Month: August 2024

Should You Risk It?

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What does risk mean to you and how do you approach risky clinical scenarios? As EM docs, we encounter risk every day. In this episode, Dr. Scott Stuckey gives us a new perspective by breaking down several frameworks and vocabulary we can use to think about and mitigate risk.

Residents: Dr. Stuckey completed this podcast as part of his Kiehl Professional Development Grant. You can submit a Kiehl grant to support your professional passion too!

Guest: Scott Stuckey, MD. Host: Kim Bambach, MD. Editors: Kim Bambach, MD and Creagh Boulger, MD.

Key Take-Aways:

  1. Volken’s Hazard Evaluator: Developed by Martin Volken, a professional mountain climber. Assign likelihood and the consequences. Risk = likelihood x consequence.
  2. What is your lateral emotional driver? Emotion plays a role in how we make decisions and it’s important to be aware of this. In medicine, we try to make objective assessments. Lateral emotional drivers are not necessarily negative- they can be critically important in goals of care discussions, for example.
  3. Graham’s Risk-Frequency Matrix: when you find yourself in a stressful situation, ask yourself which quadrant you’re in. That can help you understand where to put your attention to mitigate risk. High risk or low risk? High frequency or low frequency? For example, tooth splinting is low frequency low risk. Lac repairs are high frequency low risk. Intubation is high frequency high risk. Cricothyrotomy is low frequency high risk.
  4. The GAR (Green-Amber-Red) Risk Assessment: components of the situation are assigned a color related to the level of risk (green=least risk, amber= moderate risk, red=high risk). If you’re in red, how can you move into amber? If you’re in amber, how can you move into green? This often comes down to good communication with your team.
  5. The risky choice may still be the right choice for the patient.

References:

  1. Martin Volken’s Hazard Evaluator – Pro Guiding Service. December 22, 2013. Accessed August 28, 2024. https://proguiding.com/blog/martin-volkens-hazard-evaluator/
  2. Operational Risk Using the GAR Model. U.S. Fish and Wildlife Service. Accessed August 28, 2024. https://www.fws.gov/sites/default/files/documents/GARModelWorksheet_v20230103.pdf
  3. High Risk, Low-Frequency Events in Public Safety – Today’s Tip from Lexipol.; 2021. Accessed August 28, 2024. https://www.youtube.com/watch?v=pIpRVLkv0rg

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The New Certifying Exam

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Are you ready for the new certifying exam? The exam goes live in January of 2026, so if your graduation date is in 2025 or later, this episode is for you! Dr. Matt Wilson (PGY-5, EM/IM Chief Resident) and Dr. Diane Gorgas (Professor of Emergency Medicine and President of the American Board of Emergency Medicine) discuss what you need to know to ace the test. They also talk about why it’s important and the value of becoming a board certified EM physician.

Key take-home points:

  1. The certifying exam is replacing the virtual oral exam. You need to take the qualifying (written exam) and then the in-person certifying exam to become board certified in Emergency Medicine.
  2. The new certifying exam is designed to be less like playing a game than the oral boards and to reflect the realities of an EM shift. For example, you will be assessed on key competencies such as difficult conversations, team management, task switching, and clinical decision making.
  3. There is tremendous value to becoming certified in EM. It signifies that you have reached the highest standard and are competent in the variety of skills that it takes to be an outstanding Emergency Physician. It also increases your bottom line, too.
  4. After you become a diplomat, you’ll stay certified by completing My EM Cert modules.

Host: Matt Wilson, MD. Guest: Diane Gorgas, MD. Editors: Kim Bambach, MD and Mike Prats, MD.

References:

  1. “Certifying Exam | Emergency Medicine Certification.” Accessed August 21, 2024. https://www.abem.org/public/become-certified/certifying-exam.
  2. “Value of ABEM-Certified Physicians.” Accessed August 21, 2024. https://www.abem.org/public/about-abem/value-of-abem-certified-physicians.

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Welcome to Crash Cart EM!

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In our first episode, Kim and Mike are excited to introduce you to Crash Cart EM. Crash Cart EM is the podcast for Emergency Medicine at The Ohio State University. We love to teach here, so our goal is to bring you a variety of episodes to fill your mental “Crash Cart”. You’ll learn a little bit about the history of the familiar set of red drawers too- the quintessential symbol of Emergency Medicine. A huge thank you to all of the residents and faculty who have made this project possible!

Hosts: Kim Bambach, MD and Mike Prats, MD. Editor: Kim Bambach, MD.

References:

  1. “Emergency Crash Cart.” Accessed August 21, 2024. https://americanhistory.si.edu/collections/nmah_1409567.
  2. “Emergency Nurses Association Collection | College of Nursing | University of Illinois Chicago.” Accessed August 21, 2024. https://nursing.uic.edu/nursing-research/centers-labs-interest-groups/midwest-nursing-history-research-center/collections/organizations/emergency-nurses-association-collection/.
  3. Jacquet, Gabrielle A., Bachar Hamade, Karim A. Diab, Rasha Sawaya, Gilbert Abou Dagher, Eveline Hitti, and Jamil D. Bayram. “The Emergency Department Crash Cart: A Systematic Review and Suggested Contents.” World Journal of Emergency Medicine 9, no. 2 (2018): 93–98. https://doi.org/10.5847/wjem.j.1920-8642.2018.02.002.

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