Tactical Medicine News Blog

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this peer-reviewed case series, we focus on a real clinical case where bedside ultrasound changed the management or aided in the diagnosis. In this case, a 46-year-old woman presents with acute right-sided abdominal and flank pain.

Placing a peripheral IV under ultrasound guidance is often much more challenging than it outwardly appears, especially for novice users. One of the more difficult aspects is in making sure that the target vessel is perfectly in the middle of the screen and then guessing where that corresponds to the middle of the ultrasound probe.

Over the last 50 years, the rates of women graduating from medical school have increased leaps and bounds, from women representing 7% of US graduates in the 1960s to ~47% in the 2010s.1 The How I Work Smarter Series has had an appreciable yet still unbalanced number of women participants, with slightly more than 35% of posts from women leaders. However, in the top echelon of medicine, women are still dramatically under represented. According to AAMC, only 15% of department chairs are women.2 Dr. Deborah Diercks is one of these 15%. As the newly appointed Chair of UT Southwestern Emergency Department, she has not only taken on departmental leadership, but is also playing a key role in the creation of two entirely new hospitals whose emergency departments will be staffed by UT Southwestern. This is pretty much the definition of task overload, yet she still manages to publish regularly and completed her How I work Smarter entry faster than most. Impressive. She kindly took a moment to share a few pearls.

Although the title is ostensibly sinister, Darrell Huff’s “How to Lie with Statistics” is anything but. In medicine, we are faced with complicated statistics and “statisticulators” on a daily basis. And as the field of data science and statistics grows, so too does the complexity of these “statisticulations”. A statisticulation, defined by Huff, is “misinforming people with the use of statistical material” and, unfortunately, this is becoming all too common in the profit-driven world of medicine. With carefully crafted “non-inferiority” trials and overpowered industry-funded superiority trials cropping up in the literature, it would easy to give up on statistics altogether; but it’s imperative that we don’t. The key is harnessing the ability to identify the subtleties that statisticians use to misguide. As Huff eloquently states in his book, “The crooks already know these tricks; honest men [and women] must learn them in self-defense.”

Each year hundreds of residents apply to Pediatric Emergency Medicine (PEM) fellowships. There are multiple reasons that an EM resident might want to undertake a PEM fellowship, but over the last 15 years, fewer Emergency Medicine (EM) residents are applying for PEM fellowships than Pediatric residents, unpublished data suggesting that Pediatric candidates now outnumber EM candidates 20 to 1. Recently, a group of PEM Fellowship Program Directors formed the “EM-to-PEM task force” of like-minded individuals desiring to promote PEM fellowships to EM residents. A PEM fellowship is an excellent career move for a resident who has a passion for the emergency care and advocacy of children. In this post, we will discuss and review benefits of EM residents undergoing a PEM fellowship.