A great refresher to get you thinking how you assess patients with mental health problems in the ED. This is core Emergency Medicine, but reviews like this encourage reflection, highlighting where we could improve.
This is a great review of the management of Neuro-trauma from EM Docs and is well worth reading if you involved in any multi-trauma patient.
Check out the blog here
About EM Docs:
We are a group of seven emergency physicians who want to provide a truly current resource for the rapidly developing field of emergency medicine. We subscribe to the free, open-access medical education initiative, and our goal is to inform the global EM community with timely and high yield content about what providers like YOU are seeing and doing everyday in your local ED.
It's really easy, we just need to remember to wash our hands, how hard can it be....?
Yet we really don't do it as often as we should. Chris Nickson looks at why, and why we should.
This next bit is lifted from the SMACC website:
Hand hygiene is widely regarded as the bedrock for the prevention of healthcare associated infections (HAIs). HAIs are among the biggest killers in modern medicine. Yet, hand hygiene compliance among healthcare workers remains woefully poor.
Why can’t we learn the lessons that Semmelweis taught us nearly 150 years ago? If we can’t teach intelligent healthcare workers to wash their hands properly, what hope do we have as medical educators? This is both a patient safety and a medical education priority. Our patients’ lives are at risk and they deserve better.
So, how can we change our patient’s microbiological cultures? By changing our culture.
The power, it seems, is in our hands
For Feb 2017, a NEW....New in EM!
Great new format from the @RCEMFOAMed's Andy Neill and Dave McCreary. Looking at sternal fractures in the era of pan scans, Ketorolac, thromboprophylaxis in lower limb injury and GTN bolus for heart failure.
The new format is in preparation for a re-organised once per month podcast with multiple segments..... watch THIS space!
Great discussion on how Rudeness has developed in Medicine.
Suggested Vision Statement for everyone working in the ED from Scott:
- Be Polite
- Be Kind
- Be Open Minded
- Be Communicative
- Be Non-Accustory – errors should be looked at as an opportunity to discuss, learn, and make things better in the future.
Great Blog from BMJ: http://blogs.bmj.com/emj/2016/12/07/what-do-emergency-medicine-and-donald-j-trump-have-in-common/
Theres not a lot of #FOAMed Obs & Gynae out there in the blogosphere and even rarer still are #FOAM4GP. So I wanted to highlight this great resource from a GP Obstetrician and GP in Australia.
Authors Dr Penny Wilson and Dr Marlene Pearce produce podcasts on Obs and Gynae topics relevant to GP and EM.
Take Home Messages: (from bitsandbumps.org)
- Acute Menorrhagia can be severe enough to create haemodynamic instability, assess for shock first.
- Always perform a B-hCG to exclude pregnancy/miscarriage
- Be sure to exclude a pelvic infection in your work-up
- Consider inherited platelet dysfunction or coagulopathies in the adolescent with new menorrhagia
- Consider endometrial hyperplasia or cancer in the woman over 35
- Medical management may include NSAIDs, high-dose Progesterone, Tranexamic Acid
- Surgical management may include Dilation & Curettage
References & Resources:
Adolescent Gynaecology – Menorrhagia Clinical Practice Guidelines, Royal Children’s Hospital Melbourne (Australia)
Menorrhagia (PDF) Australian Doctor Magazine ‘How To Treat’ (2009)
Heavy Menstrual Bleeding NICE Guideline UK (2007, updated 2013)
Always wondered what actually happens when you ask for a bedside AAA rule out? Or maybe it's just a bit of revision, either way this video from EM RAP is a great quality summary of what is becoming a core EM skill.
When branching out from the basics of bedside ultrasound having a standardised approach helps improve your technique and train your brain to recognise abnormalities in the images you see.
There are standardised approaches developed by ITU docs for thoracic scanning but these are comprehensive assessments rather than the focused imaging designed to answer a specific clinical question.
