Paediatric Emergency Medicine Fellowship



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The New RSI: Rapid Sequence Internet

For Clinicians

Steven Z. Miller PEM Update Course

December 9th, 2006

Martin V. Pusic, MD MA, Maria Kwok MD MS

Columbia University Division of Pediatric Emergency Medicine

1 THE MAIN HANDOUT FOR THIS WORKSHOP IS AT:

columbia.edu/~mvp19/RSI.htm

There is a tremendous amount of knowledge support available to practicing clinicians. In the past, this material was difficult to access and often required a trip to the library. Now, through the miracles of modern technology, the knowledge is available to practicing clinicians WHEN THEY NEED IT.

In this workshop, we will show you techniques that can allow you to rapidly access high quality information in order to ensure the best outcome for your patient. We will emphasize high quality information that you can begin using from any Internet-connected computer.

This HANDS-ON session will be held in a computer lab where each participant will have their own computer. We will introduce each of the following resources with a brief demonstration and then each participant will explore the resource with the support of clinicians familiar with the resources.

1. Answering Questions at the Bedside

With our new emphasis on Evidence-Based Practice, clinicians need to be able to look up information as they are arranging the disposition of the patient. Is Prevacid better than Zantac for gastritis? Is my patient’s dietary supplement a known cause of myoglobinuria?

• Pubmed Clinical Queries

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o We will show you a rapid method of literature searching that allows you to hone down to only clinically relevant studies

o We will show you how to save your searches on the Internet so that you can access them at any time

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o An off-shoot of the Cochrane Collaboration, UpToDate is a wonderful online textbook that follows the latest Evidence-based practice principles.

• Isabel -

o Ever worry that you’ve forgotten an important element of the differential diagnosis for the complicated patient in front you? Isabel is a DDx generator that is especially strong for Pediatrics.

2. Providing Patient Education Materials

You know your patients are out there on the Internet researching their own conditions – do you want a shortcut to the good stuff?

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o Put out by the same people who bring you MedLine (the National Library of Medicine) this is a search engine that access only high-quality patient education materials put out by recognized medical bodies like the American Academy of Pediatrics.

o For example, you can quickly print out a detailed description of how to treat eczema in English or Spanish. Equally helpful for obscure and common conditions.

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o Children's Physician Network – mainly written by Barton Schmidt, an iconoclastic pediatrician who has assembled a tremendous copyright-free collection of patient education materials at this site.

3. Keeping yourself up to date

The online CME industry is thriving at sites like MD Consult, WebMD and . Here are a couple of more academic suggestions that you might not have thought of.

• Get on the listserv of some of your favorite journals – especially those that you are not able to subscribe to. Every time a new issue comes out, you’ll know all about it. It’s a very efficient way of scanning the literature. In the workshop we’ll show you how to subscribe.

• Open Access Journals – there is a revolution happening in how medical journal articles are published. Open access journals put ALL of their content online so that anyone can use it – subscriber or not. We’ll show you the most successful two examples of this phenomenon and briefly discuss why you should support it.

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o Public Library of Science

Copies of this handout can be obtained at:

columbia.edu/~mvp19/RSI.htm

mvp19@columbia.edu

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