Many residents and medical students are making career decisions that will last a lifetime. Some are aware of the financial considerations while others avoid discussing the topic for fear of being seen as shallow. This month’s ALiEM MEdIC series case considers how we might help a learners as they consider money in medicine. Please join us in discussing the case this month, we would love your thoughts and advice.
Are you getting a CT or bedside ultrasound as your first-line diagnostic approach to patients with undifferentiated abdominal or flank pain in whom you suspect kidney stones? In a landmark 15-center, multidisciplinary study published in the New England Journal of Medicine in September 2014, Dr. Rebecca Smith-Bindman (UCSF Department of Radiology) and her research team looked at exactly this question for emergency department patients. In the paper, “Ultrasonography versus CT for suspected nephrolithiasis,” Dr. Smith-Bindman and Dr. Ralph Wang (UCSF Department of Emergency Medicine) kindly joined us on a quick discussion about her paper.
I am Dr. Resa Lewiss, Director of Point-of-Care Ultrasound at University of Colorado: How I Work Smarter
Today we are back with Dr. Resa Lewiss (@), ultrasound guru and pioneer. She has championed ultrasound via each of the three pillars of academics. She is a clinical master of ultrasound, has taught its use worldwide, and has published extensively on the topic. To top is all off, she has taken institutional leadership as the past President of the Academy of Emergency Ultrasound of the Society of Academic Emergency Medicine and the current chair for the Ultrasound Section of the American College of Emergency Physicians. Plus, she has a TEDMed talk. Nominated by Dr. John Bailitz, Dr. Lewiss offers some pointers how she transduces work to success.
“Death, of course, is not a failure. Death is normal. Death may be the enemy, but it is also the natural order of things. I knew these truths abstractly, but I didn’t know them concretely – that they could be truths not just for everyone but also for this person right in front of me, for this person I was responsible for.” Atul Gawande, Being Mortal.
Welcome to the seventh ALiEM Approved Instructional Resources (AIR) Module! In an effort to reward our residents for the reading and learning they are already doing online we have created an Individual Interactive Instruction (III) opportunity utilizing FOAM resources for U.S. Emergency Medicine residents. For each module, the AIR board curates and scores a list of blogs and podcasts. A quiz is available to complete after each module to obtain residency conference credit. Once completed, your name and institution will be logged into our private Google Drive database, which participating residency program directors can access to provide proof of completion.
The ‘look-alike, sound-alike’ nature of many drug appearances and names is problematic. In high-stress environments such as the Emergency Department (ED), potential disasters can arise if “drug swap” or other medication errors occur. Drug swap is the accidental injection of the wrong drug . The anesthesiology literature contains several published reports presenting various ideas on how to properly label syringes used in the operating room to reduce medication errors. Techniques include color-coding the labels , labeling of the plunger , double-labeling [4, 5], and specific placement of the labels on the syringe .
I am Dr. Rick Body, Research Director of the Manchester Emergency Medicine & Intensive Care Research Group: How I Work Smarter
This weeks post takes us back across the pond to Manchester, UK, with Dr. Rick Body (@). Dr. Body is known in the SoMe world for his contributions to the fantastic St. Emlyn’s blog and Best BETs, a great resource which summarizes research into clinically usable information. His academic focus has been on research in cardiovascular medicine and decision-making technology/biomarkers. He’s a National Institute for Health Research Postdoctoral Research Fellow (yup, he has a PhD) and also research director of the Manchester Emergency Medicine & Intensive Care Research Group (aka EMERGING), a 12 person group dedicated to Emergency Medicine and Critical Care. On top of it all, he’s organizing the Royal College of Emergency Medicine Scientific Congress and European Congress on Emergency Medicine. He has graciously taken a few moments to shares his insights into how to navigate the information overload era.
Deep vein thrombosis (DVT) is always a consideration when patients with asymmetric lower extremity swelling. Why is one leg. Two-point focused DVT ultrasonography of the femoral and popliteal veins can be incredibly useful in the Emergency Department when trying to narrow the differential diagnosis. Drs. Margaret Greenwood-Ericksen, Joshua Rempell, and Mike Stone provide a clear, image-based clinical reference tool on this ultrasound technique.
Case: An 18 year old male presents after a single gunshot wound to his left calf. He complains of pressure-like pain near the wound and sensory numbness below his left knee. On examination, the left leg is tense. He has no dorsalis pedis pulse. Based on the history, exam, and findings in the image, which of the following is true regarding this diagnosis?