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Websites to Bookmark < Back Technology #1 Websites to Bookmark Working with PDFs PDF Converter. All the things you could ever want to do with a PDF. Create, convert, edit, split, combine, etc. How to add links to a PDF PDF Outliner . $4.99. Easily add a table of contents to facilitate searching large PDFs. Available on Mac. iAnnotate PDF . $9.99 Most user-friendly program to view and make notes on PDFs. Available on iPad. Designs 99Designs by Vista. Logos, website development, graphic design and more! I hired a designer to create my logo for my LLC. Tailor Brands. Inexpensive program to create a simple logo. I created my first logo with this company. Near endless variety. And you can download icons optimized for social media platforms (Facebook, Twitter, Instagram), application platforms (Apple and Android), and various other programs (Pinterest, Quickbooks, Etsy, Linkedin, Meetup, Youtube). Design Program- Canva. An incredible free resource for designing creative and eye-catching social media products- videos, posters, blog posts, logos, flyers, etc. I have made YouTube videos and book covers on this platform. Lots and lots of extra features in the subscription version. Miscellaneous Diagrams . Open-source software for diagram and flowchart creation. User-friendly program (website) for creating any diagram, flowchart, or table that you desire. I have used it for everything from creating clinical management algorithms to draft a PRISMA flow diagram for a systematic review. You can save templates and download the final products. Time and Date . Create personal calendars. Calculate the number of days between two dates. Embed a PowerPoint on your Wix site . A nice tool that I learned about while making this website. Grammarly. Proof-reading program. Available as an add-on for Safari, embedded application for Microsoft Word, and free-standing application on Mac. Calendly . Free online appointment scheduling software. How to: How to read a newspaper article behind a paywall - https://archive.is/ www.nytimes - archive.ph/paste the URL Previous Next

4 < Back Trauma Resources Society Guidelines American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) Best Practice Guidelines Imaging Management of Traumatic Brain Injury Management of Orthopaedic Trauma Management of Geriatric Trauma Massive Transfusion in Trauma Recognition of Child Abuse, Elder Abuse, and Intimate Partner Violence Palliative Care Western Trauma Association Algorithms. Evidence-based critical decision algorithms in trauma. Pediatric Trauma Society. Guidelines and educational resources. Brain Trauma Foundation Guidelines. Concussion, prehospital and surgical management of TBI, pediatric TBI, prognosis in TBI, combat-related head trauma. Joint Trauma System: Clinical Practice Guidelines. Evidence-based guidelines developed by subject matter experts from both the military and civilian communities. Tutorials ER-REBOA PLUS Catheter , Prytime Medical. Quick Reference Guide. ER-REBOA PLUS Convenience Kit. ER-REBOA PLUS Catheter, Instrutions for Use. ER-REBOA PLUS Catheter, Product Video. Videos and Lectures Joint Trauma System: Emergency War Surgery Course. Lecture series based on JTS CPGs and the Emergency War Surgery Book. Trauma in a Flash. Brief videos on trauma topics, hosted by the Arizona Trauma Association. American College of Surgeons Resources Resources for Optimal Care of the Injured Patient, 2014. Framework for developing a trauma system. Compares the different resources available at Level 1, 2, and 3 verified trauma centers. "An ideal trauma system includes all the components identified with optimal trauma care, such as prevention, access, prehospital care and transportation, acute hospital care, rehabilitation, and research activities. Guidelines for Field Triage of Injured Patients Recommendations of the National Expert Panel on Field Triage, 2011. Basic algorithm for triage of trauma patients based on mechanism of injury, physiologic criteria, and anatomic region of injury. Stop the Bleed. Trains non-healthcare providers in point of injury treatment for massive hemorrhage. AAST Resources Brief Topic Reviews. COVID-19, Aspiration, Blunt Cardiac Injury, Blunt Splenic Injury, Child Passenger Safety, Clostridium Difficle, ICU Illness, Wound Care Instructions, Field Triage, Epidemiology and Injury Prevention, Mechanical Ventilation, Pelvis Injuries, Rib Fractures, Sports Concussions, Thromboembolic Disease, Trauma Systems, TBI Rehabilitation. CME Opportunities. Meet the Masters, high yield journal articles, in addition to countless other resources. Some are free, and some are $25 for non-members. Virtual Grand Rounds. AAST hosts virtual grand rounds, a web-based educational series Acute Care Surgery Fellow Educational Resources. 67 Educational Modules for ACS Fellows. Created by the ACS Committee. ONLY accessible by ACS Fellows. Previous Next

