Friday, January 17, 2020

How to Approach Third Year (M3) as an EM-bound Medical Student

Image credit: Wikimedia

Author: Taylor Petrusevski, MS4
Loyola Stritch School of Medicine
AAEM/RSA Publications & Social Media Committee


You made it through the seemingly endless lectures and question blocks that consume the pre-clinical years of medical school. In third year, it’s time to bring your classroom knowledge to the bedside. It is an exciting and overwhelming transition, but it is such a transformative year and a pivotal point in your training. You are building the foundation of your clinical skills and the formulation of your practice patterns start now. Among many variables, including Standard Letters of Evaluation (SLOEs), performance on the emergency medicine (EM) clerkship, interviews, and Step scores, third year clerkship performance continues to be an important parameter that program directors use when evaluating candidates.[1] While some studies note that your third year clerkship grades do not carry as much statistical weight as these aforementioned application components, your third year clerkships serve as the foundation of clinical skills that will allow you to succeed on your EM rotations, which is heavily weighted.[2] There are several methods to successfully navigate this transition. Different learning models emphasize the best cognitive practices to bridge this transition, noting that active reflection is just as important as preparing and actually getting the clinical experience.[3] Ultimately, do what works for you. Here are some suggestions on how to approach M3 as an emergency medicine (EM) bound student:


Tuesday, January 14, 2020

Ketamine for Acute Pain Relief in the Emergency Department

Image credit: Flickr
Author: Kasha Bornstein, MSc EMT-P MSIII
University of Miami Miller School of Medicine MD/MPH Program, AAEM/RSA Modern Resident Blog Copy Editor

Bottom Line Up Front:
In comparison to 0.1mg/kg intravenous morphine, multiple studies demonstrated 0.3-0.5mg/kg ketamine was as effective in short term management of acute pain, without any increased risk of severe adverse effects. In addition to primary analgesia, ketamine may be effective as an analgesic adjunct in situations where opioids are contraindicated or for patients who have pain refractory to conventional pharmacologic approaches.

Introduction:
In the setting of the contemporary opioid epidemic, use of opioids for pain relief in the emergency department (ED) has been scrutinized. Opioid prescription presents increased risk for development of opioid use disorder and presents challenges for attainment of adequate pain control in opioid tolerant patients. Alternatives to opioids are an important topic of discussion in emergency medicine as well as in pain management subspecialties. Many institutions are adopting ketamine for analgesic use based on observational data and/or provider choice, but until recently, the high-quality evidence validating ketamine using randomized controlled trials (RCTs) has been limited. This article details a meta-analysis of RCTs comparing low-dose ketamine (LDK) to morphine for analgesia.


Thursday, January 2, 2020

Top 10 Most Read Posts of 2019

Image Source: Pexels
As 2019 comes to an end, we look forward to recognizing the year’s top 10 articles! Join me in congratulating this amazing group of authors at all levels of training and from across the USA!

Additionally, I would like to thank each of the AAEM/RSA Modern Resident Blog authors, reviewers, mentors, and editorial staff members for their tireless contributions to the blog. Without all of them, the blog would not be what it is today. Thanks for a successful 2019!

We are currently accepting articles for 2020 and are always looking for additional faculty mentors as well. Feel free to contact us at info@aaemrsa.org with questions.

Sincerely,

Alex Gregory, MD
Editor-in-Chief
AAEM/RSA Modern Resident Blog

Monday, December 23, 2019

Blast Injuries

Image by: Samuel King Jr., Team Eglin Public Affairs

This post was peer reviewed. Click to learn more.







Author: Gregory Jasani, PGY-2
University of Maryland School of Medicine Department of Emergency Medicine




INTRODUCTION
Whether through an accident or intentional act, explosions have the potential to cause injuries to many people at the same time, resulting in significant morbidity and mortality and potentially overwhelming local healthcare resources. The resulting blast injuries are something that all emergency medicine providers need to be able to promptly recognize and treat.

Blast injuries are unfortunately not uncommon. In 2014, there were over 10,000 blast injuries in the United States due to fireworks. According to the Federal Bureau of Investigation, detonation of bombs or incendiary devices caused over 4,000 injuries and 448 deaths in the United States between 1987 and 1997.

Monday, December 16, 2019

An Approach to Vulnerable Populations in Medical Education


Image credit: Pexels
Authors: Miriam Asher; Cortlyn Brown, MD; and Faith Quenzer, DOOriginally published: Common Sense
November/December 2019

It was in my second year of medical school and I was sitting in a room with nine of my classmates and a physician during our case-based learning class. The case presented that day was of a young man with a sore throat and fever. He recently returned from a business trip to South America and was in a committed, exclusive relationship with his boyfriend.

After reading the opening statement about the patient, we began the usual task of developing differential diagnosis. Infections, of course, were a significant subsection of our differential list. These question stems of theoretical patients are designed to lead us in a certain direction unlike real patients who present with both relevant and irrelevant details. To the average medical student studying their “high-yield medical pearls,” the most obvious primary differential in a young man who has sex with men is Human Immunodeficiency Virus (HIV). Even if the patient is not sick at all, we are taught to suspect HIV because we are supposed to assume that men who have sex with men have sex with multiple partners (regardless of their relationship status) and do not practice safe sex.