This Week (7/19)

VTCEM Residents &Faculty,

-Roanoke,VA hit 97dgF today!…I hope everyone took refuge in a satisfyingly cold beverage.
-Thanks to Faculty, Staff Admin, and Residents who helped to make Airway Sim Lab for the new interns last Friday successful. 

-Thanks to Dr. Sarah Chrabaszcz, Dr. Moses Lopez-Twumasi, Dr. Jamie Zink, Christie Neal, and other Staff Admin who are working hard to bring our resident recruitment video to life.  At VTCEM – “EACH DAY IS GAME DAY!” We see you!
-Good time to encourage EVERYONE to follow ‘vtcemergencymedicine’ on Facebook and Instagram. This is a private group that can be found publicly by resident applicants who are interested in seeing more about what we do.  Please send Christie Neal any exciting VTCEM or Roanoke-lifestyle relevant pictures that you have.
House Scoring

-The New Academic Year scoring system will look like the following:
 Conference Attendance: House Actual/Maximum Theoretical Attendance (Weighting 25%) Group Activities: House Actual/Maximum Theoretical Points (Weighting 25%) Rosh Quizzes: House Average (Weighting 25%) ITE performance: House Average (Weighting 25%) 
-Please send questions, concerns, or outbursts to rmhchiefs@gmail.com. Otherwise, retroactive House tallies will be presented next week.

General ED

-Please adhere to the face shield mandate: Face shields are required in all clinical interactions and ED work stations where social distancing can not be maintained. 

-Thanks to Dr. Massaro and Dr. D. Kuehl for their Introduction to RVUs talk last Thursday. Courtesy of Dr. Klemencic – the following is more on the subject:

https://www.acep.org/life-as-a-physician/residents–young-physicians/personal-finance/what-every-graduating-resident-needs-to-know-about-reimbursement/

-As encouraged by Dr. Burton and Dr. Uherick, please read the NY Times article following up the death of Dr. Lorna Breen, an Emergency Physician serving in NYC during the peak of the COVID crisis. https://www.nytimes.com/2020/07/11/nyregion/lorna-breen-suicide-coronavirus.html?referringSource=articleShare.  While it takes courage to seek help or assistance for any mental or physical health challenge, please note that there should not be any professional or privacy risk in doing so.

-Take a moment to look at and apply the handy dot phrase .TGRESOURCES to applicable LGBTQ patients – courtesy of Dr. Kip Barhaugh. You can pull the dot phrase into your discharge instructions.  It features an extensive list of community resources specifically for LGBTQ patients.  

-Please refer to the email by Dr. Klemencic on 7/13 if you interested in teaming up with the Local Office on Aging and delivering boxes of federally provided food to many members in the community who desperately need it. -Please review Dr. Perkin’s Dear Doc email sent on 7/19 about how to send your patients home with MASTERFUL discharge instructions!

-Please see email on 7/8 from Dr. Patricia Weiss and complete the appended short survey on N95 masks so improvements may be made on how we receive, use, and store our masks.

Peds Corner:

-Please review Pediatric Trauma Triage Criteria:   https://drive.google.com/file/d/1TU3YcpHZqSwOIMnSVJJYaayzHyacRWIz/view

Fellowship News:

EMS:-Please review Adult Trauma Triage Criteria:   https://drive.google.com/file/d/14tJh0UQdcW0yhPWc6UB5JifVKBPU6U57/view
Ultrasound:

-If an ultrasound machine stops working or has the ‘blue screen of death,’ then please call in the problem to GE. The contact information for GE is on a sticker on each ultrasound machine in the ED. This effort allows us to log the current maintenance problems, track where our machines are when they are off-line, and get replacements sent to us immediately.

-Please clean the US machines with the purple top wipes before and after you use them. 

US case of the week: I encourage you to look at Dr. Jon Nogueira’s 7/13 cardiac US on Patient K.G featuring McConnell’s sign in a patient who had a saddle PE that required IR intervention in addition to anti-coagulation.  Use Internet explorer: http://qpth-prd-app01/qpath/ 

