The 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 . There are few dedicated EMS curricula published in the literature, and those in existence incorporate physical ride-alongs .
The transition from residency to your first job or fellowship is an exciting time in any career. New opportunities for professional growth appear, but with them come a new and unique set of challenges. Transitioning from a structured clinical environment to more independent work and self-driven projects can be a difficult transition. For this reason, we wanted to share a few lessons we’ve learned. Although this advice is derived from our experience in EMS fellowship, we expect that it will apply and be helpful to other upcoming fellows and all people stepping away from residency to enter the workforce.
In the setting of emergent care, the ability to access equipment rapidly and reliably can be a deciding factor in patient outcome. Poor stocking, inconsistent organization, and dispersal of equipment throughout a large geographic area are realities of practice as well as barriers to rapid and effective patient care. Equipment kits are a great way to ensure rapid access to a select set of tools to deal with emergent scenarios. They result in both decreased time to arrival and decreased time to successful completion of procedure.1,2 Scenarios that can benefit from organized and well provisioned kits include central or peripheral access, airway management, initial stabilization, monitor application, chest tube placement, or cricothyroidotomy. A word of caution: equipment kits are not a substitute for skill and cannot be thought of as a fix-all. They keep a specific set of equipment in an easy-to-locate, all-in-one package for use in a predetermined set of scenarios.
Ever wonder what would happen if you were working in the emergency department (ED) when a nuclear attack happens? We’ve all had questions on boards or inservice exams about the long-term effect of radiation exposure, but would you know what to ACTUALLY DO if a nuclear attack happened? What do you do in the first few minutes? First few hours? We know that if you are in the immediate bomb vicinity, there is not much you can do. But what if you are 5 miles away? Or 10 miles?
If you look for information regarding nuclear attacks, there are no great summary resources on what to do in the immediate aftermath if you are in the ED. In order to bring this to you in an easily digestible format, we have broken this post up into a few topic areas: This blog post will cover (1) what physically happens in a nuclear attack and (2) what this means in the ED.
Emergency medicine (EM) is on the frontlines of climate change, which the Lancet Commission declared “the biggest global health threat of the 21st century” with “potentially catastrophic risk to human health.”1,2 Climate change is having broad and profound negative impacts on the health of our patients, especially for the vulnerable populations. It is also affecting our healthcare systems and mandating the creation of climate-resilient emergency departments (ED) with robust disaster preparedness. EM needs to engage climate change advocacy efforts for 2 key reasons. It has a profound impact on our specialty, and it is built into the moral fiber of our practice. As this threat continues to grow, EM is perfectly situated to lead the charge.
“EMS is wild and imperfect. Just like our patients. It’s dangerous and a little mad and possibly contagious…patients don’t come to us… we go to them, and where and how we find them, well, that, too, is part of the story. once in the field, we should expect no help.” – Kevin Hazzard
Well, it is EMS fellowship interview season again, and every year after the lovely encounter with very well qualified candidates, I am left wondering if they have achieved a good return on their investment of time and money coming to visit us. Did they really get a good idea of the important aspects of our program, or will they just have to make an educated guess about whether they would be happy spending a year or more with us?