Top 10 Most Read Posts of 2015

Flickr: Epic Fireworks

I would like to take a moment to recognize our Top 10 articles of 2015 and congratulate the authors (see below).

Additionally, I would like to thank each of the AAEM/RSA Blog authors, reviewers, mentors, and editorial staff members for a wonderful and successful 2015.

We are accepting articles for 2016 and we welcome additional faculty mentors; contact us at info@aaemrsa.org with questions. Have a safe and happy holiday season!

Sincerely,
Gregory Wanner, DO
Editor-in-Chief
AAEM/RSA Blog
@gregwanner

1. Osteopathic Emergency Medicine Match by the Numbers
Author: Muhammad Alghanem, MSIV
Medical Student, Midwestern University - Chicago College of Osteopathic Medicine

2. In-Flight Emergencies
Author: Kenneth Young, MD
Emergency Medicine Resident, University of Chicago 

3. Be a Non-Terrible Intern in Ten Easy Steps
Author: Gregory Wanner, DO PA-C
Thomas Jefferson University Hospital

4. Free Resource! 50 Drugs Every EP Should Know 
Authors: Steve Elsbecker, DO and Aryan J. Rahbar, PharmD BCPS
University Medical Center of Southern Nevada

5. Cardiac Infarctions Under Disguise

Author: Joshua Bowers, DO 

Emergency Medicine Resident, Adena Regional Medical Center

6. “A Whole Herd of Zebras:” Anti-NMDA Receptor Encephalitis
Author: Jonathan Morgan, OMSIII
Medical Student, Lake Erie College of Osteopathic Medicine-Bradenton

7.  ACE-Inhibitor Induced Angioedema
Author: Kaylinn Dokken, MSIII
Medical Student, Western University of Health Sciences

8. Updates on LBBB and STEMI
Author: Meaghan Mercer, DO
Emergency Medicine Resident, University of Nevada School of Medicine
AAEM/RSA Immediate Past President

9.  Management of Open Fractures in the Emergency Department 
Author: Bill Mulkerin, MD
Stanford/Kaiser Emergency Medicine Residency

10. Ocular Emergency: Globe Injury, A Non-Ophthalmologist Approach to Initial Treatment and Referral
Author: Fernando Pellerano, MS-4
Medical Student, Universidad Iberoamericana (UNIBE)

A FOAM Favela

Photo Credit: Flickr Dany13

Author: Sean Weaver, DO MPH and Nathan Cleveland, MD MS
University of Nevada School of Medicine

Originally Published: Common Sense, November/December 2015

Favela is a term from Brazilian Portuguese that refers to a heavily populated, urban, informal settlement. In other words, a shanty town. Born out of necessity, favelas look disorganized, haphazard, temporary, and chaotic. To its inhabitants, however, the favela represents a vibrant and constantly evolving community built on cooperative living. This vibrancy has led to some of Brazil’s most famous cultural contributions. Samba, capoeira, and funk all came from favelas.[1]

Free Open-Access Meducation (FOAM) is the favela of medical education. Early adopters of social media in emergency medicine and critical care began sharing information through Facebook, Twitter, podcasts, and blogs. As connections were made, experts began spontaneously discussing ideas and practice habits. These conversations were open to the public and anyone could participate. Over time, a structure began to develop and the number of participants increased.[2] In 2012, over a pint of Guinness, emergency physicians Sean Rothwell and Mike Cadogan named this informal online community “FOAM.”[3]

Retinal Detachment: What You Need to Know

Image Credit: Subhadra Jalal - Flickr

Author: Stephanie Cihlar, MSIII
Medical Student
Loyola University Chicago Stritch School of Medicine
AAEM/RSA Publications Committee Member

This post was peer reviewed.
Click to learn more.

Introduction
Retinal detachment is one of the most common ophthalmic emergencies, affecting approximately 1 in 10,000 people per year.[1] Because of the risk of permanent vision loss, it is important that emergency physicians are able to identify a retinal detachment and consult a retinal specialist as soon as possible.

Pathophysiology
Retinal photoreceptors (rod and cones) are metabolically highly active cells. In fact, the choroidal circulation responsible for nourishing these cells has the highest blood flow per cubic centimeter of tissue found in the human body.[2] In a retinal detachment, the neurosensory layer of the retina is peeled away from its underlying supporting tissues, the retinal pigment epithelium and choroid. The photoreceptors undergo ischemic damage, which can lead to vision loss and blindness in a matter of hours.[3]

Board Review: Hypothermia/Cold Water Submersion

Author: Kevin P. Beres, DO PGY-1
UTHealth Emergency Medicine Resident

Originally Published: Modern Resident, April/May 2015 

Growing up in Wisconsin, one of the beloved New Year’s traditions was the polar bear plunge, which translates to a group of people jumping into the cold lakes on New Year’s Day. This event brings up two important concepts: cold water submersion and accidental hypothermia. Risk factors for accidental hypothermia include alcohol, AMS, behavior, extreme ages and certain comorbidities including peripheral vascular disease, trauma and diabetes mellitus.[1,2]

Cold Water Submersion:
When the body comes into contact with cold water, it leads to activation of the Mammalian diving reflex, resulting in bradycardia, shunting of blood to the CNS system and slow metabolism and may actually prolong survival.[1] This reflex affects children more efficiently than adults. Alcohol has been shown to reduce this reflex.[3]

Chilblains:
Chilblains are red and/or blue edematous plaques and papules that appear on the distal extremities that occur secondary to prolonged cold exposure. A variety of sensory symptoms such as itching or burning can accompany the skin changes.[1]