IFEM Medical Student Symposium – Team Oceania

Dear medical students and EM community,

We invite you to the IFEM Medical Student Symposium, the first of its kind, to discuss the present and future of undergraduate emergency medicine education. The IFEM Medical Student Symposium will bring together speakers, facilitators, and attendees from seven regions of Africa, Asia, Central and South America, Europe, the Gulf, North America, and Oceania. You can find more details on the flyer below.

It will take place on June 14th, 2022, at 13:30 AEST (GMT +10). The symposium fee is 10 AUD. Thanks to IFEM leadership and the ICEM organising committee, participants intending to join the Medical Student Symposium only can use this link on the workshop page to register without an additional conference fee.

Please share this blogpost with your colleagues and trainees who might be interested in joining this conversation. We are looking forward to meeting you all virtually at the symposium.

Best regards,
Dr Elif Dilek Cakal & Dr Erin Simon
IFEM Medical Student Symposium Co-leads
IFEM Core Curriculum and Education Committee

 

 

 

 

IFEM Medical Student Symposium – Team Gulf

Dear medical students and EM community,

We invite you to the IFEM Medical Student Symposium, the first of its kind, to discuss the present and future of undergraduate emergency medicine education. The IFEM Medical Student Symposium will bring together speakers, facilitators, and attendees from seven regions of Africa, Asia, Central and South America, Europe, the Gulf, North America, and Oceania. You can find more details on the flyer below.

It will take place on June 14th, 2022, at 13:30 AEST (GMT +10). The symposium fee is 10 AUD. Thanks to IFEM leadership and the ICEM organising committee, participants intending to join the Medical Student Symposium only can use this link on the workshop page to register without an additional conference fee.

Please share this blogpost with your colleagues and trainees who might be interested in joining this conversation. We are looking forward to meeting you all virtually at the symposium.

Best regards,
Dr Elif Dilek Cakal & Dr Erin Simon
IFEM Medical Student Symposium Co-leads
IFEM Core Curriculum and Education Committee

 

 

 

IFEM Medical Student Symposium – Team North America

Dear medical students and EM community,

We invite you to the IFEM Medical Student Symposium, the first of its kind, to discuss the present and future of undergraduate emergency medicine education. The IFEM Medical Student Symposium will bring together speakers, facilitators, and attendees from seven regions of Africa, Asia, Central and South America, Europe, the Gulf, North America, and Oceania. You can find more details on the flyer below.

It will take place on June 14th, 2022, at 13:30 AEST (GMT +10). The symposium fee is 10 AUD. Thanks to IFEM leadership and the ICEM organising committee, participants intending to join the Medical Student Symposium only can use this link on the workshop page to register without an additional conference fee.

Please share this blogpost with your colleagues and trainees who might be interested in joining this conversation. We are looking forward to meeting you all virtually at the symposium.

Best regards,
Dr Elif Dilek Cakal & Dr Erin Simon
IFEM Medical Student Symposium Co-leads
IFEM Core Curriculum and Education Committee

 

 

IFEM Medical Student Symposium – Team Central and South America

Dear medical students and EM community,

We invite you to the IFEM Medical Student Symposium, the first of its kind, to discuss the present and future of undergraduate emergency medicine education. The IFEM Medical Student Symposium will bring together speakers, facilitators, and attendees from seven regions of Africa, Asia, Central and South America, Europe, the Gulf, North America, and Oceania. You can find more details on the flyer below.

It will take place on June 14th, 2022, at 13:30 AEST (GMT +10). The symposium fee is 10 AUD. Thanks to IFEM leadership and the ICEM organising committee, participants intending to join the Medical Student Symposium only can use this link on the workshop page to register without an additional conference fee.

Please share this blogpost with your colleagues and trainees who might be interested in joining this conversation. We are looking forward to meeting you all virtually at the symposium.

Best regards,
Dr Elif Dilek Cakal & Dr Erin Simon
IFEM Medical Student Symposium Co-leads
IFEM Core Curriculum and Education Committee

 

IFEM Medical Student Symposium – Team Europe

Dear medical students and EM community,

We invite you to the IFEM Medical Student Symposium, the first of its kind, to discuss the present and future of undergraduate emergency medicine education. The IFEM Medical Student Symposium will bring together speakers, facilitators, and attendees from seven regions of Africa, Asia, Central and South America, Europe, the Gulf, North America, and Oceania. You can find more details on the flyer below.

