iEM Monthly – November 2019

monthly newsletter

Monthly Newsletter November 2019

Welcome to the iEM Education Project Monthly Newsletter. We will share the achievements, information about top posts, chapters, activities and future plans of the project.

Hot News!

iEM will attend the Asian Conference on Emergency Medicine held in New Delhi, India. The conference is on 7-10 November and organized by the Society of Emergency Medicine, India. We are looking forward to meeting members of the #FOAMed family at the conference.

iEM Visitors

0
Countries
0
Visitors
october 2019
One hundred fifty-nine countries visited iEM content in October 2019. The total number of countries visited iEM platform is 189.

Top Countries in October

Top Blog Post in October

October Blog Posts

Free EM Clerkship Book

iEM Free Book (2018e) reached to >3500 downloads. The book is written by 133 authors from 19 countries. It includes 106 topics, 841 pages, 454 images.

Top Audios of September 2019 From iEM Archive

Top Audios From iEM Archive

Thinking like an emergency physician

Abdominal pain

Massive GI Bleeding

Shock

Emergency medicine: a unique specialty

Cardiac Arrest

Altered mental status

Respiratory Distress

Ovarian Abscess

Chest Pain

Top Images From iEM Archive

Top Images From iEM Archive
17 - epidural + air

Epidural hemorrhage and free air

12.1 - central catheter misplaced

Central venous catheter misplacement

757.3 - Childhood rush - HFM disease

Childhood rush – HFM disease

26.1 - pneumocaccal meningitis 1

Pneumococcal meningitis, MRI

130.1 - SAH - subarachnoid hemorrhage

Subarachnoid hemorrhage

627.3 - Figure 03 - ICH in the right parietotemporal lobe

Intracranial hemorrhage at temporoparietal location

685.2 - electrical injury entry

Electrical injury, entry

449.3 - subacute subdural3

Subdural hemorrhage

336.5 - normal PA chest x-ray HEART BORDERS

Normal heart borders, normal chest x-ray

Top chapters and blog posts of September 2019

Top chapters and blog posts of September 2019

Abdominal Pain

by Shaza Karrar Case Presentation A 39-year-old female presented to the emergency department (ED) complaining of right-lower-quadrant (RLQ) pain; pain duration was for 1-day, associated

Infographics

Vertigo in ED toxicology pearls – active charcoal Pediatric tube sizes Oceania – Countries Recognize EM as a specialty Africa – Countries Recognize EM as

How to Read C-Spine X-Ray

by Dejvid Ahmetović and Gregor Prosen Introduction C-spine x-ray interpretation is one of the fundamental skills of emergency physicians. Although current guidelines lead us to

How to read chest x-rays

by  Ozlem Koksal Introduction Chest X-ray interpretation is one of the fundamental skills of every doctor. Emergency physicians are particularly exposed to various chest x-rays

How to read head CT

by Reza Akhavan and Bita Abbasi For a standard approach to read head/brain computed tomography (CT) scan, one should adhere to systematic algorithms. The predefined

How to read pelvic x-rays

by Sara Nikolić and Gregor Prosen Introduction Pelvic fractures carry life‐threatening injury potential which should be identified or suspect during the primary assessment of patients with

Download Now! – iEM Book (iBook and pdf)

Download all content written by world-renowned professionals, emergency medicine education enthusiasts. It is a fantastic collaboration of all stakeholders. iEM Clerkship Book includes 106 topics,

Countries Recognize Emergency Medicine as a Specialty

As health care professionals working on Emergency medicine, our history is still being written. Let’s say you would like to learn which countries officially recognize

Mozambique Emergency Medicine Is On The Rise
Experiences
Jule Santos

Mozambique Emergency Medicine Is On The Rise

Africa is a magical continent. It is filled with unique cultural energy. I promise you will never regret diving into this experience. Whether in a

Core EM Clerkship Topics

Core EM Clerkship Topics

In the last ten years, there are few published undergraduate emergency medicine curriculum recommendations (Hobgood et al., 2009; Manthey et al., 2010; Penciner et al., 2013; Santen et al., 2014).

Current undergraduate curriculum trends recommend longitudinal and horizontal integration, and the topic lists related to emergency medicine are extensive for medical students.

In this post, we provide International Federation for Emergency Medicine and Society for Academic Emergency Medicine’s recommendations (Manthey et al., 2010; Hobgood et al., 2009).

The chosen topics can ideally be re-discussed in the clerkship during the senior years of medical school.

