Knowledge Bomb

K BOMB: PEDS to scan or not to scan?

Background  Between 800,000 and 1 million patients aged 17 and under present to emergency departments seeking care around the country for head injuries each year. Approximately 32% of these patients receive neuroimaging with CT scan-studies have estimated there is an increased lifetime risk of radiation induced cancers in ~1 in 10,000 pediatric patients who receive


Thrown for a Loop

Feeling Argumentative In this series we are going to pick apart the arguments and evidence surrounding a common but controversial topic in Emergency Medicine. The goal is to take a hard look at the practices we are handing down to future generations of ED docs and see what is based on opinion and what is

EM/IM Sessions

EM/IM Sessions: POCUS in Undifferentiated Hypotension

Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension? An International Randomized Controlled Trial From the SHoC-ED Investigators Atkinson et al. Annals of Emergency Medicine. October 2018. [paper] Why I Chose This Study In my brief time as a physician I have blindly accepted point-of-care ultrasonography (POCUS) as a useful tool

EM/IM Sessions

EM/IM Sessions: Effect of Occupancy on Critically Ill Admissions

Effect of Emergency Department and ICU Occupancy on Admission Decisions and Outcomes for Critically Ill Patients Kusum S. Mathews et al. Critical Care Medicine. May 2018. [paper] Why I Chose This Study “We have no beds, the MICU is now down to our crash bed” It seems all too frequent that we hear those dreaded

Knowledge Bomb

Knowledge Bomb: Antiplatelet Therapy in Ischemic Stroke

We continue the series with Knowledge Bomb #22. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background Ischemic stroke remains amongst the top five causes of death world wide impacting 6.2 million people annually¹. In the United States, 140K Americans die each year from stroke².

EM/IM Sessions

EM/IM Sessions: HFNC for Bronchiolitis

A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis Franklin, Donna, et al. The New England Journal of Medicine, March 2018. [paper] Why I Chose this Study During my recent PICU and Pediatric ED rotation, a large amount of my patients with bronchiolitis were started on HFNC liberally. Other hospitals that we rotate