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3 09, 2018

Resuscitation of a Drowning Victim: A Review

2018-09-02T23:21:41+00:00

Drowning cases peak this time of year and represent a leading cause of mortality in children. For example, drowning represents the leading cause of death in boys ages 5-14 years old, and worldwide, there are 500,000 annual deaths from drowning.1 Hypoxic injury and subsequent respiratory failure represent the primary causes of morbidity and mortality. Although providers are typically taught to be aware of possible trauma (e.g. cervical spine fracture) when evaluating a drowning case, less than 0.5% of drownings are traumatic.2 The duration of immersion, volume of aspirated fluid, and water temperature dictate clinical outcomes.1 We review the presentation, pathophysiology, and management of drowning to raise awareness about this important public health issue.
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2 09, 2018

I am Dr. Craig Newgard, EM Physician and Researcher: How I Stay Healthy in EM

2018-09-02T01:22:18+00:00

Dr. Craig Newgard is an emergency physician from Portland, Oregon. When he is not in the ED, Dr. Newgard can be found on his mountain bike, conquering the unpredictable trails of his community. Although it can be challenging to incorporate a routine schedule into life as an emergency physician, he has found that it helps him achieve balance and avoid burnout. Here’s how he stays healthy in EM!
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30 08, 2018

ACMT Toxicology Visual Pearls: Toxic Mouth Pain

2018-11-01T22:48:32+00:00

betel nut mouthA middle-aged Asian female presents to the emergency department complaining of 2-3 days of mouth pain. She has chewed betel nut for a number of years. Which of the following is true regarding her presentation and management?

  1. Debridement should be avoided.
  2. Metronidazole is contraindicated due to the potential of a disulfiram-like reaction.
  3. Oral secretagogues should be used due to the anticholinergic effects.
  4. The patient is at increased risk of oral cancer.

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28 08, 2018

IDEA Series: Building a High Fidelity Biosimulation Task Trainer for Resuscitative Hysterotomy

The Problem

idea series teaching residents quality improvementThe 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 favorable maternal neurologic outcome and the secondary goal of fetal survival.3 Given the paucity of clinical exposure to this potentially-life saving intervention, resuscitative hysterotomy is an ideal candidate for simulation-mediated deliberate practice.

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27 08, 2018

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.

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23 08, 2018

SplintER Series: Tibial Plateau Fractures | Leg Day #1

2018-08-22T09:35:14+00:00

lipohemoarthrosis tibial plateau fracturesThe 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.

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21 08, 2018

TLDR Book Review: “make it stick: The Science of Successful Learning”

2018-08-20T20:13:14+00:00

make it stickBookstore 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 we review, and present them to you in a concise, easy-to-apply format. We read the books so you don’t have to!

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