The emergency department (ED) manages acute pain on a daily basis, ranging from non-traumatic back pain to traumatic fractures. Some providers jump immediately to opioids without considering other non-opioid alternatives or start at incorrect doses. In the age of the opioid epidemic (ALiEM-Annals of EM journal club; bookclub discussing Dreamland) and medication errors, choosing the initial right agent(s) and dose(s) are important. Dr. Nick Koch and Dr. Sergey Motov (@PainFreeED) from Maimonides Medical Center present a thoughtful, evidence-based PV reference card on selecting and dosing initial pain medications for ED patients. Also congratulations to Dr. Motov and his team for their recent 2015 Annals of EM publication1 on subdissociative dose ketamine for analgesia.
For many years, end tidal CO2 monitoring initially was helpful in differentiating tracheal versus esophageal intubations. Now with continuous end tidal capnography, providers have access to so much more information during a cardiac arrest resuscitation, as summarized by the recently released 2015 American Heart Association (AHA) recommendations.1 Thanks to Dr. Abdullah Bakhsh from Emory University for a great PV card to help remind us of these key cardiac resuscitation pearls.
As emergency medicine providers become more proficient in using bedside ultrasonography as a diagnostic tool, it can be difficult to remember all of the normal cutoff values. Is it 3 or 5 mm as the cutoff? Thanks to the team at UCSF (Dr. Maria Beylin, Dr. Scott Fischette, and Dr. Nate Teismann) for creating a succinct PV card listing the key numbers to remember. You can download this PV card into your mobile device as a reference guide, or you can even print and attach to each of your ultrasound machines!
One of the five 2014 American College of Surgeons’ Choosing Wisely recommendations is to avoid routing whole-body CT imaging of trauma patents, also known as the ‘pan-CT’. Until now, no validated decision instrument existed to help guide clinicians decide whether to obtain a chest CT in the setting of blunt trauma. This month, Dr. Robert Rodriguez and the multi-institutional NEXUS Chest CT research team published a paper describing the derivation and validation of 2 decision instruments in PLOS Medicine .
Subspecialty training within emergency medicine is increasingly becoming a popular route for those interested in pursuing an academic faculty position. This year, we will cover the ins-and-outs, nuts-and-bolts, and nuances for 3 fellowships available to EM residency graduates: Simulation, Toxicology, and Ultrasound. Modeled after the wildly successful EM Match Advice for medical students applying to residency, Dr. Mike Gisondi launches and hosts another successful series — the EM Fellowship Match Advice series.
Yesterday the Electronic Residency Application Service (ERAS) opened its digital doors to medical students applying to ACGME residency programs. So we thought it was a perfect time to host another EM Match Advice Series installment. This time, we focus on the challenges that the non-LCME applicant encounters throughout the ACGME application process. These applicants include:
- Students from osteopathic medical schools
- Students from non-U.S. medical schools
- Applicants who have been in the military service and are returning for residency training
- Residents who want to transfer in from another specialty training program.
The 2015 Essentials of EM Fellowship competition was fierce with submissions by U.S. EM residents from around the country. Based on the four predefined judging criteria (design, relevance, content accuracy, and innovation), one submission stood out above the rest. Congratulations to the winner Dr. Gabe Sudario (University of California San Francisco-SFGH), who will attend the 2015 Essentials of EM conference in Las Vegas as the ALiEM Essentials of EM Fellow with all expenses paid. Check out today’s PV card, which was Gabe’s blog submission.