Wilderness: Monday, July 20th at Steph’s House (1840 Blenheim Rd SW, Roanoke, VA 24015) ***Note location and time change*** -4:30p – 5:30p Sunscreen Journal Club (See attached articles)
 -5:30 – 7:30p Dinner/Celebration of CJ and Jeremy’s Graduation (Bring a side dish to share) -RSVP to StephLareau@gmail.com
Wednesday, July 22nd at Steph’s House (1840 Blenheim Rd SW, Roanoke, VA 24015)
-8:00p Discussion of Space Medicine (See attached article). BYOB.
-8:30p-10:00p WMS Conference Keynote Speaker Stephen Robinson will be talking about his experiences during his NASA missions.
Sunday, August 2nd-If you are interested in teaching Wilderness First Aid skills at Carvin’s Cove from 4p-8p, please email StephLareau@gmail.com or text 704-661-0083.  
Swift Water Rescue: The WM Fellowship is sponsoring an American Canoe Association Swift Water Rescue (SWR) Course in Roanoke, VA and have limited availability for faculty/residents/staff to join us. Here is the tentative schedule. Email StephLareau@gmail.com for more details.Aug. 25- Day 2  L-4 SWR Skills Course (day 1.)Aug. 26- Day 3  L-4 SWR Skills Course (day 2) (Also Day 1 of the L-3 Instructor course)
Aug. 27- Day 4  Day 2 of the L-3 Instructor CourseAug. 28- Day 5  Day 3 of the L-3 Instructor CourseAug. 29- Day 6  Day 4 of the L-3 Instructor course
Advanced Wilderness Life Support-The AWLS course in Roanoke, VA will mostly be virtual this year. There will be an in-person component on Sept 18 or 19th as part of the 2 week medical student elective. More details to come.

Wilderness Medicine Pearl:Did you know that Lyme disease is endemic to Roanoke County? https://www.tickcheck.com/stats/county/virginia/roanoke-county/lyme
The CDC recommends a single dose of 200mg of doxycycline (or 4.4 mg/kg for children under 45 kg) if the tick bite is from Ixodes scapularis tick in an endemic area and the estimated time of attachment is >36h (tick is engorged).  Prophylaxis can be started within 72h of tick removal.  Please read the following for more information:  https://www.aappublications.org/news/2020/02/27/idsnapshot022720
Academic: 

-PGY 1s: Formal assignments for Foundations will start on September 1, 2020. More details to come from Dr. D. Kuehl.

-PGY 2/3s: Formal assignments for ALiEMU will start in August 2020. More details to come from Dr. D. Kuehl.

-Please review the following in the meantime: 

https://emcrit.org/emcrit/intubation-patient-shock/a
https://emcrit.org/emcrit/emcrit-intubation-checklist/https://litfl.com/surgical-cricothyroidotomy/Conference:

-Thursday Zoom Conference this week will start at 7:30a with Multi-disciplinary Critical Care Conference. Please refer to Leslie Amos’s email on 7/17 for more information. Christie Neal will send out the Zoom link for this conference later this week. 

-Please provide resident feedback about the new journal club format to rmhchiefs@gmail.com.  This week, House Clinton will present on the topic of The Impact of Timing of Antibiotics on Outcomes in Severe Sepsis and Septic Shock (Attached).

Scheduling:-Block 2 shift scheduling complete. Check posting on www.tangierweb.com
Oldies, but Goodies:-Daily Screening Passport: https://carilion.ca1.qualtrics.com/jfe/form/SV_3CTQXQfkPSHysLjWebsite: damonsdue.com

Email: rmhchiefs@gmail.com

Stay safe.

Lu Ojeifo, MD

This Week (5/31)

50th edition.  The Heme/Onc block has concluded with House Kuehl having a commanding lead. The Rosh Review quizzes are all that is left in the block, due June 2nd. We now move onto the Health Care Systems block. 

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General:

Rosh Review – quizzes are assigned and due tomorrowJune 2nd. 

p100 Cleaning – PGY3s need to prepare the bleach for cleaning DAILY during main 1 shift. This is coming from infection control, please just get it done. There is a log book in the room that needs to be signed each day. 

Volunteer Opportunity – Dr Waasdorp is in need of volunteers for an ED specific WebEx session on June 22-24. Please contact him if you are interested, <cpwaasdorp@carilionclinic.org>

Pediatric Protocols – with the help of Dr Uherick, we have uploaded several pediatric protocols for quick reference on damonsdue.com. These include things such as DKA, meth exposure, c-spine, etc. These are excellent resources on shift and available by simply going to the website. Old Items:Passport –  all employees are required to self-screen prior to each shift. These instructions have been uploaded to the COVID folder on google drive. 

ABEM Written Boards – PGY3s can do the initial application for the written boards on ABEM’s website. It is $420 now and the price doubles if you wait until September. Go to the bottom and select “initial application”. Scheduling Change –the matrix for PGY 1 & 3: 6a-2p1:30p-9:30p, and 9p-6a

PPE Selfies – Please send me a picture of you at work in your half mask with the pink cartridges. Send these to my work phone: 540-855-4994

Substance Abuse Modules – are available on the google drive under educational content > psych. Please watch these and go over the slides if you did not make it to the lecture. Leslie needs a copy of your pre-test in addition to an evaluation for EACH MODULE. Yes, each module. 

COVID-19 – continue to check the main residency drive > COVID-19 folder. I will continue to upload all the important documents as they are sent out. 

  • Attendings – if you want access to this folder send me your personal email address and I will send you a link to view. 
  • COVID-19 Links – is a document I made to keep track of the best resources to stay up to date. It is in the drive folder. 

