CME intro 2016
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This document provides an overview of the Continuing Medical Education (CME) program at the hospital. It discusses the weekly CME sessions that cover topics relevant to emergency medicine through presentations by consultants, registrars, and allied health staff. Presentations typically last 15 minutes to 2 hours. The CME program also includes workshops on airways, trauma scenarios, case reviews, radiology sessions, and quizzes. Attendance at CME sessions is considered part of registrars' term assessments and certain sessions are mandatory. The document encourages registrars to check the CME schedule, arrive on time, prepare well-researched presentations, attend as many sessions as possible, and provide feedback. An upcoming airway workshop is highlighted.
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This document outlines the format and content of the continuing medical education (CME) program at the hospital. It discusses that CME is a weekly forum focused on topics related to emergency medicine and primarily aimed at registrars but open to all clinicians. Presentations are prepared by consultants, registrars, and allied health staff on relevant topics and range from 15 minutes to 2 hours. Other regular content includes workshops, audits, trauma scenarios, case reviews, and quizzes. Attendance is considered part of registrars' term assessments and contributing presentations is encouraged after consultation with a senior mentor. An upcoming mandatory airway workshop is highlighted.
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This document outlines the format and content of the continuing medical education (CME) program at the hospital. It discusses that CME is a weekly forum focused on topics related to emergency medicine and primarily aimed at registrars but open to all clinicians. Presentations are prepared by consultants, registrars, and allied health staff on relevant topics and range from 15 minutes to 2 hours. Other regular content includes workshops, audits, trauma scenarios, case reviews, and quizzes. Attendance is considered part of registrars' term assessments and contributing presentations is encouraged after consultation with a senior mentor. An upcoming mandatory airway workshop is highlighted.
CME intro 2017.1
This document outlines the format and content of the Continuing Medical Education (CME) sessions at a hospital. CME sessions are held weekly and last 15 minutes to 2 hours. They typically include 3-4 presentations on topics related to emergency medicine practice, given by consultants, registrars, and allied health staff. Other regular content includes airway workshops, audits, trauma scenarios, morbidity and mortality reviews, radiology sessions, and quizzes. Attendance is considered part of trainees' term assessments and feedback is encouraged. Upcoming highlights include an airway workshop on the 23rd of March which is mandatory to attend.
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This document outlines the continuing medical education (CME) program at the hospital. CME sessions are held on Thursdays to provide education on emergency medicine topics primarily for registrars but also consultants and senior clinicians. The sessions include various presentations, workshops, case reviews, and quizzes on topics relevant to the registrars' training programs. Registrars are expected to attend as many sessions as possible and provide feedback. Upcoming sessions include an airway workshop which is mandatory. The hospital website provides more information on the CME program and topics.
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Objective: Determine how many EM rotations medical students are completing during their fourth year. We hypothesized that medical students are scheduling more than the recommended two rotations, and that DO students are completing more rotations than MD students.
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Formation, functions-meeting template- and reporting format for medical colle...
This document discusses establishing core committees in medical colleges to involve them in India's National Tuberculosis Elimination Program (NTEP). It recommends forming committees chaired by the college principal with members from clinical and public health departments. The committees would coordinate TB detection and treatment in their colleges per NTEP guidelines, train students and staff, conduct research, and report data quarterly to district programs. Medical colleges can significantly aid case finding, advocacy, research, and ensuring best practices for TB given their large patient volumes and educational roles. Involving them is important for NTEP's continued success in ending TB in India.
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Slides from Vanessa's presentation "year 3 overview", presented at the MUMUS introduction to clinical years day, held at Clayton campus.
A student's perspective on what to expect from year 3 MBBS, typical timetables and a few tips to get the most out of it.
Enjoy!
Pre-Med FAQ Workshop
The document provides an overview of frequently asked questions for students pursuing medical school. It discusses the medical school application process and statistics on acceptance rates. It addresses common questions about prerequisites, majors, clinical experience, research, the MCAT, GPAs, and more. Resources for advising are recommended to help students develop competitive applications and multi-year academic plans.
Examination endgame
Success rates in specialist training and certification programs should be nearly 100%. This can be achieved by a structured and supervised specialist training program. In such programs, the need for end-of-five year examination is questionable. These slides are basis of a lecture that illustrates the specialist training and certification program in internal medicine in Sweden
Grindlay2008
1. The document discusses the Database of Uncertainties about the Effects of Treatments (DUETs), which compiles unanswered questions about treatment effects to prioritize future research.
2. It explains that the National Library for Health (NLH) Specialist Libraries are well-positioned to identify uncertainties for DUETs because they comprehensively collect and analyze evidence on various health topics, including systematic reviews.