  • Abdominal pain
  • Altered mental status
  • Cardiac arrest and arrhythmias
  • Chest pain
  • GI bleeding
  • Headache
  • Multiple trauma
  • Poisoning
  • Respiratory distress
  • Shock

Because the length of the rotations can vary between institutions, the topics list can be extended according to the length of the clerkship and local needs.

References and Further Reading

  • Hobgood, C., Anantharaman, V., Bandiera, G., Cameron, P., Halperin, P., Holliman, J., … & International Federation for Emergency Medicine. (2009). International Federation for Emergency Medicine model curriculum for medical student education in emergency medicine. Canadian Journal of Emergency Medicine, 11(4), 349-354.
  • Manthey, D. E., Ander, D. S., Gordon, D. C., Morrissey, T., Sherman, S. C., Smith, M. D., … & Clerkship Directors in Emergency Medicine (CDEM) Curriculum Revision Group. (2010). Emergency medicine clerkship curriculum: an update and revision. Academic Emergency Medicine, 17(6), 638-643.
  • Penciner, R. (2009). Emergency medicine preclerkship observerships: evaluation of a structured experience. Canadian Journal of Emergency Medicine, 11(3), 235-239.
  • Santen, S. A., Peterson, W. J., Khandelwal, S., House, J. B., Manthey, D. E., & Sozener, C. B. (2014). Medical student milestones in emergency medicine. Academic Emergency Medicine, 21(8), 905-911.

iEM Monthly – October 2019

Monthly Newsletter October 2019

Welcome to the iEM Education Project Monthly Newsletter. We will share the achievements, information about top posts, chapters, activities and future plans of the project.

Hot News!

iEM team attended the Mediterranean Emergency Medicine Congress 2019 in Dubrovnik Croatia. The Xth Mediterranean Emergency Medicine Congress held between 22-25 September 2019 at the Sun Gardens Hotel. 

In addition to attending scientific sessions, iEM team also interviewed with Judith Tintinalli and Melanie Stander. Interviews will be shared from iem-student.org platform.

Melanie Stander
Melanie Stander
Judith Tintinalli
Judith Tintinalli

iEM Visitors

0
Countries
0
Visitors

iEM platform reached to more than 50.000 visitors from 183 countries.

iEM Authors in Dubrovnik​

iEM has 30 international blog authors. Three of those were in Dubrovnik. Anzal Rahman, Anthony Rodigin, and Elif Dilek Cakal. 

Top Blog Post in September

September Blog Posts

Top Countries in September

september 2019 - top countries

New Blog Author

Sumaiya Hafiz

UAE

I am a final year medical student studying in Dubai Medical College, with a strong interest in Emergency Medicine. I am also a photographer and work as a contributor for Getty Images. In my free time I like to write, research, find ways of educating the society regarding common medical issues, and travel. I also have an interest in Emergency Care in resource limited settings, public education, and raising awareness about first response emergency care.

Free EM Clerkship Book

iEM Free Book (2018e) reached to >3500 downloads. The book is written by 133 authors from 19 countries. It includes 106 topics, 841 pages, 454 images.

After MEMC19 – Dubrovnik

after memc19 dubrovnik

Great conference in a beautiful location

iEM team attended the Mediterranean Emergency Medicine Congress 2019 in Dubrovnik Croatia. The Xth Mediterranean Emergency Medicine Congress held between 22-25 September 2019 at the Sun Gardens Hotel. 

In addition to attending scientific sessions, iEM team also interviewed with Judith Tintinalli and Melanie Stander. Interviews will be shared from iem-student.org platform.

Melanie Stander
Melanie Stander
Judith Tintinalli
Judith Tintinalli

Melanie Stander and Judith Tintinalli in Panel: Women in Emergency Medicine

It was a great panel including local, regional and international female emergency medicine leaders. Each leader shared their message with audience during the panel and discussion was very fruitful at the end.

Here is the full list of panelists:

Ibtihal Mohammed Alattas, MD FAAEM (Saudi Arabia)
Ayesha Almemari, MD (United Arab Emirates)
Badria Al Hatali, MD FACMT (Sultanate of Oman)
Eveline Hitti, MD, MBA (Lebanon)
Lisa A. Moreno, MD MS MSCR FAAEM (United States)
Vicki Norton, MD FAAEM (United States)
Maria Ramos-Fernandez, MD MSc FAAEM (Puerto Rico)

Melanie Stander, MD MMed EM (South Africa)
Judith E. Tintinalli, MD MS FAAEM (United States)
Joanne Williams, MD MAAEM FAAEM (United States)

Saleh Fares received MEMC Founders Award

Saleh Fares, MD MPH FRCPC(EM) FACEP FAAEM
United Arab Emirates

This award is given at each Congress to honor an emergency physician who, through personal sacrifice and professional dedication, has had a significant and sustained impact on the development of emergency medicine as a specialty in his/her country.

