Tag Archives: ember project

Evernote Meet Google

 

Maybe it’s a hold-over from my childhood days, but September is the month of organization.  You know, the ritual purchasing of three-ring binders, pencil holders, graph paper, all with the hope and optimism that this year things will stay organized.  Inevitably by the end of the year you’re digging around your overstuffed backpack for that piece of paper with the homework assignment on it.

Now instead of three-ring binders I hoard information online: downloading, tagging, and clipping, all in the vain hope that it will stay organized for some future use. And why not.  I spend a lot of time reading and searching online for emergency medicine information for my particular learning needs. Unfortunately, most of it collects digital dust on my hard drive or cloud – the junk drawers of the digital age.

So here is a great new tool that is actually getting me to use the information I’ve already collected.  Evernote meet Google.  Evernote now allows you to simultaneously search Google and your Evernote folder on any web browser.  Want to review subtle ECG findings suggestive of STEMI?  Type STEMI into Google and it gets you 1,700,000 hits, but now it also gives me 3 notes from my Evernote account.  Since I’ve already clipped these to my account the likelihood that they are valuable to me at the moment I want it is high.

Sure enough clicking on the Evernote icon shows me I have an article from Amal Mattu about high risk ECGs, a review of subtle STEMI patterns by Dr Smith from his ECG blog, and a link to another good online ECG education site.

Wow, my preselected information side by side with the power of Google, all at my fingertips on a web browser.  Finally, I’m ready for school (can I redo fifth grade please)?

 

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Aloha

A post here has been long overdue.  For those of you who know me, the month of July has been my transition from a busy urban medical center in New York to a busy rural ED on the Big Island of Hawaii.  My new colleagues are wonderful, and the nursing staff is great (the first time I went in to repair a lac and found the wound already irrigated, prepped, with the suture tray completely set up I nearly fell over).

The most notable change is of course the acceptable attire for a day in the emergency department.  Amongst the things I’ve discovered in my first month is that the pattern on Aloha shirts can actually hide a great deal, Moray Eels are not to be trifled with, Wana (pronounced Vana) is painful, and waiting on the air rescue team during inclement weather while you watch over your deteriorating STEMI patient is anxiety provoking. Some of this will be part of the upcoming educational posts I have planned for August.

Aloha. The Ember Project moves to Hawaii

One of the traits that drew me to Emergency Medicine as a specialty is the resilience and creativity of its practitioners in the face of an endless array of unexpected and challenging clinical situations.  Nothing epitomizes this more than the rural emergency physician.  I’m already very impressed, and looking forward to growing as an EM doc in my new home.


Tools to Live by – Infectious Disease App

My recent post about subjectivity in clinical practice, and its central, but often maligned status in current medical literature has inspired me to highlight some tools that I find particularly useful because of the subjectivity infused into them.  The list is long, since in my opinion it’s what makes the new online technology so successful as an educational tool. Not the wealth of objective information, but the fact that it is suffused with subjectivity and personal insight.

My first taste of this was with the podcasts offered by Mel Herbert of EMRAP & Co.  When they first came out I couldn’t get enough of them, and initially (other than my fascination with the Aussie accent) I couldn’t put my finger on why I found them such useful learning tools.  Wouldn’t I find much of the same information myself by opening a textbook or reading the same journal articles? Well, no.

I came to realize that it was the Subjectivity of the presenters that was the true value in the podcast’s content.  I haven’t quite come up with a name for what to call this, but there is definitely some kind of contextual or experiential higher order learning taking place – something that can only come into existence when you integrate knowledge, experience, and subjectivity.

Imagine, a study that supports a certain group of patients getting thrombolysis in stroke may be of some value.  That same study filtered through the experience of a clinician who sees emergent stroke patients daily, who knows how to navigate the million challenges that stand between diagnosis and therapeutic intervention, and can help you integrate the new information into your current clinical practice?  Priceless.

Is Subjectivity is flawed? Yes.  Understanding where it’s succeeds, where it fails us; where it can fly on its own and where it needs support are all open to continued personal reflection and objective evaluation. The issue is not that it’s flawed and needs replacing with “evidence” or technology, but how best to hone it into a powerful clinical tools with the support of technology and EBM.

But this post is not really meant to be another pitch for why subjectivity sits front and center in the house of medicine, and all our science and technology serves at its pleasure. It’s about great tools that highlight the clinical value of subjectivity.  So here’s one for you.

Infectious Disease Compendium. A Persiflager’s Guide. Is an example of the value added to a clinical tool when it is infused with the author’s point of view.  It has humor, and some silliness, but it also has insight, perspective and personal context that transforms a dry Sanford guide style reference chart into an interactive app that’s as close to having an ID consult with you on your shift as you can get.

Download this app, flip through some of the sections and you will find pearls to guide your decisions beyond the usual “if A then B” of most reference guides. No doubt some of this experiential knowledge will benefit your patients, make your shifts in the ED easier when angsting over a difficult antibiotic choice, and maybe help that ID doctor in the morning figure out if the bottle of gram positive organisms growing from your admitted patient’s blood culture is a contaminant or something he really needs to worry about.


The EMBER Project Reaches 1000!!!

Recently my little online outpost passed 1000 visits.  Thanks to everyone who helped me reach that milestone.  I’ve been having a great time sharing my ideas and getting feedback from readers, and it’s been amazing to get responses from Australia to Bolivia to Norway and a dozen other countries.

From the beginning the goal has been to curate a conversation about Emergency Medicine in a way that challenges traditional didactics, explores the tools we use in our daily practice from a new perspective, and puts our well-being as EPs front and center.  I hope to keep developing these ideas and posting more content for you to enjoy over the months and years to come so stay tuned.

Now also seems as good a time as any for some self promotion.  Little blogs like mine need all the help they can get, so please go to our Facebook page and LIKE  us, follow through our RSS feed, or Twitter and get the word out to friends and colleagues who you think may find this site interesting so it can grow.

Thanks

Jonathan St. George MD


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