Patwari Academy videos: LVADs
Complications from left ventricular assist devices (LVAD) increasingly account for Emergency Department visits. What are LVADs? They are a short-term, artificial, circulatory device which performs the function of a very poorly functioning heart. It is important to understand the myriad of complications that can arise and the general approach to patients with an LVAD. These two short videos by Dr. Rahul Patwari summarize these in a nutshell. [+]
Simulation Trick of the Trade: Paper Mache
Money doesn’t grow on trees, and neither do simulation manikins, not even on simulated trees. So what to do when you are looking for a cheaper, more easily replicated solution to simulation dilemmas? This is the perfect time to fall back on skills developed in childhood during Arts & Crafts hour. Consider paper mache! So easy to use, and guaranteed to bring back childhood memories! [+]
Quick clinical tip: Rotational angulation of metacarpal fracture
Metacarpal fractures are commonly present to the Emergency Department for care. The plain film shown here shows metacarpal neck fractures of the middle and ring finger shown. There are specific criteria requiring closed reduction in the ED (PV Card). Generally ANY rotational angulation requires reduction. Detection of such angulation depends on the clinical exam rather than the plain film. How does one diagnose it? [+]
5 Rules To Guide Your Approach to Learning in Social Media
Blogs, podcasts, and other social media platforms in medical education, known collectively as Free Open Access Meducation (FOAM), are becoming increasingly popular and integrated into daily learning habits. Through various push technologies, these resources come to you in the form of RSS feeds, podcast tools, and other apps. Do you have a mental checklist to help you determine whether the content is trustworthy and accurate? How do you process the information from FOAM sites? [+]
Is FOAM to blame when a medical error occurs?
What if a resident-physician attempted a technique she read on a blog or listened to on a podcast, but the procedure didn’t go as planned and the patient was harmed? Is Free Open Access Meducation (FOAM) to blame for medical errors? What about the blog site? If the site has a disclaimer (like most medical databases), is it enough to limit liability? These are challenging questions, but ones that deserve discussion, especially in light of the recent post on St. Emlyn’s blog about a theoretical scenario just like this. [+]
Deciphering Acid-Base Disorders
Derangements in acid-base status are commonly discovered on routine emergency department evaluation and often suggest the presence of severe underlying disease. Many acute conditions can disrupt homeostatic mechanisms used to buffer and excrete acid, and these changes may necessitate immediate intervention. When you discover a patient with an abnormal pH, what is your approach to the diagnosis? [+]
ALiEM Bookclub: The House of God
Written as satire when published first, The House of God polarized the medical community. Doctors in training cheered the book as a voice for their generation to describe the grueling nature of medical training. Others were appalled by the crass language and apparent lack of humanity when describing patient care. Reading the book became a rite of passage for young trainees. [+]
Door to Balloon Time: Are We Measuring the Right Thing?
Door-to Balloon (D2B) time is a time measurement that starts with patient arrival to the emergency department (door) and ends when a catheter crosses a culprit lesion in the cardiac cath lab (balloon). The benefit of prompt primary percutaneous coronary intervention over thrombolytic therapy for acute ST elevation myocardial infarction is very well established. Because of this “time is muscle” strategy, the American College of Cardiology (ACC) launched a national Door to Balloon (D2B) initiative in November 2006. The purpose of this was to recommend a D2B time of no more than 90 minutes. Currently, there is quite a bit [+]
PV Card: Emergency Drug Cards for Adults and Children
Rob Bryant, MD (@RobJBryant13), Amie Hatch, PharmD, BCPS (@Amie_EMPharmD), and Jeremy Bair, PharmD (@bairpharm) from Intermountain Healthcare in Utah have created and adopted a fantastic medication reference card which is used by physicians and nurses in the Emergency Department. The medications were chosen because they are often prone to dosing errors and require time-sensitive ordering. They generously offered to share this incredibly compact resource for free to the Emergency Medicine community as a PV card. If you see them, give them a high-five. [+]
Residencies Embrace Twitter: An Educational Movement
The movement of FOAM and #FOAMed may have started in a pub in Dublin in 2012, but it has become legitimized through widespread acceptance. Residencies are also catching onto the idea and eager to collaborate through social media, in particular Twitter. This is evidenced by the use of Twitter accounts on #EMConf as a way to collect educational learning pearls garnered weekly at resident conferences. “The mind is not a vessel to be filled, but a fire to be kindled.” – Plutarch [+]