Dr. Fares in his role as Founder of the Emirates Society of Emergency Medicine, as well as through his leadership as the President, has profoundly impacted the development of EM in the United Arab Emirates, as well as throughout the Gulf region. His qualities as a leader and a board certified emergency physician embody the values and mission of the American Academy of Emergency Medicine and the Mediterranean Academy of Emergency Medicine.

Melanie Stander received Dr. Cristina Costin International Emergency Medicine Award

Dr. Melanie Stander
South Africa

This award is given in honor of the late Dr. Costin-Kazzi to honor a female emergency physician who, through personal sacrifice and professional dedication, has had a significant and sustained impact on the development of emergency medicine as a specialty in her country.

As one of the first physicians to qualify in emergency medicine in South Africa, as the Immediate Past President of the Emergency Medicine Society of South Africa, and as one of the first women on the Board of the International Federation of Emergency Medicine, Dr. Stander has left an indelible mark on the development of emergency medicine in South Africa and has become an inspiration to other women who seek to follow her path of excellence, leadership and dedication. Dr. Stander’s qualities as a leader and a board certified emergency physician embody the values and mission of the American Academy of Emergency Medicine and the Mediterranean Academy of Emergency Medicine.

IFEM Undergraduate Emergency Medicine Curriculum Update Process

Arif Alper Cevik, MD, FEMAT, FIFEM presented the update process of IFEM Undergraduate Emergency Medicine Curriculum in addition to overall look to the curriculums around the globe, and IFEM curriculum adopted by iem-student.org (International Emergency Medicine Education Project) platform.

iEM Blog Authors in Dubrovnik

iEM family is growing

iEM has 30 international blog authors. Three of those were in Dubrovnik. Anzal Rahman, Anthony Rodigin, and Elif Dilek Cakal. 

Cite this article as: iEM Education Project Team, "After MEMC19 – Dubrovnik," in International Emergency Medicine Education Project, September 27, 2019, https://iem-student.org/2019/09/27/after-memc19-dubrovnik/, date accessed: November 17, 2019

iEM in MEMC19 – Dubrovnik, Croatia

iEM in MEMC19

iEM team is attending the Mediterranean Emergency Medicine Congress 2019 in Dubrovnik Croatia. The Xth Mediterranean Emergency Medicine Congress will be held 22-25 September 2019 at the Sun Gardens Hotel. Pre-congress courses will be held on 22 September with the first full day of Congress programming beginning 23 September and running until 25 September.

In addition to attending scientific sessions, iEM team will also be interviewing with Judith Tintinalli and Melanie Stander. Interviews will be shared from iem-student.org platform.

Melanie Stander
Melanie Stander
Judith Tintinalli
Judith Tintinalli

Organizers

The American Academy of Emergency Medicine (AAEM)  and the Mediterranean Academy of Emergency Medicine (MAEM) are two main organizers of the 2019 congress.

Pre-Congress Courses (September 22, 2019)

Scientific Program

The scientific program will be run at 6-7 different rooms with a variety of topics presented by emergency physicians joining from different countries.

lisa moreno walton

Lisa Moreno, MD MS MSCR FAAEM, AAEM President-Elect and MEMC19 Executive Chair, invites you to join us in Dubrovnik

CME

The American Academy of Emergency Medicine designates this live activity for a maximum of 32.25 AMA PRA Category 1 Credits™.  

Cite this article as: iEM Education Project Team, "iEM in MEMC19 – Dubrovnik, Croatia," in International Emergency Medicine Education Project, September 18, 2019, https://iem-student.org/2019/09/18/iem-in-memc19-dubrovnik-croatia/, date accessed: November 17, 2019

iEM Monthly – September 2019

Welcome to the iEM Education Project Monthly Newsletter. We will share the achievements, information about top posts, chapters, activities and future plans of the project.

Hot News!

FLAME endorsed iEM

This month we received a great news from one of the regional emergency medicine organizations. Latin America Emergency Medicine Federation – Federacion Latinoamericana De Medicina De Emergencias endorsed iEM Education Project. We are looking forward to collaborate with them to improve undergraduate emergency medicine education around the globe. 

FLAME

iEM will attend MEMC2019 at Dubrovnik.

The 10th Mediterranean Emergency Medicine Congress will be held 22-25 September 2019 at the Sun Gardens Hotel in Dubrovnik, Croatia. The congress is organized by American Academy of Emergency Medicine and Mediterranean Academy of Emergency Medicine.

