About Michelle Lin, MD

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco

Trick of the Trade: Toxic sock syndrome

The olfactory nerve of an emergency physician is exposed to a broad range of smells in the Emergency Department. I’ve learned that the stinky-feet problem is a commonality amongst ED’s around the world! I call it the “toxic sock syndrome”. There are two remedies which I’ve been told of:

  • Nebulized oil of wintergreen
  • Placing a open canister of coffee grounds next to the feet (I’ve never understood this. I would imagine it would smell like stinky feet in a cafe. Plus, what a waste of coffee!)

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2019-01-28T23:54:04-08:00

TGIF: Collaborating creatively with great people

What part of your job do you love the most?

In academic emergency medicine, nothing energizes me more than brainstorming with creative, like-minded, and motivated people. From my experience, most of my past major projects have all started in similar informal, small-group settings.

For instance, the CDEM organization was built when a small group of undergraduate medical educators went to dinner during a SAEM conference. We conspired to build something bigger and better. Two years later now, we now have over 100 members and are a new member of the major interdisciplinary organization Alliance for Clinical Education.

1. This week, I got a call from Chad Kessler (Univ of Illinois-Chicago) who was interested in bringing medical education more to the forefront of EM. We brainstormed about building a “thinktank” of like-minded educators interested in pushing education to the 21st century. There is so much to be learned in the literature outside of EM and medicine in general. I suggested building a dynamic database somewhere to list the ongoing educational projects and research in EM. We too often work in silos. Collaboration is key in educational research. Any ideas how to build a database that everyone would participate in?

2. As a member of KidsCareEverywhere (KCE), I am headed off to Vietnam this month to help teach a conference jointly hosted by our organization and UCSF. This conference will assess pediatricians’ knowledge before and after learning a new decision-support software PEMSoft. The members of the KCE team met for the last time for a dry-run of the conference and a brainstorming session to anticipate potential hiccups.

One problem which I’m still a little worried about is the access to laptops and electricity. Because we are testing the participants on their ability to navigate the new technology, we need everyone to have their own laptop. We doubt that participants will all have laptops, but we have backup plans to share. We’re more concerned about poor battery life for the existing laptops and something as seemingly simple as access to electrical outlets. I have a feeling we’ll be buying long extension cords while in Vietnam.

Check out our new 1 GB USB thumb drives that just came in! We are giving out to the participants, preloaded with the PEMSoft user manual, hospital-specific documents, and the lecture slides.

3. For our residency program, I’m running the Education Area of Distinction (AOD). There are a variety of AODs available, which allow our residents to “specialize” in a niche in EM. I have two rock star residents in the Education AOD – Liz Brown and Eric Silman. We met to discuss how we were going to take the education world by storm. It always helps to do this over a BBQ meal.

iPhone photo of the inaugural meeting at Baby Blues BBQ. Sorry it’s so blurry – Digital SLR cameras apparently do don’t well when dropped on the floor. In the Canon shop.

The first project, spearheaded by Eric, involves posting interesting cases onto this blog. I’m going to open up a Saturday slot called “A Case Presentation from UCSF-SFGH”. Every Saturday, a short case from the residency program’s Follow-Up Conference series will be highlighted to illustrate key clinical pearls.

2019-09-10T14:06:37-07:00

Educator’s portfolio

Are you a medical educator and can’t quite illustrate the importance and impact of your work in your CV?

I’ve always had this problem when compiling and updating my CV. The traditional CV format caters especially to academic physicians who are active in public service, traditional research, and leadership positions. What about the great procedural course that you ran with stellar evaluations? What about the lecture you gave at a national conference?

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2018-10-28T21:34:48-07:00

Trick of the Trade: Needle thoracostomy

On a shift last week, we had a patient present with a spontaneous pneumothorax. Not only that, but it was a tension pneumothorax. Although the patient was hemodynamically stable, he was very uncomfortable and really short of breath. To give us more time to prepare for the chest tube, it was decided to perform a needle thoracostomy.

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2016-10-26T17:05:43-07:00

Sneak Peak "Trick of the Trade": Digital nerve block

The digital nerve block is common performed in the Emergency Department to provide anesthesia prior to wound closure. The digital nerves are typically accessed by injecting in the webspace on either side of the finger.

Have you had patients start to get sweaty and anxious merely at the sight of your drawing up lidocaine in the syringe? Despite your reassurance that the 18-gauge needle that you used was just to move the lidocaine into the syringe and that you’ll be using a small needle for the procedure, they don’t look very reassured. Trust is key to having the procedure go smoothly.

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2016-10-26T17:05:43-07:00