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  <url>
    <loc>https://www.postshiftpearls.com/pearllog</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2026-06-15</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/tizanidine-overdose-and-hyperemesis-gravidarum</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-06-15</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/1c3cb715-27ee-43f5-bb53-89be5e45db7c/Screenshot+2026-06-15+at+9.23.44%E2%80%AFAM.png</image:loc>
      <image:title>Pearl Log - Tizanidine Overdose and Hyperemesis Gravidarum - Make it stand out</image:title>
      <image:caption>Source: ACOG Practice Bulletin 189</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/quick-hits-airway-update-headache-guidelines</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-06-07</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/chest-pain-anticoagulated-falls-and-bug-bites</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-05-14</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/enough-is-enough-routine-coags-in-the-ed</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-05-07</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/1eaaf011-9c99-40cd-8bf1-3a225dd0d9b9/ChatGPT+Image+May+7%2C+2026%2C+02_11_27+PM.png</image:loc>
      <image:title>Pearl Log - Enough is Enough. Routine Coags in the ED. - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/aortas-rectums-and-bppv</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-05-04</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/leg-pain-pontification</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-04-29</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/45955fbb-4ee8-49d3-ad02-2595557fcb4a/jrv200010f1_1604343653.83381.png</image:loc>
      <image:title>Pearl Log - Leg Pain Pontification - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/knee-pain-and-monkeypox</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-04-09</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/quickhits-whole-blood-in-trauma-triple-negative-breast-cancer-and-the-linear-probe-for-iup</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-03-22</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/early-pregnancy-loss-in-the-emergency-department</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-03-18</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/1de1a3b4-3b1a-431b-9075-7ae1852b13a6/e23feed3-eac1-4791-a90c-4f491e049ccb.png</image:loc>
      <image:title>Pearl Log - Early Pregnancy Loss in the Emergency Department - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/2026-aha-guideline-on-acute-pulmonary-embolism</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-03-08</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/17395fc5-3b58-43a3-8654-90bdbdd24ba2/AHA%3AACC+Acute+PE+Clinical+Categories.jpg</image:loc>
      <image:title>Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/8503c6ca-9b52-41c4-87d7-1e2f72aa391f/Clinical+Evaluation+of+Suspected+PE.jpg</image:loc>
      <image:title>Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/428e58b8-aa8c-4dc3-ac51-9f832b91ed4d/Initial+Assessment+and+Management+by+Category.jpg</image:loc>
      <image:title>Pearl Log - 2026 AHA Guideline on Acute Pulmonary Embolism - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/quick-hits-pta-and-migraine-treatment</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-02-12</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/53ae7049-d7d4-4ef5-ab32-d559976c0065/d220ea99-45f5-41f9-9ec6-6f30b38665b7.png</image:loc>
      <image:title>Pearl Log - Quick Hits: PTA and Migraine Treatment - Make it stand out</image:title>
      <image:caption>Summary of evidence table by level for all treatments from the 2025 review. Robblee 2025, Headache</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/post-cardiac-arrest-management</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-02-10</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/f81ba323-63bf-4b50-b357-57d32b1d920a/Percinter.jpg</image:loc>
      <image:title>Pearl Log - Post Cardiac Arrest Management - Make it stand out</image:title>
      <image:caption>Source:AHA Guidelines 2025</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/aba4031f-a0d9-4b63-b51e-1d1f9b7ccae7/Neuroprog.jpg</image:loc>
      <image:title>Pearl Log - Post Cardiac Arrest Management - Make it stand out</image:title>
      <image:caption>Source: AHA Guidelines 2025</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/migraine-headache-pathophys-diagnosis</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-02-06</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/atrial-fibrillation-guideline-check-in</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-01-30</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/subclavian-cvcs</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-01-18</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/intraventricular-hemorrhage</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-01-12</lastmod>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - Intraventricular Hemorrhage - Make it stand out</image:title>
      <image:caption>Noncontrast CTH, Axial View. See hyperdensity in the lateral ventricles. Note the absence of intraparenchymal hemorrhage.</image:caption>
    </image:image>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - Intraventricular Hemorrhage - Make it stand out</image:title>
      <image:caption>Noncontrast CT Head, Sagittal View: See extensive hyperdensities that extend from the 4th ventricle, through the 3rd ventricle, to the lateral ventricles.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/out-of-breath-community-acquired-pneumonia-tx</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2026-01-10</lastmod>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - Out of Breath? Inpatient-Bound CAP Treatment - Make it stand out</image:title>
      <image:caption>Metlay et al. 2019</image:caption>
    </image:image>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - Out of Breath? Inpatient-Bound CAP Treatment - Make it stand out</image:title>
      <image:caption>Metlay et al, 2019.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/a-big-deal</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2025-12-31</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/50f187d9-6cb1-4530-a937-d9b250419f2d/F2.large.jpg</image:loc>
