Dear emergency physicians: WE SEE YOU. We're with you. We're in this together. Thank you for being you. - 💌 from ALiEM Send this to all the emergency physicians in your life. Video animation by soon-to-be EP Spencer Evans (@notfakespevans) youtube.com/watch?v=jtGM-BUp…

📊 What should a pediatric ED aim for? Not the average, and not perfection. PECARN set achievable benchmarks from top performers across 5.3 million visits, like steroids for asthma in 97.8%. 🩺 aliem.com/achievable-benchma… 📄 doi.org/10.1001/jamanetworko… @PECARNteam @jwoodsmd

🎓 New AIR Series: Ortho Spine 2026 Top posts: cord syndromes, epidural abscess, MAP targets & more Series Editor: Kaitlin Bowers, DO Sponsors: SAEM and CORD Earn residency conference credit → aliem.com/air-series-ortho-s… @emcrit @emdocsdotnet @stemlyns @TheSGEM @RCEMLearning

🫁 Two clinicians can listen to the same child's lungs and hear different things. A new PECARN study found that no individual exam finding met its reliability standard for pediatric pneumonia. Paper: doi.org/10.1001/jamanetworko… Our analysis: aliem.com/pediatric-pneumoni…

🧊 Your heat stroke patient is TACO'd down to 102°F. How do you stop the cooling fast, before hypothermia? Trick of the Trade by Abigail Riley and Dr. @leocho_ayylmao (@bumc_em) aliem.com/trick-trade-taco-e…

PECARN's STArT @JAMANetwork trial: IV arginine didn't shorten time to sickle cell pain crises resolution. Halted for futility. Let's discuss why, lessons learned, and the future of acute sickle pain research. aliem.com/sickle-cell-acute-… doi.org/10.1001/jama.2026.13… @PECARNteam

Trick of the Trade: Improvised Collar and Cuff Sling Using Soft Limb Holders ALiEM.com/trick-trade-improv…

🎓 New AIR Series: ACS Cardiology 2026 is live 5 top posts: post-arrest care, OMI, MI transfusion strategy, Impella & ECG patterns. Series Editor: Kaitlin Bowers, DO Sponsors: SAEM and CORD Earn conference credit → aliem.com/air-series-acs-car… @emcrit @WICSBottomLine

🫁 New PECARN study: the PERC-Peds bedside rule safely ruled out pulmonary embolism in low-risk kids, no imaging or labs needed. 99.6% sensitivity across 4,000+ children. Ellison et al. cc @PECARNteam @LaurenVonHoltz 📄 doi.org/10.1016/S2213-2600(2… Blog: ALiEM.com/beeper-perc-peds-p…

ACMT Toxicology Visual Pearl: The Fang and the Furious Envenomation from this oceanic snake would most likely lead to which of the following symptoms? Acute renal failure Blindness Descending paralysis Localized skin necrosis Read more: aliem.com/acmt-the-fang-and-… @acmtmedtox

ACMT Toxicology Visual Pearl: Black Vomit, Big Problem Which of the following substances causes rapid onset of black emesis with a garlicky or fishy odor when ingested? Acephate Brodifacoum Iron sulfate Zinc phosphide Read more: aliem.com/acmt-black-vomit-b… @acmtmedtox

ACMT Toxicology Visual Pearl: Pit Viper The venom of the pictured creature causes tissue inflammation and necrosis through which of the following mechanisms: Alpha-bungarotoxin Alpha-latrotoxin Domoic acid Phospholipase A2 Read more: aliem.com/acmt-visual-pearl-… @acmtmedtox

ACMT Toxicology Visual Pearl: Clutching Your Perles What type of EKG changes may be seen following ingestion of this medication, often prescribed for a URI? AV block Diffuse ST elevation Prolonged QTc Widened QRS Read more: aliem.com/acmt-clutching-you… @acmtmedtox

💊 New on ALiEM: Azithromycin doesn't help preschool wheezing. In 840 ED kids with wheezing, it cleared airway bacteria but didn't improve symptoms, admissions, or return visits, even in those with detectable bacteria. aliem.com/az-swed-azithromyc… AZ-SWED Trial @PECARNteam

ACMT Toxicology Visual Pearl: Who Toad you to Lick It When people intentionally lick this toad, which toxin can they be exposed to? *Bufodienolides *Ciguatoxin *Mescaline *Psilocybin Read more: aliem.com/acmt-who-toad-you-… @acmtmedtox

ACMT Toxicology Visual Pearl: Who Toad You to Lick It? When people intentionally lick this toad, which toxin can they be exposed to? *Bufodienolides *Ciguatoxin *Mescaline *Psilocybin Read more: aliem.com/acmt-who-toad-you-… @acmtmedtox

New PEM POCUS tutorial: Pediatric Musculoskeletal Ultrasound 🦴 Authors: Drs. Alyssa Goodman and Joni Rabiner Series Editor: Dr. Margaret Lin-Martore Read + take the 2-hour ALiEMU course: aliem.com/pem-pocus-series-p…

New PEM POCUS tutorial: Pediatric First-Trimester Pregnancy Ultrasound 🤰 Authors: Drs. Alex Yang, Kavita Gandhi, and Margaret Lin-Martore Read + take the 2-hour ALiEMU course: aliem.com/pem-pocus-series-p…