Academic To-Do: Heme/Onc Block

Interns – Foundations modules for this month are 27 Endo, 28 HemeOnc, 30 ImmunoDerm

27 Endo – https://foundationsem.com/endocrine-metabolic/

Endocrine & Metabolic – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 116, 117, 118, 120Hippo: electrolytes, DKA/HHS, Thyroid

28 HemeOnc – https://foundationsem.com/hematology-oncology/

Hematology & Oncology – Foundations of Emergency MedicineUnit Topics & Framework Traditional Textbook High-Yield Texts Multimedia; Heme / Onc: Hematologic Emergencies, Emergent Complications of Malignancy Approach to Sickle Cell Crisisfoundationsem.com

Rosen’s: Chapters 111, 112, 114, 115Hippo: platelets, RBCs, Leukemia

30 ImmunoDerm – https://foundationsem.com/immunology-dermatology/

Immunology & Dermatology – Foundations of Emergency MedicineFoundations 1 | Foundations 2 Foundations 1 Foundations 2 Mouse over each Article under Primary Literature to see the full titlefoundationsem.com

Rosen’s: 108, 109, 110Hippo: Derm, Immuno

PGY2/3 –Either Immune, Derm, or Endocrine

ALiEM Approved Instructional Resources (AIR) – ALiEMUWelcome to the Approved Instructional Resources (AIR) series, exclusively sponsored by the Society of Academic Emergency Medicine (SAEM)!Since 2014, this series has curated and graded open-access blog posts and podcasts in the field of emergency medicine (EM) over the previous 12 months to identify high quality, social media-based, educational resources for EM residents.www.aliemu.com

Conference:ZOOM SESSION – continues this week. Starts at7:30am with Pediatric Grand Rounds.

Scheduling:

PGY 2/3 – Block 13 is published. 

Podcast of the Week:

Internet Book of Critical Care did a great episode last week about anti-coagulation. Great review and worth a listen. https://ibccpodcast.libsyn.com/ibcc-episode-81-unfractionated-heparin-ufh-lmwh-fondaparinux-argatroban-and-bivalirudin

The Internet Book of Critical Care Podcast: IBCC Episode 81 – Unfractionated heparin (UFH), LMWH, fondaparinux, argatroban, and bivalirudinIn this episode we cover the work horses we use daily in critical care patients: anticoagulants: Unfractionated heparin (UFH), LMWH, fondaparinux, argatroban, and bivalirudin. We also cover BID dosing of LMWH prophylaxis and the essential section here is on heparin resistance. Enjoy!ibccpodcast.libsyn.com

This Week (5/18)

48th edition. There were many points to go around last week with the Kahoot session, Dear Doc, and attendance points. With 2 weeks left in the block House Kuehl has taken a strong lead. 

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General:

Passport –  all employees are now required to self-screen prior to each shift. Instructions are attached. If you have any further questions refer to Dr. Burton’s email last week. These instructions have also been uploaded to the Covid folder on goggle drive. 

Feedback – let us know your thoughts on last week’s conference attendance/quizzes. We are trying to come up with the best way to do this an open to feedback. 

ABEM Written Boards – PGY3s can now do the initial application for the written boards on ABEM’s website. It is $320 now and the price doubles if you wait until September. Go to the bottom and select “initial application”. 

p100 Cartridges – there are still 10 or so extra cartridge refills in the resident room which means that some of you didn’t get your refill box. They are in the second cabinet on the left and I purchased enough for every resident to get 1 box (= 2 replacement cartridges). Old Items:Scheduling Change –the matrix for PGY 1 & 3: 6a-2p1:30p-9:30p, and 9p-6a

PPE Selfies – Please send me a picture of you at work in your half mask with the pink cartridges. Send these to my work phone: 540-855-4994

Substance Abuse Modules – are available on the google drive under educational content > psych. Please watch these and go over the slides if you did not make it to the lecture. Leslie needs a copy of your pre-test in addition to an evaluation for EACH MODULE. Yes, each module. 

COVID-19 – continue to check the main residency drive > COVID-19 folder. I will continue to upload all the important documents as they are sent out. 

  • Attendings – if you want access to this folder send me your personal email address and I will send you a link to view. 
  • COVID-19 Links – is a document I made to keep track of the best resources to stay up to date. It is in the drive folder. 

