Stanford’s INFODEMIC Conference on COVID-19 Misinformation: Open-access podcasts

In July 2021, Dr. Vivek Murthy became the first U.S. Surgeon General to declare health misinformation a public health crisis. Specifically, COVID-19 vaccine misinformation and disinformation on social media greatly affects vaccination rates in certain populations. Rapid increases in reliable health information about COVID-19 can be overshadowed by the spread of even greater amounts of misinformation, leading to an ‘infodemic.’

The World Health Organization defines an infodemic as:

“… too much information including false or misleading information in digital and physical environments during a disease outbreak. It causes confusion and risk-taking behaviours that can harm health. It also leads to mistrust in health authorities and undermines the public health response. An infodemic can intensify or lengthen outbreaks when people are unsure about what they need to do to protect their health and the health of people around them.”

INFODEMIC Conference on Social Media and COVID-19 Misinformation

On August 26, 2021, Stanford University’s Department of Emergency Medicine and Ethics, Society, and Technology Hub co-sponsored a unique conference to address this issue, “INFODEMIC: A Stanford Conference on Social Media and COVID-19 Misinformation.” Speakers presented virtually from around the world including experts in social media, health policy, ethics, and medicine. The conference focused on the causes of COVID-19 misinformation and mitigation strategies. Vaccine Confidence, Vaccine Hesitancy, and Vaccine Equity were among the main topics of the meeting. INFODEMIC also featured representatives from Facebook, Google, and Twitter, as well as physician influencers, to discuss the role of social media companies to address misinformation online.

Below are recordings of each of the INFODEMIC conference presentations, presented as podcasts. Video recordings of these presentations are also available to view online. The conference agenda and featured speakers are listed on the Stanford INFODEMIC website.

Podcasts

By |2021-10-06T19:40:30-07:00Oct 8, 2021|Academic, COVID19|

SAEM Clinical Image Series: Pulseless and Painful Blue Leg

painful blue leg

A 57-year-old male who works as a truck driver with a history of hypertension, type 2 diabetes, and recent COVID-19 infection presents with right lower extremity pain for two hours. He reports experiencing one day of dull aching of the right leg, then being suddenly awakened with the abrupt onset of severe right leg pain and shortness of breath. He denies chest pain. EMS reports a pulseless and painful blue leg en route. The patient denies any history of trauma, irregular heartbeat, or anticoagulation.

Vitals: T 97.5°F; BP 120/78; HR 102; RR 20; oxygen saturation 100%

General: Writhing and moaning in pain

Cardiovascular: Tachycardic; 2+ pulses in all extremities except for the right lower extremity

Pulmonary: No respiratory distress

Hemoglobin: 12.9 g/dL

INR: 1.02

Phlegmasia cerulea dolens

When a patient presents with a painful, pulseless extremity, acute limb ischemia, with etiologies including aortic dissection, arterial thromboembolism, and phlegmasia dolens, is of the highest concern. Unlike a typical deep venous thrombosis (DVT), phlegmasia dolens is a DVT that causes complete occlusion, resulting in venous congestion and hypoperfusion. Risk factors for phlegmasia dolens and DVT are the same; this patient had both a sedentary occupation and recent COVID-19 as risk factors.

Phlegmasia is usually characterized early on with pale discoloration (alba) due to patency of collaterals and later with blue/cyanotic discoloration (cerulea) after complete occlusion of the venous system. It is important to remember this exam finding might be limited in pigmented skin. Venous gangrene and compartment syndrome can be delayed exam findings. The exam should include immediate evaluation of pulses with doppler and compartment checks. Imaging modalities are controversial and should not delay vascular surgery consultation. Bedside ultrasound can be rapidly performed for clot evaluation, but CT venogram would be the preferred method for surgical planning. A common femoral vein DVT can be seen on the accompanied ultrasound and CT images. The limb should be elevated, and heparin infusion should be initiated. Surgical consultation should include a discussion of thrombectomy or catheter-directed thrombolysis.

