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Thanks to Henry Curtis for an excellently prepared M&M today. Read on for some important learning tips from today’s discussion.
* In cases where the history is limited and the diagnosis is not clear, the patient must be completely disrobed and examined head to toe.
* In elderly, debilitated, or terminally ill patients, engage the patient or proxy in a discussion of goals of care. Treatment or even diagnosis of dangerous conditions may not be compatible with the patient’s or family’s wishes, but often their priorities will not be offered spontaneously and must be elicited.
* Proxies are often reluctant to take responsibility for “reducing” goals of care as they perceive this decision as contributing to the death of their loved one. When appropriate, voice your opinion supporting this type of decision. Example phrases that may be used include “If it were my mother, I would not want further testing and treatment, my priority would be keeping her comfortable,” and “It is completely appropriate to choose to let nature take its course.”
* Proxies often feel as though the decision is their own and lose sight of their role, which is to represent the wishes of the patient. “What do you think your mom would want in this situation if she were able to tell us?”
* As CT scanners evolve and their resolution improves, the benefit of contrast diminishes. A growing body of literature suggests that contrast, especially oral contrast, does not aid in the interpretation of abdominal CT scans. As emergency departments bear the burden of administering oral contrast, emergency medicine may be the stimulus for change for relevant radiology protocols

Please join us for Emergency Medicine Conference on July 22nd in Hatch Auditorium at Mt. Sinai. We are lucky to have two Grand Rounds speakers joining us on Wednesday for an excellent conference.

9am - Grand Rounds: Disaster Medicine - The Israeli Experience, Dr. Pinhas Halperin

10am - M&M, Dr Henry Curtis

11am - Grand Rounds: Biopreparedness and Bioinformatics, Dr. Kenneth Mandl

12pm - Pediatric  Core: Fever - Dr. Ari Cohen

1pm - Pediatric M&M - Dr. Scott Goldberg

 Lunch will be served 

Dr. Rabin has developed a guide for EM2 residents planning their research block, complete with expectations and resources to get the most of your month. The EM2 Research Block guide can always be accessed through the Policies page. Also of note: Dr. Rabin has put together a general resource for conducting research in our ED, with links to the IRB and GCO, conference abstract deadlines, scientific writing guides, stats help, and more. This page can also be accessed through policies or from the right sidebar under ‘Administration.’

Finally, the elective submission and review forms are now ready for use — 4-6 weeks before you begin your specialized journey of development as a physcian, you must fill out details of how you’ll spend your block, who’ll be supervising you, and more. Details will be sent to Dr. Nelson and Claribel. When you’re done, fill out a brief review that, unlike New Innovations, will actually be accessible to your fellow residents as they contemplate their electives. The Elective Submission Form and the Elective Review Form will also live under the Policies tab.

Please join us for EM Conference this Wednesday at Mt. Sinai in Hatch Auditorium. As usual, lunch will be served.

9am - M&M - Dr. Jasmine Koita
10am - How the ED Physician Thinks - Dr. Reuben Strayer
11am - Research Lecture Series - Dr. Lynne Richardson
1130am - US Case of the Month - Dr. Dena Asaad
12pm - EM1s - HAZMAT and Disaster Training
12pm - EM3s/4s -Advanced Teaching Techniques

Please join us for the first conference of 2009-2010. Much of the day will be administrative with important conversations regarding residency responsibilities and expectations, but the first conference of a month would not be complete without M&M and Trauma Conference. 

9am - Introductions, Responsibilities and more - Dr. Peter Shearer et al

11am - Trauma Conference - Dr. Scott Weingart

12pm - M&M - Dr. Edwin Wu

Second years don’t forget your introduction to the cardiac room starts at 1pm following M&M

 Lunch will be served.