U.S. medical students traditionally spend the first 3 years of training in a pre-determined curriculum. In their 4th year, however, students have significant flexibility in how they tailor their time. For this last year before residency, they shift from a learner-centered curriculum to a patient-centered curriculum. There is a shift in mentality from “I am here to learn as much as I can about medicine” to more of a “How do I best prepare myself for working in a hospital in my chosen specialty?”
The EM-RAP Educator’s Edition podcast just released its 6th podcast episode. Dr. Rob Rogers et al discuss practical tips and approaches to giving feedback on medical student presentations. Presentations in the ED are very different from those in other specialties, such as internal medicine and surgery. The discussants dissect and comment on parts of the presentation.
With this hot summer season in California, kids have been running around and getting into all sorts of orthopedic troubles. Monkey bars are a common culprit. In treating pediatric patients in the ED, it’s worth spending an extra few minutes on the subtle style points.
Trick of the Trade:
Splint the buddy bear
You should consider keeping a stash of stuffed teddy bears in the ED for those patients, whom you splint or cast. It is a nice touch to have the patient go home with a teddy bear with the same “injury” and splint/cast.
It’s the little touches that will make your patient’s day a little less sucky.
Wound care mantra: “The key to pollution is dilution.”
High-pressure irrigation best reduces the patient’s risk for a wound infection. Open fractures are unique in the ED in that they require quick, high-volume irrigation before going to the operating room for more definitive wash-out. Often times a 30 mL syringe and 18-gauge angiocatheter is too cumbersome and slow for high-volume, high-pressure irrigation.
With recent discussion about the potential closing of California Poison Control Centers due to budget cuts, I suddenly became shockingly aware of how much Emergency Departments depend on these centers for assistance. They are always so knowledgeable and helpful in managing various ingestions and poisonings.
How do you drain a peritonsillar abscess?
When evaluating a patient with a sore throat and “hot potato voice,” peritonsillar abscess (PTA) is at the top of the differential diagnosis list. As with all abscesses, the definitive treatment involves drainage of pus. This can be done either by incision and drainage or, more commonly, by needle aspiration.