Does assessment drive learning?
“The ability to secure meaning in the course of our experience is a basic human need… But meaning is not simply found; it is constructed.” – Elliot Eisner A few days ago I participated in a Twitter chat led by a physician-educator from the United Kingdom. This Twitter chat (#ukmeded) is usually held on Thursdays at 9:00 pm UK time. This was a rich discussion on Twitter, and it also allowed me to participate in a discussion with people from other parts of the world. The most recent topic was on assessment (follow the link and learn more about the subtopics discussed). [+]
Creating a successful workshop
This past week was the 2013 International Meeting on Simulation in Healthcare Simulation Society, organized by the Society for Simulation in Healthcare (SSIH) in Orlando, FL. This was the second time that I attended this conference, and the first year that I tweeted (#IMSH2013) through it. This was also the first time that I had ever organized a workshop for a conference. Boy was I nervous! I wanted it to be a great experience for those who attended. I wanted the participants to learn.. laugh.. cry… in other words, I wanted to change their lives! [+]
PV card: VBG versus ABG
You obtain a venous blood gas (VBG) on a patient with a COPD exacerbation because you are concerned about hypercarbia. You get a value of 55 mmHg. How correlative is that compared to an arterial blood gas (ABG). There has been a lot of literature on how well the pH correlates between the ABG and VBG but what about pCO2? A small study (n=89) from 20121 found that with a cutoff of pCO2 < 45 mmHg, the venous pCO2 is 100% sensitive in ruling out arterial hypercarbia. When the pCO2 was ≥ 45 mmHg, the VBG was less correlative. Below is [+]
Patwari Academy videos: Demystifiying how ECGs work
As a nice segue from the Low Risk Chest Pain videos, below is a 3-part series on Demystifying the Electrocardiogram by Dr. Rahul Patwari. It takes talent to make the complex simple. [+]
Director of Growth, [+]
App review: POC Ultrasound Guide
There is a new free app called POC Ultrasound Guide [iTunes link], created by Wexner Medical Center at Ohio State University. [+]
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General [+]
Website: Emergency Board Review
The emergency board in-training exam is a standardized exam that takes place every year in most if not all of the EM residency programs in the United States. It is administered on the last Wednesday in February. The exam is administered by the American Board of Emergency Medicine (ABEM). The knowledge assessed by this exam is what’s expected from residents in their third year of residency. According to ABEM there is a strong correlation between the in-training score and passing of the boards. [+]
RIME – Evaluating Learners
Lets talk about an effective evaluation process called RIME developed in 1999 by Pangaro. Not only is the name catchy, but it also makes intuitive sense. RIME stands for R – reporter I – interpreter M – manager E – educator / expert [+]
PV card: Diagnosis of DVT (ACCP guidelines)
A patient presents with an asymmetric leg with trace pitting edema in the affected leg. What is your diagnostic approach to such a patient? What is the role of D-dimer and ultrasound (U/S)? Does this match the 2012 American College of Chest Physicians (ACCP) guidelines? The first step is to determine your patient's pretest probability because the recommendations vary based on risk. I can tell you that many ED patients come in with a Wells score of 1-2, which places them in the "moderate pretest probability" category. There are 2 approaches you can take based on the availability of resources at [+]
One-dose vancomycin for SSTIs: Just don’t do it
You are managing an otherwise healthy patient with cellulitis but no abscess to poke. You decide this patient needs antibiotics but is stable enough to go home.”Give em’ a dose of vanc before they go,” right? [+]
Trick of Trade: Incision and loop drainage using tourniquet
The technique for abscess drainage traditionally is incision and drainage (I&D). In August 2012, I wrote about incision and loop drainage (I&LD), which it seems has gained popularity over time with similar outcomes. This technique involves using a sterile vascular loop, which is thin and long enough to form a loose knotted loop. The video below by Dr. Rob Orman reviews the steps. But, what if you don’t have a vascular loop in the ED? [+]