< Back What happens in the trauma bay? A glimpse into the inner workings of a trauma activation The radio crackles and the paramedic's voice cuts through the din of the emergency department. “Doctor to the radio”. The clock already started and time isn’t on our side. “30s-year-old male, a gunshot wound to the right arm and left back. GCS 7. Highest heart rate 110, lowest blood pressure 80 systolic. 5 minutes out.” The management of trauma starts at the time of injury, with bystanders and dispatched first responders. Immediate interventions can be performed on the scene, which is followed by rapid transport to the hospital. En route, care continues to be delivered as needed (starting IV, giving fluids/ blood, maintain an open airway, etc). The hospital is contacted to prepare them for an incoming patient. Key details dictate the resources that are mobilized in response. There are no universal criteria for what constitutes each level of trauma activation, and different hospitals have unique designations for the highest activation (Trauma Red, Level 1, Code 1, etc). However, triage is designed to rapidly transport the patient to the most appropriate facility. An adult trauma code 1 is paged out to the trauma team. As the team arrives, the minutes before the patient arrives are spent relaying key patient details shared from the pre-hospital team. For a hypotensive patient or report of massive bleeding, massive transfusion is initiated. Chest trauma? Chest tubes, possibly open thoracotomy tray. Extremity wounds? Check that the tourniquets are ready. Team roles are assigned, and a plan is discussed. When the patient arrives, the pre-hospital team presents key data to the entire team. At one of the facilities I trained, there was a standardized presentation. It was organized, succinct, and appropriately relevant; the trauma team and the pre-hospital team both knew what information was to be shared. Pre-hospital team report Age (or approximate age), gender, mechanism, time of injury, significant event details (prolonged extrication, death on the scene, etc). Significant pre-hospital interventions and events (tourniquet time and location, intubation, change in mental status). Presence of IV access (size and location) and administration of pre-hospital fluids or medications. Highest heart rate, lowest blood pressure. Trauma Evaluation/ ATLS After the report, the patient is transferred to the bed and the primary and secondary surveys are performed. Primary survey- assess airway patency, adequacy of breathing (bilateral breath sounds, chest rise and fall), circulation (control active hemorrhage, assess pulses), disability (rapid neurologic assessment with GCS and pupil exam), and exposure (remove clothing to facilitate exam, make sure they get covered with blankets to minimize hypothermia). Concurrent with the primary survey, IV access is obtained, blood is drawn, and interventions are performed based on the findings of the survey. If there are no immediate life-threatening injuries on the primary survey, the secondary survey is performed, which is a comprehensive head to toe exam (see below), including log rolling the patient to examine their back. Common diagnostic testing includes commonly, patients undergo FAST (see vignette "Blast Injury "), chest x-ray, and pelvis x-ray. Based on hemodynamic stability and injuries, patients are then dispositioned to the operating room, radiology for further imaging, admitted to the ICU or floor for ongoing resuscitation, observation, consults, serial exams, etc. Secondary Survey Head/ ears/ nose/ throat- facial abrasions/ ecchymosis/ tenderness, periorbital edema/ ecchymosis, crepitus, open wounds, blood from nares/ ears. Tympanic membrane. Jaw occlusion. Neck- c-collar in place, obvious ecchymosis, abrasions, open wounds, tenderness. Chest- wounds, ecchymosis, tenderness, crepitus. Axilla- wounds. Abdomen- wounds, ecchymosis, tenderness Pelvis- stability, pain. Back- midline spinal tenderness/ step-off, ecchymosis, abrasions, wounds. Rectal- tone, blood on rectal exam. Extremities- sensation/ motor strength. Abrasions, wounds, gross deformities Vascular- carotid, femoral, DP/PT, radial pulses bilaterally. GU- perineal ecchymosis or wounds, blood at meatus. Previous Next