It will take place on June 14th, 2022, at 13:30 AEST (GMT +10). The symposium fee is 10 AUD. Thanks to IFEM leadership and the ICEM organising committee, participants intending to join the Medical Student Symposium only can use this link on the workshop page to register without an additional conference fee.

Please share this blogpost with your colleagues and trainees who might be interested in joining this conversation. We are looking forward to meeting you all virtually at the symposium.

Best regards,
Dr Elif Dilek Cakal & Dr Erin Simon
IFEM Medical Student Symposium Co-leads
IFEM Core Curriculum and Education Committee

 

IFEM Medical Student Symposium – Team Asia

Dear medical students and EM community,

We invite you to the IFEM Medical Student Symposium, the first of its kind, to discuss the present and future of undergraduate emergency medicine education. The IFEM Medical Student Symposium will bring together speakers, facilitators, and attendees from seven regions of Africa, Asia, Central and South America, Europe, the Gulf, North America, and Oceania. You can find more details on the flyer below.

It will take place on June 14th, 2022, at 13:30 AEST (GMT +10). The symposium fee is 10 AUD. Thanks to IFEM leadership and the ICEM organising committee, participants intending to join the Medical Student Symposium only can use this link on the workshop page to register without an additional conference fee.

Please share this blogpost with your colleagues and trainees who might be interested in joining this conversation. We are looking forward to meeting you all virtually at the symposium.

Best regards,
Dr Elif Dilek Cakal & Dr Erin Simon
IFEM Medical Student Symposium Co-leads
IFEM Core Curriculum and Education Committee

 

IFEM Medical Student Symposium – Team Africa

Dear medical students and EM community,

We invite you to the IFEM Medical Student Symposium, the first of its kind, to discuss the present and future of undergraduate emergency medicine education. The IFEM Medical Student Symposium will bring together speakers, facilitators, and attendees from seven regions of Africa, Asia, Central and South America, Europe, the Gulf, North America, and Oceania. You can find more details on the flyer below.

It will take place on June 14th, 2022, at 13:30 AEST (GMT +10). The symposium fee is 10 AUD. Thanks to IFEM leadership and the ICEM organising committee, participants intending to join the Medical Student Symposium only can use this link on the workshop page to register without an additional conference fee.

Please share this blogpost with your colleagues and trainees who might be interested in joining this conversation. We are looking forward to meeting you all virtually at the symposium.

Best regards,
Dr Elif Dilek Cakal & Dr Erin Simon
IFEM Medical Student Symposium Co-leads
IFEM Core Curriculum and Education Committee

ACEP’s shiny new GEMS: the Who, What and Why that make this LP worth playing

acep gems

Introduction

The necessity of introducing emergency medicine (EM) into undergraduate medical education (here – medical school level) has been discussed, if not debated, for over four decades (1,2). More recently, two additional trends have become apparent. One speaks to the mutual co-integration and interdependence of all emergency care field components including EM (3). The other is the emergence of a keen interest in global health exhibited by both medical students and emergency medicine trainees alike (4-6).

Here we wish to present and describe a novel program for medical students that aims to address and integrate all of the three phenomena under one umbrella. 

ACEP’s Global Emergency Medicine Student Leadership Program (GEMS LP) is now in its third year, with eighteen students from various medical schools learning about topics in global health through the guidance and shared experiences of internationally minded emergency physicians.

Background

The International Section of the American College of Emergency Physicians (ACEP) is one of ACEP’s largest, with over 2600 members currently (7). In 2013 the Section’s first annual ACEP International Ambassador Conference took place in Seattle. The meeting formalized and accentuated the common vision shared by those section members who had already been actively involved in global health and international EM development in their respective nation(s) of interest (8).

In 2017 members of Emergency Medicine Resident Association (EMRA) approached ACEP’s International Ambassador Program with the idea of mentorship for medical students interested in both EM and medical work globally.

Through a collaborative effort the Ambassador Mentorship Program (AMP) was born and welcomed its inaugural class of eight medical students in 2018 (9).

Focus

To better align our name with the program’s vision, AMP was renamed the Global Emergency Medicine Student Leadership Program (GEMS LP) in 2020. Currently GEMS LP is open to medical students at all levels of training (prior to graduation) who are members of EMRA.