Academic To-Do: EMS/Wilderness Block

Interns – Foundations modules for this month are 27 Endo, 28 HemeOnc, 30 ImmunoDerm

27 Endo – https://foundationsem.com/endocrine-metabolic/

Endocrine & Metabolic – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 116, 117, 118, 120Hippo: electrolytes, DKA/HHS, Thyroid

28 HemeOnc – https://foundationsem.com/hematology-oncology/

Hematology & Oncology – Foundations of Emergency MedicineUnit Topics & Framework Traditional Textbook High-Yield Texts Multimedia; Heme / Onc: Hematologic Emergencies, Emergent Complications of Malignancy Approach to Sickle Cell Crisisfoundationsem.com

Rosen’s: Chapters 111, 112, 114, 115Hippo: platelets, RBCs, Leukemia

30 ImmunoDerm – https://foundationsem.com/immunology-dermatology/

Immunology & Dermatology – Foundations of Emergency MedicineFoundations 1 | Foundations 2 Foundations 1 Foundations 2 Mouse over each Article under Primary Literature to see the full titlefoundationsem.com

Rosen’s: 108, 109, 110Hippo: Derm, Immuno

PGY2/3 –Either Immune, Derm, or Endocrine

ALiEM Approved Instructional Resources (AIR) – ALiEMUWelcome to the Approved Instructional Resources (AIR) series, exclusively sponsored by the Society of Academic Emergency Medicine (SAEM)!Since 2014, this series has curated and graded open-access blog posts and podcasts in the field of emergency medicine (EM) over the previous 12 months to identify high quality, social media-based, educational resources for EM residents.www.aliemu.com

Conference:ZOOM SESSION – continues this week. Details to follow. 

  • Journal Club – is this week, articles can be found on google drive > education content > Heme/Onc block. Please READ THESE AHEAD OF TIME. 

Scheduling:

PGY 2/3 – Block 13 is published pending one or two changes. If you are affected by the changes you will get an email, otherwise it’s correct on Tangier. If you see any issues let us know. 

This Week (5/11)

47th edition. The Rosh quizzes have been counted and the EMS block champion is House Fortuna. This brings them into an overall tie with House Kuehl for the year-long championship. Overall most people submitted the Rosh quizzes this month so keep up the good work.

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General:

PPE Selfies – Please send me a picture of you at work in your half mask with the pink cartridges. Obviously keep any patient identifying information out of the frame. I was thinking of having people hold up a piece of paper that says “Thank You” or something along those lines.  Send these to my work phone: 540-855-4994Old Items:

SCHEDULING CHANGE –the matrix for PGY 1 & 3: 6a-2p1:30p-9:30p, and 9p-6a. This is different from last week so pay attention. 

Substance Abuse Modules – are available on the google drive under educational content > psych. Please watch these and go over the slides if you did not make it to lecture. Leslie needs a copy of your pre-test in addition to an evaluation for EACH MODULE. Yes, each module. 

COVID-19 – continue to check the main residency drive > COVID-19 folder. I will continue to upload all the important documents as they are sent out. 

  • Attendings – if you want access to this folder send me your personal email address and I will send you a link to view. 
  • COVID-19 Links – is a document I made to keep track of the best resources to stay up to date. It is in the drive folder. 

Academic To-Do: EMS/Wilderness Block

Interns – Foundations modules for this month are 27 Endo, 28 HemeOnc, 30 ImmunoDerm

27 Endo – https://foundationsem.com/endocrine-metabolic/

Endocrine & Metabolic – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 116, 117, 118, 120Hippo: electrolytes, DKA/HHS, Thyroid

28 HemeOnc – https://foundationsem.com/hematology-oncology/

Hematology & Oncology – Foundations of Emergency MedicineUnit Topics & Framework Traditional Textbook High-Yield Texts Multimedia; Heme / Onc: Hematologic Emergencies, Emergent Complications of Malignancy Approach to Sickle Cell Crisisfoundationsem.com

Rosen’s: Chapters 111, 112, 114, 115Hippo: platelets, RBCs, Leukemia

30 ImmunoDerm – https://foundationsem.com/immunology-dermatology/

Immunology & Dermatology – Foundations of Emergency MedicineFoundations 1 | Foundations 2 Foundations 1 Foundations 2 Mouse over each Article under Primary Literature to see the full titlefoundationsem.com

Rosen’s: 108, 109, 110Hippo: Derm, Immuno

PGY2/3 –Either Immune, Derm, or Endocrine

ALiEM Approved Instructional Resources (AIR) – ALiEMUWelcome to the Approved Instructional Resources (AIR) series, exclusively sponsored by the Society of Academic Emergency Medicine (SAEM)!Since 2014, this series has curated and graded open-access blog posts and podcasts in the field of emergency medicine (EM) over the previous 12 months to identify high quality, social media-based, educational resources for EM residents.www.aliemu.com

Conference:ZOOM SESSION – continues this week. Details to follow. 

Scheduling:

PGY 2/3 – Block 12 is published. We are just putting the last finishing touches on block 13 and will publish ASAP.  

Podcast of the Week:

Submission from Ben Wilkinson – Dr John Hinds has a YouTube post on motorcycle traumas. Graphic visuals so considered yourself cautioned.

