Archive for category Drugs and Treatments
What The Heck Is Your Private Blog Like?
Posted by Graham Walker, MD in Apps, Drugs and Treatments, ED Management, Information Technology, Residency, Tricks of the Trade on June 9th, 2010
A video introduction. Sorry for the mumbling.
http://www.vimeo.com/12417068Would you like to know your Ranking?
Posted by Harvey Castro, MD in ACEP News, Apps, Drugs and Treatments, Informatics, Information Technology, Residency on May 8th, 2010
As an emergency medicine resident, I remember taking tests and wondering where I stood compared to my peers. I would review different materials and focus on areas that I did not feel strong in. As a resident, I took the Ohio Acep review course and took their 700 question CD and reviewed all the explanations. I later was able to review the quiz questions and make suggestions.
Interesting enough, I was able to create the iPhone, Ipod Touch, * iPad edition of the quiz question for Ohio Acep. The app was just released and should show up on the app store in the next 48hrs. The app allows users to take the test and review each answer. It allows the user to focus on the questions or course materials they need to work on by creating custom test. The app also allows users to “know their ranking”, the app will ask users for an alias and will upload their test scores on each section of the test and will give an overall rank based on the users that have already taken the test. The ranking will update every time someone takes the test and clicks on ranking. To see the current ranking of beta testers and updated ranking please click here. To download the app or to see screen shots of the app click here.
* on iPad you will be able to double the size of the screen but the images might be slightly distorted.
Below I have included more information about the app.
Description
Emergency Medicine Quiz Questions
On Sale for limited time, Price is 20% off.
Includes a new, 50-question pictorial review! Contains 700 review questions and referenced answers in an easy-to-use multiple choice format.
** “New Rankings feature, only users to see where they are ranked compared to their peers around the world. The app will rank each person based on subject and overall ranking depending on percent correct! Visit our website for more information.” **
The Emergency Medicine Review Course held annually by Ohio ACEP offers a comprehensive review for the physician preparing for the Qualifying examination, ConCert examination or continuous certification, or who simply desires an intensive review of emergency medicine. Attended by hundreds of physicians each year from across the country, this premier review course promotes high pass rates and receives high compliments.
Email us your feedback so we can make this app even better.
They have created this CD based on years of experience with preparing Emergency Medicine Physicians. The CD edition of this program retails for 100$ US Dollars.
The iPhone app is easy to use.
Topics include:
Administrative
C-Spine
Cardiology
Dermatology
EMS
Endocrine, Metabolic & Nutritional Disorders
ENT/Dental
Environmental
Gastrointestinal
Hand
Hematology
Infectious Disease
LifeLong Learning Self Assessment (LLSA)
Medicolegal
Neurology
OB/GYN
Oncology
Opthalmology
Orthopedics
Pharmacology
Pictorial Review
Psychiatry
Pulmonary
Renal
Rheumatology/Soft Tissues
Toxicology
Ultrasound
Urology
The next Vaccine rush
Posted by Harvey Castro, MD in ABEM, Disaster Response, Drugs and Treatments, Twitter, Uncategorized on March 1st, 2010
Texas A&M was recently given a 40 million dollar grant from the U.S. Department of Defense to develop vaccines from tobacco. What is amazing is that this 21 aces with 145,000-square-foot facility could produce a billion vaccines in a month. Clinical trials should begin late 2011. Dont worry about nicotine. The plants do not have any.
Fear and Loathing in D-Dimer
Posted by Graham Walker, MD in Drugs and Treatments on February 2nd, 2010
Am I the only one who hates the d-dimer for pulmonary embolism? I can’t imagine that I am. It was supposed to reduce our number of CTs, but the data suggests that it has instead increased them. (Full disclaimer, I never practiced in the days of V/Q scans or the days without d-dimer, but this is what I’m told.)
I find my practice pattern typically using the PERC Rule and/or Well’s Criteria for PE to identify well-appearing people who are “very low risk,” who would likely be harmed more than benefitted by a d-dimer test. And then for low-risk, I’ll end up using a d-dimer.
But when the computer screen blips that the result is back, I get a similar little blip in my chest, hoping it’s going to be negative. Interesting that I feel this way, given that I have no other reaction like this, except occasionally while waiting for the altered patient’s rectal temperature.
On one hand, I wonder, if this is the reaction I’m feeling, hoping and trying to mentally will the number to be negative when I click the “View Results” button, should I have even ordered the test to begin with? And on the other is how atypical, nefarious, and sometimes-weird presentations of pulmonary embolism can be. And then on the third hand: is the pulmonary embolism in the otherwise healthy, young, well-appearing person actually cause for alarm? (Some experts would suggest that our bodies are in a constant state of coagulation/anticoagulation, and that we’re all walking around with occasional, small PEs that our lungs dissolve or filter.) Maybe this is different (“benign PE”) from the PE in the cancer patient, or the hypotensive patient, or the one with the saddle thrombus. And on the fourth hand: there’s not even any good data that anticoagulation is of any benefit in pulmonary embolism (even though it’s the standard of care, and we all still give it).
Maybe I just hate PEs, or ruling them out in seemingly low-risk patients: the time, the money, and most of all, the contrast load and radiation exposure. But for now, I guess we’re stuck with our imperfect tests, clinical gestalt, and bedside evaluations of risk and benefit.
Trick of the Trade: Laryngoscope Lifting Strength
Posted by Michelle Lin, MD in Drugs and Treatments, Medical and Surgical Procedures, Tricks of the Trade on December 16th, 2009
You are about to endotracheally intubate a patient. As you struggle to elevate the laryngoscope more anteriorly, has your left hand ever trembled while trying to see the vocal cords? Before you say, “I think the cords are too anterior, hand me the [insert your favorite backup airway adjunct]“, let’s focus on some basics.
How can you gain significantly more laryngoscope lift strength? You can do more left arm bicep/tricep exercises, or…
Trick of the Trade
Hold the laryngoscope handle as close to the blade as possible.
Grabbing part of the blade helps to stabilize against the “waggling” of the handle. Furthermore, it is easier to pull exactly along the long-axis of the handle at this grip point. I would avoid holding the laryngoscope handle as shown in the image above. Is the physician intubating or holding a fragile cup of tea?
The most stabilizing larngyoscope grip
which provides maximal lift strength.
For other airway Tricks of the Trade, take a look an older post.