      <image:title>Pearl Log - a BIG Deal. - Make it stand out</image:title>
      <image:caption>Source: Khan et al. 2020</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/scan-less-think-more-canadian-rules-for-head-and-c-spine-trauma</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2025-12-30</lastmod>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - Scan Less, Think More: Canadian Rules for Head and C-Spine Trauma - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/0b982a36-2f5c-4ecc-bf14-31dfedeab773/Streamlined+Canadian+CT-C+Spine+Clearance.png</image:loc>
      <image:title>Pearl Log - Scan Less, Think More: Canadian Rules for Head and C-Spine Trauma - Make it stand out</image:title>
      <image:caption>My own (evidence-based) C-spine clearance strategy. Remember, you only need ONE low-risk factor to move on to neck rotation assessment.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/a-scary-ekg</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2025-12-27</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/ff82905e-bb9e-4ded-b148-11c941c9304e/Triage+EKG</image:loc>
      <image:title>Pearl Log - A Scary EKG - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - A Scary EKG - Make it stand out</image:title>
      <image:caption>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 &gt; 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.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/aslanger-pattern</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2025-12-23</lastmod>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - Aslanger Pattern - Make it stand out</image:title>
      <image:caption>(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</image:caption>
    </image:image>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - Aslanger Pattern - Make it stand out</image:title>
      <image:caption>(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</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/syphilis-and-private-equity</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2025-12-07</lastmod>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - Syphilis and Private Equity - Make it stand out</image:title>
      <image:caption>Adapted from Figure 3 in Chevalier et al. 2025 Reverse Screening Algorithm.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/varicoceles-and-jones-fractures</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2025-11-30</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/07a358f7-146e-468b-b30e-fbc9e701719c/06072017vldstep1reprorenalvessels+%281%29.jpg</image:loc>
      <image:title>Pearl Log - Varicoceles and Jones Fractures - Make it stand out</image:title>
      <image:caption>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</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/34b8530a-d468-419f-bca4-ed6d3faef808/Zones-of-the-5th-Metatarsal-wikifoundry.com_.webp</image:loc>
      <image:title>Pearl Log - Varicoceles and Jones Fractures - Make it stand out</image:title>
      <image:caption>Source: Zones of the 5th Metatarsal (wikifoundry.com)</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/cb7b01db-3d41-4d33-b8cc-17bba99fee09/Avascular-Necrosis-Zone-orthobullets.com_.webp</image:loc>
      <image:title>Pearl Log - Varicoceles and Jones Fractures - Make it stand out</image:title>
      <image:caption>Vascular Watershed Zone (orthobullets.com)</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/thanksgiving-edition</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2025-11-27</lastmod>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/pregnancy-ultrasound-potpourri</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2025-11-24</lastmod>
    <image:image>
      <image:loc>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</image:loc>
      <image:title>Pearl Log - Pregnancy Ultrasound Potpourri - Make it stand out</image:title>
      <image:caption>*This algorithm needs revision since the ACOG RhoGam Update See that here: https://pubmed.ncbi.nlm.nih.gov/39255498/</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/1764003095247-IVVTEPV6G6TFJM3HAXSQ/gr2.jpg</image:loc>
      <image:title>Pearl Log - Pregnancy Ultrasound Potpourri</image:title>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/1764003095295-E3EJQ2B0UUR3AX3O35KZ/gr1.jpg</image:loc>
      <image:title>Pearl Log - Pregnancy Ultrasound Potpourri</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/utility-of-bnp-in-acute-hf</loc>
    <changefreq>monthly</changefreq>
    <priority>0.5</priority>
    <lastmod>2025-11-20</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/68f6468c1a00001b235d9e32/cda7040a-725a-4a06-9296-2752544b6ba1/gr5_lrg.jpg</image:loc>
      <image:title>Pearl Log - Utility of BNP in Acute HF? - Make it stand out</image:title>
      <image:caption>See their Figure 5. Which basically says: In acute dyspnea, a BNP &lt;100 pg/mL or NT-proBNP &lt;300 pg/mL provides an excellent negative predictive value to rule out heart failure, while BNP &gt;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.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.postshiftpearls.com/pearllog/a-case-of-altered-speech</loc>
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      <image:caption>T2 FLAIR MRI AXIAL</image:caption>
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      <image:title>Pearl Log - A Case of Altered Speech - Make it stand out</image:title>
      <image:caption>T2 FLAIR MRI SAG</image:caption>
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      <image:title>Pearl Log - Potpourri: Euglycemic DKA, Slit Lamp, Abd Pain in Pregnancy - Make it stand out</image:title>
      <image:caption>See the above flow diagram from my training hospital's ED Handbook.</image:caption>
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      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
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      <image:caption>Source: https://www.uptodate.com/contents/acute-colonic-diverticulitis-triage-and-inpatient-management?sectionName=Criteria%20for%20discharge&amp;topicRef=148747&amp;anchor=H3840488586&amp;source=bqp#H3840488586</image:caption>
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