Learning how to live with an ostomy Peer Support < Back Learning how to live with an ostomy Acute Care Surgery can lead to a need for subsequent elective procedures, including ostomy reversals, abdominal wall reconstruction after open abdomen management, and various wounds. I frequently see young, healthy males with ostomies. Thankfully, most patients are great candidates for reversal. But there are a variety of reasons why patients can't undergo reversal, at least not immediately. Injury to the anorectal sphincter complex would put the patient at a very high risk of incontinence. Another possibility is when the ostomy was created in the setting of acute bowel perforation, with an undiagnosed underlying inflammatory process. Reversing an ostomy without further workup could be problematic. I have seen several young, healthy males who have to spend at least a handful of months with their ostomy while undergoing preoperative workup, and more than one who will likely have a prolonged or permanent ostomy. This can be daunting, especially when they were anticipating minimal delay before undergoing a reversal. Common concerns include how to wear normal clothes and how to manage the odor. While I can be supportive, I don't have any first-hand experience of living with an ostomy. One particular patient expressed a desire to return to college, but he was convinced that he couldn’t go to class with an ostomy. Essentially he was resigned to putting his life on hold until his ostomy was reversed. His situation inspired me to seek out a peer who could show him it's possible to live with an ostomy. I reached out to my network of medical personnel that might know how to connect a patient with a peer support group. We have multiple support groups, including trauma survivors, epilepsy, and stroke, to name a few. Unfortunately, I quickly realized there is no group or service to link patients with someone who will answer their questions and hopefully decrease their fears and worries. Many of the trauma patients who have an ostomy are young and healthy, leading active lives. Unlike elective ostomies, such as for inflammatory bowel disease, waking up after trauma with an ostomy is unanticipated and can be very distressing. Also, there is minimal or no chance for preoperative patient education. There is a certain taboo associated with talking about certain bodily functions, and I don't think many young males would ask their trauma surgeon if there is someone they can talk to about having an ostomy. But I think this could be an opportunity to improve the quality of life for a population that is likely overlooked. Previous Next

< Back Ultrasound: Trauma E-FAST Purpose: identify acute traumatic pathology including presence of pericardial fluid, pneumothorax, and intra-abdominal fluid. Probe Can use curvilinear probe, but usually switch to the phased array for the cardiac view, so it might be easiest to just use a phased array for the whole study. The linear probe can also be used when evaluating for pneumothorax through the anterior chest wall. Abdominal Cavity Assess for fluid in 3 different regions of the peritoneal cavity. Can use curvilinear probe, but usually switch to the phased array for the cardiac view, so it might be easiest to just use a phased array for the whole study. Right upper quadrant- 1) between liver and kidney [Morrison's pouch], 2) tip of the liver in the right paracolic gutter, 3) lower right hemithorax Left upper quadrant- 1) between the spleen and kidney, 2) subdiaphragmatic space, 3) tip of the spleen in the left paracolic gutter, 4) lower left hemithorax Pelvic- males- between bladder and rectum, females- behind the uterus, anterior to the rectum (pouch of Douglas). Image in transverse and sagittal planes. Cardiac The phased-array or curvilinear probe can be used. The probe is placed inferior and to the right of xiphoid, pointed to left shoulder, with the probe in a horizontal plane (not directed to the bed). Identify presence of hemopericardium (4th trans-abdominal window of the FAST). Assess gross function (contractility). Assess volume status- full or collapsed left ventricle. Thoracic cavity- The “E” in E-FAST The linear probe is used to identify oresence of a pneumothorax. It is placed in the mid clavicular line, oriented cephalad-caudad, 3rd-4th intercostal space. Pneumothorax is present when there is lack of apposition of the pleural lining to the chest wall which leads to loss of lung sliding. Also no comet tail artifact or lung pulse, presence of a lung point (where the pleural surfaces meet, the junction between sliding and absence of sliding). The curvilinear or phased array probe can be used to identify hemothorax by visualizing fluid above the diaphragm in the upper quadrants abdominal views. References Society for Academic Emergency Medicine: FAST Exam Ultrasound Tutorial: FAST (Focused Assessment with Sonography for Trauma) scan | Radiology Nation Previous Next

