Sunday, November 21, 2010

Presentation References

Websites: (by Nancy Duarte) (by Garr Reynolds)


Presentation Zen by Garr Reynolds

Presentation Zen Design by Garr Reynolds

Slide:ology by Nancy Duarte

Examples of Great Lectures (a way to get ideas of how you want to craft your presentation)

Any TED ( lecture – these are a collection of talks about a wide variety of topics – they are for the most part all fantastic

Any Apple Keynote with Steve Jobs (

Sources for images:

iStockphoto ( – free image of the week and some cheaper images – however, most of images are not free

Stock.xchng ( – free stock photos

Wikipedia (

Any government site – NIH/DOD/FBI/CDC – since these are government owned images; they are part of the public domain

~Courtesy of Dr. James Rhee

Wednesday, November 3, 2010

Best EM Residency Contest

Hi Readers,

I need your help to help my residency program win $10,000 for education and research.

Please go this website and vote everyday. You can vote once per person per day until December 15th

Truly appreciate your help!


Wednesday, October 27, 2010

Key Changes: 2010 AHA Guidelines for CPR and Emergency Cardiovascular Care

I'm a subscriber at One of the best things are the Clinical Pearls they send out via email. Check out the Clinical Pearls below that is crucial for emergency medicine.

Key Changes: 2010 AHA Guidelines for CPR and Emergency Cardiovascular Care

  • Atropine is no longer recommended for routine use in the management of PEA/asystole. For symptomatic or unstable bradycardia, IV infusion of chronotropic agents is now recommended as an equally effective alternative to external pacing when atropine is ineffective.

  • Adenosine is recommended in the initial diagnosis and treatment of stable, undifferentiated regular, monomorphic wide complex tachycardia. (Editor’s note: Clinicians should be aware that adenosine should be used with significant caution in the setting of WCT in certain patients. Click Here for a previous EMedHome Clinical Pearl on this topic)

  • The BLS sequence of steps for trained rescuers has changed from “A-B-C” (Airway, Breathing, Chest compressions) to “C-A-B” (Chest compressions, Airway, Breathing) for adults and pediatric patients (excluding newborns).
  • Continuous quantitative waveform capnography is now recommended for intubated patients throughout the peri-arrest period - it is the most reliable method of confirming and monitoring correct ETT placement. Capnography can also serve as a monitor of the effectiveness of chest compressions and to detect ROSC.
  • Suctioning immediately after birth should be reserved for babies who have an obvious obstruction to spontaneous breathing or require positive pressure ventilation. There is no evidence that active babies benefit from airway suctioning, even in the presence of meconium, and there is evidence of risk associated with this suctioning. The available evidence does not support or refute the routine endotracheal suctioning of depressed infants born through meconium stained amniotic fluid.
  • There is increasing evidence of benefit of delaying cord clamping for at least 1 minute in term and preterm infants not requiring resuscitation.

Reference: Circulation, Vol. 122, Issue 18, Supp 3; November 2, 2010.

Go to to subscribe!

Monday, October 25, 2010

Finding Happiness in the Emergency Department

Finding Happiness in the Emergency Department
by Sam Ko, MD, MBA
CAL/EMRA President, 2010-11

“It’s too busy in the ED these days.” “Another faker.” “Why can’t they go to their primary medical doctor?” Have you ever said these words or overheard them during a shift? It can be disheartening to work a shift and see the patient chart rack mount higher and higher, as you place a central line in the patient with septic shock, then evaluate a patient with chronic low back pain, and then examine the ears of a two-year old whose fever “came right back four hours after Tylenol was given.”

Recently, I’ve discovered the secret of being happy while working in the ED. It’s a simple idea, but has profound implications. The idea stems from Srikumar Rao’s talk, “Plug into your hard-wired happiness.” He states that our mental model of happiness is flawed. Our model is based upon the logic, “I’d be happy if...”

