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31 01, 2019

Trick of the Trade: Bubble Study for Confirmation of Central Line Placement

2019-01-31T13:41:52+00:00
Ultrasound Needle

The safe placement a central venous catheter (CVC) remains an important part of caring for critically ill patients.1 Over 5 million CVCs are placed each year in the United States. It is crucial to confirm that the central line is placed in the correct position in order to rule out potential complications of the procedure (e.g. pneumothorax) and begin administration of life-saving medications. Post-procedure chest radiographs (CXR) are the standard of care for CVC placements above the diaphragm. However, the annual cost to the U.S. healthcare system for CXRs after CVC placement is estimated to be over $500 million.2 Further, in a busy ED, the limited availability of portable radiography may pose a considerable time delay. Radiography may also be limited in resource‐poor and austere settings, particularly the prehospital and military environments. We review a faster, cheaper, and more accurate alternative for evaluating CVC placement: point of care ultrasound (POCUS).

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28 01, 2019

Influenza Update: IDSA 2018 Guidelines Reviewed

2019-01-29T19:56:42+00:00
influenza

Symptomatic influenza A and B infections cause worldwide morbidity and mortality every year. Annual vaccination remains the greatest prophylactic measure, but the vaccine is not 100% effective due to mismatch between the circulating and vaccine virus strains. Although most individuals will recover from influenza without incident, some specific patient populations are at high risk for severe complications. The Infectious Disease Society of America (IDSA) recently updated their clinical practice guidelines.1 We review these key updates, including recommendations on who to test, treat, and provide chemoprophylaxis.

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23 01, 2019

Significance of a traumatic pneumothorax or hemothorax found only on CT imaging

2019-01-28T21:30:43+00:00

Pneumothorax CTA 32 year old woman arrives in your emergency department after being in a motor vehicle collision where she was the seat-belted driver. She undergoes chest CT imaging despite a negative chest x-ray because of her ongoing anterior chest wall diffuse tenderness. You discover a small 10% pneumothorax (PTX), but no other associated thoracic injuries. Should you place a tube thoracostomy (chest tube)? Should this patient be admitted to the hospital? A 2019 Annals of Emergency Medicine paper by the NEXUS Chest research group tackles these questions.1

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19 01, 2019

IDEA Series-JETem Innovation: A Low Cost Escharotomy Simulation Model for Residency Education

2019-01-15T18:38:16+00:00

The Problem

idea series teaching residents quality improvementEmergency Medicine (EM) residents are expected to be familiar with and competent in performing a wide number of procedures, including rare ones such as performing an escharotomy in a patient with severe burns. Unfortunately, there is a paucity of readily available simulation models to facilitate practice of this rare yet potentially life-saving skill.

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17 01, 2019

SAEM Research Learning Series: How to Turn Your Interest into Research

2019-01-10T18:48:02+00:00

SAEM research learning series

In this podcast episode of the SAEM Research Learning Series, Drs. Mary and Nate Haas interview Zackary Meisel, MD, MPH, MSHP from University of Pennsylvania (research bio). In this episode, Zack shares practical advice, framed by his own personal path to building a successful research career. Listen to how he evolved from originally being a prehospital researcher to carving a unique niche in research on evidence-based narratives.

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16 01, 2019

Post It Pearls initiative is moving from Twitter to Instagram

2019-01-28T21:30:24+00:00

Post It Pearls on InstagramMy 2017 new year’s resolution was to create brief educational pearls on shift called Post It Pearls, which I published to Twitter. I have increasingly noticed that many of my target learners are not on Twitter. They are, however, on Instagram. So this year’s resolution is to test out how whether Post It Pearls would reach more learners and thus be more impactful on my Instagram account (@MichelleLinMD).

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