The nine month curriculum consists of several integral components, including global health knowledge development, research, personal mentorship and networking.

Focus on global health (GH):  GH has become a field that aims to transcend not only the borders among nations, cultures, governments and organizations, but also the distinction between what is narrowly medical and what is widely ethical and social – as in rooted in people’s daily living conditions (10). It has been a consensus among GEMS LP’s participants that efforts to improve development of EM and regional emergency care systems around the world cannot be studied or pursued outside of the global health context.

At a GEMS journal club, 2020

The program runs a structured journal club done via video platforms which includes review and discussions of textbooks and original literature pertinent to GH topics.  Since 2020, journal clubs have also included a new component where students prepare local health improvement project proposals  (based on their geographic or cultural area of interest or prior experience).  These “mock” project proposals are then discussed by the journal club group at large as another way of learning.

Examples of monthly focus themes have included global health inequity, sustainability in global health, ethics of humanitarian work, need for EM expertise in low resource settings, language justice in healthcare and the future of global health.

We welcome all members of the ACEP International Section and current GEM fellows (ask us how to get involved at infoGEMSLP@gmail.com) – international voices add much to the discussion!

Focus on mentorship and networking: Through one-on-one guided phone calls with GEMS LP faculty and other International Section physician members, students are exposed to multiple examples of individual professional paths and are offered guidance in exploring their options for future training, careers and work/life balance. Student participants also have access to globally involved EM physicians across the entire Ambassador Program and the Section, both domestically and internationally. Mentors and guest speakers have also given presentations on career paths in global EM during journal club sessions to give mentees a variety of perspectives on the diverse training and career options available.

Focus on scholarship and research: Mentors involved in academic research have had mentees collaborate in groups of 2-5 on research projects. Examples have included: state of emergency care in the post-USSR zone – a literature review, Ugandan emergency mid-level training curriculum work, a review of pre-hospital medicine in resource-restrained areas within India and Sri Lanka, assisting with the ACEP Ambassador Program Country Reports, and others.

Group projects are a great way for mentees to network and build lasting working relationships, not only with the mentor leading the project, but also with their peers. While mentees are not traveling for program projects in light of the COVID-19 pandemic, the projects are still a way in which the program helps mentees build real world skills for future GH ground work. 

Learning structure

During the course of the program each student will participate in all virtual journal clubs, and will be responsible for at least one presentation of a book chapter, an original research paper or a global health project proposal. Longitudinally, students are paired up with a faculty’s research project in small groups, and as mentioned, also participate in a minimum of three one-one-one mentorship phone or video calls with different mentors focusing on various aspects of career planning. Students may also be introduced to and connected with ACEP’s international section members based on mutual backgrounds, cultural and language skills or GH interests. Finally, students are invited to attend the annual ACEP Ambassador Conference (virtually during COVID restrictions) and are expected to attend the GEMS LP program orientation and close out sessions. 

Future directions

Mentee retention: All mentees are invited to get involved with program leadership when they graduate the program, which is a constant source of energy and new ideas. This will ensure the program’s sustainability, as we build successive generations of program leadership from the trainees who themselves benefited from the program previously.

Expanding number of students and faculty mentors: As medical student interest in GEM opportunities and mentorship increases, we hope to continue expanding the program and recruit a diverse group of mentees, including international medical students. In order to facilitate this, additional faculty members will also be needed. The program hopes to continue recruiting diverse mentors, including those from international institutions (especially those from low- and middle-income countries), humanitarian organizations, community and academic emergency departments.

Expanding the research component and publications: Giving GEMS LP participants adequate exposure to academic global emergency medicine through participation in research projects and in peer-reviewed publications. Planned publications for the 2020-2021 year include: GEMS LP milestones study and a concept paper on the program. Currently mentees are interviewing the ACEP Ambassador team working in their country or region of interest on the state of emergency medicine development. We hope to publish an EM around the world country highlights article based on these interviews. Also, be on the lookout for an EM Resident piece in the April/May issue showcasing the projects that the 2019/2020 class completed.

Connecting with other organizations: GEMS LP is actively seeking to form mutually beneficial relationships with other organizations involved with EM, emergency care and global health domestically and internationally. Currently, we are working to expand collaboration with GEM fellows.

Please get in touch if your organization would be interested in collaborating at info.GEMSLP@gmail.com!

