When a patient is started on anticoagulant therapy, the purpose is to prevent clot formation or propagation. Anticoagulants can improve morbidity and mortality by maintaining cardiac stent patency, reducing the propagation of pulmonary emboli, or preventing formation of intra-cardiac thrombi.1,2 Unfortunately even after minor trauma, these medications can cause major problems. When a patient on clopidogrel is in a motor vehicle collision (MVC) or an elderly patient on warfarin falls out of their bed, the once life-improving therapy becomes potentially life-threatening. It is important for emergency care providers to maintain a high index of suspicion for life-threatening bleeds in all patients on anticoagulation following even minor injuries. The purpose of this discussion is to look beyond the intracranial hemorrhages (ICH) and to consider 5 other sources of bleeding that can occur in anticoagulated patients.
Promoting wellness is a team sport. It takes more than one individual to champion it at any institution. In medicine, when a team is formed to effect change, it is called a committee. Dr. Dan Lakoff was one of the founding leaders of the council of residency wellness committee, and has also helped lead wellness efforts at his own institution. Here he shares his thoughts, his inspiration, and practical ideas that helped improve wellness at his program.
If you are graduating from an EM residency this year, you may be feeling nervous (or petrified) about your first shift out on your own. You’re wondering how you can gain the trust of the nurses and doctors at your new hospital. Perhaps you are wondering how you will keep learning without the residency leadership forcing articles and lectures on you.
In this post we will give you our top 10 tips, each with a practical pearl, for how to succeed your first year out. These keys to success will help keep you from making common mistakes, blowing your chance at a good first impression, and also help keep you out of deep, troubled waters when it comes to HIPAA violations and keeping your medical license.
Its’ time for another installment of 60 Second Soapbox! Each episode, one lucky individual gets exactly 1 minute to present their rant-of-choice to the world. Any topic is on the table – clinical, academic, economic, or whatever else may interest an EM-centric audience. We carefully remix your audio to add an extra splash of drama and excitement. Even more exciting, participants get to challenge 3 of their peers to stand on a soapbox of their own!
The American Board of Emergency Medicine (ABEM), American Osteopathic Board of Emergency Medicine (AOBEM), and the Royal College of Emergency Medicine (RCEM) require successful completion of an oral examination as part of the certification process for the specialty of emergency medicine. Residents are seldom taught explicitly about the process of developing oral board examinations. While deliberate and guided practice can improve performance in such examinations, understanding the design and structure of an oral examination can also ease anxiety about the experience.
It’s that time of year again… when the sun is shining, the flowers are in bloom… and new senior medical students are preparing for next year’s Match.
Emergency Medicine (EM) remains a very popular specialty choice. EM enjoys a 99% annual fill rate in the National Residency Matching Program (NRMP) Main Residency Match, with approximately 80% of positions going to U.S. allopathic senior medical students. Students seek many sources of career advice when preparing for their EM clerkships and the residency interview process. Unfortunately, career advice often comes from near-peers and medical school faculty members in other specialties, rather than EM residency directors and clerkship directors. Given the variable quality of information offered as ‘career advice,’ students can be left with inaccurate and confusing opinions about how to assess their candidacy and compete in the Match.
Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where point-of-care ultrasound changed the management of a patient’s care or aided in the diagnosis. In this case, a 20-year-old woman presents with first-trimester vaginal bleeding.