Video: Crash course on Prezi
https://www.youtube.com/watch?v=5sDdyk-HHYQ Dr. Rob Rogers has started a great series of videos which highlight resources and tools which medical educators may find useful and innovative. This video takes you on a guided tour through making a Prezi presentation. Although I am still torn about using Prezi as a delivery tool because of the excessive motion-based transitions, I do like such features as: Really professional looking templates The presentations can live online and/or on your desktop Ability to easily embed videos Ability to see your entire presentation on the canvas Allows more flexibility in content delivery It just looks cool. You can [+]
Paucis Verbis: Anaphylaxis
Anaphylaxis is one of the most under-appreciated and under-treated conditions in the Emergency Department. A common misperception is that you need hypotension to diagnose it. Below is a brief summary of the diagnostic criteria and ED treatment protocol. Immediate administration of IM epinephrine is critical. A major challenge is deciding which patients can go home and which need to be admitted, because of the risk of "rebound" or a biphasic anaphylactic response. This may occur as late as 72 hours later, but typically occur within the first 24 hours. There isn't a good answer for this. What's your practice in [+]
Live-blogging: UCSF High Risk EM Hawaii conference
Today is the pre-day for our department’s 2nd annual High Risk Emergency Medicine conference in Hawaii. The day’s focus is on ultrasonography. Keep a lookout below as I try to live-blog some of the clinical pearls that I glean from the day (using Google Docs). [+]
Article review: New assessment method for medical students – A Script Concordance Test
What different ways can we assess learners? This fascinating study assesses a new tool – Script Concordance Test (SCT). Assessing clinical reasoning skills in scenarios of uncertainty: Convergent validity for a Script Concordance Test in an Emergency Medicine clerkship and residency [+]
Paucis Verbis: Pediatric fever without a source (3 mo-3 yr)
In part 3 of this "Pediatric Fever Without a Source" Paucis Verbis cards, we now cover febrile infants 3 months to 3 years old (PV cards for birth-28 days and 29 days-3 months old). Notes: The algorithm below is a guideline for NON-toxic patients. More ill-appearing children require a more broad workup. For the under-immunized (<2 PCV immunizations) and temperature ≥39.5C, blood cultures may be falling out of favor in the near future, because the incidence of blood culture contaminants is close to exceeding the true incidence of occult bacteremia. PV Card: Pediatric Fever Without a Source (3 Months-3 Years) Go [+]
Blog incubation project: New 2 winners!
And the winners of the first ever EM Blog Incubator competition are… Dr. Jim Campagna (Emergency physician at St Joseph’s Hospital Health Center in Syracuse, NY) and Dr. Timothy Peck (Beth Israel Deaconess EM resident in Boston, MA) [+]
Director [+]
Paucis Verbis: Fever without a source (29 days-3 months old)
In part 2 of this "Pediatric Fever Without a Source" Paucis Verbis cards, we now cover febrile infants aged 29 days to 3 months (PV card for birth-28 days). Note that there is no single correct answer in how to manage these patients. There can be a wide variation in practices, partly because of the slightly different criteria used by the 3 studies. The overarching principle is that "high risk" infants get admitted with IV ceftriaxone and "low risk" infants get discharged with close follow-up +/- a ceftriaxone IV or IM dose. The line between these two risk categories is the [+]
Trick of the Trade: Difficult intubation — making lemonade out of lemons
In many cases of massive GI bleeding, airway control is essential. During endotracheal intubation, suction sometimes just isn’t adequate enough to allow to get a good view of the vocal cords. The pool of blood keeps re-accumulating faster than you can suction. You think you see an arytenoid, pointing you in the direction of the trachea, and so you slide the endotracheal tube in. Unfortunately, when you bag the patient, you realize that you are in the esophagus. [+]
Paucis Verbis: Pediatric fever without a source (Birth-28 days)
Pediatric patients commonly are brought to the Emergency Department for a fever without a source. Management of these patients depends on the patient's age. Today's PV card focuses on the youngest age group: Birth-to-28 days. QUESTION to everyone: Do you correct your age calculation for prematurity? Premature neonates are more at risk for SBI, but I've seen varying practices. PV Card: Pediatric Fever Without a Source (Birth-28 Days Old) Go to ALiEM (PV) Cards for more resources. Keep a lookout for future PV cards which will address fevers without a source in pediatric patients aged 29 days-3 months and 3 [+]
Trick of the Trade: Minimizing propofol injection pain
“Ow, that burnnnnssss… ow! ow! ow! … zzzzzz… As many as 60% of patients report significant pain with the injection of IV propofol. Once a patient experiences pain, it’s too late to reverse it. Often all you can do is to tell them that the pain will subside in a few seconds. What can you do preemptively to minimize the pain of propofol injection? [+]