Trick of the Trade: Save the Ultrasound Probe Cable

You need to perform an ultrasound on your patient. You walk up to the ultrasound and upon grabbing the machine, you notice it’s stuck! You look down and realize the ultrasound probe cable (particularly the linear probe) is impeding the wheel from rolling. You push the machine back, pick the cable up off the floor and off you go to scan to find that the probe is not working. As you try to figure out why it’s not working, you realize that the cable is exposed after repeated damage from the countless times the wheels on the machine rolled over the cable. Let’s prevent this from happening!

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2019-09-28T08:29:44-07:00

SAEM Clinical Image Series: Seeing Stars

Seeing Stars asteroid hyalosis

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Chief complaint: Left eye pain, redness, and foreign body sensation

History of Present Illness: 39 year old man presents after metal grinding without protective eyewear three days prior.

He had felt something strike his left eye. He developed “burning” pain, tearing, and redness. Pain worsens with extraocular movements. He notes that vision in his right eye has always been worse than the left. Denies any other visual complaints.

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2019-09-27T21:17:56-07:00

Beyond the Abstract | Resident Motivations and Experiences in Listening to Educational Podcasts

Podcasts are all the rage these days, and it is not surprising that some residents spend more time with podcasts than any other educational resource.​1–3​ But why? And how do podcasts fit with other forms of learning, like lectures, textbooks, and clinical teaching?

In our recent article published in Academic Medicine, we explored these questions. Using qualitative interviews and analysis, we identified 3 overarching themes that shed light on residents’ podcast listening behaviors and the tensions with which listeners wrestled.​4​

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2019-09-26T11:31:25-07:00

SAEM Clinical Image Series: A Page Turner

Gray Turner's sign

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Chief complaint: Abdominal pain

History of Present Illness: A 36-year-old male with a history of alcohol abuse, hypertension, hyperlipidemia, and myocardial infarction with a subsequent stent on ticagrelor and aspirin presents with abdominal pain.

He reports 3 days of epigastric and periumbilical pain and multiple episodes of non-bloody, non-bilious emesis. He denies fever, diarrhea, blood in his stool, and urinary symptoms. He endorses bruising to his bilateral flanks and multiple falls recently while drinking.

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2019-09-23T09:58:06-07:00

SAEM Clinical Image Series: Left Shoulder Pain

Left shoulder pain

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Chief complaint: Arm pain

History of Present Illness: A 30-year-old obese male presents to the ED after a ground level fall onto his left arm with immediate isolated left shoulder pain. He did not lose consciousness and denies dyspnea, numbness, weakness, vomiting, and chest pain.

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2019-09-23T09:58:20-07:00

Techniques for Ultrasound-Guided IV Placement

Y junction access

Imagine a busy evening shift interrupted by the news that the unstable dialysis patient still has no access. Begrudgingly, you drag the ultrasound into the patient’s room. Buried beneath a layer of muscle, a tiny vein lurks below an intimidating artery with a nerve nestled close by. Making matters worse, the patient is becoming increasingly more frustrated. “This always happens. I told them not to remove my last PICC line,” he notes. The use of ultrasound-guided IV improves successful cannulation and decreases complications, but cases like this have caused many emergency providers to resent, even fear, this basic procedure.​1–4​ Below, we provide additional techniques to increase your success and to avoid the risks associated with central line placement.

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2019-09-19T17:39:55-07:00