52 Articles in 52 Weeks: Landmark EM Articles 2013
To provide a resource for evidence-based Emergency Medical education, this list of must-read landmark articles was created to supplement the Emergency Medicine (EM) internship year of training. There are 52 articles so that one article can be read at leisure each week of the year. I searched national databases and polled faculty at the University of Washington to identify articles that faculty would expect any EM resident to be familiar with or that they felt were practice-changing in EM. Articles were selected for the final list based on the quality of study design, sample size, and relevance for EM residents. [+]
Thyroid Storm: Treatment Strategies
The Case You have a 54-year-old female who presents to the emergency department with a chief complaint of “just feeling out of it.” She has felt “off and on” for the past 12 hours and has had an occasional cough with some sputum production along with “the shakes and chills.” She also feels as if her heart was “going at a mile a minute” and because of this, she is very much out of breath. [+]
MEdIC: The Case of the Woman in White – Expert and Community Response
The Case of the Woman in White brought out passionate replies from the ALiEM community. While Brent Thoma (@Brent_Thoma) and I (@TChanMD) have hosted several passionate discussions on MEdIC cases, none of which have inspired such deep and thoughtful responses. Both male and female attendings, residents, medical students and even a patient weighed in. [+]
ALiEM Bookclub: A Temporary Matter story in Interpreter of Maladies
“Her placenta had weakened and she’d had a cesarean, though not quickly enough. The doctor explained that these things happen. He smiled in the kindest way it was possible to smile at people known only professionally. Shoba would be back on her feet in a few weeks. There was nothing to indicate that she would not be able to have children in the future.” [+]
Peer Violence: A Public Health Perspective
Think back to your last shift. How many of you saw someone whose chief complaint was “assault”? What did you do for the patient? If you’re like most of us, you ruled out acute life-threatening injuries, sighed loudly (especially if the person had been in the ED before for other fight-related injuries), and dispo’ed. But do you ever wonder if you should do more? Or why? [+]
Child Whisperer Series: Just Breathe
Just breathe…. Early in my career as a Child Life Specialist, I was working with a 4 year old girl who needed her port catheter accessed. She was beginning to panic with rapid breathing and moving around. She was clearly on the verge of screaming at any moment. Her panic made everyone in the room feel anxious. I knew I had to do something, so I got on one knee, looked her in the eye and said, “Just breathe.” Without missing a beat, she leaned in closer to me and said, “I am!”… Touché my little friend. [+]
Discussing Annals EM article: Social Media and Physician Learning
I was delighted to see the News and Perspectives piece in this month’s Annals of Emergency Medicine about “Social Media and Physician Learning” (free PDF). I had totally forgotten that Jan Greene, the author, had called to talk with me several months ago. In the piece, she discusses many of the issues with which I struggle: Is peer review good or bad? What is the role of blog and podcast sites in the future of medical education? With the ease of how anyone can be “published” on blogs, how can one decide on the trustworthiness of open educational resources such [+]
5 Tips in Managing Acute Salicylate Poisoning
Salicylate is among the top 25 substances that cause the greatest number of overdose fatalities in the United States. 1 Patients can present with a wide variety of complaints including tinnitus, dyspnea, vomiting, confusion, and coma. Significant toxicity occurs when a large amount of salicylate saturates the body’s protein-binding capacity and leaves free salicylate in the serum. 2 The American College of Medical Toxicology (ACMT) recently published a guidance document on management priorities in salicylate toxicity, and it’s definitely worth a read. 3 While not an official clinical guideline, it highlights some important concepts to consider when working up and [+]
Patwari Academy videos: Testicular torsion and acute scrotal pain
There are several causes for the acutely painful scrotum. In the follow two short tutorial videos, Dr. Rahul Patwari reviews common causes, which include testicular torsion, epididymitis, orchitis, torsion of the testicular appendix, and testicular masses. [+]
MEdIC Series: The Case of the Woman in White
Once upon a time nurses were all women in hats and white skirts and doctors were readily identifiable by their formal dress, and deep, masculine voices. Changes in demographics, fashion and the health care teams have shattered these stereotypes. In doing so, it has become more difficult for our patients and fellow practitioners to identify the diverse members of a modern health care team. This week we present the case of Jenny and Justin: a couple of residents who are struggling with the assumptions of their patients and colleagues that result from their youthful looks and – in Jenny’s case [+]