Pre-congress courses will be held on 22 September with the first full day of Congress programming beginning 23 September and running until 25 September.

iEM will interview with Judith Tintinalli

iEM Team will interview with one of the icons of Emergency Medicine history, Judith Tintinalli during MEMC2019. 

iEM continues to meet and interview with world famous leaders of Emergency Medicine. Ian Stiel, Simon Carley, Tracy Sanson, Rob Rogers, Neil Cunningham are couple of them. You can watch or listen published episodes here.  

Judith Tintinalli

Free Emergency Medicine Clerkship iBook and pdf

iEM Free Book (2018e) reached to >3200 downloads. The book is written by 133 authors from 19 countries. It includes 106 topics, 841 pages, 454 images.

Blog Authors

There are three new blog authors joined our team in August, Bryn from USA, Sajan from Nepal and Neha from UAE. We welcome all of them. To see full blog authors team please click this link – https://iem-student.org/iem-blog-authors/

Bryn Dhir

USA

Bryn Dhir is a researcher and physician-scientist, interested in Emergency Medicine residency programs. Bryn has numerous leadership and management skills for various clinical, administrative, and work initiatives around the globe.

neha 2

UAE

Neha Hudlikar is a graduate of RAK Medical & Health Sciences University and is currently training in Emergency Medicine at Zayed Military Hospital, Abu Dhabi. A big supporter of the FOAMed movement, she is passionate about developing and supporting innovative ideas that promote free access to medical education for all. Her main interests in Emergency Medicine include trauma, disaster medicine, PoCUS and development of EM in resource limited settings. She currently also serves as the Associate Editor of Emirates Society of Emergency Medicine Newsletter. Outside of medicine, an avid reader, tree-hugger and an advocate of gender equality.

Sajan Acharya

Nepal

I am a medical graduate from Nepal. I am an eager supporter of FOAMed movement. I have always loved books. Medical school wanted me to read particular types, so I did. A poet at my core; I love to write about things that touch my heart. What better world to be in than medicine when you are on look out for moments that touches you. I find medicine fulfilling also because it feeds my passion for teaching.

Blog Posts

We published 12 posts during August 2019. The article “The research predicting septic shock” by Bryn Dhir was the top read article in August

Bryn Dhir
Bryn Dhir

Top Countries by Views

The iEM platform reached to 169 countries around the globe. In August, top countries by views are given below. 

iEM Content

iEM content general

iEM Website

iem webpage

iEM website is designed to provide a wide range of resources to medical students and educators. You can find all the topics of 2018 book provided by international authors, blog posts, and many details regarding iEM education project.

iEM 2018 Book in iBook and pdf formats

Download all content written by world-renowned professionals, emergency medicine education enthusiasts. It is a fantastic collaboration of all stakeholders.

2018 Book includes 106 topics, 841 pages, 454 images provided by 133 authors from 19 countries.

iEM Blog Posts

We have a wide range of blog authors from Nepal to Brazil, Canada to Sri Lanka, the USA to Tanzania. We post 2-3 times a week.

iEM Flickr Clinical Image Archive

iEM YouTube Video Archive

iEM Monthly – July 2019

Welcome to the iEM Education Project Monthly Newsletter. We will share the achievements, information about top posts, chapters, activities and future plans of the project.

This month we received two positive responses from regional emergency medicine organizations. Asian Society for Emergency Medicine and African Federation for Emergency Medicine endorsed iEM Education Project. We are looking forward to collaborate with them to improve undergraduate emergency medicine education around the globe. 

ASEM logo
AFEM logo

iEM Free Book

iEM Free Book (2018e) reached to >3000 downloads. The book is written by 133 authors from 19 countries. It includes 106 topics, 841 pages, 454 images.

Blog Authors

There are two new blog authors joined our team in July, Shaza from UAE and Masuma from Tanzania. We welcome both of them. To see full blog authors team please click this link – https://iem-student.org/iem-blog-authors/

shaza karrar

UAE

Shaza Karrar is a graduate of Sharjah University, School of Medicine, an Emergency Medicine board certified physician and a winner of multiple Resident Awards, serving as the Editor-in-Cheif of the Emirates Society for Emergency Medicine (ESEM) Newsletters. Big Medical Education Advocate and  Founder and Creator of the EM Space Podcast supporiting FOAMed and FOAMTox right out of the MENA region, with a profound interest in Toxicology and Disaster Medicine.

masuma ali

Tanzania

Masuma Ali Gulamhussein is a second-year Emergency Medicine (EM) resident in Tanzania, at the Muhimbili University of Health and Allied Sciences (MUHAS) with interests in global health and advocating for EM worldwide. She is interested in advancing in EM research and also finds it fulfilling interacting with a diverse cross-cultural society and EM colleagues from all parts of the world.

