https://www.postshiftpearls.com/pearllog daily 0.75 2026-03-22 https://www.postshiftpearls.com/pearllog/quickhits-whole-blood-in-trauma-triple-negative-breast-cancer-and-the-linear-probe-for-iup monthly 0.5 2026-03-22 https://www.postshiftpearls.com/pearllog/early-pregnancy-loss-in-the-emergency-department monthly 0.5 2026-03-18 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/1de1a3b4-3b1a-431b-9075-7ae1852b13a6/e23feed3-eac1-4791-a90c-4f491e049ccb.png Pearl Log - Early Pregnancy Loss in the Emergency Department - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://www.postshiftpearls.com/pearllog/2026-aha-guideline-on-acute-pulmonary-embolism monthly 0.5 2026-03-08 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/17395fc5-3b58-43a3-8654-90bdbdd24ba2/AHA%3AACC+Acute+PE+Clinical+Categories.jpg Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/8503c6ca-9b52-41c4-87d7-1e2f72aa391f/Clinical+Evaluation+of+Suspected+PE.jpg Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/53062901-c6f4-486c-8b13-a2997f0b8458/Screenshot+2026-03-08+at+7.32.41%E2%80%AFAM.png Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/50266a02-514a-48d9-aae1-caa8385430ec/Screenshot+2026-03-08+at+7.32.49%E2%80%AFAM.png Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/428e58b8-aa8c-4dc3-ac51-9f832b91ed4d/Initial+Assessment+and+Management+by+Category.jpg Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://www.postshiftpearls.com/pearllog/quick-hits-pta-and-migraine-treatment monthly 0.5 2026-02-12 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/53ae7049-d7d4-4ef5-ab32-d559976c0065/d220ea99-45f5-41f9-9ec6-6f30b38665b7.png Pearl Log - Quick Hits: PTA and Migraine Treatment - Make it stand out Summary of evidence table by level for all treatments from the 2025 review. Robblee 2025, Headache https://www.postshiftpearls.com/pearllog/post-cardiac-arrest-management monthly 0.5 2026-02-10 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/f81ba323-63bf-4b50-b357-57d32b1d920a/Percinter.jpg Pearl Log - Post Cardiac Arrest Management - Make it stand out Source:AHA Guidelines 2025 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/aba4031f-a0d9-4b63-b51e-1d1f9b7ccae7/Neuroprog.jpg Pearl Log - Post Cardiac Arrest Management - Make it stand out Source: AHA Guidelines 2025 https://www.postshiftpearls.com/pearllog/migraine-headache-pathophys-diagnosis monthly 0.5 2026-02-06 https://www.postshiftpearls.com/pearllog/atrial-fibrillation-guideline-check-in monthly 0.5 2026-01-30 https://www.postshiftpearls.com/pearllog/subclavian-cvcs monthly 0.5 2026-01-18 https://www.postshiftpearls.com/pearllog/intraventricular-hemorrhage monthly 0.5 2026-01-12 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/8a986212-ac5a-4227-b7d9-47c9a3b13cea/Screenshot+2026-01-12+at+11.37.59%E2%80%AFAM.png Pearl Log - Intraventricular Hemorrhage - Make it stand out Noncontrast CTH, Axial View. See hyperdensity in the lateral ventricles. Note the absence of intraparenchymal hemorrhage. https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/a0be8489-d888-404c-9c5d-7bd22c062175/Screenshot+2026-01-12+at+11.37.11%E2%80%AFAM.png Pearl Log - Intraventricular Hemorrhage - Make it stand out Noncontrast CT Head, Sagittal View: See extensive hyperdensities that extend from the 4th ventricle, through the 3rd ventricle, to the lateral ventricles. https://www.postshiftpearls.com/pearllog/out-of-breath-community-acquired-pneumonia-tx monthly 0.5 2026-01-10 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/b517bb4c-1127-43fa-98a3-b7dda9e84da2/Screenshot+2026-01-08+at+6.06.18%E2%80%AFPM.png Pearl Log - Out of Breath? Inpatient-Bound CAP Treatment - Make it stand out Metlay et al. 2019 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/55f9373e-09c8-4ecc-b7e4-b87c005be1a9/Screenshot+2026-01-09+at+4.55.46%E2%80%AFPM.png Pearl Log - Out of Breath? Inpatient-Bound CAP Treatment - Make it stand out Metlay et al, 2019. https://www.postshiftpearls.com/pearllog/a-big-deal monthly 0.5 2025-12-31 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/50f187d9-6cb1-4530-a937-d9b250419f2d/F2.large.jpg Pearl Log - a BIG Deal. - Make it stand out Source: Khan et al. 2020 https://www.postshiftpearls.com/pearllog/scan-less-think-more-canadian-rules-for-head-and-c-spine-trauma monthly 0.5 2025-12-30 