Feeling Argumentative

An Abscess Worth Packing

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: YEARS Clinical Decision Tool for PE

Simplified Diagnostic Management of Suspected Pulmonary Embolism (the YEARS study): a Prospective, Multicentre, Cohort Study. van der Hulle, Tom, et al. The Lancet 2017 . [paper] Why I chose this study Determining if a patient has a pulmonary embolism (PE) is a routine occurrence in the emergency department (ED) and on the medicine inpatient service. I

Knowledge Bomb

Knowledge Bomb: LP for Complex Febrile Seizures

We continue the series with Knowledge Bomb #16. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background Simple febrile seizures are common in the pediatric population, ages 6 months to 5 years. However, complex febrile seizures are more rare, affecting less than 1% of children.

Critical Care

We Have No Beds: Ventilator Series

We Have No Beds: Ventilator Series Assist Control So now that we have discussed how to read a ventilator screen, let’s discuss our first mode of ventilation… Assist Control (AC) This mode has the ability to completely control the patients ventilatory status. With this mode you set the rate, the means by which tidal volume is

EM/IM Sessions

EM/IM Sessions: Risk of AKI after IV Contrast

Risk of Acute Kidney Injury After Intravenous Contrast Media Administration Hinson, et al.  Annals of Emergency Medicine 2017. [paper] Why I chose this study On almost a daily basis, whether on Emergency or Internal Medicine, we all face a difficult question: “can this patient tolerate IV contrast administration for CT scan?” We are often guided

HYFTF

HYFTF: Pediatric Quick Hits

Produced and Edited by: Drs. Komal Paladugu, Jessica Zahn, and Janae Hohbein

Critical Care

The Sedation Vacation

Sedation Vacations in the Intensive Care Unit Sorry, pure EM folk, this topic primarily applies to the unit. For most of us, the idea of a “daily sedation vacation” is probably a familiar and standard practice in the intensive care unit (ICU). Generally defined, a sedation vacation is when sedatives are discontinued for a period