For example, do you remember when you were pre-med college student? You said, “I’ll be happy once I get into medical school.” Then when you were in medical school, you told yourself, “I’ll be happy once I get a high score on the boards.” Then when you were in residency, you said, “Life will be great when I’m an attending.” This mental model is flawed, because it never allows us to be happy in the current moment. Instead, we continually seek the next step to elusive happiness.

Now, can you recall a time when you were truly happy? It may have been while watching a sunset over the ocean, seeing a beautiful rainbow, or welcoming your child into the world. Why were you happy? It was because you accepted everything at that very moment. You didn’t say, “Oh, it’d be more perfect if there were less seagulls flying across the sky.”

The emergency physician’s role is to evaluate everyone who comes into the ED - regardless of how sick or not sick they appear to be - and rule out emergencies. Our realm of practice includes the most bogus visits to the most critical illnesses. The key idea is acceptance of this fact. To accept everything that is happening and every patient who comes in to the ED, no matter what. When I accept the patient with an ingrown toenail, the asymptomatic patient who meticulously measures their blood pressure at home, or the patient in DKA who doesn’t take their diabetic medications, I feel calmer and relaxed. If I don’t want to develop stress-induced hypertension, burst an aneurysm, or start loading up on benzodiazepines prior to work, I choose to accept all aspects of my field.

Every shift, we have the opportunity to relieve pain, alleviate fears, and save lives. It’s a privilege to be an emergency doctor and everything that comes along with it. So here’s the challenge: during your next shift, calmly accept everyone you see in the emergency department.

Reference: Rao, Srikumar. Accessed 8.31.10

Originally posted in CAL/ACEP Lifeline October 2010.

Monday, October 18, 2010

Top Ten Financial Tips for Graduating EM Residents

1. Save more than 20% of your income.

2. Have cash reserves for six months of expenses.

3. Automatically have savings deducted from check.

4. Take full advantage of employer's financial benefits, i.e. retirement, child care, advanced education, etc.

5. Max out your 401K, Roth IRA, or other retirement plan.

6. Review insurance policies (malpractice, disability and life insurance.)

7. Create an investment strategy based upon income, age, and risk tolerance.

8. Start an education plan for your children (529 or education IRA.)

9. Review estate planning and update your will or trust.

10. Start planning now to avoid income tax suprises next year.

Source: Lane Financial & Dew Wealth Management

Saturday, October 16, 2010

Anthony Robbins

I listen to Tony Robbins in the car. His books, Unlimited Power & Awaken the Giant Within are powerful. After listening to him, it gives me a different mental model to use and different perspective on reality.

Enjoyo this enlightening talk by Tony Robbins @ TED Conference.

Thursday, October 14, 2010

Finding your niche in Emergency Medicine

*Right mouse click the link above to save.

Dr. Amal Mattu's lecture "Finding your niche in EM" is powerful. He discusses the importance of finding your unique area in emergency medicine. His tips are to:

1) Be the Expert.
2) Go into new areas that are not too saturated (like emergency EKGs)
3) Publish like crazy on a focused topic.
4) Be broad, and not too narrow.
5) Read everything on that topic.

Whether one is going into academics or community practice, it's important to have a niche. Now, go forth and specialize.

Tuesday, June 8, 2010

Dr. Ko's Advice To Graduates

1. Be happy NOW.

2. Choose your passion. Find the point where your interests intersects the world's needs.

3. Define success. Figure out when you want to stop and enjoy.

4. Love others. If choosing between being nice or a jerk, be nice.

5. Enjoy the process, and focus less on the outcome.

6. Life is hard and intertwined with joy and woe.

7. Persistence is key to achieving what you really want.

8. Be thankful for everything you have and ask yourself, "How can I give back?"

9. Every day is a BRAND new day, and you can start fresh no matter what happened before.

10. Know that you will die. Think of it as the ultimate deadline. When you are worried about something, compare it to this fact.