3. So far, the NLH Skin Disorders Specialist Library has identified over 50 uncertainties about atopic eczema treatments by analyzing systematic reviews, and plans to continue extracting uncertainties from reviews on other skin disorders to further develop the DUETs skin module.
34 muster2014 andersen
This document discusses a distributed learning program in occupational medicine for family physicians. It aims to provide training to practicing physicians across large geographic areas without disrupting their practices. The program involves developing an occupational medicine training course with online modules and seminars to provide education, certification, and a peer network for handling work-related health issues. The founders have experience developing distributed learning programs and addressing the lack of occupational medicine training for physicians. Their goal is to sustain this program going forward to improve access to expertise in remote areas.
Blueprinting update - 2014 Ottawa Conference
This document outlines the process used to develop a defensible blueprint for physician licensing assessments. It involved gathering information from various sources, including a literature review, surveys of physicians and the public, and a 3-day meeting with 12 subject matter experts. The experts developed a proposed common blueprint with dimensions of care (e.g. acute, chronic) and physician activities (e.g. assessment, management). The blueprint defines the content and weighting for assessments leading to two decision points: entry into residency and independent practice. Developing a defensible blueprint requires defining the assessment purpose, choosing appropriate information sources, and including stakeholder judgments.
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Presented to a workshop on the challenges of detecting and diagnosing bipolar disorder at the Royal College of Psychiatrists International Conference, Edinburgh 2013.
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Standardized nursing languages implementation
Career Powerpoint
The document discusses the career path of physical therapy. It provides a history of the field from its origins in ancient Greece to its growth in the United States in the early 20th century. Physical therapists work to rehabilitate patients with injuries or chronic conditions using techniques like exercise and massage. The career is expected to grow significantly in coming years. Becoming a physical therapist requires obtaining a doctorate of physical therapy after completing undergraduate courses in subjects like anatomy and exercise science. The average salary for physical therapists is around $82,000 nationally.
Career Counselling (Medical)
A brief introduction of what a Medical student and graduate can do within and after his academics.
KIMS Kohat
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Trauma teams
The document discusses trauma teams and their roles. It defines a trauma team as a multidisciplinary group that works together to assess and treat severely injured patients. A team approach has been shown to significantly reduce resuscitation times compared to individual doctors. The roles of trauma team members are outlined, as well as techniques for effective communication, briefing, handover, and speaking up if concerns arise. Statistics from Western Australia in 2015 show the most common causes of death for major trauma patients were head injuries and brain death. Overall mortality rates were lower than the national average.
Haemostatic resuscitation
This document provides an overview of haemostatic resuscitation for trauma patients. It discusses the goals of haemostatic resuscitation which include rapidly correcting hypothermia, hypocalcaemia, acidosis and other factors impairing haemostasis. It also aims to resuscitate patients with a balanced combination of blood products resembling whole blood to avoid dilutional coagulopathy. The document reviews the components of blood, various blood products used in resuscitation and their effects, and studies supporting haemostatic resuscitation approaches. It also discusses practical considerations for haemostatic resuscitation in the emergency department setting.
Arthrocentesis
Mr. Arthur Ritis, a 52-year-old man with diabetes, hypertension, and a history of gout, presented with a hot, swollen, and painful right knee for 24 hours. Examination found a warm knee with a large effusion and mild tenderness. Blood tests showed elevated white blood cell count and C-reactive protein. Arthrocentesis of the knee found cloudy yellow synovial fluid containing urate crystals on microscopy. This confirms the diagnosis of an acute gout attack in the knee requiring treatment.
Ultrasound in cardiac arrest
This document discusses the use of echocardiography during cardiac arrest and peri-arrest situations. It provides an overview of basic echo views that can be useful. Echo can help identify the cause of arrest such as tamponade, pulmonary embolism, or wall motion abnormalities. Findings on echo such as hypovolaemia or myocardial activity can help guide management decisions. The document reviews where echo fits within the ACLS algorithm and issues surrounding its use during cardiac arrest. It provides examples of echo findings that may indicate treatable versus non-treatable causes of arrest.
Goals of patient care introduction
The document discusses the goals of implementing a new Goals of Patient Care (GOPC) form across hospitals in Western Australia to improve end-of-life care and decision making. It provides background on the form's trial implementation at various sites. The new form aims to have goals of care discussions with patients or their surrogates to determine appropriate treatment based on probable outcomes, not just resuscitation status. It outlines the form's structure with sections on baseline information, goal of care selection, discussion summary, and extended use. The document emphasizes improving communication around goals of care and ensuring treatment aligns with patients' values and preferences.
