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Tiny Tips: START Protocol for Mass Casualty Triage

In Medical Concepts, Tiny Tips by Brent ThomaLeave a Comment

My residency program discussed the EMS chapters in Rosen’s tonight and went over the START protocol for triage in mass casualty incidents. For the unacquainted, START stands for Simple Triage And Rapid Treatment. This protocol aims to make triage extremely fast and simple to allow first responders to quickly assess large numbers of patients. Triaged patients are clearly marked with colors (black = dead, red = immediate attention, yellow = delayed attention, green = …

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Tiny Tips: Altered Mental Status

In Medical Concepts, Tiny Tips by Brent Thoma6 Comments

Altered mental status is a frequent presentation with a very broad differential. Having a solid approach helps provide structure to the workup of a difficult group of patients. IS IT MEAT is a common mnemonic for this presentation and the best one that I have come across (thanks to Nadim Lalani from ermentor.com for teaching it to me and George Farjou for the quick comments to improve it). Not only do the letters have fairly intuitive …

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AnkiEM Evolution – Flashcard Exchange & Flashcards Deluxe

In Knowledge Translation by Brent Thoma6 Comments

For the background on this project check out my post The AnkiEM Project. Basically, when I started making cards to review for my board exams I knew that I wanted to use a spaced-repetition flashcard tool (thanks to Chris Nickson‘s from Life in the Fast Lane for exposing me to this concept) and Anki seemed like the best bet. However, as I collected feedback from Eve Purdy, Andrew Tagg, Joshua Power and Reuben Strayer I began to consider other alternatives. Specifically, I agreed with Joshua Power that it would …

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Tiny Tips: The Effects of TCAs

In Medical Concepts, Tiny Tips by Brent ThomaLeave a Comment

This month I’ve been reading a lot of toxicology. While running through the Antidepressant chapter in Rosen’s I realized that I was definitely going to need help remembering the ridiculous number of pharmacological effects of TCAs. Practical? Not so much. A potentially esoteric exam question? Definitely. This is the first BoringEM “Tiny Tip.” While most of my medical posts are quite long, I think there is some merit to occasionally going over something …

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The AnkiEM Project

In Knowledge Translation by Brent Thoma16 Comments

Inspired jointly by Reuben Strayer‘s catalog of EMCards on Emergency Medicine Updates and Chris Nickson‘s post at Life in the Fast Lane on spaced repetition, I will be trialing a combination of these two ideas using Anki flashcard software to create the AnkiEM Project. Dr. Strayer‘s strategy for studying for his board exam was to summarize Rosen’s Emergency Medicine onto flash cards. In the spirit of FOAM, he then scanned all 1412 cards onto his EM Updates site and made them freely available. If you haven’t already checked them out …

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Handheld Ultrasound – A Review of the VScan

In Medical Concepts by Brent Thoma27 Comments

As it seems to be ultrasound month on BoringEM (see the guest posts from Paul Olszynski here: A Pictorial Approach to Ultrasound in Shock and Chris Byrne here: Point of Care Ultrasound: A Hyperechoic Future in Med Ed), I thought I’d chime in with a review of my new toy. I just completed a four week rotation at a regional ED that is not equipped with an ultrasound unit. Fortunately, my residency program purchased a GE VScan handheld ultrasound machine for …