We need to get better taking care of out patients. One of the easiest ways to get better is to work both sides of the emergency medicine realm. The main divide rests in the prehospital environment versus the emergency department. We can still see this in the rural versus urban environment. Our experiences in different realms can make us much better providers.
Today is a brief podcast about leaving theivory tower. As a PA or physician, we have to train at such a place but with time we will leave. Not all nurses, paramedics, or others in such settings will ever see the "ivory tower" and may have their education only in rural environments or at least not at a tertiary care center. The challenge for us becomes not only getting the medical knowledge, but also how to spread it.
Today’s podcast is a little brief but covers and important topic: blood draws and patient’s rights. This comes up due to a recent incident in Salt Lake City at University Hospital when a detective of the Salt Lake City Police Department arrested Alex Wubbels, a nurse there, when the officer attempted to collect blood for testing from an unconscious patient.
“Everyone has a plan until they get punched in the mouth.” – Mike Tyson
Mental preparedness is not taught to us in emergency medicine or in healthcare generally, but it is something we are all doing to a degree. However, we need to improve our abilities and expand on them to do our jobs better. There are many approaches and everyone has their own style, but we will go over some approaches today to help improve your shifts and hopefully lead to you being a better clinician.
Everyone talks about airway all the time, and I was at first reluctant to give this talk. However, I believe it is time to talk about this important subject in a slightly different way. The last time we talked about airway management in regards to intubation was with Kris Maday (from the PAINE Podcast) in Podcast #18 where we went over the basics (a great review to listen to first if needed). There we talked mostly about rapid sequence intubation (RSI). Although commonly used, this is not for every patient. Today, we talk about RTI, which is what we need in most patients.
No matter what aspect of emergency medicine you work in (EMS, fast track, main ED, rural, remote, urban, suburban, or whatever else), you need to be a resuscitationist in my book. This is entirely my opinion, but I believe it is important one worth your time in both reading and listening.
Envision a busy night shift. It is three in the morning and somehow you still have a waiting room full of people waiting to be seen in your small ED that is hours away by ground to tertiary care. Scattered thunderstorms and overwhelmed emergency services have made it difficult to transfer out patients. You would swear it was a full moon, but when you were outside just to get a quick breath of fresh air from all the chaos you look up and it is not. Suddenly, you hear sirens in the distance and EMS reports are all coming in at once...
Tranexamic acid (TXA) is an old drug, but one that we in emergency medicine have found love for once again. In preparation for an upcoming talk at a conference, I realized I had not yet made a post regarding TXA. This is a quick summary of TXA and links to a lot of great #FOAMed resources out there you can also check out regarding the same. I have also included one bit that I have recently found very successful but with little evidence currently. Listen to the podcast for more!
After Podcast #44 regarding how to incorporate change, our friend Patrick Bafuma reached out to provide his thoughts on how to make change happen in your department. He has championed the process and has pearls that are well worth the listen.
We are having a special episode to add to what we did with Salim Rezaie on REBEL Cast recently as a guest. While we were there, we talked a lot about the TOAST trial and reviewed our own clinical use of dexamethasone. It is definitely worth your time to visit his page and listen to that podcast. However, we wanted to add our own little supplement to the #FOAMed world by adding a detailed analysis of the paper in true BEEM fashion. Please check all of this out for a more thorough understanding of the topic.
We have talked about abscess management before both here (Podcast #13) and on the Skeptics' Guide to Emergency Medicine (Podcasts #156 and #164). Even though we have talked about using antibiotics before, there has been debate on its use in smaller abscesses. Today, we cover how antibiotics are still beneficial even for the small ones given the most recent evidence out there. Listen to podcast and read this blog for all the details as we cover different points in each.