Sepsis and Pregnancy

Pregnant graffiti in Lebanon (Wikimedia)

According to an excerpt from Randi Hutter Epstein’s book Get Me Out: A History of Childbirth From the Garden of Eden to the Sperm Bank, five hundred years ago a folk healer advised Catherine de Medici, then the queen of France, to drink mare’s urine and bathe in cow manure to increase her chances of getting pregnant. And she did it. Fortunately, you won’t need mare’s urine to treat pregnant patients with sepsis. But you will need to listen to the March EM:RAP podcast or read the PDF called Sepsis and Infections in Pregnancy by Stewart Swadron MD, Gillian Schmitz MD, Rachel Bridwell MD and Brandon Carius PA.

What are the most common infections seen in pregnancy in your region? Are vital signs good indicators during maternal and fetal resuscitation? If you don’t have much time there are five quick Take Home Points for a 30-second read.

Wikimedia photo.

Who Knew? Some of the earliest women’s health books were written by monks…although they would not be my first or even seventh guess as authors. One of the most popular monk guides, Women’s Secrets, or De Secretis Mulierum, has been translated from the original text into modern language by Helen Rodnite Lemay, a medieval scholar.

Get Your Procedure Game Plan On

Perikles Kakousis, weightlifting Olympic champion. St. Louis Olympic Games, 1904. Wikicommons.

Procedures form a structural competency in our medical practices. There’s a satisfaction that goes with a well-executed procedure be it placing a chest tube or realigning an ankle dislocation. There are some bread and butter procedures we do weekly such as intubations to those that call for our expertise rarely such as a cricothyroidotomy. So how do you get your game plan on with the rarely performed procedures? Take a listen to the EM:RAP March podcast or read the pdf called Procedural Competency by Mel Herbert MD and Jestin Carlson MD for quick suggestions on how to stay on top of rarely performed procedures. You’ll be a procedural champ and win the game.

Who Knew? The most widely accepted inception date for the Ancient Olympics is 776 BC; this is based on inscriptions, found at Olympia, listing the winners of a footrace held every four years starting in 776 BC. Tradition has it that Coroebus, a cook from the city of Elis, was the first Olympic champion. (Wikipedia)

 

 

 

Funding: A Funny Thing

Asking for donations isn’t easy. There are many organizations doing vital work in small and large communities…we understand the barrage of requests especially in the world of social media. But the facts are…we can’t operate without donations. Each of us on Techies Without Borders donates our time and skills. We are asking each of you to donate to our project at Global Giving Accelerator Fundraiser. The goal is $5000 USD in 17 days…to fund our next CMES Project for HandUp Congo in the Democratic Republic of Congo. Donate here

Thank you for your support.

Giant Cell Arteritis

I’m looking at cases to post and found one that could be me…because I’m over 60. Here’s the lowdown: over 60 years old with sudden vision loss? over 60 years old with transient vision loss? over 60 years old with transient double vision? Think Giant Cell Arteritis and take a listen to the March EM:RAP podcast: Giant Cell Arteritis by Ilene Claudius MD and Edward Margolin MD.

Or take a quick look at the PDF and bring home the take home points…it’ll make you a giant in the know.

Who Knew? Tales of giants are found in many cultures. The word giant, first attested in 1297, was derived from the Gigantes (Greek: Γίγαντες[1]) of Greek mythology. (Wikipedia)

Somewhere Over the Rainbow

Dorothy’s original ruby slippers (Wikicommons)

Neonatal stools are a source of concern for parents and color changes can trigger a visit to the emergency department or outpatient clinic. What colors raise your index of concern for serious pathologies such as necrotizing enterocolitis, malrotation with midgut volvulus or intussusception? Plug in your thumb drive or roll out your CMES app and take a listen to Jess Mason MD and Jason Woods MD as they discuss the EM:RAP podcast called Neonatal Stool Rainbow. You won’t find the Wizard of Oz but you’ll take home some knowledge…even without your ruby slippers.

 

 

Rural Medicine: Diabetic Ketoacidosis

Glucometer. Courtesy Wikicommons.

Once a month I will comment on the Rural Medicine podcast from EM:RAP. It’s exciting to read CME that can be applied globally no matter where you live or what resources you have at hand. Diabetic Ketoacidosis (DKA) In The Village by Vanessa Cardy MD and Stuart Swadron MD can be found in the February 2019 EM:RAP podcasts or take a quick read of the PDF for bullet points.

The question of the month? How do you manage DKA when you don’t have access to labs? 

Urine dip strip. Courtesy Wikicommons.

And…is the urine ketone strip a good test?

Pediatric Wisdom

Pediatric patients at mobile clinic, Tena, Ecuador.

Each month EM:RAP offers a podcast called Pediatric Pearls. Take a listen or read the January edition titled: Pediatric Gynecology Complaints by Ilene Claudius MD and Emily Willner MD. Neonates with blood in the diaper, difficult catheterizations, and how are vaginal exams different in children are a few of the useful topics covered.

Share your experiences and advice. How does your facility manage pediatric emergencies?

 

 

Stress & Burnout

Your working at 5000 rpms as patient after patient after patient arrives at your Emergency Department for treatment. It’s a typical shift but this one never stops gaining momentum until you and the staff are at the breaking point. You think you can manage, but like any excellent racer…some days you can hit a wall, flame and die.

Take a listen or read the August 2018 EM:RAP podcast and PDF called; “Beating Burnout” by Annahieta Kalantari DO. It’s there for you to access using a CMES-Pi or the CMES thumb drives and it’s worth a listen. Even being retired, I was able to understand better why I felt the way I did and what happens to all of us as we deliver medical care.

Take care of yourself and your staff…it’s the only way to win the race.

 

 

Introducing C3: Continuous Core Content

C3 = Continuous Core Content. C3 is now available as a podcast or PDF files with the CMES Project. This is EM:RAP’s clinical reviews of how to approach and take care of patients with serious and common Emergency Department and Urgent care complaints. These are the basics and provide rock-solid skills to your clinical knowledge base. Each month you will find a new topic ranging from Wound Management to Adult Pneumonia. Participants with CMES-Pi can access starting January 2019. CMES thumb drive participants who receive their thumb drives after January 1, 2019 can access the C3 content along with all the other great EM:RAP CME content.

Sudden vision loss is bad. Take a listen or read from the January C3 titled: Acute Vision Loss by Jessica Mason MD, Stuart Swadron and MD, Mel Herbert MD. For those with ultrasound capabilities watch the YouTube video: Ultrasound of Retinal vs. Vitreous Detachment

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