Ectopic pregnancy is the leading cause of maternal death in the first trimester of pregnancy. A recent JAMA systematic review,1 from The Rational Clinical Examination series, looked to risk-stratify women in early pregnancy presenting with abdominal pain or vaginal bleeding for ectopic pregnancy. The authors set out to identify the accuracy and precision of elements in the history, physical examination, beta hCG, and ultrasound in ectopic pregnancy.
The app EMRA Basics of Emergency Medicine covers the 20 most common EM complaints in a concise manner. I first heard about it from Dr. Rob Orman’s (@emergencypdx) podcast (ERCast) where he endorsed it when it was only in book format. The book is great, thin, and it fits in a white coat pocket.
Here is an in-depth review of the app.
Keeping up with the literature these days is quite a daunting task. Medical information has increased exponentially over the past few decades and continues to do so. We spend a great deal of time and energy memorizing information which soon may become obsolete (see excerpt from the book The Half-Life of Facts by Arbesman).
Expecting physicians to keep a busy practice AND keep up with all the most current literature is impractical. By the time textbooks are published, the information is already a few years old and this puts us at risk of not practicing the most up to date and best evidence practice. We also know that with the increasing volume of information there has been new development on statistics on how to evaluate this vast amount of data. Most physicians are not properly equipped with the necessary statistical skills or time to analyze this vast amount of information.
So how DOES a practicing physician keep up with the most current, evidence-based medicine (EBM)? (more…)
“A fool takes in all the lumber of every sort that he comes across, so that the knowledge which might be useful to him gets crowded out, or at best is jumbled up with a lot of other things, so that he has a difficulty in laying his hands upon it. Now the skillful workman is very careful indeed as to what he takes into his brain-attic.” — Maria Konnikova 1
There is a very interesting Royal Society of the Arts (RSA) video featuring the psychologist Maria Konnikova (@mkonnikova), author of the book Mastermind: How to think like Sherlock Holmes. The video is an excellent description on the power of observation versus the cluttered mind.
A patient may present to the ED after foley catheter placement for acute urinary retention (AUR) a few days ago and now requests catheter removal. Ideally this should be performed in the urologist’s office. However, occasionally patients cannot or do not follow up with the urologist in a timely manner and return to the ED expecting urethral catheter removal. A careful history and physical should be performed along with a consulting urologist. If the eventual decision is to remove the urethral catheter in the ED, what is important to know about a Trial of Void (TOV)?
Pulmonary embolism (PE) can be a deadly disease and one of the most challenging diagnosis to make in a pregnant patient. Patients may present with signs and symptoms that might also be present in a normal uncomplicated pregnancy. Even in nonpregnant patients, the diagnosis of venous thromboembolism (VTE) such as PE can be quite challenging.
According to Wikipedia, MOOC stands for Massive Open Online Course, was coined by Dave Cormier (@davecormier) in 2008 during a course called “Connectivism and Connective Knowledge” in a course led by George Siemens (@gsiemens) and Stephen Downes (@oldaily). All three are educators from Canada who specialize in online learning, learning and technology, and connectivism. As the name implies the course is open to thousands of people online. Although thousands of people sign up only a very small percentage finish the course.