BelowJacob Avila of Ultrasound Podcast and 5minSono shares his approach for ED Thoracic US, which seems like a good place to start.
Go to his wesbite for loads of other good teaching on ED US: 5minsono.com
Heres some other great Thoracic US videos for you to get your eye in.... then give it a try!
Lets be honest; keeping up with the latest literature isn't easy.
However having your ear to the floor for the latest developments in Emergency Medicine does make you realise that 'current practice' is really just a snap-shot of an ever evolving field and theres always more than one way of doing things.
Check out the following websites which do the hard work for you, highlighting and reviewing recent evidence and developments in blog and podcast format.
1) New in EM: Monthly literature summaries from the RCEM FOAMed Team. Podcasts & written summaries. COI: I sometimes contribute my tuppenceworth....
2) The Resus Room: Monthly Podcasts and blogs on recent evidence and guidelines. Also features a very handy journal scan each month.
3) First 10 EM: Articles of the month discussed.....monthly. Blog format with a accompanying podcast on Broome Docs.
4) R&R Life in the Fast Lane: One of the original and best summaries out there. Blog.
Finally if you're keen to get abstracts delivered fresh to your email and filter them yourself then read this blog from the crew at St Emlyns on how to 'Drink from the Firehose'.
Got any others? Add them to the comments!
Great summary of some of the basics from don't forget the bubbles (DFTB) which generally focuses on Paediatric Emergency Medicine.
Check out the two Blogs:
AND.... while we're here, if it turns out to be a sprain, don't forget to consider them for the SALI study!
ITS BACK! Anatomy for Emergency Medicine vodcasts by Andy Neill from Emergencymedicineireland.com are classic #FOAMed.
These podcasts are great whether revising or brushing up on core knowledge that had been pushed out by thinking about thoracotomy to much......
CRACKcast (Core Rosens And Clinical Knowledge) aims to cover basic and core knowledge for EM. 'Pain'stakingly.......going over every inch of the Rosen's EM text book.
More obviously suitable for those starting in EM, however we 'never stop learning'.....In my case its more like 'never stop forgetting'....so its always good to refresh my core knowledge!
Check out the website and other chapters at CanadiEM and subscribe to the podcasts.
This is a great PEM induction video from the #EM3 team in the East Midlands (inc Damian Roland). Its got some great clips of clinical signs you will need to recognise in unwell children.
Some of the pattern recognition we learn in adult practice doesn't quite work as well in children. Using a structured approach if it isn't immediately apparent whats going on can help you pick your way around some of the common pitfalls. They suggest the nice traffic light system in this video.
For more excellent PEM hints and tips check out links like this:
Pre-hospital Amputation thankfully doesn't happen very often. When it does there isn't likely to be time to google it....
Thinking the procedure through and getting to know the equipment is essential to keeping a cool head when the adrenaline is pumping.
PHEMCast have put together a great podcast which can guide you through the procedure and get you started.
Check out the website for other PHEM podcasts or subscribe on your podcast manager.
'Sydney HEMS' is the Pre-Hospital and Retrieval Team for the New South Wales Ambulance Service. Members of the team: Cliff Reid, Karel Habig and Geoff Healy have got together to produce some great introductory podcasts. Although aimed at those starting in PHEM, I found listening to three well respected experts discussing some of the basics in their speciality a really valuable experience.
Easiest way to listen is to subscribe through iTunes or plug:
into the 'add URL' option on a podcast manager.
You could also just download from the Website: https://sydneyhems.com/category/podcasts/
As ever the Masters of #FOAMed Ultrasound make it look easy!
In our ED we still need to follow our local protocol, but the evidence discussed in these podcasts suggests things may change, especially in younger patients, and US may be the first line investigation.
No harm in trying to predict what the CT KUB will show and getting your eye in!
Another great summary of recent papers by the team at HEFTEMcast.
From ABCD2 Scores (are they actually useful?) through to surgical airways with a biro....
Check it out here: Papers of June Podcast Summary