Women in Academic EM video
As a joint project between Clerkship Directors in EM (CDEM) and the Academy for Women in Academic EM (AWAEM), there is a great 11 minute video about life in academic EM. For more information, check out AWAEM’s website.
Article Review: Evaluating students using RIME method
How do evaluate medical students and residents, who are rotating through your Emergency Department? Do you have a structured framework for assessing their competencies?
Have you heard of the RIME method of evaluating learners on their clinical rotation? Dr. Lou Pangaro (Vice Chair for Educational Programs in the Dept of Medicine at the Uniformed Services University) published a landmark article in 1999 on his simple yet effective approach in evaluating medical students and residents. I had the pleasure of briefly meeting Dr. Pangaro when he gave CDEM’s keynote speech in 2008.
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Paucis Verbis card: Ascites assessment with paracentesis
A paracentesis procedure is often performed in the Emergency Department to rule a patient out for spontaneous bacterial peritonitis (SBP).
- Do you check coagulation studies before performing the procedure?
- How comfortable do you feel that the patient has SBP with an ascites WBC > 500 cells/microliter or ascites PMN > 250 cells/microliter?
This installment of the Paucis Verbis (In a Few Words) e-card series provides an evidence-based review of the literature on topics related to the paracentesis procedure. Especially helpful is the pooled data of likelihood ratios. Like most everything in medicine, a lab test should be used in conjunction with your pretest probability in clinical decision making, and LR’s help with with this.
PV Card: Ascites and Paracentesis
Adapted from [1]
Go to ALiEM (PV) Cards for more resources.
Reference
- Wilkerson RG, Sinert R. The Use of Paracentesis in the Assessment of the Patient With Ascites. Annals of Emergency Medicine. 2009;54(3):465-468. doi: 10.1016/j.annemergmed.2008.09.005
Blog’s one year anniversary
The blog is already one year old! What started initially as a little educational experiment has now evolved into a potentially long-term endeavor. It was initially built as a sort of personal journal of what I’ve learned and read about in the field of academic emergency medicine and educational technologies. Now I’ve it focuses on academics, clinical emergency medicine (Paucis Verbis cards), faculty and resident development, and technologies.
Trick of the Trade: Finding the subtle pneumothorax
Can you see the pneumothorax?
Small pneumothoraces can be difficult to detect on chest xrays. Overlying ribs, other bony structures, and soft tissue can obscure subtle findings. For a patient at risk for a small pneumothorax, you can use your digital radiology PACS system to improve your ability to spot them.
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Hot off the press: Journal of Graduate Medical Education
In 2009, ACGME has launched a new journal focused on graduate medical education, called the Journal of Graduate Medical Education (JGME). For those of you with education manuscripts in need of a “home”, consider this peer-reviewed journal. It publishes quarterly.
Article Review: Impact of family presence in a code
Family presence in the ED resuscitation of a dying patient is a controversial topic. Some surveys suggest that families favor this practice and would repeat it again in a similar situation.
An article in Critical Care Medicine examines the impact of family presence on the ED personnel’s actions, rather than the impact on the families themselves. Second and third-year EM residents were randomized into paired teams in simulation exercises. All resuscitations involved a cardiac arrest patient. Each team was exposed to one of three types of resuscitation groups:
- No family witness
- Non-obstructive family witness (quiet person) – quiet crying and conversation with social worker
- Overtly grieving family witness – loud crying, attempts to hug patient during resuscitation