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

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: Observation for Heroin Overdose After Receiving Naloxone

We continue the series with Knowledge Bomb #17. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background As EM docs we see a lot of opiate overdose cases, usually heroin. As a resident learning from attendings, who have different practice patterns, I have noticed varying

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.

Knowledge Bomb

Knowledge Bomb: LOV-ED Trial

We continue on with the series with Knowledge Bomb #15. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background: Annually, 250,000 patients are mechanically ventilated in US Emergency Departments (ED). Of these patients, 20% will develop complications such as Acute Respiratory Distress Syndrome (ARDS) or

HYFTF

High Yield for the Field – Cardiology Pearls (2/2): Electrical Storm

Dr. Janae Hohbein  (PGY2) brings us part 2/2 of our cardiology pearls this week, presenting the rare phenomenon of Electrical Storm!   Dr. Janae Hohbein

HYFTF

High Yield for the Field – GI Edition

#HYFTF is back! And kicking things off with some great reviews from our GI section! First up we have Dr. Komal Paladugu with pearls on hepatic disease from a lecture given by Dr. Adam Rodos! Dr. Jessica Zahn reviews appendicitis and the use of CT in its diagnosis. Enjoy!