Trick of the Trade: I need more lidocaine but I have sterile gloves on!
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?” [+]
Simple rules to make your Powerpoint talk rock
I came across this great SlideShare set on some simple rules on slide design to make your Powerpoint-based talk great. Think of your favorite speakers (i.e. the Mattus and Weingarts) and inevitably part of the reason they are so great is because of their slide design. [+]
Article review: Inconvenient truths about effective teaching
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: [+]
Paucis Verbis: Lifetime attributable risk of cancer from CT
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
Social media in academia: Why do it?
“Why would I want to participate in Twitter and social media?” This is a common question that I get from my fellow emergency physicians. They think that social media applications are for people who have nothing better to do than to read/write about trivial personal opinions. [+]
Trick of the Trade: Fingertip injuries
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!
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.
Paucis Verbis: Pulmonary Embolism Clinical Prediction Rules
"Should I get a D-Dimer test or CT chest angiogram on my patient with atypical chest pain to rule-out a pulmonary embolism?" This is a common question asked by emergency physicians on a routine basis. Here are 3 clinical prediction rules: PERC, Wells, and Simplified Geneva Score. Personally, I've never used the Geneva Score, but it's worth looking at. A WORD of CAUTION These rules should be used with caution, because none of these scoring protocols are perfect. For instance, in a recent publication in the Journal of Thrombosis and Haemostasis, the authors found that the PERC rule does not actually [+]
Internet CME: EMedHome.com
Two weeks before renewing your license, you realize that you’re short 7 CME credits. Uh-oh…what to do now? Unfortunately, not enough time to go to a conference. Reading always gets boring after a while. Lie on your renewal application (NOT!)? If only there was a one-stop method of getting a variety of CME to keep you interested. [+]
Tricks of the Trade: Tea bags to the rescue
I have heard of using tea bags under your eyes to reduce puffiness, but to combat odors in the ED? In my growing list of “Tricks of the Trade” tips for protecting your olfactory nerves (Antacid booties for toxic sock syndrome, aerosolized orange juice, abscess drainage using suction), I got a clinical gem from Dr. James Juarez (Rogue Valley Medical Center in Ashland, OR) after my recent Tricks of the Trade talk at High Risk EM in San Francisco. [+]