Information sharing: The program is interested in building an information repository to share research, advice and resources that accumulate within the program over the years that are useful for medical students interested in EM and global health around the world.

Impact evaluation: To formally evaluate the impact of the GEMS LP program on participant’s careers going forward, starting with the 2020-2021 class, students will be given pre- and post- program surveys using modified methodology described by Douglass et al. in “Development of a Global Health Milestones Tool for Learners in Emergency Medicine” (11). The milestones study is planned to track participants at 1, 2, 3, 5, 7 and 10 years post-graduation from the GEMS LP program to assess long-term impact on careers.

Relevance for the global EM-trainee community

GEMS LP’s current hybrid educational model has evolved to match the diversity of our mentees with their need to simultaneously gain knowledge in several interconnected areas: emergency medicine, international emergency care systems and global health and planning one’s future career as a medical student.

We hope that the GEMS LP program may serve as a potential model for others involved in global EM education such as medical schools, residency programs, or international colleges of emergency medicine to create opportunities and resources for their students to grow into thoughtful and successful leaders in the field of global EM.

In the current era of COVID-19, this virtual program may also serve to engage students and trainees in global EM work despite limitations on travel, as well as to expand access to formal mentorship opportunities for students who may not have these opportunities at their home institutions.

For more information on GEMS LP and how you can get involved as a mentor, mentee, or a journal club participant please visit the page below or email us!

https://www.emra.org/be-involved/committees/international-committee/amp-program-info/

The 2021/22 GEMS LP application will open for students this spring, with a deadline of June 30, 2021. We are always recruiting faculty mentors! 

Cite this article as: Anthony Rodigin, Stephanie Garbern, Ashley Pickering, Alexandra Digenakis, Elizabeth DeVos, Jerry Oommen, “ACEP’s shiny new GEMS: the Who, What and Why that make this LP worth playing,” in International Emergency Medicine Education Project, February 21, 2021, https://iem-student.org/?p=17057, date accessed: February 21, 2021

References:

  1. Guidelines for Undergraduate Education in Emergency Medicine. Ann Emerg Med. 2016 Jul;68(1):150. doi: 10.1016/j.annemergmed.2016.04.049. PMID: 27343670.
  2. Beyene T, Tupesis JP, Azazh A. Attitude of interns towards implementation and contribution of undergraduate Emergency Medicine training: Experience of an Ethiopian Medical School. Afr J Emerg Med. 2017 Sep;7(3):108-112. doi: 10.1016/j.afjem.2017.04.008. Epub 2017 Apr 20. Erratum in: Afr J Emerg Med. 2017 Dec;7(4):189. PMID: 30456120; PMCID: PMC6234139.
  3. Carlson LC, Reynolds TA, Wallis LA, Calvello Hynes EJ. Reconceptualizing the role of emergency care in the context of global healthcare delivery. Health Policy Plan. 2019 Feb 1;34(1):78-82. doi: 10.1093/heapol/czy111. PMID: 30689851
  4. Havryliuk, Tatiana et al. Global Health Education in Emergency Medicine Residency Programs. Journal of Emergency Medicine, Volume 46, Issue 6, 847 – 852. March 7, 2014.
  5. Dey CC, Grabowski JG, Gebreyes K, et al. Influence of international emergency medicine opportunities on residency program selection. Acad Emerg Med 2002;9:679–83.
  6. Cox JT, Kironji AG, Edwardson J, Moran D, Aluri J, Carroll B, Warren N, Chen CCG. Global Health Career Interest among Medical and Nursing Students: Survey and Analysis. Ann Glob Health. 2017 May-Aug;83(3-4):588-595. doi: 10.1016/j.aogh.2017.07.002. Epub 2017 Aug 30. PMID: 29221533.
  7. http://www.acep.org; Search: “International Membership FAQs”. Accessed 1/16/21
  8. https://www.acep.org/globalassets/sites/intl/media/site-documents/1st-annual-acep-international-ambassador-conference-proceedings.pdf. Accessed 1/16/21.
  9. Patino, Andres. “GEMS LP – Global EM Student Leadership Program. The New AMP”. GEMS LP Program Orientation virtual meeting, PPT presentation. October, 2020.
  10. Cemma, Marija. “What’s the Difference? Global Health defined”. Global Health NOW. Sept. 26, 2017. https://www.globalhealthnow.org/2017-09/whats-difference-global-health-defined. Accessed 1/16/21.
  11. Douglass KA, Jacquet GA, Hayward AS, Dreifuss BA, Tupesis JP, Acerra J, Bloem C, Brenner J, DeVos E, Douglass K, Dreifuss B, Hayward AS, Hilbert SL, Jacquet GA, Lin J, Muck A, Nasser S, Oteng R, Powell NN, Rybarczyk MM, Schmidt J, Svenson J, Tupesis JP, Yoder K. Development of a Global Health Milestones Tool for Learners in Emergency Medicine: A Pilot Project. AEM Educ Train. 2017 Sep 11;1(4):269-279. doi: 10.1002/aet2.10046. PMID: 30051044; PMCID: PMC6001724.

