CMES-Pi Participant Highlight: Mount St. John’s Medical Center, Antigua

Meet Dr. Vonetta George who works at Mount St. John’s Medical Center (MSJMC) in Antigua. Dr. Vonetta works in all critical care areas of the hospital including supervising the 15 doctors and 2 dozen+ nurses in the Emergency Department.

Antigua is located in the West Indies, a Leeward Island in the Caribbean. Mount St. John’s serves the population of Antigua and also Barbuda. Working on an isolated island directly affects the doctors and nurses ability to access current continuing medical education in a cost effective manner. Dr. Vonetta was the gail force hurricane behind getting the CMES-Pi Project installed in her hospital. MSJMC installed a CMES-Pi in June last year. Using our smart phone apps the staff can look up CME current practice topics at bedside. The CME is provided by our partner Emergency Medicine Reviews and Perspectives. The PDF files provide helpful bullet points and take seconds to read. The MP3 files are providing topics for weekly group CME conferences and discussions. The CMES-Pi Project directly impacts access to CME for 101 doctors and 179 nurses at the hospital. Thank you Dr. Vonetta!

Who Knew? The first inhabitants were the Siboney, who can be dated back to 2400 BCE. Arawaks settled subsequently, around the 1st century CE. The Caribs arrived later, but abandoned Antigua around the 16th century, due to the shortage of fresh water. Christopher Columbus sighted the larger island in 1493, and named it after a church in Seville, Santa Maria de la Antigua. (Commonwealth)

C3: Psychiatric Emergencies Part 2

Wikimedia image.

Last week I introduced you to C3, Continuous Core Content, the newest medical education available to all CMES and CMES-Pi participants. The March C3 content is part two of psychiatric emergencies covering depression, anxiety and eating disorders. You can access the C3 folder with the thumb drive or the smartphone apps using the CMES-Pi.

Do you know what endocrine disorder can mimic depression or that pulmonary emboli can present with a common and misleading psychiatric complaint? A quick read of the Take Home Points will lift your spirits and lessen your anxiety when faced with a psychiatric emergency.

Who Knew? Psychiatric illness were recognized over 4000 years ago In the second millennium B.C. in Mesopotamia where there are written accounts of depression. It was thought to be a spiritual condition and therefor treated by priests instead of healers.

Introducing C3: Continuous Core Content

Photo from Wikimedia.

WooHoo…C3 is here for your listening and viewing pleasure! EM:RAP has generously provided Techies Without Borders their C3 content to add to our cloud based server. This CME content is available to participants using either the thumb drive (USB) or Raspberry-Pi access options. It will be in a separate folder and you can use the Search for specific topics.

C3 is a clinical based review on how to assess and treat common and grave Emergency Department and Urgent Care complaints. It’s ideal for all practitioners wanting to review the basics efficiently and quickly. Think of it as your basic Lego set.

The same great MP3 and PDF formats are available. The audio file contains a focused summary at the end of the talk, so if you are short on time you can fast forward. The PDF files start off with the all important Take Home Points for a quick update. You can also test your knowledge with the uploaded questions and answers.

Build up or reinforce your basic knowledge with C3. Thank you EM:RAP.

Who Knew? “The Lego Group began in the workshop of Ole Kirk Christiansen (1891–1958), a carpenter from Billund, Denmark, who began making wooden toys in 1932.[7][8] In 1934, his company came to be called “Lego” derived from the Danish phrase leg godt [lɑjˀ ˈɡʌd], which means “play well”.” (Wikipedia)

 

 

Aneurysms: It’ll Blow Your Mind

Abdominal aorta MRI. (Wikimedia)

Practicing in rural and remote regions globally with limited staff and resources poses challenges not faced by your colleagues in larger cities and academic centers. Case presentations from those working in rural regions help us understand the restrictions, challenges, and downright genius solutions from treating to to saving a life. I find these stories uplifting, invigorating, and deserving of a standing ovation.

Take a listen or read about The Case of the Man with the Aneurysm by Vanessa Cardy MD and Mel Herbert MD in the EM:RAP April files. It’ll expand your knowledge.

 

Who Knew?

On 17 April 1955, Einstein experienced a ruptured abdominal aortic aneurysm, which had previously been reinforced surgically by a surgeon in 1948. He took the draft of a speech he was preparing for a television appearance commemorating the State of Israel’s seventh anniversary with him to the hospital, but he did not live long enough to complete it. Einstein refused surgery, saying, “I want to go when I want. It is tasteless to prolong life artificially. I have done my share; it is time to go. I will do it elegantly.” He died early the next morning at the age of 76, having continued to work until near the end. (Wikipedia)

 

DevelopingEM: A Model for Emergency Medicine Collaboration

Dr.Mereoni Voce from Labasa Hospital at the DevelopingEM Conference in Fiji.

DevelopingEM is a partner of Techies Without Borders. DevelopingEM is a nonprofit corporation from Australia with a model to promote and develop Emergency Medicine globally through collaboration. Last December Dr. Deb was invited to speak at their sixth conference in Fiji. Each conference is designed to deliver excellent emergency medicine and critical care content. Not only is the conference for practicing EM specialists but the model brings local health providers to the conference supported by the conference fees and contributions. They encourage global collaboration between countries where EM is developing and gaining momentum as a specialty.

DevelopingEM is heading to Cartagena, Colombia for their seventh Emergency Medicine and Critical Care conference. Consider joining them in March 2020 for a chance to support this forward-thinking team.

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.

 

 

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