Advice for the new EM interns, part II
As a followup to a previous post on “The 10 Commandments in Emergency Medicine”, we would like to pay tribute to our pediatric friends. More than a decade after it was initially published, Timothy Givens (also from Vanderbilt but the pediatric side) published “The 10 commandments of pediatric Emergency Medicine”. Although the original commandments still hold true, the pediatric commandments augment them nicely and are geared towards our littler patients. [+]
Paucis Verbis: Spinal epidural abscess
One of the most challenging diagnoses to make is that of a spinal epidural abscess (SEA), especially if you work in an Emergency Department which cares for many IV drug users and HIV patients. There's never before been a published diagnostic guideline or algorithm which helps you with risk-stratification. In the Journal of Neurosurgical Spine, a diagnostic guideline was prospectively evaluated on a small population (n=31) as compared to historical controls (n=55). They found that an ESR test had a sensitivity of 100% if a patient had at least 1 risk factor for SEA. A CRP test was much less [+]
Faculty hero: Dr. Jim Adams (part 2)
Continuing from the Part 1 (Aug 2, 2011 post), here is the rest of my conversation with Dr. Jim Adams: What cool things are you working on right now? The big projects that I am working on include: [+]
Trick of the Trade: Balloon animals in the ED
Back in July 2010, I wrote about using the Candleflame app to encourage pediatric patients to take deep breaths for a pulmonary exam. This app has also been useful in helping me roughly gauge the patient’s peak flow. [+]
Faculty hero: Dr. Jim Adams (part 1)
There are many leaders in Emergency Medicine but there are few who are true visionaries. Dr. Jim Adams (Chair at Northwestern’s Department of EM) is one such visionary. He’s given numerous lectures, providing sage advice to faculty, residents, and students. I’ve always thought it a shame these aren’t more available to people. So I contacted Jim to learn more about him, his career path, and advice for young emergency physicians. [+]
Article Review: Performing a database search
At the end of each Academic Medicine journal issue, there is a great “last page” one-page teaching point in medical education research. There’s no earth-shattering news, but they are great reviews of key elements in education research. The most recent issue reviews the process of performing an effective database search in medical education research. It was authored by my friend Lauren, who is a medical education librarian at Stanford and a co-author with me on an annual series “Critical Appraisal in Emergency Medicine Education Research”. [+]
Paucis Verbis: Fibrinolytics for Acute Pulmonary Embolism
When would you give fibrinolytics for a Pulmonary Embolism? This Paucis Verbis card summarizes recommendations found in Circulation's recently published Scientific Statement from the American Heart Association. Although it is rare to give fibrinolytics for a pulmonary embolism (PE) in the Emergency Department, it is important to remember when lytics are indicated. PV Card: Fibrinolysis for Acute Pulmonary Embolism Adapted from [1] Go to ALiEM (PV) Cards for more resources. Reference Jaff M, McMurtry M, Archer S, et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart [+]
New guest blogger: Dr. Hans Rosenberg
Let's make it official. Dr. Hans Rosenberg has been contributing great content for this site. We're honored to have him officially join our blogging team! Dr. Rosenberg did his residency at the University of Ottawa, graduating in 2009. He now works at the Ottawa Hospital Emergency Department as a Consultant Staff Physician and is an Assistant Professor at the University of Ottawa. His interests in medical education are specifically related to our interaction with technology and how we use it to learn, educate and improve our practice of Emergency Medicine.
Inspirational graduation speech by Conan
“Your perceived failure can become a catalyst for profound reinvention.” “No specific job or career goal defines me, and it should not define you.” — Conan O’Brien I found this inspirational 2011 graduation speech by Conan O’Brien at Dartmouth College. It is a great mix of silly, witty, inspirational, and profound. Check it out. For those in Medicine and medical training, your dreams may change over time… and that’s ok. [+]
Trick of the Trade: Making a beanie hat
Scalp lacerations are a common condition in the Emergency Department. Some require no bandage over once the injury is repaired. Because the scalp is so vascular, others require a pressure dressing over the site to minimize hematoma formation. How do you bandage these patients? It is difficult to secure any wrap or square gauze over the site, because the head is round and the hair is slippery. [+]