Update on Countries Recognize EM As A Specialty

We currently published an article about countries recognize Emergency Medicine (EM) as a specialty. There is a huge interest from the international EM community. We received feedback from many FOAMed followers/enthusiasts. There were 70 countries on our list. After the new information and feedback, the countries reached 82. What an amazing help! And, What a fantastic specialty growing and spreading all around the globe.

70

82

If you have new information or update about countries please let us know!
We will be happy to update our list.

A 20-months-old head trauma: CT or Not CT?

by Stacey Chamberlain

A 20-month-old female was going up some wooden stairs, slipped, fell down four stairs, and hit the back of her head on the wooden landing at the bottom of the stairs. She did not lose consciousness and cried immediately. She was consolable after a couple of minutes and is acting normal per her parents. She has not vomited. On exam, she is well-appearing, alert, and has a normal neurologic exam. She is noted to have a left parietal hematoma measuring approximately 4×4 cm.

Should you get CT imaging of this child to rule out clinically significant head injury?

PECARN Pediatric Head Trauma Algorithm

Age < 2

Age ≥ 2

  • GCS < 15, palpable skull fracture, or signs of altered mental status
  • Occipital, parietal or temporal scalp hematoma; History of LOC≥5 sec; Not acting normally per parent or Severe Mechanism of Injury?
  • GCS < 15, palpable skull fracture, or signs of altered mental status
  • History of LOC or history of vomiting or Severe headache or Severe Mechanism of Injury?

The PECARN (Pediatric Emergency Care Applied Research Network) Pediatric Head Trauma Algorithm was developed as a CDR to minimize unnecessary radiation exposure to young children. The estimated risk of lethal malignancy from a single head CT in a 1-year-old is 1 in 1000-1500 and decreases to 1 in 5000 in a 10-year-old. Due to these risks, in addition to costs, length of stay and potential risks of procedural sedation, this CDR is widely employed given the frequency of pediatric head trauma ED visits. This CDR has the practitioner use a prediction tree to determine risk, but unlike some other risk stratification tools, the PECARN group does make recommendations based on what they consider acceptable levels of risk. In the less than 2-year-old group, the rule was found to be 100% sensitive with sensitivities ranging from 96.8%-100% sensitive in the greater than two-year-old group.

This algorithm does have some complexity and ambiguity. It requires the practitioner to know what were considered signs of altered mental status and what were considered severe mechanisms of injury. In addition, certain paths of the decision tree lead to intermediate risk zones. In these cases, the recommendation is “observation versus CT,” allowing for the ED physician to base his/her decision to image or not based on numerous contributory factors including physician experience, multiple versus isolated findings, and parental preference, among others.

Other pediatric head trauma CDRs rules have been derived and validated; however, in comparison trials, PECARN performed better than the other CDRs. Of note, in this study, physician practice (without the use of a specific CDR) performed as well as PECARN with only slightly lower specificity.

Case Discussion

For purposes of the case study, the patient falls into an intermediate risk zone of clinically important brain injury. However, a sub-analysis of patients less than two years old with isolated scalp hematomas suggests that patients were higher risk if they were < 3 months of age, had non-frontal scalp hematomas, large scalp hematomas (> 3cm), and severe mechanism of injury. Given the large hematoma in the case study patient and a severe mechanism of injury (a fall of > 3 feet in the under two age group), one might more strongly consider imaging due to these two additional higher risk factors.

iEM Newsletter – April 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.

iEM Education Project

Meet The Blog Authors

We are starting to activate our blog and here are the current blog authors and it is counting. If you have something to share with medical students/interns in order to promote emergency medicine or improve undergraduate emergency medicine education, you are welcome! Contact us.

