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Social Issues - Burnout
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Social Issues - Gun Violence
Educational
Social Issues - Goals of Care & PTSD
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Social Issues - Immigration
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Social Issues - Health Policy
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Winner of 2019 SAEM’s Got Talent

SAEM’s Got Talent: A FOAMed Showcase (SAEM Social Media Committee Sponsored)
Ryan LaFollette, MD, Seth Trueger, MD, MPH, Ali Raja, MD, MBA, MPH, Nicholas E. Kman, MD, Blake Briggs, Daniel Mirsch, Carlos Rodriguez, MD, Cleavon Gilman, MD

Click here for full video!

Video - Educational

Elevated Troponin Differential Diagnosis Mnemonic – “SPARED HEART PHASE”

Stroke
Pericarditis 
Arrhythmia
Rhabdo
Exercise
Dissection 
Hypotension
Embolism
Anemia
Renal failure
Trauma
Plaque rupture
Heart failure 
Amyloid
Sepsis 
Environmental (carbon monoxide)  

Resources:

Article
Residency, Resilience, and Rap Music -Q&A with Cleavon Gilman, MD, an emergency physician and hip-hop artist

By Shannon Firth (@shannonfirth) Washington Correspondent, MedPage Today

MedPage Today: Do you remember your first song?
The first real song I ever wrote was called “I Never Asked to be Born,” which was a letter to my biological father, following the death of my stepfather who had HIV/AIDS due to a heroin overdose, while I was in Navy boot camp in Great Lakes, Michigan.

Read the full article here!

Social Issues - Burnout

This song speaks to clinician resilience and the journey from burnout to well-being. It was accepted to the National Academy of Medicine Expression of Clinician Well-Being Gallery, which called on artists to explore what clinician burnout, clinician well-being, and clinician resilience looks, feels and sounds like to people across the country.

Article

Looking forward, I’m going to continue to create medicine-related hip-hop songs, which I hope will ultimately get high school and college students interested in medicine…

Read the full article here!

Social Issues - Gun Violence
To be honest I was very hesitant to write a song about guns because the topic is so polarizing. With that said, my objectives were to show the listener the pattern of gun violence in America. I wanted to create a bipartisan timeless piece that would be relevant during acts of gun violence. Politics aside discusses the epidemic of gun violence in America, evinced by mass shootings, suicides, gang violence, and killings by police officers. 
  • Every day, 318 people are shot in murders, assaults, suicides & suicide attempts, unintentional shootings, and police intervention.
  • Every day, 96 Americans are killed with guns.
  • Every day, 222 people are shot and survive
Video

Overview
1. Atlanto-Occipital Dislocation – Children, Lateral Neck XR, Power’s Ratio greater than 1, craniocervical fusion
2. Atlanto-Axial Dislocation – Rheum, Down Syndrome, Lateral Neck XR, ADI greater than 3.5 is unstable
3. Atlanto-Axial Subluxation – Grisel Syndrome, dynamic CT
4. Unilateral Facet Dislocation – reverse hamburger sign; closed reduction
5. Bilateral Facet Dislocation – reverse hamburger sign; surgery

Click here for Study Guide & Resources

Social Issues - Goals of Care and PTSD

This song speaks to relationships around death. Verse one is about advance directives for end of life decisions. A family gets a call that their mother has a life threatening condition. What would their loved one want? What is life vs. quality of life? Verse 2 speaks to death following war. Many veterans suffer from survivor’s guilt and PTSD, resulting in 18-22 veteran suicides per day.

Neurology
Cardiology
Brady, Brady, Here’s ya CHANCE to AVOID IT 
Clonidine, Head ICP, Cholinesterase poisoning
Nodal block, Electrolytes, Old Age, and Vagal Tone
Oxygen, Infection, Drugs, Thyroid & naked Cold
Clondine
Head ICP
Acetylcholinesterase poisoning
Nodal Block
Cold
Electrolytes
 
TO
Age
Vagal Tone
Oxygen
Infarction
Drugs – CCB, BB, Digoxin
 
Infection
Thyroid
Social Issues - Immigration
This song is an attempt to humanize the Central American refugee crisis by illustrating the perilous journey from El Salvador to the United States border.
 
