ED teaching 27 November 19

Teaching today was hampered by anumber of factors - exceptionally high clinical peak demand sabotaged attempts to run a multidisciplinary simulation session; loss of SMPs from the teaching to cover the floor; and a delayed start due to various meetings and interviews.

Nevertheless, between Jolmer, Sinead, Elise, and Tom, some solid content was covered.

Case based discussions:
- on learning to accept people have weird self-resolving symptoms that we might not be able to explain
- interdisciplinary frustrations and medical tribalism

Venous thromboembolism:

Elise: some experimental Prezzi magic exploring upper limb DVT of the non- CVC, non-cancer variety

Sinead: outpatient management of PE using the PE severity index to stratify patients

Tom: Judgement day - clinician judgement vs clinical decision instruments in the work up for possible PE, as told through the allegory of the terminator universe

Elise: Rapid review of the evidence - EM practitioners can use POC ultrasound to diagnose and exclude DVTs

Sinead: tPA for submissive PE: seems to work but kills old people with head bleeds

Wellness

We spoke a bit about departmental culture and identified some changes that could be made to support registrars spreading their wings and feeling supported.