Trick of the Trade: Warfarin tablet strength identification
Medical providers commonly encounter patients in the emergency department who state they are anticoagulated with warfarin, but they have no idea what dose they are taking. “I know that I take two pills of warfarin daily.” Dosing becomes critically important especially when continuing their medication as an inpatient, refilling their medications, or adjusting their outpatient dose because of an inappropriately high or low INR level. How can you determine the patient’s warfarin dose? [+]
Trick of the Trade: A cleaner way to apply dental cement for a tooth fracture
The management of a dental fracture is a core skill of the emergency physician.1 When the enamel is violated and the underlying dentin is exposed (i.e. Ellis Class II or greater), the dental pulp becomes at risk.2 Protecting the exposed dentin in a timely manner, therefore, is paramount. This is best accomplished through the use of dental cements. The application of dental cement to a fractured tooth, while a relatively rare procedure, is one often fraught with difficulties. With many of the formulations requiring the rapid application of a fast-drying cement, time for accurate and clean application is limited. This often clumsy, [+]
AIR-Pro: Toxicology (Part 2)
Welcome to the Toxicology (Part 2) AIR-Pro Module. Below we have listed our selection of the 12 highest quality blog posts related to 5 advanced level questions on toxicology topics posed, curated, and approved for residency training by the AIR-Pro Series Board. The blogs relate to the following questions: One-pill-could-kill ingestions for pediatrics patients Decontamination techniques Physostigmine Alcohol Withdrawal High dose insulin therapy In this module, we have 8 AIR-Pro’s and 4 Honorable Mentions. To strive for comprehensiveness, we selected from a broad spectrum of blogs identified through FOAMSearch.net and FOAMSearcher. [+]
Wellness and Resiliency During Residency: Work-Life Balancing Act
“The hardest thing for me was trying to find time to do things aside from being a resident. When you’re working six 12 hours shifts in a week, there’s only so much time left in the day to do anything else. Especially in the winter, you wake up, you get to work before the sun comes up, you work a 12 hour shift, you leave, and the sun’s gone. By the time you get home, you have enough time to wash the grime off, shovel a sandwich in your mouth, and pass out. And there was nothing else except for [+]
MEdIC Series: Case of the Fatiguing Fourth Year – Expert Review and Curated Community Commentary
The Case of the Fatiguing Fourth Year outlined a scenario many of us deal with at some point throughout our careers, that of a senior emergency resident struggling to cope with the physical, emotional and mental exhaustion of working in our chosen field of medicine. This month, the MEdIC team (Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, Alkarim Velji and Brent Thoma), hosted a discussion around this case with insights from the ALiEM community. We are proud to present to you the Curated Community Commentary and our 3 expert opinions. Thank-you to all participants for contributing to the very rich [+]
PV Card: Elbow Injuries
Elbow injuries are a common presentation to the Emergency Department. This pocket card reviews some the imaging, acute management, and some pearls for the following injuries: elbow dislocation, radial head subluxation, supracondylar fractures (such as the xray on the right), radial head fracture, epicondylitis, condyle fractures, and olecranon fracture. Thanks to Dr. Jonathon Hancock (Doctor's Hospital orthopedist) for the expert peer review. PV Card: Elbow Injuries View other PV Cards.
Wellness and Resiliency During Residency: Strategizing with ZDoggMD
Unless you are living under a rock, many healthcare and public media platforms are talking about the insidious problems with burnout in the health professions world. One thought leader out there is especially vocal about wellness, resiliency, and mindfulness — Dr. Zubin Damania (alter ego: ZDoggMD). For instance, do you know the difference between empathy and compassion, and why that is important to differentiate this as a clinician? We were honored to have him join the Wellness Think Tank to field questions that we peppered at him, specifically around resident wellness. [+]
ALiEM Book Club | Show and Tell by Dan Roam
“Its all about the audience” is a nice sentiment, but only half true” ― Dan Roam, author of “Show and Tell” book Public speaking and presentation building skills are critical aspects of medical education and academic careers. Despite how important it is to develop these skills, many educators often “wing it” or copy the same boring format they have seen in the past. Show and Tell: How Everybody Can Make Extraordinary Presentations by Dan Roam is a worthy investment for anyone seeking to improve their public speaking skills. And this concise book stands out among the plethora of books available in this genre; not only is [+]
I am Dr. Ian Julie, Medical Simulation Fellowship Director: How I Stay Healthy in EM
Dr. Ian Julie is an emergency physician based out of UC Davis Medical Center. He is currently an Assistant Professor of emergency medicine, Director of the Medical Simulation Fellowship, and Interim Director of UC Davis Center for Virtual Care. Dr. Julie keeps well by taking an active role to incorporate activity and make healthy choices in his daily life. His approach of “talking things out” with his patients, is a form of therapy we should try. Here’s how he stays healthy in EM! [+]
MEdIC Series: The Case of the Fatiguing Fourth Year
Welcome to season 4, episode 3 of the ALiEM Medical Education in Cases (MEdIC) series! Our team (Drs. Tamara McColl, Teresa Chan, John Eicken, Sarah Luckett-Gatopoulos, Eve Purdy, Alkarim Velji and Brent Thoma) is pleased to welcome you to our online community of practice where we discuss the practice of academic medicine! In this month’s case, a senior resident is experiencing the effects of physician fatigue and burnout. [+]