Finding a Mentor

Author: Nick Pettit, Ph.D. OMS II
Ohio University Heritage College of Osteopathic Medicine

“Don’t go into that field of medicine, I know fifty burned out doc’s in that field.” While on one of my first clinical experiences I found it discouraging when I expressed an
interest in emergency medicine (EM) and the attending I was working with immediately
rejected my idea of going into this field with a negative opinion. Unfortunately, such
negative connotations frequently arise when mentioning EM, especially with non-EM
faculty.[1] As such, due to the brevity of medical school, it is imperative as medical
students to not only find a good mentor but to find one as early on as possible.

Drug Seeking Behavior: Identifying and Managing Patients

Author: Wendy Perdomo, MS-4
Universidad Iberoamericana (UNIBE)

The most common reason patients visit the emergency department (ED) is due to pain of which represents 75% of complaints in the ED, and the third most common health care
problem.[1] Of these visits to the ED, about 20% of these patients are categorized as “drug-seeking,” which is defined as

Rules of the Road: Ch 16 Summary: "Planning Ahead for Success in Your Third and Fourth Years"

Originally Published: AAEM's Rules of the Road for Medical Students, First Ed. Chief Editors: A. Antoine Kazzi, MD FAAEM MAAEM; Joel M. Schofer, MD RDMS FAAEM
Chapter Summary by: Adrian Tripp, MSIII

Thinking about which specialty to select can bring about feelings of uncertainty and uneasiness in every medical student. It is an important decision that should be made with an open mind, honest self-evaluation, and after thorough investigation. Fortunately, if you have already decided on emergency medicine (EM), or have at least narrowed down your list of possibilities to include EM, AAEM's Rules of the Road for Medical Students can help you prepare for a successful match.

Planning a Student Symposium

Author: Bill Burns
Stritch School of Medicine, Loyola University 

The following details the experience of the 2012 AAEM Midwest Medical Student Symposium

planning team. The 2012 event was the 6th Midwest Symposium held at Loyola University Stritch School of Medicine and we owe a debt to all those student leaders who preceded us and whose great work, in developing strong relationships with the

Clinical Exam for Shoulder Injuries: Which are worth the time?

Author: Andrew W Phillips, MD Med

Stanford/Kaiser Emergency Medicine Residency Program

Shoulder injuries are not uncommon in the emergency department (ED), and although shoulder soft tissue injuries are typically non-emergent, the patient can be helped greatly knowing if s/he likely has a serious shoulder injury. Magnetic resonance imaging (MRI), however, is costly and not usually indicated in the ED setting, so the clinician is left with the physical exam. With over 70 different shoulder exams (1), which ones provide enough positive and negative likelihood ratios (LR) to be helpful?  (This free access article explains LR well: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495095/(2). Look for a +LR>1.5 and a –LR<0.5 the minimum for clinical significance.)

If you have the time, Luime (3) and Hegedus (4) created what appear to be the definitive reviews to date, and a new, well-powered prospective study is on its way, based on a

Acute Carpal Tunnel Syndrome in Pediatric Distal Radius Fractures

Authors: Andrew W Phillips, MD MEd and Emily Niu, MD
Stanford University/Kaiser Emergency Medicine Residency Program and
Stanford University Orthopedics Residency Program

Summary points:

• Acute carpal tunnel syndrome complicates up to 9% of distal radius fractures.
• Large displacement increases the probability of developing acute carpal tunnel syndrome. 
• Early carpal tunnel release is associated with improved outcomes.

The common scenario: An adolescent child crashes bicycle and presents with only L wrist pain. He reports mild numbness of his index finger but full sensation and movement are present on physical exam of the entire left hand. Is it a simple splint and follow up with orthopedics in a few days?

Click to enlarge.

Click to enlarge.

Helpful Document: Shock & Vasopressors - A Quick Review

Author: Alexander A. Simakov, MPH FP-C MSIV, Medical Student Council, International Ex Officio Representative

Things were much simpler back in the Roman days. When one was stabbed by a sword he/she bled and died of “cold” — or hypovolemic — shock. If the person got lucky and was only wounded by the dirty blade, they probably died of “warm” — or septic — shock. Today our knowledge has advanced well past “cold” and “warm,” and leaves us with at least 10 types of shock commonly encountered in the emergency department (ED) and intensive care unit (ICU) (Table 1). Each represents a constellation of physiologic effects that require a tailored approach to management. Cardiovascular support with the assistance of vasopressors is a common method, while identification and treatment of the underlying disease process remains the ultimate goal.¹

How to Dive into the FOAMed Movement

Authors: Meaghan Mercer, DO, University of Nevada, Las Vegas
                AAEM/RSA President

                Mary Calderone, MSIV, Loyola Stritch School of Medicine, Chicago
                Medical Student Council President

What is FOAM? — This is not the future of medicine, it is medical education NOW! Like many great ideas that evolve in medicine, the concept of FOAM (Free Open Access Meducation) project was born in a pub over a pint of Guinness. Doctors Mike Cadogan and Chris Nickson  from lifeinthefastlane.com (LITFL), recognized that social media has changed how we communicate and educate; ideas traverse the globe in hours allowing an open interactive approach to how we learn and practice medicine. As one of the education leaders of AAEM and greatest teachers of our specialty, Dr. Joe Lex, stated, “If you want to know how we practiced medicine 5 years ago, read a textbook. If you want to know how we practiced medicine 2 years ago, read a journal. If you want to know how we practice medicine now, go to a (good) conference. If you want to know how we will practice medicine in the future, listen in the hallways and use FOAM.” FOAM is the concept, enacted via the Internet. #FOAMed is the conversation, enacted via Twitter.

