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Paucis Verbis: Methotrexate for ectopic pregnancy
Ectopic pregnancies account for as many as 18% of patients who present with first-trimester bleeding or abdominal pain in the Emergency Department. This Paucis Verbis card summarizes the 2008...
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Trick of the trade: Foley catheter for DUB
Your next patient has heavy dysfunctional uterine bleeding (DUB). She is tachycardic and pre-syncopal. While you establish an IV, resuscitate her, and wait for the gynaecology team to arrive, is there...
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Trick of the Trade: Urine pregnancy test without urine
A 25 year old woman presents to the Emergency Department having syncopized in the waiting room, where she was triaged with the chief complaint of abdominal pain. Ectopic pregnancy immediately...
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Trick of the Trade: Alternative to Word catheter for Bartholin abscess
Bartholin abscesses are challenging to manage, partly because of Word catheter insertion. Sometimes, the space is not large enough (unable to fit the catheter) or too large (catheter falls out). How...
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PE in pregnancy: which diagnostic tests do you use?
Pulmonary embolism (PE) can be a deadly disease and one of the most challenging diagnosis to make in a pregnant patient. Patients may present with signs and symptoms that might also be present in a...
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Trick of the Trade: No pelvic bed? No problem
Often finding a pelvic examination bed for a female patient needing a speculum exam can be challenging. Without the elevated foot stirrups, the bed under the patient’s buttocks obstructs the pelvic...
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Sim Case Series: Perimortem C-Section
Case Writer: Clare Desmond, MDPeer Reviewer and Editor: Nikita Joshi, MD Keywords: Cardiac arrest, Perimortem C-section Educational Objectives Medical: Recognize and manage cardiac arrest in pregnant...
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PV card: Ectopic pregnancy
Ectopic pregnancy is the leading cause of maternal death in the first trimester of pregnancy. A recent JAMA systematic review [1], from The Rational Clinical Examination series, looked to...
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Is Pelvic Exam in the Emergency Department Useful?
Women with undifferentiated abdominal pain and/or vaginal bleeding commonly present to the emergency department. Many textbooks advocate for the pelvic exam as an essential part of the history and...
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PV Card: Focused 1st Trimester Pregnancy Transabdominal Ultrasound
Although history, physical, and lab tests are obtained for patients with first trimester vaginal bleeding and abdominal pain, none compare to the utility of bedside ultrasonography. Today’s PV card...
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PV Card: Focused 1st Trimester Pregnancy Transvaginal Ultrasound
Early 1st trimester pregnancies can be challenging to risk stratify when patient present with bleeding or pain. The pregnancy may be still too early for transabdominal ultrasonography, which was...
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AIR Series: Ob/Gyn Module 2015
Welcome to the seventh ALiEM Approved Instructional Resources (AIR) Module! In an effort to reward our residents for the reading and learning they are already doing online we have created an Individual...
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4 Pitfalls of Bedside Ultrasonography During First Trimester Pregnancy
One of the more common indications for the use of bedside ultrasound (US) is to evaluate patients who present to the emergency department (ED) with pain or bleeding during the first trimester of...
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Ultrasound For The Win! – 20F with First Trimester Vaginal Bleeding #US4TW
Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where point-of-care ultrasound changed the...
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Trick of the Trade: Using Linear Transducers for Point of Care Ultrasound in...
The volume of women presenting to the emergency department (ED) with newly diagnosed first-trimester pregnancies and suspected ectopic pregnancies sometimes seems like an infinitely growing number. As...
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Trick of the Trade: Using Linear Transducers for Point of Care Ultrasound in...
The volume of women presenting to the emergency department (ED) with newly diagnosed first-trimester pregnancies and suspected ectopic pregnancies sometimes seems like an infinitely growing number. As...
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Trick of the Trade: Linear Transducers for Point of Care Ultrasound in...
The volume of women presenting to the emergency department (ED) with newly diagnosed first-trimester pregnancies and suspected ectopic pregnancies sometimes seems like an infinitely growing number. As...
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ALiEMCards: Preeclampsia
Preeclampsia is on a spectrum of pregnancy related illness that includes eclampsia and HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets – debate exists about if this is a separate...
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ALiEMCards: Tranexamic Acid
Tranexamic acid (TXA) is a synthetic form of the amino acid lysine that binds to receptors on plasmin and prevents it from breaking down fibrin clots. Numerous studies have investigated its utility in...
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ALiEM Cards: Maternal Cardiac Arrest
Maternal cardiac arrest is a low-frequency, high-risk pregnancy complication with 2 lives at stake. Incidence is approximately 1 in 12,000 to 50,000 pregnancies with a greater than 40% mortality rate....
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