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    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

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    Rural Medicine: Diabetic Ketoacidosis

    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

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  • Testicular Torsion – A Convoluted Case

    The 14-year-old male patient complained of right lower quadrant pain which varied in intensity for 1 day. He denied nausea, vomiting or fever. The abdominal exam revealed bowel sounds and

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  • Thumbs Up Nigeria

    Meet Dr. Dare Ogunlusi from Ekiti State University Teaching Hospital in Nigeria. He is an attending in the Department of Accident and Emergency. He is the newest recipient and participant in

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  • Time to Charge Your Battery…

    With a jolt of information on button battery ingestions by pediatrician Ilene Claudius. The November 2017 EM:RAP edition has a podcast sure to shock you. From one end of the

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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

Nigeria’s Newest Hospital: The Helping Hands Specialist Hospital

Dr. Dare Ogunlusi is a surgeon in Nigeria. He participates in the CMES Project and had this to say, “I read “The Happy MD’s Guide to Physician Wellness” by Mike Drummond MD and Rob Orman MD. It is brief but loaded and will help my administrative skills.” Dr. Dare shared this recent accomplishment in establishing a new hospital with emergency services which was urgently needed in an outlying area of Ekiti State.

The Helping Hands Specialist Hospital (THHSH) is a subsidiary of Health Foundation Global Services Nigeria Limited registered in Nigeria in May 2011. The 30-bed healthcare facility was registered in October 2018 and Commissioned on 17th November 2018.  It will provide Orthopaedic and Trauma care, Accident and Emergency care, Medical, Mother and Childcare, Surgical, Training and Research facilities, and Laboratory services.

Our goal is to provide high quality, holistic, and affordable healthcare to all patients through our highly motivated staff and integrated health management system.  We aim to be healthcare providers to everyone irrespective of his or her status as a model of excellence for healthcare services.

THHSH is situated in a serene location within a green ambient environment where the air is clean and devoid of carbon pollution. It is located on the outskirt of Ado-Afao Road in Ado-Ekiti, Ekiti State. The closest hospital facility to the location of THHSH is about 3km away. The population in the area is estimated to be about 5,000 households and building. The current occupation of these houses is estimated to be about 30%; that is, 1,500 households with an average of 4 family members. This gives a current total population of 6,000 people.

Anyone interested in supporting or visiting THHSH can contact Dr. Dare on Whatsapp- +17587192605.

 

 

 

Dr. Yan and Dr. Manoj’s Paper Accepted

Dr. Yan Li and Dr. Manoj Thomas will be presenting a paper at the The 15th International Conference on Social Implications of Computers in Developing Countries in Tanzania, May 1-3, 2019. https://2019ifipwg94.net
Well done Manoj and Yan for having a paper accepted at this important conference. In layman’s terms, they are recommending ToC to track ICT4D project outcomes, which can be a tricky prospect.

Title: Adopting Theory of Change for ICT4D project Impact Assessment

Dr. Manoj, Dr. Deb, Dr. Yan, Sarbu and Ben in San Francisco Dec. 2018.

Abstract: A compendium of impact assessment (IA) frameworks are available to understand the impact of ICT4D initiatives in Low-Income Countries. However, existing frameworks do not adequately address the unique challenges of IA for ICT4D, especially the multi-level and time variant characteristics of the IA. To address these challenges, we propose the use of Theory of change (ToC) as a generic framework for IA of ICT4D projects. Based on the seminal work by Weiss (1995), we argue that ToC can be viewed both as a methodology and a deep critical reflection process. We demonstrate the ToC approach for IA using a case study of an ICT4D project for LICs.

One of TWB’s goals for 2019 is to improve our tracking of CMES/CMES-Pi usage and ToC provides a framework for the project.

CMES Thumbs Up for Dr. Aloima Taufilo

Dr. Aloima is an Emergency Department Registrar at the Princess Margaret Hospital in Tuvalu. It is the only hospital in the country, and the primary provider of medical services for all the islands of Tuvalu.

She was a delegate at the DevelopingEM Conference held in Fiji in early December. As a regional delegate she networked with similar doctors struggling to introduce Emergency Medicine concepts and management into their Oceania countries.

Dr. Aloima trained on the CMES thumb drive and will share it’s content with her colleagues at the Princess Margaret Hospital. TWB plans to install a CMES-Pi at the hospital in 2019.

Who Knew? The food culture of Tuvalu is based on the coconut and the many species of fish found in the ocean and lagoons of the atolls. Desserts are made from coconut milk instead of animal milk. The traditional foods eaten in Tuvalu are pulaka, taro, bananas, and breadfruit. Food taken from the sea includes coconut crabs, fish and seabirds.

 

How to Kill a Patient During Airway Management

Airway Management is just that…managing the airway upside down and inside out. Take a quick read of the PDF or listen to EM:RAP’s November MP3 audio podcast called Strayerisms: Fluid Filled Airway. It’ll float your boat.

Correct ET tube placement, but if you tube the esophagus, leave the ET tube in place and use it as a landmark.

According to Dr. Reuben Strayer MD, the author, there are four ways to harm your patient during airway management: failure to oxygenate; failure to ventilate; worsening perfusion; and aspiration. His suggestions are doable no matter where you practice or what resources you lack…remember…your greatest resource is knowledge.

 

 

 

Who Knew? Probably the oldest recovered boat in the world, the Pesse canoe, found in the Netherlands, is a dugout made from the hollowed tree trunk of a Pinus sylvestris that was constructed somewhere between 8200 and 7600 BC. This canoe is exhibited in the Drents Museum in Assen, Netherlands. (Not looking too seaworthy these days.)

 

 

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