Hands Up For Health: Simulation Extending to Community Education
Medical simulation is not just for the clinical learner. Rather, it can have far reaching impact and can contribute meaningfully to the community. In this post, Dr. Beth Thomas describes the work of Hands Up For Health which uses the power of simulation to reach young people. [+]
Trick of the Trade: Nasal foreign body removal using foley catheter
A healthy 4 year-old boy is brought in by mom for a plastic bead up his nose. The mom states, “The last time the other doctors had to be called, and it took forever. Oh, and I have to pick up his brother from school in 30 minutes. Can you get it out, doc?” The patient is squirming even as you take a quick peek at his nose, but you catch a glimmer of the bead up his right nare. [+]
MEdIC Series: Case of the Not So Humorous Humerus
Unprofessionalism. It is notoriously hard to define and dependent upon the eye of the beholder. And yet, as medical educators, we often are asked to intervene when it occurs. Join our discussion on how to handle a case where a patient discloses to you, the supervising physician, that a resident has been less-than-professional. What would you do? [+]
Vote which Annals of EM articles to be open-access in July
Here’s your chance to help choose two articles to be open access in July’s Annals of Emergency Medicine . Take a look at the article abstracts accepted for publication in July’s issue. Vote on your top two choices over the next 4 days, and the top two will be made open after the July issue of Annals of EM goes online. This may be the last month we are doing this, so if you like this opportunity, please vote! Your participation will help us decide whether or not to continue this feature. [+]
Presentation Design for Medical Education: Slide set for CORD 2014
Drs. Tyson Pillow, Stacey Poznanski, Robert Tubbs, and I will be teaming up to deliver a Presentation Design Bootcamp talk for medical educators at the 2014 Council for EM Residency Directors (CORD). The session is on April 2, 2014 at 1:30-2:20p in New Orleans, LA. Because it is a short 1-hour intensive workshop, we want to offer participants the opportunity to prepare themselves by reviewing the slide set ahead of time. [+]
ALiEM-Annals of EM Journal Club: Targeted Temperature Management
We are very excited this month to bring you our third Global Journal Club. We hope you will participate in an online discussion based on the clinical vignette and questions below from now until March 27th. Respond by commenting below or tweeting (#ALiEMJC). On Tuesday, March 25, 2014 at 1630 EST, we will be hosting a 30-minute live Google Hangout with Dr. Niklas Nielsen, the lead author of the Targeted Temperature Management (TTM) study, that is informed by the discussion. Later this year a summary of this journal club will be published in Annals of Emergency Medicine. [+]
Trick of the Trade: Parting the hair for scalp laceration repair
Trying to suture or staple a scalp laceration is oftentimes a hairy proposition for emergency physicians who repair these types of wounds regularly. Although the “hair apposition technique” method is one option, if one opts for sutures or staples, the most difficult part of the procedure is trying to avoid trapping hair strands within the wound, which may cause wound dehiscense, a foreign body reaction, or a local infection. [+]
ProCESS Study: Identify sepsis early and treat aggressively
Today, the New England Journal of Medicine just released a landmark paper by the ProCESS (Protocolized Care for Early Septic Shock) trial investigators. There has already been much buzz about this on various blogs and websites, including St. Emlyn’s, MedPageToday, and MDAware. I received an email from my colleague Dr. Michael Callaham, who shared some direct comments and pearls from Dr. Donald Yealy, (professor and chair of emergency medicine from the University of Pittsburgh Medical Center) who was the first author of this writing team. Thank you to Dr. Yealy for allowing me to share your team’s comments with the ALiEM readership. [+]
Article: Elevated INR May Overestimate Coagulopathy in Trauma and Surgical Patients
A 55 year old woman presents as the driver of a motor vehicle collision. She has moderate abdominal tenderness diffusely and a seat belt sign, but has a negative abdominal/pelvis CT. Her INR, however, was noted to be 2.1. She is not on any vitamin K antagonists. The surgeons admit her to the hospital to observe for a potential hollow viscus injury and requests that you order 2 units of FFP for her. Seems reasonable… or is it? What is the logic? [+]
Trick of the Trade: Nasopharyngeal Oxygenation
A 76-year-old obese male with a history of severe COPD presents to your emergency department (ED) in acute respiratory distress. The patient’s large beard prevents an adequate seal with the NIV (non-invasive ventilation) mask, and the patient continues to desaturate. You are fairly sure that this patient will be a difficult airway and optimizing oxygenation prior to and during your intubation attempt would be ideal. Now what? [+]