Rules of the Road: Ch 7 Summary: "The Residency Application Process - Visits and Interviews"

Originally Published: AAEM's Rules of the Road for Medical Students, First Ed. Chief Editors: A. Antoine Kazzi, MD FAAEM MAAEM; Joel M. Schofer, MD RDMS FAAEM
Chapter Summary by: Kari Gorder, Medical Student Council, Regional Representatives - Northeast

Choosing a residency program is one of the most significant decisions a medical student will make. While the match experience can induce a considerable amount of anxiety, it is also an exciting and memorable time. With the right amount of research and preparation, applicants can navigate the process with skill and success—and hopefully the least amount of stress possible! This chapter briefly outlines the steps of interviewing for an EM residency.

Rules of the Road: Ch. 19 Summary: "The Clinical Years - Research & Scholarly Projects"

Originally Published: AAEM's Rules of the Road for Medical Students, First Ed. Chief Editors: A. Antoine Kazzi, MD FAAEM MAAEM; Joel M. Schofer, MD RDMS FAAEM
Chapter Summary by: Faith Quenzer, Vice President, Medical Student Council 

      ●     Should you do research or other forms of scholarly projects in medical school?

             ○       Depends on your interests

             ○       Formal research and publication of a manuscript is highly regarded as the most valuable form of academic involvement and skill

            ○       Research projects can be presented at conferences

    

FOAM — This is not the future of medicine, it is medical education NOW!

Originally Published: Common Sense, Jul/Aug 2013

Original Author: Meaghan Mercer, DO AAEM/RSA President

Like many great ideas in medicine, the concept of FOAM (Free Open Access Meducation) project was born in a pub over a pint of Guinness. Doctors Mike Cadogan and Chris Nickson, from www.lifeinthefastlane.com (LITFL), recognized that social media has changed how we communicate and educate. Ideas now traverse the globe in hours, allowing an open and interactive approach to how we learn and practice medicine. As one of the fathers of AAEM and greatest teachers of our specialty, Dr. Joe Lex, stated,

Resident Journal Review: Procedural Sedation

Originally Published: Common Sense, Mar/Apr 2013

Original Authors: Authors: Kami Hu, MD; Michael Allison, MD; Michael Scott, MD; Phillip Magidson, MD MPH; David Wacker, MD PhD; David Bostick, MD MPH

Editors: Michael C. Bond, MD FAAEM; Jay Khadpe, MD FAAEM

Introduction
The ability to administer procedural sedation and analgesia (PSA) is a necessity for today’s emergency physician (EP), and the list of indications for its use have grown over the years. The quest to determine the safest, most efficacious method continues, producing ongoing research on sedation techniques both old and new. This edition of Resident Journal Review focuses on selected updates on familiar agents and investigations into novel regimens over the past two years.

“Too good to be true? It just might be.” — Notes and Pitfalls from the Job Trail

Originally Published: Common Sense, Jan/Feb 2013

Original Author: Leana S. Wen, MD MSc, AAEM/RSA President

‘Tis the season to find a job. At least it is for me and my senior resident colleagues across the country.

The first thing we learn is that this job search process is unlike any other we’ve gone through before. It’s certainly different from the rest of our medical training. Getting into medical school was no walk in the park, but it was a structured process, often with ample guidance from professors. The Match may have its own share of problems, but the process was uniform. Now, looking for an attending job, there are so many options and so many uncertainties. Whether it’s community or academia, there is no clear path to getting that ideal job.

Resident Journal Review: Anticoagulation

Originally Published: Common Sense, Jan/Fab 2013

Original Authors: Authors: Susan Cheng, MD MPH; Jonathan Yeo, MD; Allison Regan, MD; Eli Brown, MD

Edited by: Michael C. Bond, MD; Jay Khadpe, MD

This Resident Journal Review focuses on the new oral anticoagulants and their use for stroke prophylaxis in patients with atrial fibrillation, venous thromboembolism (VTE), and acute coronary syndrome (ACS). Vitamin K antagonists such as

On the Horizon: Shock - Administered Uninterrupted Chest Compressions

Originally Published: Modern Resident, Dec/Jan 2013

Original Author: Meaghan Mercer, DO University of Nevada Las Vegas

Submitted by: Rachel Engle, DO; Joe Lex, MD MAAEM FAAEM, Temple University Hospital
 
It is important to revisit and challenge dogma in medicine. When you think of defibrillation you hear the word "CLEAR" and know your primary job in that one instant is to make sure that none of the medical professionals participating in that code situation are at risk of receiving a life threatening shock. However, with the advent of gel adhesive pads is it still dangerous?

Spotlight on Leaders in Emergency Medicine: Antoine Kazzi, MD FAAEM

Originally Published: Common Sense, January/February 2013
Original Author: Ali Farzad, MD
AAEM/RSA Publications Committee Chair
Linda J. Kesselring, MS ELS, Copyeditor

A. Antoine Kazzi, MD FAAEM

 Many of our readers may be familiar with Dr. Antoine Kazzi, recognizing him as a past president of AAEM and a dynamic leader who has spent many years representing our specialty in a variety of capacities. Born and raised in Lebanon, Dr. Kazzi was trained and board certified in emergency medicine in the United States. He has received numerous awards and recognitions for his leadership and scholarly pursuits. As an advocate for our specialty, he has focused on policy creation, reimbursement and practice issues, and international emergency medicine. Dr. Kazzi has been recognized by our Academy with a number of national awards, including the David K. Wagner and the International EM Leadership Awards for his contributions to the  specialty of emergency medicine.