We would be remiss to not acknowledge the unique challenges we as emergency providers have faced over the last few months. Prevention of burnout and active wellness management is more important now than ever. This month on our “How I stay Healthy” series, we’re featuring Dr. Christian Rose, clinical informatics fellow at Stanford University and staff physician at Kaiser Permanente. He shares some guiding principles when facing difficult clinical decisions, his belief in the power of connection, and his favorite noise machine!
We invite all of you to join the first-ever all-EM residency graduation event to celebrate the #EMClassof2020 who are embarking on their professional careers in an especially tumultuous time in history. Although this online event cannot replace the experience of an in-person departmental event, we hope that we can all take a collective pause to realize how connected we are in EM and even find some joy in these dark times. As a testament to this momentous “leveling-up” event, world-class speakers, Dr. Esther Choo, Dr. Mel Herbert, and Dr. Amal Mattu will headline a series of well-wishes and inspirational words. We have pulled out all the stops and spared no expense to honor YOU, the future of EM!
Providing medical care for patients at the frontline can be physically demanding. Exercise is an important part of a routine that can help mitigate the physiologic stressors that come with providing care at the frontline, but in the setting of decreased time and space, providers may have difficulty developing new routines. We worked with a physiotherapist to create an exercise regimen for frontline providers that requires little space, little time, and can still help keep us healthy in the face of an ever more challenging work environment.
Given overcrowded hospitals and limited availability of personal protective equipment (PPE), showing up for work can feel like entering a battleground without ammunition for many physicians during the COVID-19 outbreak . Despite this, doctors and nurses show up every day ready to do their jobs. While we have committed to the Hippocratic Oath, our families have not. How can we do our duty while preventing exposure of our loved ones at home [2, 3]?
Sudden cardiac death accounts for almost 400,000 deaths per year in the United States, and EM providers must be adept at discerning subtle, high-risk ECG findings. With the advent of triage ECG protocols, one of the most common interruptions in the ED is a request to “sign off” on an ECG. We present a reference of some of the most important high-risk ECG findings, intended to help ED providers systematically screen patients in triage and the waiting room.
You are caring for a patient with an incredibly swollen eye – like a scene out of almost any Rocky film. This patient is likely going to the CT scanner, but regardless of the finding (retrobulbar hematoma, orbital wall fracture, etc.) you still need to evaluate for extraocular muscle entrapment and loss of pupillary response. There’s only one problem: you can’t see the eye. The old standards like getting the patient to retract their lid using paperclips or a cotton swab may help, but sometimes there is just too much swelling, and those techniques are just not enough. Without brute force – and potentially causing more trauma – you likely won’t be able to examine this patient’s eye.
With the start of the year, we welcomed a new group of faces into our respective residency programs. We can all still remember how daunting it was to tackle learning the immense volume of material to be a great emergency medicine physician. We have so many amazing resources, but no road maps for where to start. The purpose of this list is to help guide the new interns as well as to highlight some resources that even the more seasoned clinician may find useful.