ALiEM Book Club: The Immortal Life of Henrietta Lacks
Just like scores of other premedical students all striving to get acceptance to medical school, I volunteered and did research during college. I elected to work in the Virology department because I wanted to study viruses like HIV, RSV, and SARS that were causing havoc on our society. I do recall that we used HeLa cells frequently in our research. In fact, most scientists in that department used HeLa cells on a regular basis regardless of the focus of their projects. I didn’t think much of the cells and I definitely never thought of where or from whom those cells [+]
Launching the ALiEM Book Club
Everyone involved in medicine has read a significant amount of books over their lifetime. Some of those books were read willingly, whereas others not so willingly (sorry, Histology textbook). Regardless, most of us have an inner love of reading and continue to do so even when we are not forced to do so for a test or class. We are launching “The ALiEM Book Club”! [+]
The Dirty Epi Drip: IV Epinephrine When You Need It
You’re a recent graduate picking up an extra shift in a small ED somewhere north of here. At 3 AM an obese 47 year-old woman presents with shortness of breath and difficulty speaking after eating a Snickers bar an hour earlier. She admits to history of hypertension, peanut allergy, and a prior intubation for a similar presentation. She is becoming more obtunded in the resuscitation room as you are collecting your history. A glance at the monitor shows: HR 130 BP 68/40 O2 saturation 89% on room air [+]
Brugada Syndrome: An ECG Pattern You Need to Know
Brugada Syndrome is an abnormal ECG (Right Bundle Branch Block Pattern with coved ST elevation over the right precordial leads of V1-V3), which leads to ventricular fibrillation (VF) and sudden cardiac death (SCD) in patients with structurally normal hearts. It has been recognized as a clinical entity since 1992. Why should all ED physicians know about this entity? Although a rare syndrome, it is often mistaken as a STEMI and more importantly the clinical spectrum can be asymptomatic to SCD. [+]
Trick of the Trade: Got a shoulder dislocation? Park it
Myriad techniques exist to reduce shoulder dislocations, which includes scapular rotation, Hennepin, Snowbird, Cunningham, and Legg maneuvers. They are nicely reviewed at ShoulderDoc.co.uk. You can also supplement any technique with ultrasound-guided intraarticular lidocaine for improved pain control. Recently, Dr. Jay Park (Beth Israel Medical Center in New York) contacted me about his novel approach to shoulder reduction which anatomically makes sense. If his animation video doesn’t convince you, check out the video of an actual reduction. [+]
Anterior Shoulder Dislocation: Are Prereduction Films Needed?
A patient comes into your department with an obvious shoulder dislocation. You know you can easily reduce the shoulder and have the patient discharged before the orthopedic consultant calls back. But what if there is a fracture? Do you need to get that plain film before popping it back into place? [+]
Patwari Academy video: Torsades de Pointes
Torsades de pointes is a polymorphic form of ventricular tachycardia. Why does this occur? What does it characteristically look like? Why is this an important form of ventricular tachycardia to differentiate from the more classic monomorphic ventricular tachycardia? View this short 9 minute video on QT intervals and Torsades de Pointes. [+]
Reflections on CMS Simulation Instructor Course
I just completed the 4 day intensive Center for Medical Simulation Institute for Medical Simulation Instructor Course. The title of the course is a mouthful and just as intense and high yield as the actual course was itself. The chief purpose of the course is to develop debriefing skills as a medical instructor. The structure and nature of the course seemed so effortless and fluid, and yet at the end of the 4 days, I knew that the debriefing skills I had learned were ingrained into my brain. I highly recommend this course to any medical educator with simulation interest. [+]
Navigating the waters of medical education and social media
SUNY Downstate Department of Emergency Medicine held a lecture series May 22, 2013 as a primer for the EM residents on how to use social media to enhance medical education. This session was designed to be an introduction for the novice on how to get the most out of FOAM (Free Open Access Meducation), Twitter, and Blogging with a section on professionalism. Invited speakers included Drs. David Marcus, Jeremy Faust, Jordana Haber, and myself Nikita Joshi. The slides from the session are presented below. Enjoy! [+]
Pitfalls to avoid in collecting patient related teaching materials
Educators are eager to gather valuable learning tools such as EKGs and x-rays to be used in teaching for our learners, whether from our home institutions or internationally through the internet. However, this may not always be seen as altruistic; history and even modern day medicine is full of examples of misguided attempts to further medicine at the expense of patients such as the Tuskegee Syphilis Experiment from 1932-1972. The focus of this post is how to go about collecting patient data for teaching purposes and avoiding confidentiality and consent violations while always remaining respectful of the patient and their [+]