π day & RPN Calculator.app

March 14th, or π-day, this year takes on additional numerical significance. Only once in a hundred years we are able to celebrate π to its billionth decimal place.

3.141592653

3/14/15 9:26:53

I wonder if Galileo Galilei geeked out on 3/14/1592 6:53:59.

In other mathematically geeky news, while doing several calculations on my Mac I was longing for my old HP scientific calculator with reverse polish notation. Looking through the Mac app store at all the emulators, I decided to see if the built-in calculator app had this feature. And guess what it does.

calculator_app

In the View menu, you can select “RPN mode” and now you get a calculator with a stack visible 2 deep. I don’t know if this was possible in previous versions of OS X, but I love the geeks at Apple that made this happen.

Happy π-day. Now we wait for May the Fourth.

Odds vs Risk Ratios

Odds ratios and risk ratios always confused me. I never really understood the reason behind having an odds ratio. It is so unintuitive to me, even still.

There’s a great article from the Southern Medical Journal that explains it all! Watch the video then read the article.

Viera AJ. Odds ratios and risk ratios: what’s the difference and why does it matter? South Med J. 2008 Jul;101(7):730-4. PMID: 18580722

Instructional Scaffolding in the Pre-Brief

  • students walked into the sim lab like wide-eyed deer in the headlights
    • their performance pretty much mirrored that analogy
    • did they learn anything just by being scared?
  • pre-briefs are defined as short sessions before the simulation
    • set expectations and roles (take this thing seriously)
    • familiarize students with equipment and debrief procedures
    • but teaching doesn’t usually happen here (or in the debrief for that matter)
  • simulation is often incorporated into the flipped classroom
    • watch a video (or read something) at home and then come to class to do simulation
  • we inserted a pre-brief using instructional scaffolding between the home module and the simulation session
    • students watch videos at home & complete a 1-page fill-in-the-blank worksheet
    • before simulation they learn their roles, expectations but also go through some mini-cases using that worksheet
    • then evaluated their performance on a checklist
    • their performance significantly improved on the checklist and their impressions of the sessions were better

Pulseless Arrest With Blanks

Outcomes

  • checklist
    • immediately (<10 seconds) started CPR upon determining patient is pulseless
    • initiated defibrillation upon observing a shockable rhythm
    • switched compressors every 2 minutes with brief (<10 seconds) pause in compressions
    • gave proper doses of vasopressors and anti-arrhythmic at the appropriate time
  • reflection
    • I feel confident in performing a resuscitation of a patient in pulseless arrest (strongly disagree…)
  • quiz
    • fill in the worksheet without a crutch
    • given scenarios, pick the next step

Systematic Reviews and Meta-Analyses

Systematic reviews sit atop the evidence-based medicine pyramid as the strongest form of evidence we have. This is so because it incorporates more data than individual studies. To avoid bias in making reviews, the authors need to follow a systematic process. In this video we look at this process the authors would follow and you should note when reading such reviews.

CORD 2014 – There’s an App For That (Paperless Edition)

CORD-Anniv-FinalLogoHello CDEM and CORD attendees. Each year for the past few years, a colleague and I have presented some of the most useful apps of the past year. This year, Jason Wagner (@TheTechDoc) and I have been asked to do the same.

Feedback from those previous sessions really focused around providing demonstrations rather than just a list and description of what applications we found useful. Respecting our time constraints, I’ve put some quick demonstrations of useful software below. I will be spending most of my time talking about screencasting software and principles, but I’m happy to discuss any thing (here or at the conference).

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The Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act, also known as the Affordable Care Act or ObamaCare, is the biggest change in health care policy since Medicare in 1965. Despite its importance, very few understand it. This is not surprising given its complexity. Popular news outlets and politicians (on both sides) capitalize on our ignorance by exaggerating, distorting or misrepresenting pieces of it. As health care providers and citizens, love it or hate it, we have a duty to understand it.

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Hyperglycemic Emergencies

Diabetics often present to the Emergency Room with high blood sugar. Sometimes it’s just high and nothing else is wrong. Lower the sugar and send them on their way. Sometimes this represents something more ominous. In the next two videos we review the hyperglycemic emergencies of diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome.

Active Shooter

Today, September 16, 2013, marks yet another day when a gunman opened fire upon civilians, killing unnecessarily. It seems that this is happening more frequently, and it would be foolish to think it is limited to schools, movie theaters and military compounds. As grim as it sounds, we should open the conversation as to what would we do? Is it possible to prepare. In this episode of EM:RAP, Ilene Claudius speaks with Mike Clumpner, paramedic, PhD, and active shooter expert. A lot of this seemed counter-intuitive to me.

Listen and feel free to comment below.

active_shooter