Have you noticed that on “Who Wants To Be A Millionaire”, asking the audience as a lifeline almost always results in the right answer (over 90% of the time)?
Dr. David Thorisson (Lund University, Scandinavia) recently approached me with a novel idea of doing the same for Emergency Medicine questions. These questions are currently posted to a public Google Docs document, which allows anyone to post and answer questions.
Answer: aVR Lead
This lead can provide some unique insight into 5 different conditions:
Adapted from [1-4]
Go to ALiEM (PV) Cards for more resources.
See also:
Are you a medical student interested in EM? Want to get your registration costs waived at a national meeting? Want to come say hi to me? Here is an announcement from the SAEM website (deadline Feb 1, 2012):
“My lecturing was ineffective, despite the high evaluations.”
“The traditional approach to teaching reduces education to a transfer of information.”
– Dr. Eric Mazur
Dr. Eric Mazur is a Harvard Professor of Physics and Applied Physics who talks about his “confessions of a converted lecturer”. He focuses on the power of peer teaching and the ineffectiveness of the traditional lecture format in a classroom.
This talk is 72 minutes long. Take some time to listen and learn. Dr. Mazur is such an engaging talk that I couldn’t stop watching. Maybe it’s because he looks a little like the comedian Steve Carell.
Ectopic pregnancies account for as many as 18% of patients who present with first-trimester bleeding or abdominal pain in the Emergency Department. This Paucis Verbis card summarizes the 2008 American College of Obstetricians and Gynecologists (ACOG) guidelines on the use of methotrexate (MTX) for ectopic pregnancies. Not all ectopic pregnancies require operative management.
What are the indications and contraindications to MTX? When should they follow up with their obstetrician?
Answer: In 4 days for a repeat b-HCG and possible second dose of MTX
Note that one of the eligibility criteria is that the patient must have an “unruptured ectopic pregnancy”. Many would consider that any ultrasonographic evidence of free fluid may be a sign of an early rupture. It is left up to clinician judgment in how “unruptured” is interpreted.
Adapted from [1]
Go to ALiEM (PV) Cards for more resources.
Who loves relocating shoulder dislocations as much as I do? I know you do.
Often patients undergo procedural sedation in order to achieve adequate pain control and muscle relaxation. Alternatively or adjunctively, you can inject the shoulder joint with an anesthetic. Personally, I have had variable effectiveness with this technique. In cases of inadequate pain control, I always wonder if I was actually in the joint.
How can you improve your success rate in injecting into glenohumeral joint injection?
Did you know that the American Association of Poison Control Centers reports that 10% of poison center calls are related to acetaminophen ingestions? That’s a lot. This Paucis Verbis card reviews the basics of acetaminophen toxicity. I included the Rumack Matthew nomogram to help you plot out the patient’s risk for hepatotoxicity.
In the Emergency Department, we often screen for acetaminophen toxicity for patients who may have ingested substances as a suicide attempt. We check the serum acetaminophen level 4 hours post-ingestion. Occasionally, we are surprised by a toxic level because in the first 24 hours, because symptoms are can be mild and nonspecific (abdominal pain, nausea, lethargy).
Adapted from [1]
Go to ALiEM (PV) Cards for more resources.