Physiology Directed CPR
This document discusses physiology directed CPR and haemodynamically directed CPR. It notes that cardiac arrest is not a diagnosis and various underlying pathologies must be considered. During closed chest compressions, a proportion of cardiac output is generated through cardiac and thoracic pumping. Studies show that targeting specific blood pressure and coronary perfusion pressure goals during CPR improves survival outcomes compared to standard AHA guidelines. Monitoring diastolic blood pressure and central venous pressure can help guide interventions like fluid administration or vasopressor use to meet haemodynamic targets and optimize circulation during CPR.
Ultrasound confirmation of ETT placement
This document discusses using ultrasound to confirm endotracheal tube placement. It states that ultrasound is a simple, fast, and reliable adjunct technique that can be used when other confirmation methods like capnography are unreliable or not available. There are two ultrasound techniques described - direct (transtracheal) ultrasound looks inside the trachea or esophagus to see if the tube is correctly placed, while indirect (transthoracic) ultrasound looks for movement of the pleura indicating lung ventilation. Ultrasound is not meant to replace capnography and auscultation but can be a helpful additional method in emergency situations or for patients who are not responding as expected after intubation. The document provides details on how to
Palliative care in the emergency department
This document provides guidance on symptom management for palliative patients in the emergency department. It outlines approaches for managing common symptoms like pain, delirium, dyspnea, nausea and vomiting. It recommends opiate medications for pain management, depending on whether the patient is opiate naïve or tolerant. It also provides guidance on managing other symptoms like bladder and bowel issues, secretions and more uncommon complications. The document emphasizes the importance of palliative care consultation and ensuring patients are not left to die alone.
Wilderness crisis and decision making weekend April 2018
This document announces a wilderness crisis and decision making weekend to take place in Margaret River, Australia from April 20-22, 2018. The weekend aims to build teamwork skills through quotes about collaborating, working together, and making decisions as a group. Activities will involve solving problems as a team rather than individuals.
Patient confidentiality in emergency department
Patient confidentiality must be maintained in the ED. Personal information about patients cannot be disclosed without consent, except in emergencies or if required by law. Duty consultants should be aware of any VIP patients but provide the same standard of care. Confidentiality must be respected even for those not under the practitioner's direct care. Mandatory notifications to regulatory bodies are required only for specific conduct issues. Advice can be sought from designated hospital staff if questions arise about disclosing information.
Abscess management
This document summarizes several studies on the use of antibiotics for abscess management. A 2016 RCT of over 1000 patients found that high-dose Bactrim led to higher cure rates of abscesses over 2cm compared to placebo, especially for those with MRSA, fevers, or immunosuppression. A 2017 RCT of under 800 patients found Bactrim and clindamycin had similar cure rates of abscesses under 5cm as placebo. However, antibiotics were associated with higher adverse gastrointestinal events. Overall, meta-analyses show antibiotics reduce treatment failures and new skin infections compared to incision and drainage alone, but with a risk of serious drug side effects.
Hyperthermia and hypothermia
This document discusses hyperthermia and hypothermia. It defines hyperthermia as a core body temperature above 41.5°C and describes the pathophysiology and various causes, including exercise-associated collapse, heatstroke, and drug-related illnesses. It also discusses hypothermia, defined as a core temperature below 35°C, and covers causes, clinical features at different temperature stages, complications, investigations, and management approaches including warming techniques. The prognosis depends on factors like maximum temperature reached and duration of temperature elevation.
Electrical injury
- This document contains information on various electrical injury cases presented to the emergency department, including details on mechanisms of injury, clinical presentations, investigations, and management strategies. Key points include treating electrical injury patients as trauma patients, avoiding premature withdrawal of resuscitation due to the unreliable signs of death, monitoring for cardiac dysrhythmias, rhabdomyolysis, and neurovascular compromise of injured extremities. High voltage or lightning injuries can cause severe internal injuries despite minor external burns and require prolonged cardiac monitoring and aggressive IV fluid resuscitation.
D-dimer audit
This document summarizes an audit of CTPA scans ordered without a D-Dimer test for patients over 50. Of 53 CTPA scans reviewed, 49 did not have a D-Dimer. For most scans, the decision not to order a D-Dimer was appropriately documented. However, for 8 scans (16%) there was no documented reason for not ordering a D-Dimer. The audit concluded that CTPA scans are generally being ordered appropriately to diagnose PE, but better documentation of the reasons for not ordering D-Dimers could help reduce unnecessary CTPA use.
It's all about the documentation
Good clinical documentation is critical for continuity of patient care, patient safety, legal records, and supporting accurate medical coding. The documentation provides information on why the patient was admitted and what treatments they received. The coders assign diagnosis and procedure codes based solely on the documented information. Ambiguous or incomplete documentation can result in inaccurate coding that affects funding. Ensuring documentation clearly specifies diagnoses, management plans, and interventions helps ensure patients are assigned to the appropriate Diagnosis Related Group (DRG) and the hospital receives appropriate funding for the services provided.
