Patwari Academy videos: Low risk chest pain
One of the most common complaints in the Emergency Department is chest pain. Is it something serious? How do I risk-stratify patients with potential acute coronary syndrome? What should I be thinking of and not missing? Rahul goes over the low-risk chest pain patient in 2 great, short teaching videos, based partly on the 2010 AHA/ACC Guideline for ACS risk stratification. [+]
The Socratic Method
Diagnostic reasoning is one of the most complex, analytical, and intuitive processes to develop in the medical profession. Even seasoned physicians spend a lot of time fine tuning this skill. Although charged with teaching others, some excellent diagnosticians find it difficult to explain in detail how they arrived at a diagnosis or a differential diagnosis. Some might even find themselves in a position in which they have to assess someone else’s diagnostic reasoning. This task is even more daunting since we are not all taught much about this process, even less how to teach it to others. [+]
Lost in translation: What counts as asynchronous learning?
Reiter et al 1 just published a review on Individual Interactive Instruction also known as asynchronous learning in the Annals of Emergency Medicine. They chronicled the events in 2008 that led CORD (Council of Emergency Medicine Residency Directors) to recommend integration of individual interactive instruction into the residency curriculum. The summary recommendations by Sadosty et al 2 discuss components, strengths, and weakness of both asynchronous and synchronous learning paradigms along with background about Malcolm Knowles and andragogy. [+]
P-video: Remembering NEXUS criteria
https://www.youtube.com/watch?v=fUulc4cjH00 [+]
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General Hospital;
Chief Scientific Officer, Conductscience.com
Diminishing Returns: The MIC Creep Dilemma with Vancomycin
The story of vancomycin all started when a missionary from Boreno sent a sample of dirt to a friend at Eli Lilly. The compound isolated had activity against most gram positive organisms. In fact, it got its name from the word ‘vanquish.’ Vancomycin was FDA-approved in 1958. [1] Vancomycin is still a powerful tool against gram positive organisms, but there are some important learning points for using it properly in the critically ill ED patient. [+]
Trick of Trade: Rule of 10’s for burn fluid resuscitation
A patient presents with burns to both his arms, chest, and abdomen (anteriorly only) from a flash fire. That’s about 27% total body surface area (TBSA). So how much IV fluid should be given? Be aware of a phenomenon known as “fluid creep”, where patients actually get WAY too much IV fluids than they should, which can cause delayed complications such as ACS, pulmonary edema, and compartment syndrome. Don’t forget that patients often get a lot of IV fluids in the prehospital setting, which should also be factored in. [+]
Bridging the quality gap: Becoming a peer-reviewed blog
We are now a peer-reviewed blog. It starts today. I have been frustrated (in a good way) by the recent social media discussions (see BoringEM.com) about how social media content is viewed with a skeptical eye by medical educators, academicians, and professionals because of the lack of formal quality-control mechanisms. [+]
Patwari Academy videos: Presenting patients in the ED
Doing well on your Emergency Medicine rotation, whether you are a medical student or resident, will depend in large part on your ability to deliver a coherently concise presentation to the senior resident or attending physician. It’s about telling a story that fits into the construct of how the expert physician thinks. [+]
Mentorship: Who benefits?
Mentorship is one of the professional relationships that fascinates me the most. We’ve all had those people in our lives that help us advance our careers, gain more insight to our practice, guide us to a more work/life balance. Some might call these people mentors, while other call them coaches or guides. Even after completion of training or schooling, people make use of these coaches/mentors as is the case in sports or medicine. For example Atul Gawande writes how a mentor helped him improve his practice as a surgeon years after completing his training. [+]
SimWars: A “warring tigers” competition
SimWars You’ve seen this word on the agenda at the most recent Emergency Medicine conference that you attended. It sounded interesting… but you ended up going to a happy hour and missed out on the event. And so you are left with the burning question, what is SimWars? I have now heard Dr. Haru Okuda (Director of VA SIMLEARN) introduce SimWars a few times at the start of competitions at conferences. He usually has a photo of two cute little kittens with great big sweet eyes juxtaposed with a photo of two warring tigers fighting each other. He uses this comedic [+]