3 General Surgery Lectures General Surgery .pdf Download PDF • 152.12MB Anorectal .pdf Download PDF • 1.55MB CT Scan and X-ray .pdf Download PDF • 564KB Vascular .pdf Download PDF • 13.57MB Suture .pdf Download PDF • 4.94MB

12 Barking Up The Wrong Tree The Surprising Science Behind Why Everything You Know About Success Is (Mostly) Wrong - Good grades in school- likely to be a "rule follower", and less likely to be innovative, think outside the box. - Introverts are more likely to be experts, extroverts tend to make more money (socializing, "networking"). We should look at "networking" as "making friends". This disputes the "nice guys finish last"... - Match your strengths/ passion/ skill to the right context. - Flattery (sucking up to the boss) can work in the short term, but in the end, when people see their colleagues/ neighbors/ etc cutting corners and reaping benefits, this leads to a general collapse into distrust and rule-breaking. - IQ only matters up to a certain point, but then it yields diminishing returns. After that, hard work is what makes the difference. - Tradeoffs- every hour that you spend working is an hour spent away from other things (family, hobbies). In this age of constant accessibility, you have to decide to leave work behind (ignore your emails when you're at your kid's ball game). - Gratitude in relationships- on their deathbed, people regret working too much and not saying thanks to the people in their life. - Some helpful things I learned...please note that tact and delivery matter and these are not appropriate in every scenario. - When someone is getting upset or frustrated and starts yelling, "Please speak more slowly, I want to help." Or try, "What would you like me to do?" - When someone is upset, validate/ name their feeling. "Sounds like you’re angry/ hurt/ frustrated." If you're wrong, give them the chance to correct you. - Gratitude to relationships. Previous Next

How not to lose everything < Back Organizational Hacks How not to lose everything All my life, I've been forgetful and easily distractible. I joke that I'd lose my head if it wasn't attached. This challenge is part of my ADHD, and I can't overcome it with sheer willpower. The list of things that I've lost over the years is staggering- homework (oh so much homework…it was usually stuffed somewhere in my locker), clothing, books, charging cables, water bottles, earrings (what am I supposed to do with the remaining single earrings?) and a white polar bear stuffed animal (he was left in a hotel room on a road trip as a child). I'm looking forward to learning where all my things went when I die and go to heaven. So if this can’t be overcome with sheer willpower, how can you adapt? Check out these techniques or tools to see if you find something that would be useful for yourself. Information * Create a tool for yourself for storing the data you need to be able to access reliably. This website is full of high-yield medical information that is rapidly accessible, but a website is a labor-intensive option. You don’t have to invest time and money into a website. Here are some other options (check out this post for more details ): - Invest in a planner . Electronic options that sync are useful because they minimize the need to re-write things in multiple places. Another option that I prefer is one notebook that keeps all my events in one place, along with my collection of lists and reminders. - Write everything down. My planner is my note repository. The Apple Notes application is also useful because it can sync across multiple Apple devices. At home or work, dry-erase poster paper can be used to take notes, keep track of schedules and provide reminders for long-term tasks and due dates. - Trello is a user-friendly free application with multiple functions, including the creation of lists, storage of documents, and the ability to share notes or documents among team members/ family members. Items * Magnet strips . Using magnetic sheets the size of business cards, cut pieces and strips to put on various items and stick them to the fridge or other magnetic surface of your choice. For example, if you use dry-erase poster paper on the refrigerator, thin strips of magnet can be cut to fit along the length of several dry eraser markers, so they're always on hand when you have something to jot on the whiteboard * Keys on a hook by the front door. 3M hooks work well, but the hook design isn’t as important as placement, ideally not in direct sight of the door. You can also hang your work ID badge or any other small items you need when you leave the house. * Keep track of all your cords with these tie wraps . Inexpensive and sturdy. I didn’t think there was any way I’d use 50- I figured maybe a couple, just for a handful of my charging cables that always end up in a jumble. But trust me, you'll find plenty of uses for them! Finances and Important Documents * Save receipts for anything valuable. If it was purchased online, download the digital receipt. Use the "Create PDF" function to combine receipts. For paper receipts, an envelope in a drawer is a simple option. Every so often, review the receipts, and if there is anything you don't need anymore, toss it. * Paper shredder . Anything with personal information should be destroyed before being thrown away. This is technically not about avoiding losing something, but it’s an important task so it is included here. * Taxes. Instead of waiting until tax season, keep track of key documents and expenses throughout the year. A running spreadsheet of business expenses, donations, etc, can avoid the frantic search in March. * Metal rack of hanging file folders. Each folder has a different label, including taxes (donation receipts, investment statements, etc), moves (signed leases, welcome packet with key information, etc), and business (bank paperwork, original EIN and registration forms, deposited checks). Previous Next

