Every year emergency departments are inundated with cases of influenza-like illness. Rapid flu testing (RFT) offers the promise of a quick and relatively noninvasive rapid diagnostic test. However, the use of this test has significant limitations that can lead to increased risk for both the patient and the provider.
When I first contacted Dr. Sean Fox (@) regarding participating in the How I Work Smarter series he described his work style as “a bull in a china shop”, questioning if he was a worthy participant. This, in fact, makes him an ideal contributor as most of us can relate to the difficulties of achieving organizational zen. But Dr. Fox is also being humble. He is double boarded in Emergency Medicine and Pediatrics. In his young career, he has already received several teaching awards including the ACEP National Faculty Teaching Award. He’s also embraced teaching through FOAM via his great site pedemmorsels.com. Dr. Fox generously took some time out to share some great thoughts on how he tries to shoot the efficiency moon.
The use of online open access secondary has increased recently. Many clinicians are turning to these resources for continuing education. There is debate about these resources that can occasionally result in conflict between early adopters and those with a more traditional approach. Please join us in discussing the case this of the FOAM Faux Pas. We would love your thoughts and advice.
Trick of the Trade: Ultrasound confirmation of pediatric endotracheal tube placement – TRUST your tube
Following intubation the confirmation of endotracheal tube placement and depth is essential. While dynamic etCO2 monitoring has revolutionized the confirmation of endotracheal placement, there are still several circumstances in which this modality may be misleading (e.g. prolonged arrest, severe status asthmaticus/PE/pulmonary edema, etCO2 detector contamination with drugs/gastric contents). Additionally, etCO2 detectors cannot confirm appropriate endotracheal tube depth, leading to delayed recognition of mainstem placement.
I am Dr. Sam Ghali, EM Faculty and Ultrasound Expert at The University of Kentucky: How I Work Smarter
As you can see from our How I Work Smarter (HIWS) mapping post, Lexington Kentucky is emerging as a powerhouse of EM leaders and social media gurus. After WildcatEM HIWS contributions from Matt Dawson, Rob Rogers, and Chris Doty, we have Dr. Sam Ghali (@) taking a swing. Dr. Ghali is an up and coming member of the SoMe circuit with a focus on point-of-care ultrasound, resuscitation, and critical care. Nominated by Haney Mallemat, Dr. Ghali generously shares his thoughts about career and life management.
Dr. Lalani (@ERMentor) is no stranger when it comes to wellness. He is without a doubt an individual who is always striving to improve himself on every level. Currently, he is the Assistant Program Director of the University of Saskatchewan FRCPC EM Program, creator of the blog ERMentor, and has recently completed his certification to be a Life Coach (check out his personal website here). When he’s not in the ED torturing his residents with his top secret set of tough questions, he can be found on the golf course working on his pro swing. Dr. Lalani is a mentor to many, and his residents often look to him for advice outside of medicine. Take a look at how he stays healthy in emergency medicine!
Performing a two layer wound closure can be a challenging procedure in the Emergency Department for clinicians with limited wound care experience. Challenges include suture choice, suture placement, and the technique of burying the knot in the deep layer of the wound, and the availability of ready ‘volunteers’ with complex wounds willing to let novices practice on them. Commercially available suture models are expensive, and can be cumbersome to store, and difficult to obtain in a timely manner to provide the learner with opportunities to practice prior to wound repair on a patient in the department.
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 pregnancy. When performing this study, providers should be aware of several potential pitfalls that pose significant risk to both the patient and the provider.