Recently, a patient presented with angioedema after starting taking an ACE-inhibitor. There was upper lip swelling, similar appearing to the case above. He also experience a hoarse voice. Before the advent of fiberoptic nasopharyngoscopy, it was assumed that there may be laryngeal edema. Fortunately, using technology, we were able to visualize a normal epiglottis and a grossly normal laryngeal anatomy.
A 6-year old boy has placed a hard bead in his ear and presents to the ED for care. How do you remove this foreign body as painlessly as possible? You can just barely see the edge of the bead by just looking at the external ear.
By experience, you know that mini-Alligator clips and forceps will not be able to sufficiently grab the edges of the bead. Additionally it may push the bead in even further.
I’m working on writing a CORD consensus article on the impact of ED crowding on education and innovations towards maintaining educational excellence. We posited 2 scenarios of ED crowding:
- Overwhelming numbers of active ED patients
- Many ED boarders who are awaiting inpatient beds and who are taking up rooms which normally would have been used to see new patients
What approaches do you know of which improve the ED educational experience for learners? We have thus far categorized innovations into 3 areas:
“Medical Education in the United States and Canada in 1910” was a landmark article, published by Abraham Flexner (shown in photo) in 1910. It’s commonly referred to as the Flexner Report. It revolutionized medical education in its call for higher quality and standardization.
In summary the report advocated for the improvement of medical education and medical schools in 4 areas:
How accurate is the clinical knee exam?
JAMA published a meta-analysis trying to answer this question. Although they include patients with acute and chronic knee pain, it’s a good general review of the knee anatomy, historical clues, and exam elements.
In the ED, the knee exam is challenging because we see very acute injuries where knee pain and swelling often preclude an accurate exam. For patients with an equivocal exam, be sure to refer for orthopedic follow-up. A repeat exam should be performed once the pain and swelling subside.
When the number of people (police officers, security guards, nurses) is greater than the patient’s pupil size, you KNOW that you’ll need some chemical sedation.
What intramuscular sedation regimen do you use?
I need your help with a project!
My poster on blogging was accepted to the annual UCSF Academy of Medical Educator’s Education Day. Feelings of joy and validation were quickly followed by terror and inadequacy.
In order to get my poster costs reimbursed, I have to get feedback from my co-authors and incorporate that feedback into the poster. As you can see from the poster title on top, I have no co-authors! Since you are all my virtual co-authors, I thought I’d solicit for comments and suggestions.