From the Residency Desk


Happy May. The great weather has arrived, and with it, HemeOnc Block is upon us. If you are behind on Mother’s day shopping, how about some wall art for her home or office? I think you still have time with express shipping for this nice print…https://www.etsy.com/listing/749078323/t-cells-watercolor-print-immune-cells?gpla=1&gao=1&&utm_source=google&utm_medium=cpc&utm_campaign=shopping_us_low-low_d-art_and_collectibles-prints-giclee&utm_custom1=765df1a7-ae53-4138-99f5-eea9da4d868b&utm_content=go_6723177821_83065245761_388321021804_pla-354814757658_c__749078323&utm_custom2=6723177821&gclid=EAIaIQobChMIhJLwx6-c6QIV8R9lCh3mGgeLEAQYASABEgKiwvD_BwE

T-Cells Watercolor Print Immune Cells Medical Art Science Histology T Cells Biology Art Oncology immunology Clinic Office Cancer Chemo-1473DO WE SELL DIGITALS ? ❤ We are UNABLE to offer/sell DIGITAL DOWNLOADS! We only offer PRINTS for sale. SIGNATURE Please note we do NOT SIGN velvet/canvas and large paper posters ( A2-A1-A0 ) if you like them to be signed please add a note on checkout otherwise we do not take responsibility.www.etsy.com

Schedule/Shifts: 
First I want to thank everyone for being so flexible over the past months. We have all felt the shifting sands, and the residency program is right in the middle of it. The current iteration of our schedule will always strive to first provide education then coverage.  We will continue this current coverage of zones until June 30th.  The new interns will likely orient on shifts in all zones except Main. We will plan on returning to our regular scheduled programming Aug 1 with two shifts for seniors on main, and round the clock interns back to main…but stay tuned, it is subject to change. 
Conference:
We will continue to have online /virtual conference. We have some good programming upcoming, including Palliative Care in the ED this week with our very own Dewitt and Phillips show.   Next week make sure you login for our Grand rounds with Dr. Wilkerson on best practices in  Sickle Cell disease management. Lots of good stuff. 
Residency Participation Citizenship. 
I anticipate being able to bring back the shadow-shifts as soon as possible. Since we are not having simulation, we will examine alternate ways for you to fulfill these hours.  We will be asking in July for direct shadow shifts with our incoming interns for baseline assessments and we anticipate a good number of these. I will keep you posted.   In the meantime, consider joining a resident in a quality project or research project.
Graduation:
We will not be holding a graduation event…in person. I know this is a terrible pill to swallow but its the right thing to do. We look forward to this event every year, and this class deserves a nice tribute. In keeping with VT, VTC, and all other graduations that have been cancelled, this one also can’t happen as it has previously.  We still want to honor our graduates and all the hard work this department has done in the past academic year so we will proceed with an online event. More details to come, but you should have received a save the date. This is an extra special event because no pants are required (depending on where your camera is focused).   
Orientation:  
Really tricky. We are constantly evaluating the possibilities but onboarding the new interns will be challenging, depending on what the next 30 days brings. Likely, we will be moving much of our regular GME onboarding to online format however, Ultrasound boot camp, Central Line training, and the EM specific Suturing, Airway, and Ortho Skills labs will all be live in some fashion so look at those as opportunities for Residency Citizenship hours also. 
Faculty Bios:
Our website needs fixing. Currently it looks like we have 6 faculty… Over the coming weeks though, Program Leadership will be reaching out to each of you to ensure you have an updated photo, and bio for our website. Watch for requests. 
And as always…if you have ideas or suggestions to improve our program, let us know. If you see something, say something.

DK

This Week (5/3)

46th edition. The EMS block has concluded. Finish your Rosh Quizzes by tomorrow in order to be counted towards the championship. We are now starting the HemeOnc block. 

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General:

SCHEDULING CHANGE –as of NOW, the matrix for PGY 1 & 3 is as follows: 6a-2p1:30p-9:30p, and 9p-6a. This is different from last week so pay attention. 

PPE Selfies – I would like to come up with some way to send thanks to my friend that allowed us to obtain all of the half respirators. Please send me a picture of you at work in your half mask with the pink cartridges. Obviously keep any patient identifying information out of the frame. I was thinking of having people hold up a piece of paper that says “Thank You” or something along those lines. I’m open to suggestions. Send these to my work phone: 540-855-4994

Substance Abuse Modules – are available on the google drive under educational content > psych. Please watch these and go over the slides if you did not make it to lecture. Leslie needs a copy of your pre-test in addition to an evaluation for EACH MODULE. Yes, each module. Old Items:Resident Respirators –if you have not had a chance, go to employee health to get a replacement p100 cartridge for our half mask respirators. These are half the size of the pink cartridges so a little lighter to wear. Go now while supplies last. 

COVID-19 – continue to check the main residency drive > COVID-19 folder. I will continue to upload all the important documents as they are sent out. 

