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.
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.
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.
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) of Greek mythology. (Wikipedia)
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.
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 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?
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.
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.
Napo River, Tena, Ecuador. Local means of travel for many doctors and nurses in the Amazon.
Tomorrow is Giving Tuesday…the kickoff to end-of-year and charitable giving.
If you have previously donated this year consider sharing this information via social media and spreading the word.
Dr. Cristian gives a thumbs up while using the CMES-Pi app to search for medical topics of interest.
Dr. Cristian is a full-time Family Practice doctor at the Centro de Salud Hombro a Hombro Clinic (CSHH) in Santo Domingo, Ecuador. CSHH was established in 2007 and partners with Timmy Global Health during brigades. The clinic has three medical exam rooms, dental room and services, an office and a pharmacy. This small but mighty clinic, staffed by two nurses, one part-time and Dr. Cristian, serves approximately 20,000 patients from the poor urban neighborhoods each year.
Centro de Salud Hombro a Hombro Clinic (CSHH) in Santo Domingo, Ecuador.
Dr. Cristian and his staff have few opportunities or financial resources to attend continuing medical education (CME) conferences in Santo Domingo or Quito. A CMES Raspberry-Pi device was installed in the clinic and using smartphone apps the doctors and nurses can access free CME at the clinic. Every month about 20 new topics are available in Spanish as PDF files.