' Guide to EM

DECEMBER 16, 2023

Clinical Question: How can patient perceptions of microaggressions that occur during an ED visit inform potential interventions and prevent future occurrences? Background: Patient experiences of care are associated with health outcomes and may impact perspectives of ED care and the patient recovery process.(1-5) Reference: Punches el al.

Emergency Department 292

Emergency Department ED ALS OR 292

ALiEM

AUGUST 7, 2023

Author information Andrew Washington Medical Student University of South Alabama College of Medicine | The post SAEM Clinical Images Series: Back Yard Football Injury appeared first on ALiEM. The patient is reluctant to abduct the right arm secondary to pain. Anterior dislocations are mostly caused by medial impact to the lateral shoulder.

Emergency Department 246

Emergency Department OR EMS ED 246

ALiEM

NOVEMBER 17, 2023

Author information Rebecca Yue, MD Resident Physician UT Southwestern Medical Center | The post SAEM Clinical Images Series: Pediatric Genitourinary Bleeding appeared first on ALiEM. Urethral prolapse is a rare condition occurring in prepubertal female pediatric patients. View other cases from this Clinical Image Series on ALiEM.

Emergency Department 250

Emergency Department OR 250

ALiEM

JUNE 15, 2023

PMID 12801736 Author information Sheila Goertemoeller, PharmD, DABAT, ICPS Clinical Toxicologist and Educator Drug and Poison Information Center Cincinnati Children's Hospital Medical Center | The post ACMT Toxicology Visual Pearl: The Heart Won’t Go On and On appeared first on ALiEM. ouabain, poison rope) Asclepias spp.

ALS 246

ALS ED OR 246

ALiEM

JULY 22, 2023

Author information Michael Cataldo, DO Emergency Medicine Resident Emergency Department South Brooklyn Health | The post Trick of Trade: Alternative to a Pressure Bag for IV Fluids appeared first on ALiEM. In the unused port, attach a 10 or 20 cc syringe. Interested in Other Tricks of the Trade? Read the series Buy the print book!

Emergency Department 241

Emergency Department OR Critical Care 241

Core EM

AUGUST 1, 2024

Always refer to the packaging for flow rate information, which highlights the differences between catheter types. . - Practical Implications: - In emergency situations requiring rapid volume infusion, such as trauma or severe GI bleeding, bilateral 16-gauge IVs are often more effective and quicker to place than a central line.

OR 198

OR Critical Care 198

The Skeptics' Guide to EM

OCTOBER 12, 2024

Comparison: None Outcome: Primary Outcome: Children’s perspectives on their emotional, practical, and general informational needs and experiences. He is accompanied by his worried parents. Before entering the room, she says to you, “This is the first time I’ve seen a pediatric patient.

Emergency Department 227

Emergency Department ED ALS OR 227

ALiEM

MAY 24, 2023

Author information Meraj Fatima, MBBS Resident Emergency Medicine Aga Khan University | The post Trick of Trade: Removal of Entrapped Metal Zipper appeared first on ALiEM. All revolve around understanding zipper anatomy and obtaining adequate exposure to assess how the skin is entrapped. Genitourinary trauma.

ED 233

ED OR 233

ALiEM

JUNE 5, 2023

Human illness is most commonly acquired by handling animal fluids or pelts. There are several forms of anthrax, however cutaneous is the most common (95% of cases) and the least complicated to treat [2]. What are the symptoms of cutaneous anthrax? [3, 3, 4] Naturally occurring cases develop after spores of B. Is cutaneous anthrax reportable? [6,

ALS 256

ALS OR ED 256

EMS 12-Lead

MARCH 30, 2024

We will be using redacted information from different cases where paramedics attempted TCP in the field. Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the first installment of a blog series showing how transcutaneous pacing (TCP) can be difficult, and how you can improve your skills.

CPR 312

CPR Paramedic Ambulance Defibrillator 312

Core EM

JANUARY 25, 2024

SUMMARY: Upon initial evaluation of patients in the emergency department with clinical signs of soft tissue infections, consider using POCUS as a valuable tool to gather more information in patients with a high suspicion for the diagnosis and/or are too unstable to undergo CT imaging. REFERENCES: Castleberg E, Jenson N, Dinh VA.

E-9-1-1 246

E-9-1-1 Emergency Department OR 246

ALiEM

OCTOBER 23, 2023

Author information Peter Alsharif Resident Physician Department of Emergency Medicine Rutgers New Jersey Medical School | The post SAEM Clinical Images Series: Dangerous Eye Drainage appeared first on ALiEM. He reported that his vision had been normal before these symptoms started. pneumoniae and Strep. Indian J Otolaryngol Head Neck Surg.

Emergency Department 278

Emergency Department OR 278

ALiEM

JULY 20, 2023

More in-depth information regarding the Social Media Index. These posts have been flagged by and agreed upon by AIR Board members as worthwhile, accurate, unbiased, and appropriately referenced despite an average score. Please go to the above link. You will need to create a free, 1-time login account.

