In some trauma patients with head and face trauma, you will need to check their pupillary response to light. Severe periorbital and eyelid swelling, however, make this difficult. You want to minimize multiple attempts to retract the eyelids because of the risk of a ruptured globe. What’s a minimally painful and traumatic way to check for pupillary constriction?
You know how chief complaints present to the ED in multiples? In one week, I had several cases where patients were asking for post-exposure prophylaxis treatment NOT in the content of a sexual assault. I haven’t had to manage such cases in a long time and so needed to look up the recent guidelines from the CDC.1
The trick is not to forget about all the co-existing problems and infections beyond just HIV. Specifically, don’t forget about gonorrhea, chlamydia, and trichomonas.
Adapted from [2]
Go to ALiEM (PV) Cards for more resources.
The American Medical Association (AMA) is harnassing the innovative power of the people in its “AMA App Challenge”. What do you think would be the perfect app for medical students, residents, and/or practicing physicians in their day-to-day life?
This challenge is the perfect opportunity for all those with great app ideas but are too busy (or lazy) to do the technical, legal, and business groundwork to make the idea a reality. The down side is that once you submit the idea, AMA has full proprietary ownership of it.
Lacerations of elderly patients or chronic corticosteroid users can be a challenge because they often have very thin skin. Sutures can tear through the fragile skin. Tissue adhesives may not adequately close the typically irregularly-edged laceration.
How do you repair these lacerations?
Do you just slap a band-aid on it?
Nancy Duarte, the author of “Resonate — Present Visual Stories that Transform Audiences” and CEO of Duarte Design, recently gave a talk at TedxEast. The title was:
A conference called “A 2020 Vision of Faculty Development Across the Medical Education Continuum” was held at Baylor College of Medicine in 2010. At this conference, experts convened to discuss the changing role of technologies in medical education.
Their conclusions were summarized in this Academic Medicine article, which discusses 5 trends and 5 recommendations.
Reference
Robin BR, McNeil SG, Cook DA, Agarwal KL, Singhal GR. Preparing for the Changing Role of Instructional Technologies in Medical Education. Acad Med. 2011 – in early press. PMID: 21346506.
Haldol, Ativan, and Versed… oh my.
In the Emergency Department, some patients present very acutely and aggressively agitated. This is usually the result of illicit drug use or a schizophrenic who hasn’t been taking medications (or both!). Fortunately, we have an arsenal of medications to help sedate the patient.
One study looked to answer the question of what single IM sedation agent is most effective, as measured by the shortest time to sedation and time to arousal.
Adapted from [1]
Go to ALiEM (PV) Cards for more resources.