• Diarrheal monster

Paucis Verbis: Clostridium Difficile

By |Jun 24, 2011|Categories: ALiEM Cards, Gastrointestinal, Infectious Disease|

I just finished taking the 2011 LLSA exam to remain eligible for recertification. The only good thing about this test is that it gives me interesting topics for my Paucis Verbis cards. Here's a card on a disease process that is becoming increasingly prevalent -- Clostridium difficile. This is a summary based on the 2010 guidelines by Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Because healthcare workers are often the culprit for transmitting C. difficile to other patients, be sure you wash your hands with soap and water really well. Wear gloves. Be aware [+]

  • Shoulder dislocation xray

Trick of the Trade: Cunningham maneuver for shoulder dislocation

By |Jun 22, 2011|Categories: Orthopedic, Tricks of the Trade|Tags: |

We commonly see patients with shoulder dislocations in the Emergency Department. There are a myriad of approaches in relocating the joint, which includes scapular rotation, Snowbird, and Kocher maneuvers. I recently stumbled upon the Cunningham technique after hearing about it from Dr. Graham Walker (of MDCalc fame) on TheCentralLine.org. [+]

  • Professionalism

Article review: Professionalism in the ED through the eyes of medical students

By |Jun 20, 2011|Categories: Education Articles, Medical Education|Tags: |

Teaching professionalism in a formal curriculum is so much different than demonstrating professionalism in the Emergency Department. So much of what students and residents learn about professionalism are from observed behaviors of the attending physicians — that is, the hidden curriculum. In a qualitative study assessing medical student reflection essays during an EM clerkship, the authors (my friends Dr. Sally Santen and Dr. Robin Hemphill) found some startling results. The instructions to the medical students were to “think about an aspect of professionalism that has troubled you this month. Write a minimum of one half-page reflection describing what was concerning and how [+]

  • Lidocaine Bottle

Trick of the Trade: I need more lidocaine but I have sterile gloves on!

By |Jun 15, 2011|Categories: Tricks of the Trade|

How often has this happened to you — You are in the middle of a sterile procedure (chest tube, suturing, central venous line, lumbar puncture) and you realize that you need more lidocaine to provide better topical anesthesia. You don’t have any more in your kit and you are alone in the room with the patient. “Uh, can someone help me out there?” [+]

  • Greys anatomy

Article review: Inconvenient truths about effective teaching

By |Jun 13, 2011|Categories: Education Articles, Medical Education|

  At the CDEM meeting during the SAEM national meeting this past week, the keynote speaker (Dr. Charles Hatem from Harvard) mentioned a great editorial article called “Inconvenient Truths About Effective Clinical Teaching.” Here’s a summary of the opinion article from Lancet: [+]

  • Risk

Paucis Verbis: Lifetime attributable risk of cancer from CT

By |Jun 10, 2011|Categories: ALiEM Cards, Radiology|

How great would it be if you could give patients concrete numbers when you are talking about cancer risk and CT? Well, Dr. Hans Rosenberg (Univ of Ottawa)  has come up with just such a table. Using this table you can say that the risk is about "one in ..." PV Card: Cancer Risk from CT  Adapted from [1] Go to ALiEM (PV) Cards for more resources. Reference Smith-Bindman R. Radiation Dose Associated With Common Computed Tomography Examinations and the Associated Lifetime Attributable Risk of Cancer. Archives of Internal Medicine. 2009;169(22):2078. doi: 10.1001/archinternmed.2009.427

  • Urine Cup Finger

Trick of the Trade: Fingertip injuries

By |Jun 8, 2011|Categories: Orthopedic, Trauma, Tricks of the Trade|

Fingertips can get injured in a variety of ways such as machetes, meat grinders, and broken glass. You name it, and we’ve probably seen it. Some don’t actually need anything invasive done because the skin is basically just torn off. The wound just needs to be irrigated, explored, and then bandaged to allow for secondary wound closure. What do you do if the finger injury keeps oozing and the finger tip is too painful for the patient to apply firm pressure? Poking the finger with 2 needles to perform a digital block seems a bit overkill. [+]

SAEM National Meeting a success!

By |Jun 6, 2011|Categories: Medical Education|Tags: |

The national SAEM meeting in Boston just concluded and was a success. As part of the SAEM Social Media Committee, I was encouraged to see how many people were tweeting events from the meeting. Check out the tweets with the #SAEM11 hashtag. To view beyond the most recent 100 tweets, you can view here.