Stabilization (STAB) Series: Episode 1

 

STAB Series: Episode 1 with Dr. Marco Salmen, PGY-4

 

Learning Points:

  1. Suspect right ventricular myocardial infarction (RV MI) when ST elevation in lead III is greater than ST elevation in lead II.
  2. Suspect RV MI when there is ST elevation in lead V1 in the setting of an inferior STEMI.
  3. Confirm RV MI with right-sided EKG displaying ST elevation in the right-sided leads.
  4. Ultrasound findings in RV MI are a poor functioning right ventricle and evidence of high right-sided pressures (i.e, septal bowing, D-sign)
  5. StO2 monitoring when used continuously can detect worsening shock states.
  6. Anticipate post-intubation hyposention.

 

The post Stabilization (STAB) Series: Episode 1 appeared first on HQMedEd.com.

SAEM 2015 – San Diego

The Intern Class

The Intern Class

 

Alright, everyone. I just wiped the In-n-Out Burger grease off my hands and its time to talk about this year’s Annual Meeting of the Society for Academic Emergency Medicine in San Diego, California. We had an incredible turnout for the conference this year, including our wonderful intern class, the rising chief residents, numerous other resident presenters, and many of our faculty.

A Few Highlights

There were so many great moments from SAEM 2015, but a few really stuck out. The conference itself started off with the keynote address given by Dr. Steven Stack, the president-elect of the AMA. His talk was entitled, “Listen people, now this is how you give a presentation.” No, I am just kidding, but probably should have been. Dr. Slack gave a great talk on the history of our specialty and its role within AMA. He used no slides, no notes and the audience was hooked. The only time people looked down at their phones was to “tweet” one his pearls.

Which brings me to my next highlight: Twitter. Social media and Twitter in particular had an enormous presence at SAEM this year (or should I say, #SAEM15). Another possibility: maybe it has always been a big presence but I am just figuring it out. Anyway, I am going to stick with possibility #1. Twitter offered a ton of information, ranging from great teachable moments to bragging about your colleagues to letting everyone know where the Croquet game was at the opening reception. Social media is certainly here to stay as an integral part of conference culture.

Dr. Hart Presenting at the Plenary Session

Dr. Hart Presenting at the Plenary Session

Another highlight this year was the Plenary Session, featuring our very own Dr. Danielle Hart. Dr. Hart presented her work on training and testing advanced emergency procedures on high fidelity simulation models versus animal models. Another great Plenary talk was about a novel clinical decision rule for evaluating serious bacterial illness in febrile infants. Their rule, which included a UA WBC count, neutrophil count and procalcitonin, had excellent sensitivity (97%) and negative predictive value (>99%) for identifying serious bacterial illness.  One of their main points, you might notice, is that lumbar puncture results were not part of their assessment, even in infants that are less than 28 days. I believe I saw #deathoftheLP start trending after that one.

 

Hennepin Research

The Hennepin research presence was ubiquitous this year. We had numerous posters, uh, I mean, ePosters, as well as oral abstracts and presentations. Here is a list of all of the Hennepin presentations and posters (sorry if I missed anyone!).

Didactic and Oral Presentations
Posters
368 LFTlipaseSAEM 2015
2015 SAEM Dodd – Repol in LBBB Poster 721 FINAL
480 Hyperglycemia iatrogenic hypoglycemia SAEM 2015
2015 SAEM Dodd – ST changes in LBBB Poster 383 FINAL
Face and content poster 5.6.15
Agitation ExDS 2015 SAEM poster
SAEM OLANZAPINE KLEIN
Airway pilot poster 4.30.15 v2
SAEM OLANZAPINE AGITATION KLEIN
SAEM LVA KLEIN

Resident and Faculty Reflections

As much as I know everyone wants to exclusively hear my thoughts and ramblings on SAEM, I thought I would query the other Hennepin attendees for their reflections. Here are a few:

What struck me about the conference was the polish and preparation of the HCMC speakers- from cutting edge simulation to olanzapine and agitation (to prehospital intubation in kids!)- all presenters set the bar high by giving very balanced and measured talks on important EM topics. They represented HCMC well”

“SAEM was a great learning and networking experience. It was interesting to see how differently EM is practiced across the country and meet some of the leaders in the field.”

“Heads Up CPR! A great talk given by one of our own, Dr. Moore, and may be the future of CPR”

“There was a great lecture on cost of EM care; Healthcare Bluebook is a website that can help providers get an idea of the mean cost for encounters or service.”

“The people I was most inspired by at the conference were advocators (such as the opening speech from Dr. Slack).”

“A few Twitter rules of thumb: (1) It’s not Facebook, (2) don’t “friend” your friends (use it as a professional outlet), and (3) you can rebuild your presence and follow / unfollow people as your interests change, (4) use it!

“One of the highlights of the conference was the EMRA International Committee meeting. We met with the newly elected GEMA president and mapped out what international emergency medicine entails. IEM can be a nebulous topic for residents, and a very intimidating one to get involved with, but this was a truly eye-opening and clarifying exercise that all of us really enjoyed. Follow GEMA on Twitter and on Instagram @GEMA_social using #GEMA for any posts.”

Final Thoughts

The conference really did bring to light (as always) the breadth and depth of research and academic progress in Emergency Medicine.  My take away? We are very lucky to be in this field of medicine. See you next year! (#SAEM16?)

The post SAEM 2015 – San Diego appeared first on HQMedEd.com.