  • Attendings – if you want access to this folder send me your personal email address and I will send you a link to view. 
  • COVID-19 Links – is a document I made to keep track of the best resources to stay up to date. It is in the drive folder. 

Academic To-Do: EMS/Wilderness Block

Interns – Foundations modules for this month are 27 Endo, 28 HemeOnc, 30 ImmunoDerm

27 Endo – https://foundationsem.com/endocrine-metabolic/

Endocrine & Metabolic – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 116, 117, 118, 120Hippo: electrolytes, DKA/HHS, Thyroid

28 HemeOnc – https://foundationsem.com/hematology-oncology/

Hematology & Oncology – Foundations of Emergency MedicineUnit Topics & Framework Traditional Textbook High-Yield Texts Multimedia; Heme / Onc: Hematologic Emergencies, Emergent Complications of Malignancy Approach to Sickle Cell Crisisfoundationsem.com

Rosen’s: Chapters 111, 112, 114, 115Hippo: platelets, RBCs, Leukemia

30 ImmunoDerm – https://foundationsem.com/immunology-dermatology/

Immunology & Dermatology – Foundations of Emergency MedicineFoundations 1 | Foundations 2 Foundations 1 Foundations 2 Mouse over each Article under Primary Literature to see the full titlefoundationsem.com

Rosen’s: 108, 109, 110Hippo: Derm, Immuno

PGY2/3 –Either Immune, Derm, or Endocrine

ALiEM Approved Instructional Resources (AIR) – ALiEMUWelcome to the Approved Instructional Resources (AIR) series, exclusively sponsored by the Society of Academic Emergency Medicine (SAEM)!Since 2014, this series has curated and graded open-access blog posts and podcasts in the field of emergency medicine (EM) over the previous 12 months to identify high quality, social media-based, educational resources for EM residents.www.aliemu.com

Conference:ZOOM SESSION – continues this week. Details to follow. 

Scheduling:

PGY 2/3 – Block 12 is published. Take a look and let us know if you see any issues. Block 13 will be finalized in the this week.  

Podcast of the Week:

EM:RAP did a breaking news podcast week that was an update to vent management in COVID.  It’s very good and worth a listen. This was done by Haney Mallemat, MD who is an attending at Cooper Health so I am a little biased. https://www.emrap.org/episode/emrap2020april7/emrap2020april

April 2020 – EM:RAP 2020 April 27th Breaking News – Ventilator Management Update – EM:RAP 2020 April 27th Breaking News – Ventilator Management Update | EM:RAPEpisode Guidewww.emrap.org

This Week (4/26)

45th edition. The EMS block continues with all houses are still in contention. 

Image

General:

SCHEDULING CHANGE –as of TODAY, the matrix for PGY 1 & 3 is as follows: 7a-3p2:30p-10:30p, and 10p-7a. This has been done to mirror the changes made to the attending schedule. 

Resident Respirators –need to be fit tested & cleaned daily. Go to employee health to pick up a pair of p100 filters for the masks. These are lighter than the cartridges and every resident gets 1 pair. Go get them while supplies last. The google drive folder now has detailed instructions on how to clean. There are instructions in the COVID folder on the drive for more specifics. There will be a video on how to clean sent out shortly on the cornerstone. Old Items:
Housing Survey – Faiz & Rahul have created a survey to help incoming residents with housing decisions. Please complete ASAP so we can get them the information now while they are deciding where they want to live. https://forms.gle/zmU8c4UsB2zmuEwaA

Living in RoanokeWe are trying to gather some general info on where residents live, eat out, exercise, and other things people do in Roanoke (pre- and post-Covid) in order to help the incoming interns.forms.gle

PEC Survey – Anne and the program evaluation committee need our feedback on ways to improve charting and other parts of the program. This is very important and helps us make positive changes. Please complete now so we can use it at our next meeting.https://www.surveymonkey.com/r/G2XHXR6

PEC SurveyTake this survey powered by surveymonkey.com. Create your own surveys for free.www.surveymonkey.com

Med Hub GME Module – has been assigned in place of the in-person sessions in the Med Ed building for obvious reasons. Please get this done by the end of the month. It does not take too long. If you are having trouble logging into the video website through Carilion, you need to use “carilion\username” and then your normal password. 

COVID-19 – continue to check the main residency drive > COVID-19 folder. I will continue to upload all the important documents as they are sent out. 

  • Attendings – if you want access to this folder send me your personal email address and I will send you a link to view. 
  • COVID-19 Links – is a document I made to keep track of the best resources to stay up to date. It is in the drive folder. 