Suicide – An Emergency Priority of Public Health Care

Suicide An Emergency

A significant number of emergency department visits annually arise as a result of intentional self-harm. Although no accurate description explains what leads to suicide or what comes after, it is a multifaceted phenomenon of public health urgency during a global health crisis. In the United States alone, suicide is the 10th leading cause of death and worldwide claims up to 800,000 lives each year. The international community must unite to come up with solutions to prevent the loss of life, as every single life lost is one too many.

With the COVID-19 pandemic, such an emergency naturally affects both individuals’ health and well-being and the communities in which they live. Unprecedented times unleash various emotional reactions from isolation, grief and trauma to other unhealthy behaviours, noncompliance with public health guidelines and the exacerbation of mental health conditions. While those who’ve been emotionally, sexually or physically abused in the past are more vulnerable to the psychosocial effects of a crisis, supportive interventions such as the Zero Suicide program and Cognitive Behavioural Therapy designed to promote wellness and enhance coping should be implemented [1]. 

In honour of World Suicide Prevention Week, and World Suicide Prevention Day held on the 10th of September every year, it is important to raise attention to the global importance of suicide prevention. Suicide impacts all people and particularly the world’s most marginalized and discriminated groups. It is a huge problem in developed countries and just as serious in low-and middle income countries where resources and access to healthcare professionals are scarce. In many regions of the world, the taboo and stigma surrounding suicide persist, causing people in need of help to be left alone. 

Suicide prevention with awareness campaigns ought to be prioritized on the global health and public policy agendas as a major public health issue. Routine screening for suicidal ideation by health care professionals providing care should identify and assess suicide risk among populations. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), risk factors of suicide include mental illness, substance use diagnoses, trauma or conflict, loss, family history of suicide, and previous suicide attempts [2].

Effectively implementing suicide prevention strategies at the populational, sub-populational and individual level requires ensuring patients’ lethal means are restricted, reduced, and that all accesss to weapons of self-harm are removed from the nearby environments. Healthcare providers should keep up to date with new developments, research, and technologies screening for suicidal ideation, allowing them to effectively serve patients beyond their clinics’ walls. Key to prevention are strong physician patient relationships that help ensure care transitions allow for physicians to act as supportive contacts reaching out with calls, texts, letters and visits to their patients particularly when services are interrupted. With access to technology the role of psychiatrists, and psychologists may continue uninterrupted as telemedicine serves as an effective platform providing patients with access to care, even during lockdowns. Besides these objectives, greater awareness and education into the community means encouraging the responsible portrayal of suicide in mainstream media. A sensitive issue of this magnitude ought to be communicated responsibly placing special attention to not trigger susceptible individuals. With school based interventions, professionals may act sooner before worsened prognosis’ effectively ensuring that access to peer support services is available. 

Suicide prevention is a responsibility of healthcare systems, medical professionals and communities. All countries must stand in solidarity and unify in collaboration to battle this common threat as preventing the tragic loss of life to suicide is of utmost importance. 

References & Further Reading

  1. In Health and Behavioral Healthcare. (n.d.). Retrieved September 14, 2020, from http://zerosuicide.edc.org/toolkit/treat/interventions-suicide-risk 
  2. Psychiatry Online: DSM Library. (n.d.). Retrieved September 15, 2020, from https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596 
Cite this article as: Leah Sarah Peer, Canada, "Suicide – An Emergency Priority of Public Health Care," in International Emergency Medicine Education Project, October 19, 2020, https://iem-student.org/2020/10/19/suicide-an-emergency-priority-of-public-health-care/, date accessed: July 2, 2022

The Kawasaki Disease Enigma Continues 150 years Later

kawasaki disease

Kawasaki disease (KD), or mucocutaneous lymph nodes syndrome is an immune-mediated inflammation in the walls of medium-sized arteries throughout the body. It’s complications result in the coronary arteries expanding, heart attacks, and premature death.

