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.

 

 

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.

 

Giving Tuesday

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.

Please consider making a donation to Techies Without Borders (TWB). Our current project, Continuing Medical Education on Stick (CMES), provides free continuing medical education to doctors and nurses in resource-challenged countries globally. You can donate here or here by clicking the green Donate button.
If you have previously donated this year consider sharing this information via social media and spreading the word.
With gratitude,
TWB Team

Meet Dr. Cristian Carreon, Santo Domingo, Ecuador

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.

Ecuador Gets a Slice of CMES-Pi

Dr. Debra Stoner departs this week to install CMES-Pi at two sites and dispense CMES thumb drives at two other sites in Ecuador, including Quito, Santo Domingo, Guangaje, and Tena.

The CMES thumb drives and CMES-Pi give rural doctors and nurses access to cutting-edge continuing medical education (CME). Timmy Global Health, a Techies Without Borders (TWB) partner, works alongside local health providers in Ecuador to provide healthcare in remote regions. The CME is provided free of charge by another TWB partner, Emergency Medicine Reviews and Perspectives (EM:RAP).

Visit TWB Twitter, Instagram and Facebook pages for more photos later this week.

Bone Up on Your Rongeur Skills

EMRAP‘s YouTube channel has a plethora of tutorial videos and today’s recommendation will take less than 3 minutes to view. Take a quick review of how to rongeur a fingertip bone to facilitate skin closure. Added bonus…how to make a finger tourniquet from a glove. View here.

Who Knew? Think of a rongeur as a heavy duty forceps used to remove bone. The word is derived from the French noun meaning “rodent” or the adjective meaning “gnawing”.

Testicular Torsion – A Convoluted Case

What do Chubby Checker and testicular torsion have in common? (Wikimedia photo)

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 mild tenderness to palpation in the right lower quadrant without rebound. His abdominal ultrasound was inconclusive; the white blood cell count mildly elevated, and the urine microscopy normal. He was admitted for observation. Twelve hours later the patient developed a fever and severe groin pain. A genital exam revealed classic findings for testicular torsion. The testicle was not salvageable. Unfortunately, the patient was born monorchism and rendered sterile by the orchidectomy. The lesson from this case: always include a genital exam in patients with lower abdominal pain.

Can you rely on the history and physical exam to rule out testicular torsion? Is the testicle salvageable after 6 hours? Wrench yourself away from your music downloads and listen to the EM:RAP August podcast called Testicular Torsion by Rob Orman MD and Larry Mellick MD. Get an update and review on this twisted entity and you won’t spiral out of control when faced with the possibility.

Who Knew? “The Twist” is an American pop song written and originally released in 1959 by Hank Ballard and the Midnighters. It was made popular by Chubby Checker, an American rock n’ roll icon, who put his stamp on the song with the twist dance style.

So what do Chubby Checker and testicular torsion have in common? As Mr. Checker said, “Come on let’s twist again…”. Testicular torsion pain can come and go.

 

A Word…or Two…from Mel Herbert at EMRAP

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Who and what is EM:RAP? Emergency Medicine: Reviews and Perspectives (EM:RAP) is our sponsor and source of the continuing medical education (cme) materials brought to you by the Techies Without Borders (TWB) program called Continuing Medical Education on Stick (CMES) and CMES-Pi. Listen to a free podcast by Mel Herbert MD MBBS FAAEM as he discusses the future of EMRAP here.

As a participant in CMES or CMES-Pi we wanted you to appreciate this is a company that goes beyond the mission of excellent cme. It makes a commitment to helping you be the best you can and embracing colleagues worldwide. We at TWB gratefully acknowledge EM:RAPs forward vision and passion.