Intro 02: Secondary Survey

Here’s the second video, on how to perform a focused history and physical (using your differential diagnosis) and then assigning pretest probabilities and ordering diagnostic tests.More

Intro 01: Triage and Primary Survey

I didn’t like the way the first videos came out, so I re-recorded them differently here. In this one, you’ll follow a patient (me) who develops chest pain then makes the decision to come to the ER. After calling an ambulance, the patient is triaged (sorted) and then the doctor (you) assesses the primary survey…More

Neuro 01: Treatment of Status Epilepticus

This is a 12 minute review of the treatment of status epilepticus in the Emergency Department. I’m still playing with the format so feel free to tell me what you like and what you don’t like, what works and what doesn’t. Do you feel that this actually teaches you something? When we work together in…More

Inservice in the Breakroom: New ACLS Guidelines – Part 1

The American Heart Association released the 2010 Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) earlier this month. We can look at the different guidelines in subsequent posts, but this month, we’ll review the Executive Summary. The summary stresses the changes from prior recommendations. The most evident change is the stress put on…More

Inservice in the Break Room: Therapeutic Hypothermia

On the topic of critical care, I thought we could bring up the idea of therapeutic hypothermia after cardiac arrest. We’re talking about a patient who comes in with v-fib or v-tach arrest (for less than 25-30 minutes) and is shocked, their rhythm is restored but they’re still not getting up. What to do? Cooling…More

Inservice in the Break Room

I’m going to try to resuscitate this blog to try to get some nursing-doctor educational-conversational action here. It is absolutely impossible to get all the nurses together for an in-service, and I always thought it was a futile task to gather those who are around with the overhead page “in-service in the break room” while…More

Inservice In The Break Room: Pressors

What do you do when presented with a hypotensive patient resistant to IV fluids? Maybe throw some steroids at ’em but more likely you start dopamine. This is our go-to drug of choice as a pressor. However recent literature has shown it to be falling out of favor (ie, septic shock). So what should we…More

Med Student Shadowing – Think Out Loud

Being a hospital associated with a medical school, we’re bound to have students interested in emergency medicine — even M1’s. Some of them may want to hang out with us in the ER to get a feel of what it’s like. I know what you’re thinking: They don’t know enough of anything to be helpful.…More

One Minute Teaching in the ER

We (doctors) are notoriously bad teachers, relying on pimping, lectures and just overloading the learners with information. Good teachers actively engage the learner, provide specific and immediate feedback (especially positive feedback), limit the content and are willing to admit ignorance. Adult learners prefer to learn concepts (not facts) and need to apply them quickly for…More

safe med practice: administration of IVPB meds

during the staff meeting, the question was raised on safe practice– some staffs were asking- re: how much flush is needed after IVPB meds/antibiotics was infused per heplock so patients receive 95-100% of their IVPB meds. ( that means, no other fluids are infusing per heplock except the antibiotics)— remember– they’re concerned that there should…More