As the leading cause of heart disease in North American and Japanese children, KD continues to bewilder clinicians and researchers – even in the midst of a global pandemic. Possible links to SARS-CoV2 has even stirred uneasiness in patients, and physicians making diagnoses.

Beginning in Victorian-era England, a young boy presented to the doctor’s office with symptoms suggestive of scarlet fever; however, noticing heart disease in this child was just baffling. Despite being unaware of this rare disease, it was beyond physicians at the time; since then, progress has been limited as clinicians still fail to comprehend the disease’s root cause.

Dating back to 1874, KD was discovered by Samuel Gee while he was dissecting the cadaver of a seven-year-old boy.

He noticed something strange, “The pericardium was natural. The heart natural in size, and the valves healthy. The coronary arteries were dilated into aneurysms at three places, namely, at the apex of the heart a small aneurysm the size of a pea; at the base of the right ventricle, close to the tip of the right auricular appendix, and near to the mouth of one of the coronary arteries, another aneurysm of the same size; and at the back of the heart, at the base of the ventricles, and in the sulcus between the ventricles, a third aneurysm the size of a horse bean. These aneurysms contained small recent clots, quite loose. The aorta near the valves, and the aortic cusp of the mitral valve, presented specks of atheroma.

From his autopsy, evident was that Gee found aneurysms in the coronary arteries running across the surface of the boy’s heart. He then placed the specimen in a jar and provided it to the Barts Pathology Museum in London. Little did he know, that his specimen marked evidence of the earliest recorded case of KD and sparked worldwide medical curiosity. Unfortunately, when physicians 100 years later were hoping to retrieve samples from the specimen containing the boy’s heart, they were informed that it was missing.

A few years later, the disease was recognized in 1967 by the Japanese physician, Tomikasu Kawasaki. Although some researchers claimed the virus was unknown, others stated KD resulted from a bacterial or fungal toxin. The windborne theory suggested that the disease was seasonal, and as such, the direction of the swaying wind played a role in infection. Others stated that since children’s immune systems are still developing and since they have just lost the protective antibodies from their mothers, they are susceptible to infection. Therefore, in Asian American household’s diets rich in soy put Asian children at greater risk due to the isoflavones. In the 1980s, the Center for Disease Control and Prevention (CDC) suspected chemicals as the cause of KD, inferring that disease stems from agents that trigger an overreaction of the patient’s immune system. No one knew exactly what the mechanism or cause of KD was, although many scientists speculated some theories.

Over the last decade, significant progress toward understanding the pathogenesis, history, and therapeutic interventions of KD has been fruitful. Treatment aimed at the intravenous infusion of gamma globulin antibodies derived from the plasma of blood donations has helped children recover. In contrast, other therapies of corticosteroids for immunoglobulin-resistant patients and tumor inhibitors such as etanercept, infliximab, and cyclosporin A have been other medications providing relief.

The most significant clinical debate was over the possible link between the rash and the cardiac complications seen in Asian American children. Factors responsible for KD were introduced into Japan after World War II and re-emerged in a more virulent form spreading through the industrialized Western world. Advancements in medicine, improvements in healthcare, and, notably, the use of antibiotics reduced the burden of rash and fever illnesses significantly allowing KD to be recognized as a distinct clinical entity.

Nonetheless, the enigma pervades even during the COVID19 pandemic; this time, more pressing as the ever-elusive cause of KD that troubles children’s hearts affects physicians’ sleep and worries parents’ minds. Although the story of Kawasaki disease began decades ago when a young boy’s heart was locked inside a glass specimen, its ending is still being crafted. By the time the heart is found again at the museum, and placed safely for visitors treasuring ancient history, what further knowledge and progress will the scientific community have achieved? How far will humanity have come to find answers to KD and fill in the perplexing missing piece of the puzzle?