Blog Posts

We published 12 posts during July 2019. The article “Pediatric tube sizes” is the top read article in July. It reached 939 views. 

Top Countries by Views

The iEM platform reached to 169 countries around the globe. In July, top countries by views are given below. 

Toxicology Pearls – Active Charcoal – Infographic

toxicology pearls - active charcoal

Activated Charcoal Application

Emergency Indications

  • Oral intake < 60 minutes
  • the life-threatening dose of the toxic substance

Multi-Dose Activated Charcoal (MDAC) Indications

  • Life-Threatening Oral Intake of
    • Carbamazepine
    • Dapsone
    • Phenobarbital
    • Quinine
    • Theophylline

Contraindications

  • For patients with compromised airway reflexes, unless they are intubated. If the critical situation of the patient indicates intubation, then, gastric lavage may be performed. Intubation, only for decontamination, is not recommended.
  • Oral intake of caustic substances
  • Late presentation
  • Increased risk and severity of aspiration associated with AC use (e.g., hydrocarbon ingestion)
  • Need for endoscopy (e.g., significant caustic ingestion)
  • Toxins poorly adsorbed by AC (e.g., metals including iron and lithium, alkali, mineral acids, alcohols)
  • Presence of intestinal obstruction (absolute contraindication) or concern for decreased peristalsis (relative contraindication)

Equipment and Patient Preparation

There is no specific equipment for activated charcoal administration. However, drinking the charcoal can be very unpleasant for many patients, especially children. Therefore, mixing with fruit juice can be an option. In addition, if necessary nasogastric or orogastric tube placement can facilitate the active charcoal treatment.

Procedure steps

  • Recommended empirical single-dose of activated charcoal is as follows:
    • <1 year – 0.5-1 g/kg or 10-25 g
    • 1-12 years – 0.5-1 g/kg or 25-50 g
    • >12 years – 1-2 g/kg or 25-100 g
By James Heilman, MD [CC BY 3.0 (https://creativecommons.org/licenses/by/3.0)], from Wikimedia Commons
By James Heilman, MD [CC BY 3.0 (https://creativecommons.org/licenses/by/3.0)], from Wikimedia Commons
  • Multidose activated charcoal
    • Give the recurrent dose of charcoal by 0.5 g/kg (≤50 g) every 4 hours
  • How to administer:
    • If the patient is awake and cooperative, AC may be given orally. Alternatively, it may be given by gastric or nasogastric tube, if these procedures are indicated.
    • Mixing the activated charcoal with fruit juices increases tolerability.
    • If the patient is unconscious or airway is compromised, gastric lavage should be done, and activated charcoal should be given after intubation. Tracheal intubation is not recommended solely in order to give activated charcoal. Only activated charcoal is to be given, the nasogastric tube is adequate and is preferred.
    • If MDAC is indicated, the gastric tube should be withdrawn after gastric lavage and the first dose of activated charcoal. Further doses should be given via nasogastric tube.

Hints and Pitfalls

  • The substances that cannot bind to activated charcoal are as follows:
    • Lithium
    • Strong acids and bases
    • Metals and inorganic minerals
    • Alcohols
    • Hydrocarbons
  • Multi-dose activated charcoal enhances elimination of (But not necessarily indicated in all)
    • Amitriptyline
    • Aspirin
    • Caffeine
    • Carbamazepine
    • Cyclosporine
    • Dapsone
    • Digoxin
    • Disopyramide
    • Nadolol
    • Phenobarbital
    • Phenytoin
    • Piroxicam
    • Quinine
    • Sotalol
    • Sustained-release thallium
    • Theophylline
    • Valproate
    • Vancomycin
  • MDAC increase the risk of constipation and bowel obstruction in some cases. Therefore, consider adding a cathartic agent to the second or third dose of AC.

Post Procedure Care and Recommendations

  • Control possible nausea and vomiting.
  • Look for traces of aspiration or gastrointestinal complications.

Complications

Complications of AC and MDAC include:

  • Constipation, diarrhea, vomiting
  • Pulmonary aspiration

Pediatric, Geriatric, and Pregnant Patient Considerations

  • In pediatric and geriatric patients, extra caution should be exercised to avoid and monitor complications.
  • Activated charcoal is considered safe for pregnant women.

You may want to look these too...

Cite this article as: iEM Education Project Team, "Toxicology Pearls – Active Charcoal – Infographic," in International Emergency Medicine Education Project, July 29, 2019, https://iem-student.org/2019/07/29/toxicology-pearls-active-charcoal-infographic/, date accessed: November 17, 2019