Emergency Department 188

Emergency Department EMS OR 188

High Performance EMS

AUGUST 9, 2024

Even that, however, was a step beyond the simpler model of a predetermined “ run card ” that often lacked any automated vehicle location (AVL) information at all. Today, we have many more decision constraints that complicate the assignment process. Life-threatening requests are similarly streamlined.

BLS 264

BLS CAD Advanced Life Support Life Support 264

ALiEM

APRIL 1, 2024

Author information Walter L Green, MD Professor Emergency Medicine University of Texas Southwestern | The post SAEM Clinical Images Series: Red Rash on My Legs appeared first on ALiEM. The rash began the day before presentation when she became overheated while wearing sweatpants in 104°F weather. The rash was mildly pruritic but not painful.

OR 189

OR 189

EMS 12-Lead

SEPTEMBER 8, 2024

We will be using information from different cases where paramedics attempted TCP in the field. Unfortunately, no information is available about the in-hospital portion of this patient’s care. Details are edited and redacted to preserve patient anonymity. Rhonchi are auscultated bilaterally.

Paramedic 230

Paramedic EMT EMT EMS 230

ALiEM

FEBRUARY 5, 2024

2023.02.011 , PMID 36967275 Author information Chris Belcher, MD Editor, ALiEM AIR Series Assistant Professor and Assistant Program Director Department of Emergency Medicine University of Kentucky College of Medicine | Twitter | The post ALiEM AIR Series | Toxicology Module appeared first on ALiEM. Please go to the above link.

Overdose 215

Overdose Critical Care EMS Emergency Department 215

ALiEM

FEBRUARY 9, 2024

Low-risk patients do not routinely require stress testing in the ED. Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. That’s because these values are assay specific. She does not smoke.

E-9-1-1 276

E-9-1-1 ED Coronary ALS 276

ALiEM

JANUARY 13, 2025

Author information Rachel Whittaker, MD Resident Physician University of Chicago | The post SAEM Clinical Images Series: Spontaneous Eye Luxation appeared first on ALiEM. Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. References Kelly, E.W. and Fitch, M.T.

Emergency Department 169

Emergency Department ED ALS OR 169

ALiEM

APRIL 10, 2023

Author information Madeline Field, MD Pediatric Emergency Medicine Fellow Medical College of Wisconsin | The post SAEM Clinical Images Series: A Rare Pediatric Scalp Rash appeared first on ALiEM. The image is of the cutaneous manifestation of neonatal lupus erythematosus. Fifty percent resolve by four months of life and 100% by one year.

OR 246

OR 246

ALiEM

NOVEMBER 3, 2023

2023.02.011 , PMID 36967275 Author information Chris Belcher, MD Editor, ALiEM AIR Series Assistant Professor and Assistant Program Director Department of Emergency Medicine University of Kentucky College of Medicine | Twitter | The post ALiEM AIR Series | Trauma 2023 Module appeared first on ALiEM. Please go to the above link.

Critical Care 211

Critical Care EMS Emergency Department ALS 211

Core EM

JANUARY 25, 2024

Analgesic Onset Elimination Half Life IV Infusion Rates Side Effects and Other Information Fentanyl 1 – 2 min 2 – 4 hr 0.7 – 10 μg/kg/hr Rapid onset. Patients in the analgesia only group had statistically significantly more days without mechanical ventilation and on average shorter ICU length of stays. Short acting. mg/kg 0.01 – 0.1

ICU 246

ICU Emergency Department Critical Care ALS 246

ALiEM

NOVEMBER 22, 2024

Author information Elizabeth Glowacki, MD Resident Physician Thomas Jefferson University Hospital | The post SAEM Clinical Images Series: Rectal Bulge appeared first on ALiEM. Case Question: What is the treatment for intussusception? Air or hydrostatic enemas have a 70-85% success rate in current literature.

OR 183

OR ED 183

ALiEM

FEBRUARY 2, 2024

Author information Walter L Green, MD Professor Emergency Medicine University of Texas Southwestern | The post SAEM Clinical Images Series: Back Lesion appeared first on ALiEM. It was not painful unless she touched it, and then only mildly tender. She denied any known cause, wound, prior rash, or other lesions.

Emergency Department 169

Emergency Department OR 169

High Performance EMS

JUNE 20, 2024

The experience gap forces younger staff to either ignore an issue or take personal actions with information that is often poorly calculated or presented. Independent of organizational upheaval at the federal or state level, there is more that individual agencies can do specifically to stem the loss of collective workforce understanding.

EMS 240

EMS First Responder Emergency Response OR 240

Core EM

OCTOBER 16, 2024

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

Allergic Reaction 188

Allergic Reaction Plasma ED Epinephrine 188

ALiEM

OCTOBER 25, 2024

Author information Winston Wu, MD Resident Physician University of Virginia | The post SAEM Clinical Images Series: When Needles Go Beyond Sewing and Acupuncture appeared first on ALiEM. Additional Images Physical Exam Extremities : When palpating the right forearm, multiple linear hard objects are felt in the subcutaneous tissue.

ED 177

ED OR 177