Tactical Medicine News Blog

Beyond ACLS: Cognitively Offloading During a Cardiac Arrest

Posted by Marco Torres on

The focus of this talk is on how to cognitively offload our minds as we are running a resuscitation. ACLS provides us with a framework in treating adult victims of Cardiac Arrest (CA) or other cardiopulmonary emergencies. This helps get providers who don’t commonly deal with CA, to improve things, such as the quality of CPR, minimizing interruptions during CPR for pulse checks, and the timing/dosing of epinephrine. Emergency Medicine (EM) and the prehospital world are different than many environments in medicine. We get minimal information at the time of patient arrival while at the same time the disease process that is taking place has not quite defined itself.  We are constantly expected to acutely manage and resuscitate anyone who comes in our doors 24-7-365, many times without crucial information. Our job therefore should be to ensure coronary and cerebral perfusion are at their highest quality, but also simultaneously putting the pieces of the puzzle together to figure out why our patient is in CA. It can be very difficult to do both and many times we sacrifice one for the other. It is therefore important to cognitively offload ourselves during the resuscitation of our patients in CA and focus our attention on why they are in CA. As a disclosure for this lecture I did state that some of the recommendations made have evidence to support them and others are more theoretical and certainly up for discussion.

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PEM Pearls: Perfecting your pediatric lumbar puncture using ultrasound

Posted by Ashley Foster, MD on

A lumbar  puncture (LP) is a common procedure that every emergency physician must master. Pediatric LPs can be challenging for even the most experienced clinician due to small anatomy, difficulty with patient cooperation, and lack of frequency performed. A successful procedure is defined by obtaining cerebrospinal fluid and/or performing a non-traumatic lumbar puncture. There are multiple variables that lead to a successful pediatric lumbar puncture including provider experience, use of anesthesia, and patient positioning. Success rates for pediatric lumbar punctures are variable, with a large range from 34%-75%.1

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10 Tips to Become a Successful Interviewer: Do’s and Don’ts

Posted by Meg Pusateri, MD on

As fall approaches, senior medical students and Emergency Medicine (EM) residency programs alike are beginning to prepare for the upcoming interview season. As part of the process, many programs have current residents interview potential candidates – their future colleagues! For most residents, though they have often been the interviewee, this is the first time they have filled the role of the interviewer. Among all the busy shifts and learning everything you need to know to be an amazing EM physician, there is little time for practice or formal training. To help, we have compiled our top “10 Tips to Become a Successful Interviewer.” Here’s to making this interview season the best one yet!

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EM Cases Course 2017 Speakers Confirmed!

Posted by Anton Helman on

Announcing the speaker line-up for the 2nd annual EM Cases Course on February 4th, 2017! After getting feedback from our sold out course in 2016 we have a superlative line up in store for you, with more simulation, live podcasts, small group workshops, prizes and fun learning. The post EM Cases Course 2017 Speakers Confirmed! appeared first on Emergency Medicine Cases.

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BEEM Cases 3 – Acute Respiratory Failure: NIPPV & POCUS

Posted by Anton Helman on

Shortness of breath is a very common chief complaint in the emergency department, but despite our familiarity with this symptom, management is not always straightforward. The differential diagnosis is extensive, including the common cardiorespiratory conditions, but extending to toxicologic, hematologic, neuromuscular, metabolic, and psychiatric causes. Over the past decade, we have seen the widespread adoption of new technologies to help us manage these patients. This post will look at some new evidence on two of those technologies: noninvasive positive pressure ventilation (NIPPV) and ultrasound (POCUS). We will answer 3 questions based on 3 systematic reviews using the BEEM critical appraisal framework... The post BEEM Cases 3 – Acute Respiratory Failure: NIPPV & POCUS appeared first on Emergency Medicine Cases.

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