Academic To-Do: EMS/Wilderness Block

Interns – Foundations modules for this month are 12 Trauma III, 22 Tox II, 23 Env

Trauma III – https://foundationsem.com/trauma/

Trauma – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 56, 134Hippo: thermal burns, electrical burns, special populations, skin & soft tissue

Tox II, Env – https://foundationsem.com/tox-environmental/

Tox / Environmental – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 143, 147, 151, 152, 153, 157, 158, 131, 132, 133, 135, 136, 137Hippo: high altitude, bites, CCB

PGY2/3 –Environmentalhttps://www.aliemu.com/courses/environmental-2018/

Environmental – 2018 – ALiEMUEnvironmental – 2018. AIR STAMP OF APPROVAL AND HONORABLE MENTIONS. Below we have listed our selection of the 3 highest quality blog posts within the past 12 months, as assessed in December 2017 related to Environmental emergencies in the Emergency Department, …www.aliemu.com

Conference:ZOOM SESSION – continues this week. Details to follow. 

Scheduling:

PGY 2/3 – Block 12 is published. Take a look and let us know if you see any issues. Block 13 will be finalized in the next week.  

This Week (4/19)

44th edition. The EMS block continues are due to record-setting attendance, all houses are still in contention. Not a lot of new updates this week so I will keep it short. 

General:

Resident Respirators –need to be fit tested & cleaned daily. There are instructions in the COVID folder on the drive for more specifics. There will be a video on how to clean sent out shortly on the cornerstone. Old Items:
Housing Survey – Faiz & Rahul have created a survey to help incoming residents with housing decisions. Please complete ASAP so we can get them the information now while they are deciding where they want to live. https://forms.gle/zmU8c4UsB2zmuEwaA

Living in RoanokeWe are trying to gather some general info on where residents live, eat out, exercise, and other things people do in Roanoke (pre- and post-Covid) in order to help the incoming interns.forms.gle

PEC Survey – Anne and the program evaluation committee need our feedback on ways to improve charting and other parts of the program. This is very important and helps us make positive changes. Please complete now so we can use it at our next meeting.https://www.surveymonkey.com/r/G2XHXR6

PEC SurveyTake this survey powered by surveymonkey.com. Create your own surveys for free.www.surveymonkey.com

Med Hub GME Module – has been assigned in place of the in-person sessions in the Med Ed building for obvious reasons. Please get this done by the end of the month. It does not take too long. If you are having trouble logging into the video website through Carilion, you need to use “carilion\username” and then your normal password. IM Resident Survey – Previously I sent out a pre-survey as a QI for one of the IM residents. For obvious reasons, he is unable to complete the in-person training component to complete his project. Please go over the attached PowerPoint presentation and fill out his post-survey. It doesn’t take long so please help out a fellow resident. Post survey link:
https://docs.google.com/forms/d/e/1FAIpQLSdzSrVQYsZl48qM44zUspFTfsHMZsrmbLKb1bRbOXs-qS3Kfg/viewform

COVID-19 – continue to check the main residency drive > COVID-19 folder. I will continue to upload all the important documents as they are sent out. 

  • Attendings – if you want access to this folder send me your personal email address and I will send you a link to view. 
  • COVID-19 Links – is a document I made to keep track of the best resources to stay up to date. It is in the drive folder. 

Academic To-Do: EMS/Wilderness Block

Interns – Foundations modules for this month are 12 Trauma III, 22 Tox II, 23 Env

Trauma III – https://foundationsem.com/trauma/

Trauma – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 56, 134Hippo: thermal burns, electrical burns, special populations, skin & soft tissue

Tox II, Env – https://foundationsem.com/tox-environmental/

Tox / Environmental – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 143, 147, 151, 152, 153, 157, 158, 131, 132, 133, 135, 136, 137Hippo: high altitude, bites, CCB

PGY2/3 –Environmentalhttps://www.aliemu.com/courses/environmental-2018/

Environmental – 2018 – ALiEMUEnvironmental – 2018. AIR STAMP OF APPROVAL AND HONORABLE MENTIONS. Below we have listed our selection of the 3 highest quality blog posts within the past 12 months, as assessed in December 2017 related to Environmental emergencies in the Emergency Department, …www.aliemu.com

Conference:ZOOM SESSION – continues this week. There will be an ALIEMu session as well that requires some preparation. Be on the lookout for instructions to come from Jen via email. 

Scheduling:

PGY 2/3 – Block 12 will be published in the next few days. We are just finishing the PGY2 portion. If you have specific questions or need to make plans that can’t wait for publishing, email one of the chiefs and we can let you know. 

Podcast/Blog of the Week:

EmCrit part 2 of the APRV ventilation strategy. Be sure to look at the blog post itself for visuals. This is complicated so I found that the visuals help quite a bit with understanding the physiology. https://emcrit.org/emcrit/philosophy-of-aprv-tcav/

EMCrit Wee – The Philosophy of APRV – TCAV with Nader HabashiA zentensivist discussion of ventilator management. If I get it right, the Patient is breathing spontaneously on a “PEEP or CPAP-level” of 30cmH20 during approximatly 90 percent of the respiratory cycle (during p-High), while you do not monitor the pressure during P-Low (which basically equals PEEPi).emcrit.org

This Week (4/13)

43rd edition. The EMS block continues online learning with great attendance again last week. After tallying the Rosh quizzes from last month, House Fortuna has claimed the GI crown and pulls into a tie for second place overall with House Clinton. 