11 Made to Stick Why Some Ideas Survive and Others Die 6 Principles of Sticky Ideas - Simple - Unexpected- crash at the end of the car commercial. - Concrete - Credibility- the ability to test. Before you vote ask yourself if you are better off today than you were 4 years ago- Reagan. - Emotions - Stories Curse of knowledge- we find it hard to imagine not knowing what we have learned. Can’t imagine what it’s like not to understand a certain concept that we accept as fact Previous Next

Medical Literature Evidence-Based Medicine After you have established a firm foundation of the basics of your chosen specialty, you're ready to develop regular habits to stay up to date on the newest research. Evidence-based medicine is the basis of high-quality patient care, but it can seem overwhelming to try to keep up with the ever-growing body of research. There are countless journals, and it would be time-consuming to search them regularly. So how does one go about navigating the vast ocean of available data? Registering for email alerts is a simple way to get notified when there are new publications. With a quick skim through the article titles to see if anything is relevant, followed by a review of the abstract/ article itself, you can be on the cutting edge of the latest information in your field. Several require individual registration, but it's a very simple and quick process. Many journals require a subscription, often available through your medical school or hospital library. If you are military, you have access to AMEDD Virtual Library (abundant medical resource collection). Thankfully, three publishers (LWW Wolters Kluwer , Springer and Elsevier ) have centralized their journals, so you can quickly subscribe to several journals [these journals are designated by L, S or E]. Medicine and Critical Care Journal of the Ameri can Medical Association New England Journal of Medicine Intensive Care Medicine Critical Care Medicine (L) Current Opinions in Critical Care (L) Journal of Intensive Care (S) Critical Care (S) Journal of Critical Care (E) Critical Care Clinics (E) Surgery World Journal of Surgery World Journal of GI Surgery JAMA Surgery J Gastrointestinal Surg Advances in Surgery Annals of Surgery (L) Annals of Surgery Open (L) BMC Surgery (S) Surgery (E) American Journal of Surgery (E) Journal of the American College of Surgeons (E) Surgical Clinics of North America (E) Advances in Surgery (E) Trauma and Emergency Surgery European J Trauma and Emergency Surgery Trauma Surgery and Acute Care Open Journal of Trauma and Acute Care Surgery (L) World Journal of Emergency Surgery (S) World Neurosurgery (E) Other Specialities Journal of Neurotrauma World Journal of Cardiology JAMA Cardiology JAMA Neurology JAMA Network Open Anesthesia and Analgesia (L) Current Opinion in Anesthesiology (L) Current Opinion in Clinical Nutrition (L) Current Opinion in Infectious Diseases (L) Current Opinion in Neurology (L) Diseases of the Colon and Rectum (L) Journal of the American College of Cardiology (E)

