Last night I lay comfortably in my bed, not being able to sleep. I plugged the miniature headphones to my Android and listened to Scott Weingart's EMCrit podcasts on treating the severe asthma patient. After that Amal Mattu's EM Cast about a 2 year old lethargic child with fever and that's when I Mr. Mattu started to echo and I found my self drifting away into the world of jumping sheep.
Earlier this week I was asked to have a short clinical case for my colleges in the hospital and as preparation time was essentially none I picked three excellent 5-minute videos from HQMedEd, all presenting a clinical scenario where the ultrasound in the ED saved the patients life (walkin and talkin!). I had even prepared to show Vanderbuilt's ultrasound video collection to show my ED colleges that learning to use ultrasound in year 2010 doesn't require an expensive international course - just a comfortable sofa with your laptop/mobile and some interest in the field!
Then, preparing for an exam next week - the insanely great Lifeinthefastlane has provided me with invaluable texts on everything I ever wanted to know about ECG, arrhythmias, electrolyte disorders (and other lab-abberancies), intoxications and ED medicines like Magnesium in acute asthma. It's so much more than just a blog. Of course I have my dear Tintinalli resting quietly in the book-shelf, just in case - but LITFL has simply provided me with everything I need to know. It's a true emergency medicine website; written by emergency physicians for emergency physicians - just the facts. The cream of the cake. The brass of the music.
With all this knowledge at the top of my cortex I was prepared for that unconscious patient the other day presenting with a new LBBB which I correctly diagnosed as hyper-K induced. After some insulin+glucose, a new ECG revealed a normal sinus rythm and a resource-draining trip to the angio-lab was spared.
And I haven't told you all the useful things I've learned by reading through my RSS subscriptions... oh my oh my...
December 1, 2010
An interesting little thing to remind us of the possibility that a patient can have more than one diagnosis at presentation - something every emergency physician should be aware of! Saint's triad is the simultaneous diagnosis of cholelithiasis, hiatal hernia and diverticulitis:
Saint's triad is named after the British surgeon Prof C.F.M.Saint, the term's eponym, who established the first school of surgery in South Africa. He emphasized the importance of considering the possibility of multiple separate diseases in a patient whenever his or her history and the results of the physical examination were atypical of any single condition. Traditionally, there is thought to be no pathophysiological basis for the coexistence of these three diseases. Saint emphasized that more than one disease may be responsible for a patient's clinical signs and symptoms, and his Triad provides a counterexample to the commonly used diagnostic principle that "the explanation of any phenomenon should make as few assumptions as possible," also known as Occam's Razor . The principle underlying Saint's triad is also expressed as Hickam's dictum.