For now, there are no answers, but the enigma continues…

Cite this article as: Leah Sarah Peer, Canada, "The Kawasaki Disease Enigma Continues 150 years Later," in International Emergency Medicine Education Project, July 24, 2020, https://iem-student.org/2020/07/24/kawasaki-disease-enigma-continues/, date accessed: July 2, 2022

References and Further Reading

Home Made IV Access Ultrasound Phantoms

home made IV access ultrasound phantom

We recently had the 3rd Tanzanian Conference on Emergency Medicine. Point of Care Ultrasound (PoCUS) training was one of the pre-conference workshops. Ultrasound-guided intravenous cannulation can be very challenging for many doctors in the emergency department.

Therefore, we had a station providing a real-time opportunity to practice IV access using our homemade ultrasound phantoms. And I shall share with you how we came up with this solution.

Ingredients

Ingredients for making the mixture
Ingredients for making the mixture
Food coloring dye
Food coloring dye
Equipment for making vessels
Equipment for making vessels

How to make your mixture

Take a cooking pot and fill it with 1200 mls of water (we used this as our molding device could accommodate this amount of mls) bring it to a boil (just as it begins to form tiny bubbles on the base add gelatin powder 8 tablespoons and stir with a hand mixer until it completely dissolves. Thereby add 2 tablespoons of Metamucil and 1 tablespoon of detergent and continue stirring with low flame until the mixture begins to thicken. At this point, you will also see foam that sits on top of the mix. Use a sieve to get the foam out. You can, at this point, add any colors that you would want. Let the mixture cool a little before pouring it into the container. As it cools, you will notice it becoming thicker.

How to set-up your mold/containers

You will need to make a hole on both ends on the container using a hand drill or a hot pointed knife. For this case, since we didn’t have a drill, we used a knife with a pointed tip – heated it up in a burner until it was hot enough and used it to make holes through the plastic container using a circular motion. It is important for the holes not to be too big but estimated to the caliber/ diameter of the long balloons since we need just enough space to pass the balloons across.

For our case, we made 4 holes, 2 on each end. But you can do more if you want. You can arrange balloons in superficial or deeper locations.

To setup the vessels using the long balloons, you will need half cup of water and red color dye. Mix just enough to make a mixture that looks like blood. This can be filled in the balloons with a syringe. Since the color dye can stain your fingers, it is important to use gloves just to prevent your fingers from staining.

Tip: To make an artery, you can fill the balloon much more so that there is minimal compressibility and for the vein, you can fill just enough and have room for compressibility. Don’t fill the balloons before passing it through the container; if you do this, the filled balloon won’t manage to fit into the holes. Once fixed, tie both ends to make knots that are big enough to cover the seal the holes made.
Before pouring the mixture into the container, spray it with some oil, or you can use a cloth dip it in oil and apply it on the inside of the container.

After that, pour your mixture in the container and let it cool. You can place it in the refrigerator and use it the next day. We left ours for 24 hrs prior use.

You can use silicone seals at the holes if you notice to have any leaks. Otherwise, if you don’t have this, you can use plastic food wrap to create a seal between the balloon knots and the container just so the mixture does not leak out until it has set.

Cooling in the refrigerator, note the plastic food wraps used as seal here and the knots
Cooling in the refrigerator, note the plastic food wraps used as seal here and the knots
6 hours after refrigeration
6 hours after refrigeration
Final product
Final product

And finally, the images that you will have on ultrasound.

Short axis/transvers view
Short axis/transvers view
Long/longitudinal axis view
Long/longitudinal axis view
TACEM - IV access workshop under US guidance
TACEM - IV access workshop under US guidance
Cite this article as: Masuma Ali Gulamhussein, "Home Made IV Access Ultrasound Phantoms," in International Emergency Medicine Education Project, November 18, 2019, https://iem-student.org/2019/11/18/home-made-iv-access-ultrasound-phantoms/, date accessed: July 2, 2022

ACEM2019 and Incredible India

ACEM 2019 and increadible India

The 10th Asian Conference on Emergency Medicine was successfully completed in New Delhi, India, during the last couple of days. The conference hosted around 1700 attendees around the globe, mainly Asia. There were approximately 300 speakers from all continents. Dr. Tamorish Kole and Dr. Sirinath Kumar were the two Emergency Medicine professionals who behind the success of this conference. Both experts are also a member of the board of directors of the Asian Society for Emergency Medicine (ASEM). At the end of the conference, Dr. Kole took over the presidency from Prof.Dr. Yildiray Cete (Turkey) who served to ASEM for two years.

