MEdIC Series: The Case of the Culture Clash
Our hospitals are abound with international citizens who travel across the globe to learn about medicine. Frequently, individuals complete some aspect of their training in another country, bringing with them their own cultural perspectives. This month in the MEdIC Series, we invite you to discuss a case of culture clash and how consider how our learners’ backgrounds can affect their medical education. Join Mary in her tribulations as she considers how to approach the very different styles of her learners: Jane, Irina, and Shamila. [+]
Does The Medium Change The Culture?
According to Paul Levinson, a Marshall McLuhan scholar, “The medium is the message” in the digital age means that the way we use the medium to consume and produce information is much more important than the content itself. This phrase originated from a book authored by Marshall McLuhan in 1964 called Understanding Media: The Extensions of Man. McLuhan talked about the electronic age as a catalyst for creating a global village. These were some of McLuhan’s viewpoints even before the Internet had been invented. If the ultimate purpose of publishing is to communicate with each other, we should explore how [+]
Vote which Annals of EM articles to be open-access in June
In line with our prior two months of voting, we are back again to ask for your help in choosing which two articles from the June Annals of EM issue will be open access. Take a look at the article abstracts accepted for publication in June’s issue. Vote on your top two choices over the next 4 days, and the top two will be made open after the June issue of Annals of Emergency Medicine goes online. [+]
Amylase Level for Pancreatitis: Stop doing it
A patient actively vomiting is wheeled into your ED. Within minutes IV access is obtained, and your nurse asks what tests and medicines are wanted. A liter of normal saline, ondansetron, and an H2 blocker are easy, but what labs to order? I think we can all agree on a metabolic profile to look at electrolytes and liver function tests, and a lipase level to assess for pancreatitis. But what about an amylase level? Originally from Clinical Monster blog [+]
ALiEM Bookclub: Drive – Synopsis and Discussion
Why do we do what we do? This is the question at the heart of this month’s ALiEM Book Club selection. Drive 1 , by author Daniel Pink, discusses the history of motivational theory before provocatively making the case that we’re doing it wrong. He argues that having met our base desires (food, drink, sex), a reliance on extrinsic motivators (reward and punishment) will stifle intrinsic motivation and prevent us from functioning at our highest capacity. The three features described for optimizing intrinsic motivation are: Autonomy: control over task (what we do), time (when we do it), team (who we [+]
Expertise in Clinical Decision Making
We make decisions every day, all day long. Sometimes we are aware of it and sometimes we are not. Our decision process is affected by many factors. Some are under our conscious control while others are not. In order to sharpen our decision process, we gain knowledge, practice, and then reflect. We are selective and gain knowledge from different sources, practice in the appropriate setting, and reflect alone or with others for feedback. It is important to explore all possible clinical reasoning pathways as we don’t know which process will get us in the right path. [+]
New Cardiology PV Cards available on your phone and tablets!
After getting many requests for more PV cards, we are excited to launch 13 new topics located in the Cardiovascular folder of the Emergency Medicine: PV Cards collection on AgileMD. These new cards were made based off of blog posts from ALiEM’s authors. [+]
Population vs Public Health: A False Dichotomy?
My department chair recently forwarded me a provocative little video regarding how we should conceptualize “population health.” The video encapsulates a number of hot topics in public health, labeled here as “population health”. It appropriately emphasizes the importance of addressing not just prevention among healthy populations, but also improving the health outcomes of high utilizers. [+]
Blood Cultures in Pneumonia
A 75 year old woman is found to have pneumonia. With a CURB-65 of 3 and a PORT score of 95, she is correctly treated her for community acquired pneumonia with Ceftriaxone and Azithromycin, and admitted. Unfortunately, the admitting service points out that no blood cultures were drawn! What is the evidence for this? Originally from Clinical Monster blog [+]
Cyclobenzaprine vs TCA Toxicity
Should we treat a cyclobenzaprine (Flexeril) overdose similar to a tricyclic antidepressant (TCA) overdose? With the only difference between the commonly prescribed muscle relaxant, cyclobenzaprine, and the TCA amitriptyline consisting of a single double bond, should the emergency provider be concerned for life threatening arrhythmias in cyclobenzaprine overdose? [+]