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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EMRad: Radiologic Approach to the Traumatic Knee

Radiology teaching during medical school is variable, ranging from informal teaching to required clerkships [1].​​ Many of us likely received an approach to a chest x-ray, but approaches to other studies may or may not have not been taught. We can do better! Enter EM:Rad, a series aimed at providing “just in time” approaches to commonly ordered radiology studies in the emergency department. When applicable, it will provide pertinent measurements specific to management, and offer a framework for when to get an additional view, if appropriate. We recently covered the elbow, wrist, shoulder, ankle, and foot. Next up: the knee.

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By |2020-06-24T07:34:48-07:00Jun 29, 2020|EMRad, Orthopedic, Radiology, Trauma|

EMRad: Can’t Miss Adult Knee Injuries

knee radiology

Figure 1: Normal AP knee x-ray. Case courtesy of Dr Andrew Dixon, Radiopaedia.org, annotations by Stephen Villa MD.

Have you ever been working a shift at 3am and wondered, “Am I missing something? I’ll just splint and instruct the patient to follow up with their PCP in 1 week.” This is a reasonable approach, especially if you’re concerned there could be a fracture. But we can do better. Enter the “Can’t Miss” series: a series organized by body part that will help identify injuries that ideally should not be missed. This list is not meant to be a comprehensive review of each body part, but rather to highlight and improve your sensitivity for these potentially catastrophic injuries. Now: the knee.

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By |2020-06-24T07:43:05-07:00Jun 29, 2020|EMRad, Orthopedic, Radiology, Trauma|

PEM Pearls: Metered-Dose Inhaler versus Nebulizer

metered-dose inhaler

An 8-year-old is brought in by her parents with shortness of breath and wheezing. She’s been receiving her “rescue inhaler” at home and continues to have symptoms. You examine her and find that she has normal oxygen saturation, mild tachypnea and retractions, and diffuse wheezes. You think that she’s experiencing an acute asthma exacerbation. Given the current pandemic, and a recent report that administering nebulizer treatments to COVID-19 positive patients was correlated with transmission of COVID-19 to healthcare workers [1], what is the best way to treat the patient?

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By |2020-07-01T07:58:37-07:00Jun 24, 2020|PEM Pearls, Tox & Medications|

Silence is not an option: Addressing structural racism in medical education

racismThe year 2020 has been a year of upheaval. The COVID pandemic revealed disparities in healthcare and its effects on marginalized groups such as the Black community. The pervasive effects of structural racism affect all of us, including in medical education. We cannot and must not remain silent. As we honor Juneteenth, #BlackLivesMatter, and #WhiteCoatsforBlackLives, let us reflect on ways we can address racial injustice in our direct environment.

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By |2020-06-19T08:37:15-07:00Jun 19, 2020|Academic, Emergency Medicine, Life|

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|
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