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/78e2c272-0ffb-4ff9-ab21-10c9939b5750/ChatGPT+Image+Dec+30%2C+2025%2C+10_26_27+AM.png Pearl Log - Scan Less, Think More: Canadian Rules for Head and C-Spine Trauma - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/0b982a36-2f5c-4ecc-bf14-31dfedeab773/Streamlined+Canadian+CT-C+Spine+Clearance.png Pearl Log - Scan Less, Think More: Canadian Rules for Head and C-Spine Trauma - Make it stand out My own (evidence-based) C-spine clearance strategy. Remember, you only need ONE low-risk factor to move on to neck rotation assessment. https://www.postshiftpearls.com/pearllog/a-scary-ekg monthly 0.5 2025-12-27 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/ff82905e-bb9e-4ded-b148-11c941c9304e/Triage+EKG Pearl Log - A Scary EKG - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/164a67c8-5525-40fe-a3f2-f3f1c3e17de2/Screenshot+2025-12-27+at+2.10.06%E2%80%AFPM.png Pearl Log - A Scary EKG - Make it stand out Diffuse ST elevations in a non-coronary artery distribution. Reciprocal depressions only in aVR and V1. Primarily concave upwards STE (I and AVL are a little worrisome…). STE Lead II > Lead III. Diagnosis here leans “myopericarditis”. Especially when considering the patient’s history and exam. But… definitely get a cardiologist involved for final decision-making. https://www.postshiftpearls.com/pearllog/aslanger-pattern monthly 0.5 2025-12-23 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/2e3a72d9-3e1a-4b07-a4b3-37d60db937d3/Aslanger-pattern-of-ECG-chages-in-inferior-myocardial-infarction-2020-1024x598.png Pearl Log - Aslanger Pattern - Make it stand out (1) STE in III but not in any other inferior lead (2) ST depression in any of leads V4 to 6 with a positive (at least terminally positive) T-wave (3) ST in lead V1 higher than ST in V2 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/b138fd12-0614-4dfd-bff5-3f4e6358fe29/Screenshot+2025-12-23+at+11.21.11%E2%80%AFAM.png Pearl Log - Aslanger Pattern - Make it stand out (1) STE in III but not in any other inferior lead (2) ST depression in any of leads V4 to 6 with a positive (at least terminally positive) T-wave (3) ST in lead V1 higher than ST in V2 https://www.postshiftpearls.com/pearllog/syphilis-and-private-equity monthly 0.5 2025-12-07 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/87409926-57d8-42c0-8202-e1ecdcb7e00c/Screenshot+2025-12-07+at+11.01.43%E2%80%AFAM.png Pearl Log - Syphilis and Private Equity - Make it stand out Adapted from Figure 3 in Chevalier et al. 2025 Reverse Screening Algorithm. https://www.postshiftpearls.com/pearllog/varicoceles-and-jones-fractures monthly 0.5 2025-11-30 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/07a358f7-146e-468b-b30e-fbc9e701719c/06072017vldstep1reprorenalvessels+%281%29.jpg Pearl Log - Varicoceles and Jones Fractures - Make it stand out See how the left gonadal vein takes a hard turn into the left renal vein and then gets squished a bit by the SMA? The right gonadal vein has a smooth shot back into the IVC. This is what makes right-sided varicoceles rarer and more concerning. Source: Step 1 Medbullets https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/34b8530a-d468-419f-bca4-ed6d3faef808/Zones-of-the-5th-Metatarsal-wikifoundry.com_.webp Pearl Log - Varicoceles and Jones Fractures - Make it stand out Source: Zones of the 5th Metatarsal (wikifoundry.com) https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/cb7b01db-3d41-4d33-b8cc-17bba99fee09/Avascular-Necrosis-Zone-orthobullets.com_.webp Pearl Log - Varicoceles and Jones Fractures - Make it stand out Vascular Watershed Zone (orthobullets.com) https://www.postshiftpearls.com/pearllog/thanksgiving-edition monthly 0.5 2025-11-27 https://www.postshiftpearls.com/pearllog/pregnancy-ultrasound-potpourri monthly 0.5 2025-11-24 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/00e85dee-81c4-4eed-ae15-50ef350103ad/Screenshot+2025-09-06+at+11.17.06%E2%80%AFAM+%281%29.png Pearl Log - Pregnancy Ultrasound Potpourri - Make it stand out *This algorithm needs revision since the ACOG RhoGam Update See that here: https://pubmed.ncbi.nlm.nih.gov/39255498/ https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/1764003095247-IVVTEPV6G6TFJM3HAXSQ/gr2.jpg Pearl Log - Pregnancy Ultrasound Potpourri https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/1764003095295-E3EJQ2B0UUR3AX3O35KZ/gr1.jpg