DilEMmas

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

High Yield for the Field

HYFTF: First Trimester Vaginal Bleeding

Written and Edited by Dr. Jessica Zahn

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

Midnight Musings

Midnight Musings

Midnight Musings Why I’m a Nocturnist Hi.  I’m Tim Meehan. I’m one of the nocturnists at UIHealth.  I’m hoping this semi-regular column will help shed some light (hehe) on the practice of EM in the wee hours of the day. Things that we will (hopefully) talk about over the course of this experiment: How to

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