IDEA Series: Building a High Fidelity Biosimulation Task Trainer for Resuscitative Hysterotomy
The Problem The peri-mortem cesarean section, rebranded in recent years as the “Resuscitative Hysterotomy”, is a potentially lifesaving procedure for both a pregnant mother and her child. It is both daunting and infrequently performed, necessitating frequent review of indications, techniques, and pitfalls to ensure the best possible outcome for mother and baby. The decision to perform this procedure should be made only in pulseless women with a uterine fundus above the umbilicus, which indicates a gestation of >20 weeks.1,2 Prior studies suggest the procedure should be performed within 5 minutes of maternal cardiac arrest in order to maximize the probability of [+]
Ultrasound For The Win! – 57F with Chest Pain and Dyspnea #US4TW
Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where point-of-care ultrasound changed the management of a patient’s care or aided in the diagnosis. In this case, a 57-year-old woman presents with chest pain and dyspnea. [+]
John MacIsaac, BSc. Hons, MD Candidate (2019)
SplintER Series: Tibial Plateau Fractures | Leg Day #1
The SplintER series is back with a new sub-series – Leg Day! We will review lower extremity orthopedic injuries, introduce advanced concepts, and highlight ways to implement these into your next shift. In this post, we summarize the appropriate way to evaluate, diagnose, and manage tibial plateau fractures. This post is peer-reviewed by Dr. Kori Hudson, one of our expert sports medicine colleagues! Please read below for her commentary. [+]
TLDR Book Review: “make it stick: The Science of Successful Learning”
Bookstore shelves and Amazon lists are filled with self-help titles that promise to make you a better manager, a better parent, or a better fishmonger. But most of them suffer from the same weakness: 2 pages of good practical advice is padded with 298 pages of filler. Our new column TLDR (Too Long Didn’t Read) is a solution to what we call the McNugget Problem: trying to find the 5 bullet points of meaty goodness suspended within a mass of stale anecdotes, overcooked platitudes, and bad food analogies. Our TLDR goal is to find the critical take-aways in each book [+]
I am Dr. Cynthia Griffin, Flight Physician: How I Stay Healthy in EM
Dr. Cynthia Griffin is an emergency physician and flight physician from Madison, Wisconsin. Dr. Griffin believes that laughter is the best medicine. When she’s not conquering the ED or saving lives in the sky, she can be found spending time with her family and her adorable chocolate lab. Here’s how she stays healthy in EM! [+]
Replace dolutegravir (Tivicay) with raltegravir (Isentress) for post-exposure prophylaxis
Post-exposure prophylaxis (PEP) of patients who may have been exposed to HIV includes a combination HIV nucleoside analog reverse transcriptase inhibitor emtricitabine/tenofovir (Truvada) plus an integrase inhibitor. The CDC initially recommended the integrase inhibitor dolutegravir (Tivicay). However on May 18, 2018, the CDC placed an alert about the neural tube defect risk with dolutegravir.1 How does this change our ED practice? The evidence Based on an interim analysis in an ongoing safety of dolutegraivir, the U.S. Health and Human Services announced: The concern stems from a preliminary unscheduled analysis of an ongoing NIH-funded birth surveillance study in Botswana, which has reported [+]
From One Medical Student to Another: 5 Tips for Research Success
One of the most challenging aspects of medical school is the sheer volume of information that must be absorbed in a short period. This can pose a problem for those interested in developing research skills and pursuing an independent project. As colleagues, we know that our inherent curiosity is satisfied by discovering new information as much as it is by learning clinical content. We believe that it is important to showcase our hard work through a formal research project, but there are systematic barriers to finding a research mentor and team. Although there are many resources to guide you on [+]
ALiEMU AIR Peripheral Vascular Disease Module
Welcome to the Peripheral Vascular Disease (PVD) 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 PVD emergencies. 2 blog posts within the past 12 months (as of May 2018) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 0 AIR and 2 Honorable Mentions. We recommend programs give 1 hour (about 30 minutes per article) of III credit for this module. [+]
Approaching Wellness in the ED: A Conversation with Wellness Expert Dr. Shahina Braganza
The Wellness Think Tank created a podcast with wellness expert Dr. Shahina Braganza from the Gold Coast in Australia. Facilitated by Dr. Annahieta “AK” Kalantari and joined by EM residents Dr. Alecia Gende and Dr. Adrienne Taren, the conversation covers a broad range of topics including the concepts behind Emotional Contagion, Dr. Braganza’s published “oneED” program1, and the challenges of adopting wellness initiatives in the ED. We present the podcast and highlights below. [+]
MEdIC Series: The Case of the Medication Mishap – Expert Review and Curated Community Commentary
Our last case of season 5, The Case of the Medication Mishap, presented the scenario of a senior resident, Tim, who inadvertently administers an incorrect medication dose that leads to a serious adverse event. He then struggles with how to handle this situation as we often aren’t coached on the approach to physician errors and disclosing adverse events throughout our medical training. Physicians aren’t allowed to make mistakes, right? If you haven’t had a chance yet, we urge you to check out the case and share your thoughts on this important topic! The MEdIC team (Drs. Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, [+]