How I Educate Series: Jessie Werner, MD
This week’s How I Educate post features Dr. Jessie Werner, the Clerkship Director and Medical Education Fellowship Director at UCSF Fresno. Dr. Werner spends all of her shifts with learners which include emergency medicine residents, off-service residents, medical students, physician assistants, nurse practitioners, and fellows. She describes her practice environment as a busy (120,000 patients/year) ED in the central valley healthcare desert. Below she shares with us her approach to teaching learners on shift. Name 3 words that describe a teaching shift with you. Educational, hands-on, and accessible. What delivery methods do use when teaching on shift? I'm [+]
SAEM Clinical Images Series: ‘Tis Not the Season to be Wheezing
A 2-year-old male with a history of solitary kidney presented with greater than one month of daily coughing, wheezing, and decreased appetite. The patient was previously seen by his primary care physician after three weeks of symptoms where he was prescribed albuterol as needed for viral bronchospasm. The patient’s wheezing did not improve after two weeks of albuterol treatment so a chest x-ray was ordered. The patient’s mother denied any fevers, vomiting, diarrhea, weight changes, or night sweats. Vitals: BP 131/60; Pulse 148; Temp 36.7 °C (98.1 °F) (Axillary); Resp 28; [+]
Trick of the Trade: Managing Epistaxis with Merocel Nasal Packing and an Angiocatheter
There are many ways to manage epistaxis. Once nasal clamping and cauterization fail, the next step is to consider using tranexamic acid (TXA) and performing nasal packing. Inflatable packing devices such as a Rhinorocket are painful to insert and do not conform well to the shape of the naris. The expandable Merocel nasal packing, a compressed, dehydrated sponge, provides a softer, alternative option, although the insertion process can be painful given its initial rigid, edged structure. We propose 2 strategic tricks to optimize your nasal packing technique using the Merocel sponge. Trick of the Trade: Strategic expansion of the [+]
SplintER: Pop, Lock & Drop It
A 38-year-old female presents to the ED with right shoulder pain after a fall directly onto that shoulder. She noticed immediate pain and difficulty moving the arm associated with mild tingling in her right fingers. The radiographs above were obtained in the ED (Image 1. AP and lateral radiographs of the right shoulder, author’s own images). [+]
SAEM Clinical Images Series: An Enlarging Scalp Mass
A 27-day-old female infant born at 34 weeks 4 days with a prenatal history of maternal syphilis treated with penicillin presented with an enlarging scalp mass since birth. Since birth, the patient has had a 1 cm erythematous and flat lesion on her scalp. Since that time, the lesion has continued to grow and develop scales. On the day of presentation, the lesion was noted to be 7-8cm in diameter with multiple surrounding smaller lesions. There is some clear to bloody drainage coming from the main lesion. The patient has otherwise been growing and developing [+]
SplintER Series: Let the Feet Drop
A 20-year-old male distance runner who was jogging and happened to be running past the emergency department presented with severe bilateral leg pain, foot pain, and foot numbness that had resolved by the time he was evaluated in the ED. The x-ray above was obtained (Image 1. X-ray of the leg. Case courtesy of Andrew Murphy, Radiopaedia.org, rID: 41408). [+]
How I Educate Series: Stephanie Lareau, MD
This week’s How I Educate post features Dr. Stephanie Lareau, the Wilderness Medicine Fellowship Director and Medical Director of Emergency Services at Virginia Tech Carilion Clinic. Dr. Lareau spends approximately 50% of her shifts with learners which include emergency medicine residents, off-service residents, and medical students. Her practice environment is split between an academic and community hospital. She spends 25% of her time at the academic level 1 trauma center that is home to an EM residency and medical school. The other 75% of her clinical shifts are at a 12-bed community ED which also has both resident and [+]
The Fall of FOAM
The landscape of emergency medicine and critical care (EM/CC) blogs and podcasts has changed dramatically over the past 20 years. The number of free, open-access EM/CC blogs and podcasts has plummeted. As reported by Lin and colleagues in JMIR Education (2022), these sites decreased in number from 183 in 2014 to just 109 this year– a drop of 40.1% [1]. via GIPHY This comes after a period of rapid growth of these educational resources in the late 2000's [2], with expectations that new sites would continue to come online. It is unclear when the combined number of EM/CC blogs [+]
How I Educate Series: Molly Estes, MD
This week's How I Educate post features Dr. Molly Estes, the Clerkship Director and Medical Education Fellowship Director at Loma Linda University. Dr. Estes spends approximately 80% of her shifts with learners which include emergency medicine residents, off-service residents, and medical students. She practices at a university hospital that is a level 1 trauma center, STEMI receiving center, and comprehensive stroke center. Below she shares with us her approach to teaching learners on shift. Name 3 words that describe a teaching shift with you. Humorous, practical, stretching. What delivery methods do use when teaching on shift? Mostly verbal discussion, [+]
PEM POCUS Series: Pediatric Focused Assessment with Sonography for Trauma (FAST)
Read this tutorial on the use of point of care ultrasonography (POCUS) for Pediatric Focused Assessment with Sonography for Trauma. Then test your skills on the ALiEMU course page to receive your PEM POCUS badge worth 2 hours of ALiEMU course credit. Take the ALiEMU PEM POCUS: Pediatric FAST Quiz Module Goals Summarize the indications and role of the FAST in the evaluation of injured children Describe the technique for performing the pediatric FAST Identify anatomical views and landmarks necessary for a complete pediatric FAST Accurately interpret each pediatric FAST anatomic view and corresponding landmarks [+]