Take-Home Points

  • Phlegmasia cerulea dolens is an uncommon complication of DVT that presents with a discolored, painful, pulseless extremity, and is associated with high morbidity and mortality.
  • Initial management includes vascular surgery consultation, elevation of the extremity, and heparinization.
  1. Baker, William, and Samuel Kim. “Risking Life And Limb: Management Of Phlegmasia AlbaAnd Cerulea Dolens”. Emra.Org, 2020, https://www.emra.org/emresident/article/risking-life-and-limb-management-of-phlegmasia–alba-and-cerulea-dolens/.
  2. Gardella L, Faulk J. Phlegmasia Alba And Cerulea Dolens. 2020 Oct 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 33085284.

 

 

IDEA Series: An asynchronous EMS curriculum implemented during COVID-19

asynchronous emsThe novel coronavirus pandemic (COVID-19) resulted in the cancellation of educational experiences for emergency medicine (EM) residents at many institutions, including emergency medical services (EMS) ambulance ride alongs. The Accreditation for the Council of Graduate Medical Education (ACGME) requires that residents have educational experiences related to EMS, emergency preparedness, and disaster medicine. EMS experiences must include ground unit runs, direct medical oversight, and participation in multi-casualty incident drills [1]. There are few dedicated EMS curricula published in the literature, and those in existence incorporate physical ride-alongs [2].

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Hydroxychloroquine Toxicity

hydroxychloroquine toxicityAs the COVID-19 pandemic continues to unravel, the role of hydroxychloroquine (HCQ) in the treatment of patients with this disease has been a major focus of discussion on the news and social media. Despite the lack of good data supporting its use in the clinical setting, there have been numerous reports of individual consumption of HCQ resulting in accidental overdose and even death. It is therefore important to recognize and manage patients who may present with HCQ toxicity.

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By |2020-06-16T09:03:04-07:00Jun 17, 2020|COVID19, Tox & Medications|

Social Distancing Simulation: Tips for Leading a Virtual Session With Student Learners

We’ve all had to get a bit creative over the past few weeks. COVID-19 has ushered in an era of not only pushing healthcare workers and hospitals into uncharted territory, but also challenging the structure and delivery of medical education. Simulation education is one of many teaching modalities that is affected by this change given its case-based, in-person structure with a team of learners. These characteristics unfortunately violate the 6-foot rule of social distancing. While traditional simulation is not typically conceptualized as a virtual modality, many of its principals can be successfully adapted for remote learning.

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By |2020-05-31T19:16:34-07:00Jun 1, 2020|COVID19, Education Articles, Simulation|

I’m an Emergency Medicine Physician With COVID-19, Now What?

COVID-19 physicianA 35-year-old female emergency medicine physician presents for evaluation for severe myalgias, headache, fatigue, mild nasal congestion, profound anosmia, cough, and subjective fevers and chills. She has no measured temperature above 100.4°F, but has been taking anti-inflammatories around the clock. The day previously, she called occupational health and received testing for the novel coronavirus. The next day, her test returns positive. What happens next? We are here to share our personal experiences with COVID-19 and provide some resources to best support yourselves, your families, your learners, and your colleagues throughout this uncertain and ever-changing situation.

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By |2020-04-10T23:25:40-07:00Apr 10, 2020|COVID19, Life|

Healthcare Providers in the COVID-19 Era: Keeping Clean When Coming Home

COVID coronavirus keeping clean when coming homeGiven overcrowded hospitals and limited availability of personal protective equipment (PPE), showing up for work can feel like entering a battleground without ammunition for many physicians during the COVID-19 outbreak [1]. Despite this, doctors and nurses show up every day ready to do their jobs. While we have committed to the Hippocratic Oath, our families have not. How can we do our duty while preventing exposure of our loved ones at home [2, 3]?

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By |2020-04-02T13:52:58-07:00Apr 8, 2020|COVID19, Infectious Disease, Life|
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