Tactical Medicine News Blog

For the CORD Distinguished Educator’s Coaching Program, Dr. Gus Garmel has kindly offered to share his top 50 points to improve one’s speaking skills. These tips are great for anyone who plans to do public speaking. Thus far, this “be a great speaker” series has reviewed 20 pearls.

Case Synopsis17 yo girl, 24 weeks pregnant, is brought to the ED with an overbearing, controlling, and older boyfriend (BF). The chief complaint is abdominal discomfort and vaginal spotting. The patient is initially reluctant and quiet, but then gets hysterical as the case progresses. Upon questioning, the patient admits that she took cocaine prior to arrival to induce an abortion, because her BF is married and does not want her to keep the baby.

One of my interests is medical simulation and the writing of simulation cases. I have already written two related posts: Case Writing and Story Board Writing. I believe that simulation is a wonderful modality to engage learners, teach critical EM concepts, and keep the patients safe.

Every year there are 6 million visits to the Emergency Department (ED) for chest pain, and approximately 2 million hospital admissions each year.1 This is approximately about 10% of ED visits and 25% of hospital admissions with 85% of these admissions receiving a diagnosis of a non-ischemic etiology to their chest pain (CP).2 This over triage has enormous economic implications for the US health care system estimated at $8 billion in annual costs.

Venous thromboembolism (VTE) is often treated with low molecular weight heparins (LMWH) such as enoxaparin. For patients with normal renal function, dosing is as follows: Enoxaparin: 1 mg/kg subcutaneously every 12 hours, or 1.5 mg/kg every 24 hours Dalteparin 200 IU/kg subcutaneously once daily Tinzaparin: 175 IU/kg subcutaneously once daily What about the obese patient? Is there a maximum dose for enoxaparin?