Elif Dilek Cakal

Elif Dilek Cakal

Turkey

Lucas Silva

Lucas Silva

Brazil

Kilalo Mjema

Kilalo Mjema

Tanzania

Temesgen Beyene

Temesgen Beyene

Ethiopia

Arif Alper Cevik

Arif Alper Cevik

UAE/Turkey

Helene Morakis

Helene Morakis

Canada

Henrique A. Puls

Henrique A. Puls

Brazil/USA

Jule Santos

Jule Santos

Brazil

Ibrahim Sarbay

Ibrahim Sarbay

Turkey

John A. Lee

John A. Lee

USA

Download Free EM Clerkship Book in pdf and iBook

Thank you for your interest in iEM’s free Emergency Medicine Clerkship book. We published its chapters on the website in May 2018. Pdf and iBook formats were announced to download last week and downloaded more than 2000 times in a week.

Blog Posts Published in April 2019

Top 5 Countries in April 2019

Mexico

12%

Thailand

12%

USA

11%

Turkey

Turkey

10%

Costa Rica

6%

We are hiring!

Thank you for your interest in iEM’s free Emergency Medicine Clerkship book. We published its chapters on the website in May 2018. Pdf and iBook formats were announced to download last week and downloaded more than 2000 times in a week.

We believe students/interns around the globe will be enjoying the content prepared by emergency medicine experts and enthusiasts from all levels. This is a great initiative of international emergency medicine community.

Today, we are inviting new contributors to iEM Education Project as a blog author, chapter author in 2021 book, as well as for many other contribution options.

If you would like to help medical students/interns by providing free emergency medicine education resources, please contact us by filling the form below.

iEM Weekly Feed 18

Sharing is caring!

With this feed, you will find all posts and news about iEM published during last week. Click the “title” or “read more” to open each page you interested in.

Posts from last week

In 3 days, more than 1000 downloads!

0
downloads

Thank You!

You can download now!

A Week Before!

Wellness Books For Medical Students

We recently asked FOAMed family! Dear #FOAMed family. Which books are you recommending for medical students for wellness, wellbeing, life-work balance? @umanamd @EM_Educator @amalmattu @srrezaie

Read More »

Wellness Cards

We share the wellness cards including ACEP Wellness Recommendations. Also Read! Wellness Week Dear students! This week is exceptional for all emergency medicine … iEM

Read More »

Wellness Week

Dear students! This week is exceptional for all emergency medicine professionals. EMERGENCY MEDICINE WELLNESS WEEK (EMWW). EMWW is created by ACEP to remind emergency physicians

Read More »

What Was Hot In March?

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, 454 images/tables provided by 133 authors from 19 countries.

This book is a product of an international collaboration of emergency physicians and Emergency Medicine enthusiasts. It intends to show that we can produce a free book and resource if we work collaboratively.

iEM Book Cover

A Free Book for
Emergency Medicine
Clerkship Students

iEmergency Medicine for Medical Students and Interns – 2018

1st Edition, Version 1

Arif Alper Cevik, UAE

Lit Sin Quek, Singapore

Abdel Noureldin, USA

Elif Dilek Cakal, Turkey

Undergraduate Emergency Medicine Education (UEME) is an undervalued area in the development of Emergency Medicine around the globe. If you read the articles regarding Emergency Medicine clerkships or if you travel to different countries and discuss their undergraduate education with local leaders, you can easily recognize the gaps between countries. 

Today, there are few countries in the world that have appropriately designed UEME programs in their medical schools. The majority of the countries (even some developed ones) have no guidelines, curricula, or enough educational resources. In addition, there are limited resources (textbooks, websites) for medical students/interns which covers their educational needs based on current UEME recommendations. 

This book is a product of an international collaboration of emergency physicians and Emergency Medicine enthusiasts. It intends to show that we can produce a free book and resource if we work collaboratively. It is a product of endless hours of hard work of all Editors, authors, and contributors. We thank all of them for trusting us in this journey. 

This is just a start to build up better Emergency Medicine resources for medical students and interns, especially for developing countries. It is a continuous process, and there are a lot of areas that we need to improve in this book. Therefore, we are looking forward to your feedback and collaboration.