Surgery trainee education. Trauma surgeon. Acute Care Surgery. Collaboration Interested in being a guest contributor? Any suggestions and contributions will be promptly reviewed and added to the appropriate page/ subpage. The contributor will be noted on the website- you can choose if you want your name or Twitter handle or whatever other identification you would like (or none at all if you would like to be anonymous). Content currently under development. Note- this list is NOT all-inclusive. Database of clinical vignettes in key topics of trauma, critical care and emergency general surgery. Focused on more complex scenarios (ie not run-of-the-mill appendicitis)! Please check out the vignettes I currently have to get an idea of what I’m trying to create- and reach out with any suggestions or cases. Literature reviews - deep dives, high-yield articles, etc Procedural or skill tutorials (pre-peritoneal packing, using the ultrasound in critical care, reading a chest x-ray). Each tutorial is followed by a list of primary sources, encouraging readers to pull information from multiple references. If there is any particular procedure or skill that you would like to create a tutorial for, or something that is currently on the website that you would like to enhance (for example, more advanced ultrasound techniques or ventilator settings), please feel free to reach out with suggestions! There is a wide array of other content that you can add to as well. Note templates Recommendations on networking opportunities Recommendations on social media accounts to follow Educational resources (textbooks, journal articles, training courses, web based open access medical education) Please send me an email (form at the bottom of the page) or contact me on Twitter @doc_on_the_run if you have any questions or want to submit something.

Surgery trainee education. Trauma surgeon. Acute Care Surgery. FAQs Why did you make this website? Over these years of learning about the practice of surgery, I've also learned a lot about myself. I am not an expert, and I did not follow a typical pathway- but I have some knowledge and resources to share. As I transition into my new Acute Care Surgeon role after 17 years in training, I'm pausing to share my experience, tips for success, and random nuggets of wisdom. This will be a work in progress, and I look forward to seeing how it evolves. My goal is to share my experience and knowledge in the hopes of helping those who desire to follow this path. But why do we need another medical education website? There are so many good resources already... There are endless ways to explain clinical concepts- pictures, text, analogies, clinical cases, podcast discussions of cases or principles, review articles, etc. There are also different learning styles. When I was trying to grasp advanced ventilator management, I read basic critical care textbooks, a book dedicated solely to ventilator management, and various websites and journal articles. This website is another way to interact with the information. Hopefully you will understand some of the concepts in a new way that helps you remember and apply them in clinical scenarios. In addition, I have also tried to create a comprehensive collection of all the useful resources I know, like apps and open access medical education resources (websites, clinical guidelines, etc) in one place for trainees to What does Doc on the Run mean? The summer before my last year of medical school was the start of my running career. My focus was enjoying the outdoors, not pace or distance. During my residency, I met someone who helped me refine my running. I started timing myself, training, and racing. Within a year or two, I pushed through personal barriers to become a "runner." My first half marathon was on Thanksgiving in my third year of surgical residency. I am at the end of my formal training, I am now an Acute Care Surgeon. As a surgeon, there are numerous factors that I can't control. It's fast-paced, demanding, and dynamic. I enjoy the organized chaos and high-stakes cases. Running is key to my work-life balance. Unlike in the operating room or the trauma bay, I have control over most aspects of my runs- pace, distance, route, and thoughts. It's not chaotic- it's basically the polar opposite of my work. During the day, my mind is going a million miles an hour. When I run, everything becomes clearer- I can solve problems, mull over ideas, or process dilemmas. And perhaps the most concrete impact is the runner's high that I enjoy after finishing. I have continued to run 10Ks, 10 milers, and the occasional 5K or 15K. I have learned more about the science of running (HR training zones, different paces for tempo/ interval/ long runs/ short runs) and I've learned how to adapt training schedules to fit my life. Unfortunately, I have suffered my share of injuries, including most recently nerve impingement in my foot. While I may have scaled back, running will always be part of my identity. Did you really build this website yourself? Yes, I did. No, I didn't do all the intricate coding by myself. But I did design, format, and create the content. So are you a computer/ technology guru? Whatever I know about technology, I learned from my brother and from spending many hours researching problems online. While my parents might consider me an expert, I literally just search online to solve most issues. When I get to the end of the internet and still haven't found the solution, my next step is Apple tech support (obviously only if the problem is with my iPhone or Mac). What did you learn while making this website? - Formatting the working space on a website - URL redirect - Domains and subdomains - Search engine optimization (SEO) - Establishing custom domains - Which text/ background colors are easiest to read - Anchors If you weren't an Acute Care Surgeon, what would you do? I'd be a chef. I love cooking! Is there anything that is overwhelmingly gross in your job? I have had almost every body fluid on me- stool, urine, blood, etc. So very little grosses me out. But I can't stand oral or nasal secretions (aka saliva, slobber, snot, etc.).