Yours Truly,
Dr. Ko

Friday, May 21, 2010

Business Card Trick of the Trade

Have you ever gone to a conference and gotten a grip of business cards in your hand?

I used to store mine in a little box in the deep recesses of a banker box never to be opened again.

But then I discovered how to leverage and the iPhone. Here's what you can do:

1) Take a picture of each business card (the back side if there is something on it) with your iPhone.

2) Find your Evernote incoming email address, click here, if you don't know how.

3) Email all the business card photos to the Evernote email address using iPhone photos

4) Go to Evernote website and log in. You can search the business card photo's content by name, company, etc. etc.

5) Now throw each and every one of your business cards into the closest recycle bin like a ninja!

Thursday, March 11, 2010

Prisoners Get Access to Healthcare, Should Others?

Is health care a right in the U.S.? If not, then why do prisoners get it for free?

At some level we must believe that basic health care should be provided to the residents of the U.S. Can you believe that some prisoners get better health coverage than hard workers in America?

Of course someone could argue, they get cable TV. But not everyone in the U.S. does! Just because they get it in jail, doesn't mean that is a right. Then again, cable TV and other privileges can be revoked. If a prisoner is sick, regardless of their behavior, they will get seen by a health care practitioner.

One fear I have about making health care "free," will lead to the under appreciation of it. For example, public bathrooms are free and nobody really takes care of it.

**Fast Forward to 3:10

Wednesday, March 3, 2010

Dr. Ko's Emergency Ultrasound Course

Addictive Learning That Sticks

In a hurry? Enroll in the course here.

Learn by answering a few emailed questions every other day? SpacedEd co-founder and CEO Duncan Lennox says that is precisely what his product is doing for physicians. (SpacedEd was invented at Harvard Medical School.)

SpacedEd is a platform designed to allow learners and teachers to harness the educational benefits of spaced education. It is based upon two core psychology research findings: the spacing effect and the testing effect. In more than 10 randomized trials completed to date, spaced education has been found to:

  • Improve knowledge acquisition,
  • Increase long-term knowledge retention (out to 2 years),
  • Change behavior,
  • Boost learners’ abilities to accurately self-assess their knowledge.

In addition, spaced education is extremely well-accepted by learners.

The SpacedEd approach is predicated on a set of core principles:

    • Short Repeated Bursts: Because it uses a regular schedule and an adaptive algorithm, learning can be delivered in small amounts that can take as little as 3 minutes a day.
    • Push Learning: The learning comes to you on a regular schedule. You don’t have to remember to do it or set aside large chunks of time.
    • Adaptive: The daily content adapts based on past performance automatically to drive long-term retention while requiring less time.
    • Immediate Feedback: Once a question is answered, detailed educational feedback is provided. Users are also given performance data (their course progress and performance relative to peers) which feeds their addiction to the courses.

Do you practice emergency medicine?

Have you ever used an ultrasound machine?

Want to get updated on the latest ways to leverage ultrasound?

If your answer is, "Yes," to any of the above...

...then sign up for this course now!


The "Emergency Ultrasound" course includes 25 questions with images, videos, and detailed explanations. More importantly, each explanation ends with a primary Clinical Bottom Line so you can apply it immediately in your practice.


Thanks to all faculty, staff, & colleagues at Loma Linda University and Riverside County Regional Medical Center in Southern California for their assistance in creating this ultrasound course.

Check out this EM Ultrasound Course now!

Thursday, February 11, 2010

Ten Emergency Medicine Websites I Love and Will Marry

1. - EM news, ultrasound images, and "WhiteCoat's Callroom"

2. - All things related to Academic EM

3. - Crazy amounts of information on nexus of EM and Critical care

4. - Amazing EM blogger

5. - Powerful Clinical Pearls

6. (best viewed in Internet Explorer) - Loads of information, medical calculators, and cool small pox images

7. - Classic ER

8. - Best EM ultrasound site alive

10. - Tricky Cases, Free Ultrasound Images, & Pocket books