How I Educate: Graham Snyder, MD
This week’s How I Educate post features Dr. Graham Snyder, the Associate Program Director at the University of North Carolina and Director of Education for WakeMed Health and Hospitals. Dr. Snyder spends approximately 90% of his shifts with learners which include emergency medicine residents, off-service residents, and medical students. He describes his practice environment as a Level 1 trauma center that sees 125,000 patients annually. Below he shares with us his approach to teaching learners on shift. Name 3 words that describe a teaching shift with you. Practically Academic, Comradery, Rejuvenating What delivery methods do use when teaching on [+]
SAEM Clinical Images Series: Breast Swelling
A female in her 50s with a past medical history of coronary artery disease, pacemaker placement, hypertension, and ESRD presented to the emergency department with the chief complaint of missed dialysis, breast engorgement, and an increase in vascularity in her chest and abdomen. The patient reported an increase in breast swelling and increased vascularity in her belly over the past three months. Additionally, she woke up short of breath on the morning of presentation and reported dyspnea at rest. She denied chest pain, diaphoresis, breast pain, fever, rash, trauma to the breasts, or drainage. [+]
ALiEM AIR Series | CVA 2022 Module
Welcome to the AIR CVA Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to CVA emergencies in the Emergency Department. 7 blog posts met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 2 AIR and 5 Honorable Mentions. We recommend programs give 4 hours (about 30 minutes per article) of III credit for this module. AIR Stamp of Approval and Honorable Mentions In an effort to [+]
How I Educate Series: Guy Carmelli, MD
This week's How I Educate post features Dr. Guy Carmelli, who is an Assistant Professor at UMass Medical School and co-leader of their EM Sub-I rotation. Dr. Carmelli spends approximately 80% of his shifts with learners which include emergency medicine residents, off-service residents, and medical students. He describes his practice environment as a tertiary care academic center with trauma, stroke, and cardiac cath capabilities. Below he shares with us his approach to teaching learners on shift. Name 3 words that describe a teaching shift with you. Enthusiasm, excitement, and engagement What delivery methods do use when teaching on shift? [+]
SAEM Clinical Images Series: Localized Weakness
A 69-year-old Caucasian female with a past medical history of seizures, cerebral vascular accident, and Parkinson’s disease presents by EMS for evaluation of a 30-minute episode of left upper and lower extremity weakness and left facial drooping. The patient complains of a right-sided “migraine-type” headache similar to that experienced with her prior stroke. Vitals: Temp 36.5°C; BP 186/74; P 74; RR 18; O2 Sat 95% General: Alert; no acute distress Skin: Warm; dry; dark red discoloration localized to the left side of face, neck, chest, and upper extremity HEENT: Normocephalic; left-sided facial [+]
How I Educate Series: Moises Gallegos, MD
This week's How I Educate post features Dr. Moises Gallegos, the Clerkship Director at Stanford University. Dr. Gallegos spends approximately 75% of his shifts with learners which include emergency medicine residents, off-service residents, medical students, and physician assistant students. He describes his practice environment as an academic Emergency Department at a medical research institution that serves as a Level 1 Trauma facility. Below he shares with us his approach to teaching learners on shift. Name 3 words that describe a teaching shift with you. Collaborative, Safe, Growth-oriented What delivery methods do use when teaching on shift? My teaching approaches [+]
Suboxone and the Emergency Physician: Get Waivered Training
Clinical scenario: A 56-year-old male with a past medical history of opioid use disorder presents to the emergency department with acute on chronic right lower flank pain. The patient states the pain was exacerbated while shoveling snow over the weekend and worsens with movement. He feels nauseous but denies any chest pain, shortness of breath, vomiting, abdominal pain, or pain with urination. He denies any history of kidney stones, recent surgeries, and recent injuries. He does not smoke cigarettes, but does drink alcohol almost daily. His pain actually first started 2 months ago due to a work incident, for [+]
How I Educate Series: Fareen Zaver, MD
This week's How I Educate post features Dr. Fareen Zaver, the Deputy Head of Education in the Department of Emergency Medicine at the University of Calgary. Dr. Zaver spends approximately 30% of her shifts with learners at two tertiary care hospitals which include emergency medicine residents, off-service residents, and medical students. Below she shares with us her approach to teaching learners on shift. What is one thing (if nothing else) that you hope to instill in those you teach? Take the time to give proper and SIMPLE discharge instructions for every patient you see. No medical jargon, clear follow-up [+]
SAEM Clinical Images Series: Found Down
A 67-year-old caucasian male experiencing homelessness was “found down” in a parking lot. EMS reported that he had a GCS of 6 with a systolic blood pressure in the 80’s, finger stick glucose of 100, and no response to intranasal naloxone. He was intubated in the field and arrived to the emergency department unresponsive with a BP of 95/60, HR 125, T 38°C, and O2 Sat 100%. Hemodynamic stabilization was achieved with central venous access, and laboratory and imaging studies for the evaluation of altered mental status ensued. General: Disheveled male [+]
How I Educate Series: Michael Gisondi, MD
This week's How I Educate post features Dr. Michael Gisondi, the Vice Chair of Education at Stanford University. Dr. Gisondi spends approximately 80% of his shifts with learners which include emergency medicine residents, off-service residents, medical students, and physician assistant students. He describes his practice environment as a busy, high-acuity, university-based, suburban hospital with an annual ED census of 85,000. One-third of the patients speak a language other than English and one-third are without health insurance. Below he shares with us his approach to teaching learners on shift. Name 3 words that describe a teaching shift with you. Direct [+]