Inservice in the Break Room

I'm going to try to resuscitate this blog to try to get some nursing-doctor educational-conversational action here. It is absolutely impossible to get all the nurses together for an in-service, and I always thought it was a futile task to gather those who are around with the overhead page "in-service in the break room" while … Continue reading Inservice in the Break Room →

Inservice In The Break Room: Pressors

What do you do when presented with a hypotensive patient resistant to IV fluids? Maybe throw some steroids at 'em but more likely you start dopamine. This is our go-to drug of choice as a pressor. However recent literature has shown it to be falling out of favor (ie, septic shock). So what should we … Continue reading Inservice In The Break Room: Pressors →

Med Student Shadowing – Think Out Loud

Being a hospital associated with a medical school, we're bound to have students interested in emergency medicine -- even M1's. Some of them may want to hang out with us in the ER to get a feel of what it's like. I know what you're thinking: They don't know enough of anything to be helpful. … Continue reading Med Student Shadowing – Think Out Loud →

One Minute Teaching in the ER

We (doctors) are notoriously bad teachers, relying on pimping, lectures and just overloading the learners with information. Good teachers actively engage the learner, provide specific and immediate feedback (especially positive feedback), limit the content and are willing to admit ignorance. Adult learners prefer to learn concepts (not facts) and need to apply them quickly for … Continue reading One Minute Teaching in the ER →

safe med practice: administration of IVPB meds

during the staff meeting, the question was raised on safe practice-- some staffs were asking- re: how much flush is needed after IVPB meds/antibiotics was infused per heplock so patients receive 95-100% of their IVPB meds. ( that means, no other fluids are infusing per heplock except the antibiotics)--- remember-- they're concerned that there should … Continue reading safe med practice: administration of IVPB meds →

Showing feedback – answer 2

You grab a big angiocath and stick it into his chest at the second intercostal space, mid-clavicular line. You get small gush of air coming out. His blood pressure starts to rise. Your colleague, having just witnessed this, says "you know, I had a similar case last week. I got an x-ray and while I … Continue reading Showing feedback – answer 2 →

Showing feedback – answer 1

You get the chest x-ray and pull up the film immediately, but before you can get a good enough read the nurses call you to the bedside. "Your patient is coding!" Return to original post