We also believe that international UEME will reach the minimum required standards in all countries based on the endless collaboration of emergency medicine professionals.

There is continuous work for the iEM book process. We applied multiple editing and reviewing steps. We continue this process for many chapters with the feedback from our readers and contributors.

We used original images, illustrations, diagrams provided by the Editors and authors as much as possible. However, there were chapters that we needed to use some copyright free material, Creative Commons licensed images, illustrations, and diagrams with attribution to the original owners. We are continuously searching for better images, illustrations, and diagrams. If you have copyright free clinical images, illustrations or diagrams, please share them with us. We would like to use them with your credentials in the book, online archive, and website.

“if you want to go fast go alone, if you want to go far go together”

African Proverb

Interview – Vicky Noble – US training in medical schools

We interviewed with world renowned emergency and critical care US expert “Vicky Noble” about US training in medical schools.

Read US Chapters and Posts

iEM Weekly Feed 17

Sharing is caring!

With this feed, you will find all posts and news about iEM published during last week. Click the “title” or “read more” to open each page you interested in.

Wellness Books For Medical Students

We recently asked FOAMed family! Dear #FOAMed family. Which books are you recommending for medical students for wellness, wellbeing, life-work balance? @umanamd @EM_Educator @amalmattu @srrezaie

Read More »

Wellness Cards

We share the wellness cards including ACEP Wellness Recommendations. Also Read! Wellness Week Dear students! This week is exceptional for all emergency medicine … iEM

Read More »

Wellness Week

Dear students! This week is exceptional for all emergency medicine professionals. EMERGENCY MEDICINE WELLNESS WEEK (EMWW). EMWW is created by ACEP to remind emergency physicians

Read More »

A Week Before!

iEM Flickr Image Archive

Our Flickr Image Archive Is Viewed More Than 150.000 times. Free Images and Short Videos Use them freely in your presentations, exams.

Read More »

Interview: Jesus Daniel Lopez Tapia

We interviewed with Dr. Jesus Daniel Lopez Tapia. He is the Dean of University Monterrey, College of Medicine and immediate past president of Mexican Society

Read More »

Video Interview – Rob Rogers – Part 3

Great messages for medical students, interns and new EM residents! Part 1 Part 2 Watch the part 3 here! You can listen full interview here!

Read More »

What Was Hot In March?

pdf and iBook are ready to download soon!

Wellness Books For Medical Students

We recently asked FOAMed family!

Thanks to all FOAMed leaders and enthusiasts for their answers. We received fantastic book recommendations for our students.

Although some of the books are not directly related to wellness, their content indirectly guides you to be more competent, mindful, grateful, happy in order to reach your life long wellbeing.

Here are amazing recommendations through twitter responses! (alphabetical order)

  • Being mortal
  • Daring greatly
  • Deep survival
  • Deep work
  • Designing your life
  • Enjoy every sandwich
  • Everything happens for a reason
  • Extreme ownership
  • Factfulness
  • Getting things done
  • Grit
  • How to win friends & influence people
  • How will you measure your life
  • Ikigai
  • In shock
  • Inclusion and diversity in workplace
  • Leaders eat last
  • Man’s search for meaning
  • Mindset
  • No ego
  • Peak
  • Rigor mortis
  • The 7 habits of highly effective people
  • The power of habit
  • The upside of stress
  • When breath becomes air
  • Why we sleep

You can find exact twitter messages including authors of the books below.

Here is the full list, again!

  1. Being mortal
  2. Daring greatly
  3. Deep survival
  4. Deep work
  5. Designing your life
  6. Enjoy every sandwich
  7. Everything happens for a reason
  8. Extreme ownership
  9. Factfulness
  10. Getting things done
  11. Grit
  12. How to win friends & influence people
  13. How will you measure your life
  14. Ikigai
  15. In shock
  16. Inclusion and diversity in workplace
  17. Leaders eat last
  18. Man’s search for meaning
  19. Mindset
  20. No ego
  21. Peak
  22. Rigor mortis
  23. The 7 habits of highly effective people
  24. The power of habit
  25. The upside of stress
  26. When breath becomes air
  27. Why we sleep

Also Read!

