83rd Saturday Summit: WACEM Weekly Global e-Grand Rounds - Point of Care Ultrasound in EM ~ The Water Bath Technique

 16th October 2021

Water Bath Technique for Extremity Injuries 

Speaker:

Professor Sanjeev Bhoi from AIIMS New Delhi.

The Water Bath Technique

Fill a Tub with Luke warm water. Place the patient extremity either foot or hand in the tub totally submerged. 

You can then take a Linear Probe with a Frequency of 7-10 MHz.

Run the probe along the surface of the water covering the part to be scanned adjusting the Sonography machine for depth as water will add to the interface and act as a contrast medium.

The Long Axis views get a better image of tendons, skin and bone while the transverse view helps evaluate multiple areas.

Water Contrast increases the diagnostic quality. 

This technique can diagnose: Fractures, Infection. Foreign Bodies and Tendon Tears. 

82nd Saturday Summit: WACEM Weekly Global e-Grand Rounds - Evidence Based Medicine

 

9th October 2021

 Neutrophil-lymphocyte ratio as predictor of outcome following traumatic brain injury Systematic review and Meta-analysis 

 

Speaker: Dr. Rakesh Mishra Assistant Professor Neurosurgery research and education at the Institute of Medical Sciences, Banaras Hindu University. 

 

Moderator: Dr Amit Agrawal on behalf of Neutrophil-lymphocyte ratio Research Group

 

Evidence-based medicine has revolutionized the decision-making process in different specialties of medicine. Systematic review and meta-analysis have been the
most important research tool for evidence synthesis and identifying the quality of evidence. Systematic review is an arduous task with iterative steps and requires extensive cooperative team work. In the talk the essential concepts, steps, philosophy and necessity of systematic review and meta-analysis was discussed using NLR in TBI as the model.

 

At the end of the session:

 

- Understand the concepts of systematic review and meta-analysis.

 

- Using NLR model the process of systematic review and meta-analysis was discussed into and all the individuals’ steps were deliberated upon. 

 

- Discuss on several research questions of importance to health care and emergency medicine and find the right approach for the evidence synthesis.

 

81st Saturday Summit: WACEM Weekly Global e-Grand Rounds - The Quaterly Resident Rumble : Evidence Based Wound Care in the ED

WACEM Quarterly Resident Rumble

2^nd October 2021

 

Presenter: Dr. Courtney Kirkland, DO

                    PGY III

                    Florida State University

                    EM Residency Program, Sarasota, Florida.

 

Part I of the Presentation:

Journey of PGY III Resident and Status Today:

• Description of Sarasota Memorial Hospital acuity and volumes

• Responsibilities of an EM resident physician

• A list of skillsets and procedures that we are proficient in.

 

Part II of the Presentation:

Evidence Based Wound Care:

 

• Literature review with various data on controversial wound care management topics

• Consensus on “time since wounding” for primary closure vs. delayed primary closure regarding clean wounds is 6-10 hours for extremity wounds and 10-12 hours or even more for wounds on the face and scalp

• Contaminat4ed, infected or high-risk wounds should be closed by delayed primary closure

• Always obtain an x-ray when concerned about a retained glass foreign body, physical examination alone is not enough to rule it out

• Standard for wound irrigation consists of high-pressure irrigation with saline or water

• Tap water is just as effective for irrigation as saline

• Sterile gloves show no benefit over regular gloves for wound closure

• Certain immunocompromised populations may require prophylactic antibiotics

• Currently bite wounds above the clavicle are recommended to be closed with careful consideration of primary closure of bite wounds to the extremities

80th Saturday Summit: WACEM Weekly Global e-Grand Rounds on Congnitive Theory in Simulation

25th September 2021

 

Speaker: Dr. Afrah Ali is an assistant professor with expertise in medical education and simulation at the University of Maryland School of Medicine. 

Topic: Cognitive load theory in Debriefing 

Debriefing is a complex skill that requires deliberate practice. The cognitive load theory when applied to debriefing helps to mitigate the various loads on the working memory. It helps enhance the debriefing experience for the learners and promote faculty development.

At the end of the session, the attendees were able to :

- Understand the concepts of cognitive load theory and its application in simulation.

- Categorize the many potential mental loads that can affect the faculty

debriefer as a learner. 

 

- Discuss mitigation strategies that can be considered by faculty development
programmed to enhance professional development of debriefing staff.