DRC to Dar: one physician’s journey to emergency medicine

Dr Mundenga Mutendi Muller is a young doctor from Kindu province in the Democratic Republic of Congo (DRC), currently training in the Emergency Medcine Residency at Muhimbili National Hospital in Dar es Salaam, Tanzania. He was interviewed in Dar es Salaam by Ellen Weber, EMJ Editor. This is an excerpt of their conversation.

An edit of the conversation is also available as a EMJ article: http://emj.bmj.com/content/31/8/611.full

Diagnosis by face

Clinicians use nonverbal cues from patients, including their facial expression content and variability, to make inferences about how ill a patient is. However the diagnostic accuracy of facial expressions as a method of physical diagnosis hasn't previously been scientifically examined.

Research just published in EMJ is the first to examine this question, and provides proof of concept that patients with serious cardiopulmonary disease processes manifest facial expressions with decreased variability and emotional content than patients with no serious cardiopulmonary diagnosis.

EMJ editor Ellen Weber discusses the findings with lead author Jeffrey Kline, professor in the Department of Emergency Medicine, Indiana University School of Medicine.

Read the full paper: http://goo.gl/MFvaxC

Emergency medicine and the military

Janos P Baombe (EMJ associate editor) meets with Sir Keith Porter (professor in Clinical Traumatology at the University of Birmingham). They discuss the place of evidence based medicine in military care, lessons for civilian emergency medicine, the concepts of right turn resuscitation, damage control surgery, and consultant-delivered care in military emergency medicine.

Clinical decision rules: a meeting with Professor Ian Stiell

Dan Horner, a research fellow from Manchester, talks to the person behind the Ottawa ankle, knee and Canadian c-spine rules. Ian Stiell is a professor of Emergency Medicine, clinical epidemiologist and chair of Emergency Research at the University of Ottawa.

They discuss implementation of decision rules in emergency medicine, current projects in Ottawa, the benefits of aggressive emergency department management of atrial fibrillation, and the unpublished findings from the recent Resuscitation Outcomes Consortium investigators about compression depth in cardiopulmonary resuscitation.