Wellness Cards

We share the wellness cards including ACEP Wellness Recommendations.

Also Read!

iEM Weekly Feed 16

Sharing is caring!

With this feed, you do not miss anything. You will find all published blog posts and chapters during this week. Click the “title” or “read more” to open each page you interested in.

iEM Flickr Image Archive

Our Flickr Image Archive Is Viewed More Than 150.000 times. Free Images and Short Videos Use them freely in your presentations, exams.

Read More »

Interview: Jesus Daniel Lopez Tapia

We interviewed with Dr. Jesus Daniel Lopez Tapia. He is the Dean of University Monterrey, College of Medicine and immediate past president of Mexican Society

Read More »

Video Interview – Rob Rogers – Part 3

Great messages for medical students, interns and new EM residents! Part 1 Part 2 Watch the part 3 here! You can listen full interview here!

Read More »

A Week Before!

Expert Opinion: Luis Vargas – ED Overcrowding

EMERGENCY DEPARTMENT OVERCROWDING Dear students, emergency departments are suffering overcrowding since long time. There are various causes of this situation as well as solutions. It

Read More »

ICEM2020

Dr. Edgardo Menendez and Dr. Gonzalo Camargo present ICEM2020 and invite medical students to the Buenos Aires, Argentina. ICEM2020 – Invitation – English ICEM2020 –

Read More »

Video Interview – Rob Rogers – Part 2

Great messages for medical students, interns and new EM residents! Are you ready to meet the genuine people behind the professional? iEM team proudly presents

Read More »

iEM Weekly Feed 15

Welcome to iEM Weekly Feed! Sharing is caring! With this feed, you do not miss anything. You will find all published blog posts and chapters

Read More »

What Was Hot In March?

iEM Flickr Image Archive

Our Flickr Image Archive Is Viewed More Than 150.000 times.

Use them freely in your presentations, exams.

Interview: Jesus Daniel Lopez Tapia

We interviewed with Dr. Jesus Daniel Lopez Tapia. He is the Dean of University Monterrey, College of Medicine and immediate past president of Mexican Society of Emergency Medicine. 

Highlights from the interview

How many medical school in Mexico?

180

What percentage medical schools have EM course for medical students?

80%

How many EM residency spot every year?

400

How many EM residency program in Mexico?

75

What do graduates do after the graduation?

80% starts working in the EDs. 20% starts residency.

Video Interview – Rob Rogers – Part 3

Great messages for medical students, interns and new EM residents!

Watch the part 3 here!

You can listen full interview here!

iEM Newsletter – March 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.

Meet the new contributors

Want to be a contributor?

Mexico is one of the leading countries which using the iEM platform in 2018 and 2019. Therefore, iEM is invited to the 30th conference of Emergency Medicine Society of Mexico to present iEM Education Project.

Drs Gonzalo Camargo (Argentina), Arif Alper Cevik (Turkey/UAE), Edgardo Menendez (Argentina), Eric Revue (France), Jesus Daniel Lopez Tapia (Mexico).

Drs Jesus Daniel Lopez Tapia (Mexico), Arif Alper Cevik (Turkey/UAE), Elif Dilek Cakal (Turkey), Eric Revue (France) – after the plenary session presentations. iEM Education project was presented to the Mexican and Latin American emergency medicine professionals.

Dr. Edgardo Menendez and Dr. Gonzalo Camargo present ICEM2020 and invite medical students to the Buenos Aires, Argentina.

ICEM2020

Top Reads!
82%

Top 5 Countries in First Quarter

Mexico

20.8%

USA

15.1%

UAE

11.7%

Turkey

Turkey

6.1%

Germany

5.1%