Although escharotomy is rarely performed by emergency physicians during the initial management of burns, it is a life and limb-sparing skill important to know as a trainee and provider in emergency medicine [1,2]. There are few models made to accommodate procedural training, and the ones available are often cost-prohibitive. It is critical to have a method for learning and practicing this important procedure [3,4].
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 [1]. There are few dedicated EMS curricula published in the literature, and those in existence incorporate physical ride-alongs [2].
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.
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.
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?
The abuse of which common office supply substance can result in syncope and the EKG findings shown?
The 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.