12.6.18 Conference Summary

“Rocking out Mentorship”: Dr. Matthew Stull

  • Mentorship: “A process for the information transmission of knowledge, social capital, and psychosocial support perceived by the recipient as relevant to career and personal development”

  • Benefits of mentorship

    • Higher income

    • More work satisfaction

    • Better patient care

  • Mentorship is not about assigning a relationship at a defined period time; it is about connecting with another human being that can provide career and personal development

  • What makes a good mentor?

    • Effective listener

    • Shares personal experience/insights

    • Accessible

    • Provides honest and constructive feedback

    • Inspirational

    • Guides rather than demands

    • Opens doors/opportunities

    • Supports personal interests

  • Top mentoring “Pearls”

    • “Know Thyself”

      • Internal reflection is the first step to a good mentor/mentee relationship

    • Use the “M-word”

      • Define the individual you approach specifically as a mentor

    • “Build a safe space”

      • Confidentiality is paramount to building the right type of relationship

    • “Mentor Up”

      • Many mentees expect others to approach them; you must manage the relationship as the mentee

    • “Polygamentor”

      • No single mentor can provide all the essential tools for perfect mentoring; mentees must approach and build relationships with multiple mentors as this will provide more support and a deeper satisfaction

    • “Do your homework”

      • If a mentor provides the mentee with work, DO IT

  • Having a mentor makes your future easier and pushes you to be better!!!!!!!!

Emergency Medicine Essential Skills Stations

  • Slit Lamp exam

    • Used to evaluate the cornea, anterior chamber, posterior chamber, and retina for pathology including corneal abrasions, foreign bodies, corneal ulcers, hyphema, and hypopyon, among many others

Slit Lamp

Slit Lamp

Hypopyon

Hypopyon

  • Splinting techniques

    • Depending on angulation, displacement, and location of fracture, selection of splint type is tailored to individual fractures

    • Goal is maintenance of bone cortices and minimizing displacement/angulation, while fixing limb in certain location to allow as little movement as possible

    • Examples include:

      • Ulnar gutter splint (distal ulnar and certain carpal'/metacarpal fractures)

      • Radial gutter splint (distal radius and certain carpal fractures)

      • Thumb spica (scaphoid and 1st MC fracture)

      • Short posterior leg splint (distal tib/fib and tarsal fractures)

      • Long posterior leg splint (proximal tib/fib fractures near knee joint)

Long Posterior Leg Splint

Long Posterior Leg Splint

  • Dental Blocks

Diagram of Teeth with number orientation

Diagram of Teeth with number orientation

  • Designed to provide anesthesia to certain teeth depending on desired location

    • Often a 1:1 mixture combination of 3 mL 1% lidocaine with epinephrine and 3 mL 1% bupivicaine to provide immediate and delayed pain control for up to 6 hours

      • Addition of epinephrine allows for bleeding control and better anesthetic success

    • Types of nerve blocks

      • Inferior alveolar nerve block

        • Most common block performed and will provide pain control/anesthesia to teeth 25-32/17-24

        • Approach: 45 degrees of angulation aimed just medial to tooth 17/24 until bone is palpated

      • Mental nerve block

        • Provides anesthesia to teeth 20-24/25-29

        • Approach: aim inferior near mental foramen until bone in palpated near buccal mucosa of teeth 22 or 27 depending on side desired for pain control

      • Infraorbital nerve block

        • Will provide pain control to teeth 4-8/9-13

        • Approach: intraoral injection near 5-6/12-13 and aiming superiorly into buccal mucosa approx 1-2 cm

  • Thoracostomy tube placement

    • Designed to evacuate pneumothorax or pneumothorax

      • Technique: Identify the fifth intercostal and the midaxillary line. The skin incision is made in between the midaxillary and anterior axillary lines over a rib that is below the intercostal level selected for chest tube insertion.

Thoracostomy tube entering thoracic cavity

Thoracostomy tube entering thoracic cavity

Thoracostomy tube drainage system with atrium

Thoracostomy tube drainage system with atrium

  • Non-Invasive Respiratory Support (i.e. CPAP/BiPAP)

    • Most useful for COPD and CHF exacerbations to provide assistance with ventilation and oxygenation

    • Avoid if patient is altered or obtunded as risk of aspiration is high if vomiting occurs

    • Types:

      • CPAP: Continuous positive airway pressure

      • BiPAP: Bi-level positive airway pressure

        • Provides an inspiratory and expiratory pressure to allow for more patient comfort

      • Both forms are designed to decrease the work of breathing

BIPAP machine with facemask attached

BIPAP machine with facemask attached