ASEM board
Asian Society for Emergency Medicine, Board of Directors

Vice-President of India, Venkaiah Naidu, opened the conference with promising support to the improvement of Emergency Medicine care in India as well as highlighting the implementation of Emergency Medicine into the undergraduate curriculum. As many countries in Asia, Indian medical graduates are working in acute care settings after graduation. Therefore, focusing on undergraduate education can help many countries in the same context. 

Venkaiah Naidu
Venkaiah Naidu, Vice-President of India

This topic one of the items discussed in the ASEM Board of Directors meeting. Creating a widely acceptable undergraduate curriculum is a necessity for Asian countries, especially those in the development stage of Emergency Medicine. ASEM board formed a sub-committee to work on this highly significant problem. Dr. Mohan Tiru (Singapore) and I will be leading board members to continue and finalize the process. Because the International Federation for Emergency Medicine (IFEM) currently working on a comprehensive update process for its’ undergraduate curriculum, there is no need to reinvent the wheel for ASEM. Taking the updated version of the IFEM undergraduate curriculum as the main framework and working on it to create a precise Asian undergraduate curriculum will be enough and probably the fastest way. However, there is a need to understand the current situation and needs in Asian countries. Therefore, the sub-committee of ASEM will work on learning needs assessment and current situation analysis until the IFEM undergraduate curriculum finalized. The expected time for the new updated version of the IFEM undergraduate curriculum is April-May 2020. Completing learning needs assessment and current situation analysis of Asia by March-April 2020 will give the Asian board a chance to move forward with updated IFEM undergraduate curriculum. Probably, developing the Asian curriculum will be possible in a short period of time until the end of 2020.

ASEM board meeting
Asian Society for Emergency Medicine, Board of Directors Meeting

While ACEM2019 continues, I was able to meet a couple of contributors to the International Emergency Medicine Education Project. I visited Rob Rogers’ well-known course, Medutopia, which aims to increase the quality of the teaching skills of educators. According to Dr. Rogers, this is the most enthusiastic and knowledgable group since the Medutopia journey has begun. Dr. Andy Little and Dr. Mike Giosondi were other two experts who gave the course with Dr. Rogers. You can read and listen to Dr. Rogers’ contributions to the International Emergency Medicine Education Project here.

I also came across to Dr. Simon Carley from Manchester, who is well-known for ST.EMLYN’s blog. He gave a couple of amazing talks during the conference, including one plenary presentation.

Simon Carley, plenary session
Simon Carley, plenary session
Arif Alper Cevik and Simon Carley
Arif Alper Cevik and Simon Carley

One of the surprising things was meeting with one of our blog authors Dr. Kaushila Thilakasiri (Sri Lanka) and her team. This energetic group was not only coming for ASEM to attend meetings, but they also came to compete in SimWars. And of course, they won the first prize.

Kaushila Thilakasiri and Sri Lanka team

Two days of workshops and three days of the busy scientific program passed like lightning. In addition to scientific activities, ACEM 2019 team prepared many social events for participants. I think, socially and scientifically, ACEM 2019 was a very busy conference. This created many networking opportunities.

One of the final event was graduation ceremony of 2018-2019 class of Emergency Medicine residents. Around 120 new graduated were appreciated with a nicely setted up ceremony with attendence of leaders of Emergency Medicine such as Prof. Lee Wallis (Past President of IFEM), Dr. Taj Hassan (Pas President of Royal College of Emergency Medicine) and Prof. James Ducharme (President of IFEM) as well as local leaders of Emergency Medicine of India.

2018-2019 Indian Emergency Medicine Graduates
2018-2019 Indian Emergency Medicine Graduates

As a summary, ACEM2019 was a successful gathering for international Emergency Medicine experts and Asian emergency physicians, residents and medical students.

ACEM 2021 will be in Hong Kong. ASEM board of directors decided to give ACEM2023 to Manila, Phillipines and ACEM2025 to Dubai, United Arab Emirates. We hope to see you all in these upcoming events.

Cite this article as: Arif Alper Cevik, "ACEM2019 and Incredible India," in International Emergency Medicine Education Project, November 13, 2019, https://iem-student.org/2019/11/13/acem2019-and-incredible-india/, date accessed: July 2, 2022