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

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