Tactical Medicine News Blog

Welcome to the Second Neurology Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index the ALiEM AIR Team is proud to present the highest quality neurology content relating to headaches, seizures, and other neurologic emergencies. Below we have listed our selection of the 17 highest quality blog posts within the past 12 months (as of December 2015) related to neurologic emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 9 AIRs and 8 Honorable Mentions.

So this is the second installation of Advice to Graduating Residents. Again, many 3rd year residents will be graduating in just a few short months and taking on their first jobs as attending physicians. I was lucky enough to sit down with the amazing Amal Mattu and pick his brain. He gave some valuable words of wisdom, which I will try and summarize in this post, but for the full advice, be sure to checkout the podcast.  

Welcome to season 3, episode 6 of the ALiEM Medical Education in Cases (MEdIC) series! Our team (Brent Thoma, Sarah Luckett-Gatopoulos, Tamara McColl, Eve Purdy, John Eicken, and Teresa Chan) is pleased to welcome you to our online community of practice where we discuss difficult medical education cases each month. As usual, the community discussion will be reviewed using qualitative research methods to produce a curated summary that will be combined with two expert responses to create a functional teaching resource. This month’s case takes us to a team on rounds. There is a rich history in medicine of questioning learners about the mundane, the weird, the esoteric, the wonderful and everything in between. At worst this approach is known as “pimping” and when done well it is known as the Socratic method. How can teachers question the team in a way that is supportive of learners? Similarly how can peers and near peers best support each other in these situations? We will have the discussion open for a whole two weeks before the expert commentaries are released!

Post Written By: Sam Ghali (Twitter: @EM_RESUS) In cardiac arrest care there has been a lot of focus over the years on limiting interruptions in chest compressions during CPR. In fact, this concept has become a major focus of the current AHA Guidelines. Why? Because we know interruptions are bad [1,2]. One particular aspect of CPR that has gotten a lot of attention in this regard is the peri-shock period. It has been well established that longer pre- and peri-shock pauses are independently associated with decreased chance of survival [3,4].

A 52-year old man presents via EMS with a chief complaint of “racing heartbeat” for one hour. He is placed on a cardiac monitor which shows a heart rate of 185, an ECG reveals supraventricular tachycardia (SVT), and his blood pressure is 143/95 mmHg. As you ask the nurse to procure 6 mg of adenosine, the patient’s eyes grow wide. “Please doc…” he pleads, “anything but that! Last time they gave that to me I thought I was gonna die!” You recently read about using calcium channel blockers (CCBs) for paroxysmal SVT (PSVT), but can’t recall the last time you actually considered using them. After all, it’s been over 20 years since we switched to using adenosine first-line.