EM/IM Sessions

EM/IM Sessions: SALT-ED Trial

Balanced Crystalloids versus Saline in Noncritically Ill Adults WH Self et al. New England Journal of Medicine, March 2018. [paper] Why I chose this article This article is another flashpoint in the long debate – typically between internists and surgeons – regarding the use of normal saline versus balanced crystalloids for resuscitation. I remember being

Knowledge Bomb

Knowledge Bomb: Route of Diltiazem in Afib with RVR

We continue the series with Knowledge Bomb #21. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background Atrial fibrillation (afib) with rapid ventricular rate (RVR) can lead to adverse effects on cardiovascular hemodynamics. Sustained elevated rates of disorganized atrial electrical activity leads to the absence

Tamara O'Neal

Remembering Tamara O’Neal

In Memory On November 19th, 2018 the BrownCoat family lost one of our own, Dr. Tamara O’Neal, in a horrific act of violence that also took the lives of three others: police officer Samuel Jimenez, pharmacy resident Dayna Less, and the perpetrator of the shooting. We grieve and remember a life so bright and taken

Resident Narratives

What is a Browncoat

What is a Browncoat After years of undergraduate education, followed with more years of medical school, I had matched in my top choice emergency medicine residency program. It was the last of twenty-two interviews I had been on. I received the invitation on just a few days’ notice but I went anyway. I had no

EM/IM Sessions

EM/IM Sessions: ED Efficiency

Key High-Efficiency Practices of Emergency Department Providers: a Mixed-Methods Study. Morgan R. Bobb et al. Society for Academic Emergency Medicine, Dec 2017. [paper] Why I chose this study Efficiency matters, and not just for the physician. Efficiency has a profound impact on patient care and patient outcomes. We all have heard of (or perhaps have

Knowledge Bomb

Knowledge Bomb: Fluid Resuscitation in Pediatric DKA

We continue the series with Knowledge Bomb #20. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background Cerebral edema is one of the most feared complications in pediatric patients with diabetic ketoacidosis (DKA). It is the leading cause of death from this disease process. Thankfully

EM/IM Sessions

EM/IM Sessions: Hypothermia for In-Hospital Cardiac Arrest

Association Between Therapeutic Hypothermia and Survival After In-Hospital Cardiac Arrest. Chan, Paul  et al. JAMA. Oct 2016. [paper] Why I chose this study I recently rotated through the ICU and experienced multiple in-hospital cardiac arrests. There is research that suggests therapeutic hypothermia improves outcomes for out-of-hospital cardiac arrest. We were cooling patients with in-hospital cardiac arrest