Pearl Log - Pregnancy Ultrasound Potpourri https://www.postshiftpearls.com/pearllog/utility-of-bnp-in-acute-hf monthly 0.5 2025-11-20 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/cda7040a-725a-4a06-9296-2752544b6ba1/gr5_lrg.jpg Pearl Log - Utility of BNP in Acute HF? - Make it stand out See their Figure 5. Which basically says: In acute dyspnea, a BNP <100 pg/mL or NT-proBNP <300 pg/mL provides an excellent negative predictive value to rule out heart failure, while BNP >400 pg/mL and age-adjusted NT-proBNP cutoffs help rule in the diagnosis, though rule-in thresholds must be interpreted cautiously because many conditions can falsely raise or lower natriuretic peptide levels. About 20 percent of patients land in a gray zone between rule-out and rule-in, and roughly half of these will have acute HF, making clinical features (history of HF, JVP, prior diuretic use) and ancillary testing essential. Interpretation is strongest when compared with the patient’s baseline “dry” BNP/NT-proBNP, since a 25–30 percent change from baseline, indicates a meaningful clinical shift such as decompensation. https://www.postshiftpearls.com/pearllog/a-case-of-altered-speech monthly 0.5 2025-11-07 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/0deb1094-9029-4073-ac5f-5a4305e2f082/Screenshot+2025-11-07+at+2.13.24%E2%80%AFPM.png Pearl Log - A Case of Altered Speech - Make it stand out CT HEAD WITHOUT. AXIAL View.Black Circle: Hypodensity in the Corpus Collosum https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/c0363a83-b2b4-4436-ab0e-402f18447103/Screenshot+2025-11-07+at+2.12.34%E2%80%AFPM.png Pearl Log - A Case of Altered Speech - Make it stand out T2 FLAIR MRI AXIAL https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/6e898cba-dfbd-40ec-9120-0fb1f51f29b9/Screenshot+2025-11-07+at+2.13.04%E2%80%AFPM.png Pearl Log - A Case of Altered Speech - Make it stand out T2 FLAIR MRI SAG https://www.postshiftpearls.com/pearllog/diverticula-and-dislocations-shoulder monthly 0.5 2025-11-05 https://www.postshiftpearls.com/pearllog/apixaban-or-rivaroxaban-for-vte monthly 0.5 2025-10-26 https://www.postshiftpearls.com/pearllog/ultrasound-for-pneumoperitoneum-and-c-collar-clearance monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/potpourri-recurrent-hypoglycemia-valproic-acid-overdose-vertigo-and-autism monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/bactrim-briefing monthly 0.5 2025-10-26 https://www.postshiftpearls.com/pearllog/potpourri-euglycemic-dka-slit-lamp-abd-pain-in-pregnancy monthly 0.5 2025-10-27 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/29e630cc-12aa-4eea-a141-4d82e175e9bc/1-s2.0-S0953620519301037-gr2.jpg Pearl Log - Potpourri: Euglycemic DKA, Slit Lamp, Abd Pain in Pregnancy - Make it stand out Barski, 2019 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/ff557cd9-db24-42b9-ba0c-5af591f75668/Screenshot+2025-09-06+at+11.17.06%E2%80%AFAM.png Pearl Log - Potpourri: Euglycemic DKA, Slit Lamp, Abd Pain in Pregnancy - Make it stand out See the above flow diagram from my training hospital's ED Handbook. https://www.postshiftpearls.com/pearllog/fecal-occult-blood-testingjust-stop-please monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/priapism-management monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/a-post-shift-potpourri-levocardia-fascicular-vt-multiple-systemnbspatrophy monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/cpr-in-traumatic-arrest monthly 0.5 2025-10-24 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/d7217d83-db39-4833-a0f3-244c774139fa/screenshot-2025-07-26-at-9.16.49-pm.png Pearl Log - CPR in Traumatic Arrest - Make it stand out Carenzo et al, 2025 https://www.postshiftpearls.com/pearllog/rectal-exam-in-the-neutropenicnbsppatient monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/a-case-ofnbsppalpitations monthly 0.5 2025-10-24 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/6f82a7e2-4336-4643-8b2a-0fb3d6fe520e/screenshot-2025-06-28-at-11.29.46e280afam.png Pearl Log - A case of&nbsp;palpitations - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://www.postshiftpearls.com/pearllog/acute-pancreatitis-innbsp2025 monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/pediatric-dka-a-quicknbspblurb monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/dialysis-after-contrast-in-patients-withnbspesrd monthly 0.5 2025-10-24 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/21f48fc3-aa42-4041-92d4-ba8b33954a6e/jhm2757-gra-0001-m.jpg Pearl Log - Dialysis after contrast in patients with&nbsp;ESRD? - Make it stand out Ninan, 2022. https://www.postshiftpearls.com/pearllog/acute-diverticulitis-updates monthly 0.5 2025-10-24 https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/73bc1ebe-b6f8-4698-985b-6573c767c930/Screenshot+2025-05-24+at+4.42.44%E2%80%AFPM.png Pearl Log - Acute Diverticulitis Updates - Make it stand out Source: https://www.uptodate.com/contents/acute-colonic-diverticulitis-triage-and-inpatient-management?sectionName=Criteria%20for%20discharge&topicRef=148747&anchor=H3840488586&source=bqp#H3840488586 https://www.postshiftpearls.com/pearllog/the-beta-hcg-and-ectopic-pregnancy-myth-busting monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/diabetic-ketoalkalosis monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/lactate-lactate-lactate monthly 0.5 2025-10-24 https://www.postshiftpearls.com/pearllog/category/Potpourri monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Opthalmology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Pediatric+Emergency+Medicine monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Nephrology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Infectious+Disease monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Endocrine monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Procedures monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Pharmacology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/ENT monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Trauma monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Urology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/General+Emergency+Medicine monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Neurology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/OBGYN monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Toxicology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Immunology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Orthopedics monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Gastroenterology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Electrocardiography monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Radiology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Critical+Care monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Cardiology monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Ultrasound monthly 0.5 https://www.postshiftpearls.com/pearllog/category/Resuscitation monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Afib monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Varicocele monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Central+Line monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Leukocytoclastic+Vasculitis monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/TMP-SMX monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/dinamo monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Valsalva monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Tylenol monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/ectopic monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Fascicular+VT monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/C-Collar monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Vertigo monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Rivaroxaban monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Traumatic+Brain+Injury monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Apixaban monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Apraxia monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/shoulder monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/FARES monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Atrial+Fibrillation monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Clinical+Decision+Rules monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/diverticulitis monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/transvaginal+ultrasound monthly 0.5 https://www.postshiftpearls.com/pearllog/tag/Neutropenia monthly 0.5 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