Tactical Medicine News Blog

Background: CT scans are frequently done after minor head injury to evaluate for intracranial hemorrhage. While CT scans are an excellent tool for diagnosing or ruling out this disorder, they are not without harms including radiation exposure, cost and department delays. Much of the time, CTs are negative, or find injuries for which no intervention is ever done and do not clinically affect the patient. Clinical Decision Instruments may aid clinicians in determining which patients are higher risk and require imaging and which do not.

Although we would never wish negative thoughts to those who are applying for residency slot in an emergency medicine program this year, it is also important to be completely honest with yourself. Given your application packet and interviews, how likely is that you won’t match and have to enter the post-match Supplement Offer and Acceptance Program (SOAP)? What is the SOAP? This EM Match Advice installment provides advice about the experience of NOT matching and the next steps.

Dr. Ambrose Wong (@ambrosehwong) is a healthcare simulation educator and researcher, with a passion for teamwork and collaboration across professions and disciplines. He grew up in Vancouver, Canada and moved to the United States for medical school and residency, but now calls New England his home. He recently completed his simulation fellowship at NYU School of Medicine, and joined the brand new state-of-the-art Yale Center for Medical Simulation as a budding educational researcher. Wellness is especially important as a junior faculty member, and he’s excited to share his experiences. Here’s how he stays healthy in EM!

“Our life revolves around Chernobyl. Where were you when it happened, how far from the reactor did you live? What did you see? Who died? Who left? Where did they go? I remember in the first months the night life started buzzing again – “you only live once,” “if we’re going to die, let’s do it to music.” The soldiers came and the officers came. But now Chernobyl is with us every day. No matter what happens, everyone says: Chernobyl. pg 116

  The Ontario Prehospital Advanced Life Support (OPALS) Study Background: Sudden cardiac arrest is common and, obviously, very bad. In the US, there are about 500,000 cardiac arrests each year. About half of these cardiac arrests are OHCA and the survival rate is pretty poor. The most recent survival estimates put it at 7 – 9.5% in most communities. About 10-12 years ago, the American Heart Association built the 4-step “chain-of-survival.” Step One – Early access to emergency care Step Two – Early CPR Step Three – Early defibrillation There is little debate about these three steps as the sum of the data supports that they lead to better outcomes. The 4th step in the chain, however, is slightly more controversial; early advanced care. This basically means rapid access to ACLS type resuscitation skills (intubation and intravenous drug therapy). Despite it being the 4th step, ACLS has little evidence to defend it.