Tactical Medicine News Blog

Dr. Resa Lewiss is Director of Point-of-Care Ultrasound and Visiting Professor of EM at Thomas Jefferson University in Philadelphia. An espresso aficionado, when she is not working in the department, she is often teaching ultrasound. Dr. Lewiss keeps herself centered with a list of “essentials.” Check these out and how she stays healthy in EM!

Welcome to season 5, episode 3 of the ALiEM Medical Education in Cases (MEdIC) series! Our team (Drs. Tamara McColl, Teresa Chan, John Eicken, Sarah Luckett-Gatopoulos, Eve Purdy, Alkarim Velji, and Brent Thoma) is pleased to welcome you to our online community of practice where we discuss the practice of academic medicine! This month, we present a case of a junior faculty member who is apprehensive about presenting at M&M Rounds after a recent “public shaming” of one of his fellow colleagues.

The Problem Early recognition of a patient presenting with a toxidrome is essential to providing high-quality emergency care. Learners are often first exposed to this topic, however, in one comprehensive grouping, which makes it challenging to learn the nuances that distinguish one toxidrome from another. Both learners and experienced clinicians alike often employ rote memorization (and sometimes suboptimal mnemonics) to differentiate these presentations. This can make it difficult to convert the details into long-term memory.

Background: Acute congestive heart failure (AHF) is a common complaint seen in the ED and associated with a high morbidity, mortality, cost, and resources.  Many patients with AHF, ultimately end up being admitted and interventions in the ED can make a huge difference in the outcomes of these patients.  The REALITY-AHF (Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure) was a prospective, multicenter, observational study with the primary goal of evaluating the door to furosemide time in the treatment of AHF and clinical outcomes.

Patient handoff at sign-out rounds is a high-risk period for clinical oversights and errors. The key to minimize this is to have a clear strategy. This means being precise yet concise, methodical, and forward-thinking in your presentation to the oncoming clinician and team. There are various tools like I-PASS1 to frame your script, but the following are 10 additional key tips to consider.