Paediatric rashes
This document provides an overview of common paediatric rashes. It begins with describing the anatomy of the skin and definitions of common rash morphologies such as macules, papules, vesicles and pustules. Common rashes that are described include scabies, acne, contact dermatitis, atopic dermatitis, impetigo, tinea and nonspecific viral rashes. Specific viral exanthems like measles, rubella and scarlet fever are also reviewed. Emergent rashes like erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis are discussed in terms of their presentations, causes and treatments. References are provided at the end.
Choosing Wisely - Rational Antibiotic Usage
This document summarizes a case study of a 28-year-old Australian woman who developed a rash and respiratory symptoms after returning from travel to Thailand. Initial testing ruled out common infections like malaria, dengue fever, and influenza. Her rash and symptoms were consistent with measles. Further diagnostic testing confirmed infection with herpes simplex virus 1 via a positive PCR test. The case highlights the importance of considering uncommon infections in returning travelers who present with rashes and respiratory symptoms.
What's Hot in Emergency Medicine June 2018
This document summarizes several hot topics in emergency medicine:
1) A study found imaging and blood cultures are often inappropriate for evaluating uncomplicated cellulitis according to guidelines.
2) A new pulmonary embolism pathway was introduced in 2018.
3) The Surviving Sepsis Campaign updated their sepsis bundles to a single 1-hour bundle in 2018.
4) There is debate around the evidence and recommendations of the Surviving Sepsis Campaign.
5) The terms used to describe new oral anticoagulants, like NOAC, are still appropriate according to hematology experts.
Emergency ophthalmology
- The document appears to be a slide presentation on ophthalmic examination techniques. It includes descriptions of examining the orbit, extraocular movements, pupils, anterior segment, cornea, anterior chamber, iris, lens, and discs using a slit lamp. It also mentions assessing vision, intraocular pressure, and performing direct ophthalmoscopy.
- The presentation notes that the value of experience is not just seeing much, but seeing wisely. It asks if the viewer sees what the presenter sees.
- A list of time-critical conditions that require urgent attention is provided, including acute angle closure glaucoma, penetrating eye injuries, endophthalmitis, and retinal artery occlusion.
Code Brown - Disaster Medicine in the ED
The document outlines the emergency department's response plan for a "Code Brown", which refers to mass casualty incidents that exceed the hospital's normal capacity. The 4 phases of response are notification, standby/preparation, reception of casualties, and stand down. Key steps include activating staff call backs, setting up triage and treatment areas, prioritizing patient care, and addressing issues like family inquiries, transportation bottlenecks, and media relations. The plan emphasizes timely triage, treatment and flow of patients. A post-incident debriefing within 7 days allows for evaluating the response and making improvements.
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Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
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Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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CME intro 2016
- 1. CME Intro 2016/1 James Wheeler
- 2. What is CME? • CME – continuing medical education • A non-confrontational forum for education on topics related to emergency medicine • Primarily focused at Registrars but also for Consultants and Senior Clinicians
- 3. Format? • Weekly topics to include topics relevant to primarily the Part 2 teaching program of that week • Presentations prepared by: ▫ ED Consultants & Registrars (with an allocated consultant mentor) ▫ Specialty consultants or reg’s ▫ Appropriate allied health staff • Duration ranges depending on topic 15mins – 2 hour • Usually ~3-4 presentations per session and a quiz
- 4. Other Content • Airway workshops (1 per 6/12) • Trauma scenario’s (1/month) • M & M / Interesting case reviews (1/month) • Radiology Sessions (1/month) • Education Registrar – What’s Hot in EM (1/month) • Toxicology core knowledge • Ultrasound core knowledge • Current research in ED • Weekly Quiz– VAQ’s (ECG, Gases, etc…) • Emergency medicine outside of the tertiary hospital
- 5. What do we expect from you? • Check the CME Timetable on the website (scghed.com) ▫ esp. if you are rostered for Day Shift on a Thursday • Arrive on time • When asked, prepare well researched content (with suitable references) in consultation with a senior mentor • Attend as many mornings as possible ▫ Certain sessions (ie. Airway workshop) are mandatory ▫ Part 1 & 2 candidates highly recommended to attend all possible during there teaching program ▫ Attendance is considered as part of your term assessment! • Give Feedback
- 6. Upcoming Highlights!! • Airway workshop ▫ 3rd March ▫ Attendance mandatory and very beneficial!
- 7. SCGHED.COM • What is it? • How do I use it? • Is the site complete? • Can I contribute?