General:

Resident Respirators –need to be fit tested & cleaned daily. There are instructions in the COVID folder on the drive for more specifics. 

Rosh Quizzes – need to be completed and are not optional. Usually, there are only a couple of people (if any) that do not get these done but this month there were several incompletes. Now that we are doing most of the learning online these are MORE important, not less. It only takes maybe 20 minutes to do the three quizzes before the deadline and then you can review them at your leisure. Housing Survey – Faiz & Rahul have created a survey to help incoming residents with housing decisions. Please complete ASAP so we can get them the information now while they are deciding where they want to live. https://forms.gle/zmU8c4UsB2zmuEwaA

Living in RoanokeWe are trying to gather some general info on where residents live, eat out, exercise, and other things people do in Roanoke (pre- and post-Covid) in order to help the incoming interns.forms.gle

PEC Survey – Anne and the program evaluation committee need our feedback on ways to improve charting and other parts of the program. This is very important and helps us make positive changes. Please complete now so we can use it at our next meeting.https://www.surveymonkey.com/r/G2XHXR6

PEC SurveyTake this survey powered by surveymonkey.com. Create your own surveys for free.www.surveymonkey.com

Old Items:

Med Hub GME Module – has been assigned in place of the in-person sessions in the Med Ed building for obvious reasons. Please get this done by the end of the month. It does not take too long. If you are having trouble logging into the video website through Carilion, you need to use “carilion\username” and then your normal password. IM Resident Survey – Previously I sent out a pre-survey as a QI for one of the IM residents. For obvious reasons, he is unable to complete the in-person training component to complete his project. Please go over the attached PowerPoint presentation and fill out his post-survey. It doesn’t take long so please help out a fellow resident. Post survey link:
https://docs.google.com/forms/d/e/1FAIpQLSdzSrVQYsZl48qM44zUspFTfsHMZsrmbLKb1bRbOXs-qS3Kfg/viewform

COVID-19 – continue to check the main residency drive > COVID-19 folder. I will continue to upload all the important documents as they are sent out. 

  • Attendings – if you want access to this folder send me your personal email address and I will send you a link to view. 
  • COVID-19 Links – is a document I made to keep track of the best resources to stay up to date. It is in the drive folder. 

Academic To-Do: EMS/Wilderness Block

Interns – Foundations modules for this month are 12 Trauma III, 22 Tox II, 23 Env

Trauma III – https://foundationsem.com/trauma/

Trauma – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 56, 134Hippo: thermal burns, electrical burns, special populations, skin & soft tissue

Tox II, Env – https://foundationsem.com/tox-environmental/

Tox / Environmental – Foundations of Emergency MedicineTo create a free, open-access, comprehensive Emergency Medicine curriculum that will serve as the educational gold standard within our specialty.foundationsem.com

Rosen’s: Chapters 143, 147, 151, 152, 153, 157, 158, 131, 132, 133, 135, 136, 137Hippo: high altitude, bites, CCB

PGY2/3 –Environmentalhttps://www.aliemu.com/courses/environmental-2018/

Environmental – 2018 – ALiEMUEnvironmental – 2018. AIR STAMP OF APPROVAL AND HONORABLE MENTIONS. Below we have listed our selection of the 3 highest quality blog posts within the past 12 months, as assessed in December 2017 related to Environmental emergencies in the Emergency Department, …www.aliemu.com

Conference:ZOOM SESSION – will be happening Thursday morning. Stay tuned for a link with a schedule of lectures. Pay attention to emails because part of conference will be an Aliemu session that you will need to sign up for ahead of time. 

Scheduling:

PGY 2/3 – Block 11 is now published and we are working on Block 12. Please let us know if you haven’t already if you have any conflicts during this block that are still happening. 

Podcast/Blog of the Week:

EmCrit did an episode last week as part 1 of a two-part series on APRV. It’s a ventilation strategy that has shown some promise with COVID patients so worth listening to. The blog post is also helpful with visuals that help explain what they are talking about. https://emcrit.org/emcrit/aprv-primer/

COVID19 Respiratory Rescue and Ventilatory Optimization – Airway Pressure Release Ventilation (APRV) Time-Controlled Adaptive VentilationI was able to use APRV (Bivent in SVI vent) as a rescue mode on one of these patients Thursday night and it may have saved him from coding. I started on Phigh 30 (Pplat measured at 30 on prior setting) Plow 0 T high 4.0s Tlow 0.5s.emcrit.org