Be a great speaker: 10 practical pearls (part 1 of 5)
Have you seen how some speakers can seemingly just give AMAZING talks? It actually takes a lot of hard work to make impactful talks look easy and effortless. The CORD Academy for Scholarship in Education in Emergency Medicine recently has started the “Distinguished Educator’s Coaching Program” to help established educators improve their presentation skills. The concept of coaching for mastery is a hot topic, often discussed by Dr. Atul Gawande (surgeon at Brigham and Women’s and professor at Harvard Medical School and the Harvard School of Public Health). [+]
Is it time to trash the stethoscope? The age of ultrasound
Is the physical exam a relic of the past, because our tools are relics of a prior era? It is important to do and teach a thorough physical exam. I cautioned against the overreliance on diagnostic testing in lieu of a physical exam, which can be initially burdensome and prolonged. But perhaps our difficulty with the physical exam is not the exam itself, but the tools that we have at our disposal to perform an exam, rather than the exam itself. [+]
What’s the Code Dose of tPA?
Suppose you have a patient in whom you highly suspect a pulmonary embolism (PE) that devolves into PEA arrest while awaiting a CT angiogram. Or, what about a patient with an ECG showing clear STEMI that loses pulses? [+]
Lytics for sub-massive PE: Ready for primetime?
There was recently a great study published in the American Journal of Cardiology (2012) by Sharifi et al1, questioning whether we should be considering tPA in patients other than those patients with massive pulmonary embolism (PE)? You know the big “Saddle Embolus” we all fear? Well it turns out this is only about 5% of all PEs. Should we be considering tPA in patients with sub-massive PEs? [+]
Welcome new blog team member: Dr. Salim Rezaie
Please help me welcome Dr. Salim Rezaie, a star from the academic world of Emergency Medicine! I have been secretly stalking him on Twitter and finally found an opportunity to meet him and recruit him onto the ALiEM blog team while at the recent Council of Residency Directors (CORD) for EM annual conference. [+]
Trick of the Trade: Ambient noise and creative cognition
For many of us in academia and medical education, we accomplish a tremendous amount of work outside of the workplace. This can be in our home office, on the public transit system, or in the library. Interestingly, creative cognition occurs best with a moderate amount of ambient noise (not too much and not too little), according to a 2012 article from Journal of Consumer Research. [+]
Need your input! PV cards becoming an app
It’s all about luck, opportunity, and timing. I will be releasing the blog’s first ever Paucis Verbis (PV) native app this year. After a few years of brainstorming and lots of reader inquiries about an app, we were approached by two different app-building companies in the same week. I’m incredibly humbled to be approached by organizations, who can see the potential of these pocket cards (which started as actual index cards while I was in residency). It is an incredibly exciting time to be in the world of education and social media! I need your help with step 1. [+]
Patwari Academy videos: Chest trauma
In the third and fourth video in the Trauma series (first two videos = primary and secondary survey), Dr. Rahul Patwari discusses about chest trauma, divided into blunt and penetrating mechanisms. What is “the box” that everyone keeps referring to? [+]
PE in pregnancy: which diagnostic tests do you use?
Pulmonary embolism (PE) can be a deadly disease and one of the most challenging diagnosis to make in a pregnant patient. Patients may present with signs and symptoms that might also be present in a normal uncomplicated pregnancy. Even in nonpregnant patients, the diagnosis of venous thromboembolism (VTE) such as PE can be quite challenging. [+]
Trick of the Trade: External jugular tourniquet
Paitents can be a challenge when trying to obtain peripheral IV access. The vein may be collapsed from dehydration or scarred because of IV drug use or repeated cannulation. Before thinking about an ultrasound-guided deep vein IV or a central line, take a look at the external jugular (EJ) vein. There are, however, a few problems that exist when trying to cannulate this site: There is no tourniquet for the neck. To distend the vein, you often need to put the patient in Trendelenburg, which may be uncomfortable or intolerable for some [+]