How to teach procedures in the Emergency Department
As I was going through the free EM-RAP Educator’s Edition podcasts, somehow missed the March 2010 podcast on how to teach procedures in the Emergency Department. In the 36-minute podcast, Dr. Mak Moayedi (Univ of Maryland) discusses a framework to teaching procedures. Check it out. More specifically, Dr. Moayedi talks about how teaching procedures has moved beyond the antiquated “see one, do one, teach one” philosophy. Instead, we should follow principles based on accepted adult learning theories. [+]
Trick of the Trade: OKN drum to test psychogenic coma
Occasionally, emergency physicians see patients who present because they are unresponsive despite normal vital signs and an otherwise normal exam. You detect no drugs or alcohol on board. You suspect a psychiatric or malingering etiology, but aren’t sure. They seem non-responsive to voice and minimally responsive to very painful stimuli. Is this a case of psychogenic coma or true coma (with bilateral hemispheric dysfunction)? What test can you do to reassure yourself that this may indeed be psychogenic coma? [+]
Essential tool for academicians: Cordless presenter
In academic medicine, you inevitably will need to give presentations. This may include giving lectures on clinical topics, summarizing your research findings, or presenting your meeting agenda. Usually these are displayed using a laptop and a LCD projector. Depending on the room, you may or may not be provided a cordless presenter. [+]
Article Review: What do EM learners want from teachers?
Evaluations of clinical faculty typically incorporate comments from rotating medical students and residents regarding their teaching ability. In the Emergency Department (ED), how do you balance your pressing clinical responsibilities with teaching? [+]
Director of Growth, [+]
Paucis Verbis card: Penetrating abdominal trauma
When I did my residency training in Emergency Medicine and in the first few years as an attending, we regularly performed diagnostic peritoneal lavages in patients with stab wounds injuries to the abdomen. Patients also routinely went to the operating room for exploration. Now with the evolution of CT imaging technology and more clinical studies, there is now a role for a less invasive management approach. These are the Eastern Association for the Surgery of Trauma (EAST) guidelines. PV Card: Penetrating Abdominal Trauma Adapted from [1] Go to ALiEM (PV) Cards for more resources. Reference Como JJ, Bokhari F, Chiu WC, [+]
Trick of the Trade: Blowing out the candle
How do you teach pediatric patients, especially toddlers, how to cooperate with your pulmonary exam? How do you get them to take adequately deep breaths in and out? [+]
Director of Growth, Strategic Alliance Initiative, Center [+]
Work NOT in progress: ACEP Tricks of the Trade column
Since 2006, I have been the ACEP News columnist on “Tricks of the Trade in Emergency Medicine.” Four years later, I’ve published and co-published 33 articles on various both low-tech and high-tech pearls. It’s official — I’ll be stepping down from the ACEP News columnist position and handing off the reins to someone with fresher ideas. Frankly, I’m running out of innovative ideas worth publishing about. [+]
Paucis Verbis card: Burn Wounds
Burn classification and management are key skills for ED providers to remember. Depending on the prevalence of burns in your ED, it may be hard for forget the details. So here is a PV reference card on the rule of 9's, different classifications of burns, and indications for burn unit referral. Update (April 22, 2016): This card was updated by Dr. Christian Rose (UCSF-SFGH) to reflect current evidence that topical antibiotics and honey are IN, while silver sulfadiazine is OUT for partial-thickness burns. PV Card: Burn Wounds Adapted from [1-3] Go to ALiEM (PV) Cards for more resources. References Gómez R, Cancio L. Management of burn wounds in the emergency department. Emerg [+]
Video: Caution about patient hand-offs in the ED
Kudos to Dr. Vineet Arora (Univ of Chicago) on creating a great video on the importance of clear, concise, and updated hand-off information on patients. This is especially important in the Emergency Department where patients are constantly being “signed out” to other residents for continued acute care. Whatever hand-off process you are using now, we can always do better. [+]
Trick of The Trade: Peritonsillar Abscess Drainage 2.0
Back in September of 2009 Michelle shared valuable Tricks of The Trade regarding drainage of peritonsillar abscesses. Today we revisit the topic and add two more tricks to avoid hitting “big red” a.k.a. the internal carotid artery. [+]