Tactical Medicine News Blog

What is the most commonly fractured carpal bone in adults? It’s the scaphoid bone. As a bonus it has the dreaded complication of avascular necrosis. So how good are the physical exam and imaging modalities in diagnosing a fracture? What is the likelihood ratio (LR) that snuffbox tenderness predicts a fracture? Bottom lines: The exam is highly sensitive but poorly specific, such that one can only confidently state that a NON-tender snuffbox and scaphoid tubercle essentially rule out an acute scaphoid fracture. Also negative x-rays for patients with scaphoid tenderness still yield a fracture post-test probability of 25%. This PV card breaks down all the LRs.1

A few months ago, the ALiEM Chief Resident Incubator launched a nation-wide competition to find the best EM residency wellness ideas out there. Today we announce the winner, Dr. Kory Gebhardt and the Northwestern EM residency program. Thanks to the Chief Resident Incubator’s sponsor EBSCO Health/DynaMed Plus for generously underwriting this grant, which focuses on the crucial and often underappreciated aspect of graduate medical education and training — wellness.

Are you creative? Got a knack for acronyms and catchy names? Want to have bragging rights on naming a major American College of Emergency Physicians (ACEP) initiative? Want to win a $250 prize? Here is your chance. ALiEM has partnered with ACEP to help be the social media wing in their ambitious, grand-scale quality improvement collaborative based on Choosing Wisely recommendations.

The Case of the Awkward Assessors outlined a scenario where faculty members are put in a difficult position as they try to provide negative feedback to a medical student working in the ED. What did the ALiEM community think of this case? This month the MEdIC team, led by Brent Thoma (@Brent_Thoma) and Teresa Chan (@TChanMD) hosted a MEdIC series discussion around this issue with insights from the ALiEM community. We are proud to present to you the Curated Community Commentary and our 2 expert opinions. Thank-you to all our participants for contributing to the very rich discussions last week.

Below we have listed our selection of the 14 highest quality blog posts related to 5 advanced level questions on pediatric topics posed, curated, and approved for residency training by the AIR-Pro Series Board. The blogs relate to the following questions: Pediatric arrhythmias Procedural sedation in pediatrics The neonate in distress Toddlers with a limp Pediatric syncope In this module, we have 10 AIR-Pro’s and 4 honorable mentions. To strive for comprehensiveness, we selected from a broad spectrum of blogs identified through FOAMSearch.net. This module we also had two editorial board guests trained in Pediatric Emergency Medicine to increase the strength of our recommendations – Dr. Robert Cloutier and Dr. Jason Woods.