Have you ever feared for your life? Have you ever lost a loved one? Could you imagine living in a country where you only made 2 dollars a day? Wouldn’t you want more for your children, for yourself? 
 
The song highlights the reasons for emigration from Central America, which include violence and political instability. Many refugees travel through Guatemala and then cross the Suchiate River, which divides Mexico and Guatemala. In Mexico they ride atop a train called “La Bestia” which means The Beast, during which many are maimed, kidnapped, extorted, raped, and even killed. 
 
With that said, see it through their eyes.  As captured by the wonderful photo journalists credited in the captions. 
Dermatology
I wrote this song to help  differentiate and treat common causes of vesicular rashes in children and also score you points on your STEP 1/2/3 Exams and Residency Board Exams. The mnemonic SICCC GERMS stands for:

S – Smallpox
I – Impetigo
C– Coxsackie virus
C– Chickenpox
C– Contact Dermatitis (Poison Ivy)

G – Gladitorium HSV
E – Eczema
R – Rickettsia Akari
M – Molluscum Contagiosum
S – Scabies

Dermatology
Discusses the presentation and management of the classic childhood maculopapular exanthema
  • 1st Disease – Measles
  • 2nd Disease – Scarlet Fever
  • 3rd Disease – Rubella
  • 5th Disease – Erythema Infectiosum
  • 6th Disease – Roseola Infantum
  • *Extra Disease – Mononucleosis
Clinical Decision Making Rules
Video
Performance as part of a physician panel discussion on digital content engagement with healthcare providers
Social Issues - Health Insurance
Ophthalmology
Ophthalmology
Symptoms:
– Pain, decreased vision, loss of fluid from eye
– History of trauma, fall, or sharp object entering globe
Diagnosis:
– Seidel Test
– Slit Lamp to look for corneal defects
– CT Brain & Orbits to r/o IOFB
– Gentle B-Scan US to localize posterior rupture sites (usually done by optho)
Management
– Antibiotics: Cefazolin, Vancomycin, FLQs 
– Tetanus
– Surgical repair 
– Antiemetics
Ophthalmology
Lens Dislocation
Sx: monocular diplopia, iridodonesis
Dx: ultrasound, eye exam
Tx: Urgent (not emergent) ophthalmology follow-up

 

Retinal Detachment
Sx: floaters described as “spider webs” or “coal dust”, visual field cuts
Fundoscopy: retina appears like “dunes on a beach”
Ultrasound: retinal flap, curtain folded forward
Tx: optho, if macula still attached and acuity intact, surgical repair by a retina specialist is recommended within 24–48 hours (to prevent macula from detaching also).
Ophthalmology
Ophthalmology
How do you treat it?
– Elevate HOB to allow blood to settle
– Eye shield (metal or clear plastic)
– Pain Controlwith Atropine and Prednisolone acetate 1%
– Increased IOP 
         Topicals – Timolol, Brimonidine
         Acetazolamide 500 mg PO q12h (Not in Sickle Cell patients)
         Mannitol 1-2 g/kg IV over 45min q24h
– Stop Bleeding – Aminocaproic acid, Tranexamic acid
– Surgery: 8 Ball Hyphema, Sickle Cell Patients, prolonged or elevated IOP

Who should be admitted?
– Sickle cell patients, 8 ball hyphema, violated globe, elevated IOP

What are the discharge instructions?
– Eye Rest
– Rebleed: up to 20% may rebleed in 2-5 days
– Follow-up: 3-5 days, traumatic glaucoma is insidious cause of blindness
Pediatrics

Consider volvulus, shock, early sepsis, myocarditis, and intussusception in well appearing children with extreme tachycardia and tachypnea.

Normal HR in Children
  • Infancy (0-6 mo) 150
  • Infancy (6-12 mo) 140
  • 1 year 140
  • 2 years 130
  • 3 years 120
  • 4 years 120
  • 5 years 110
  • 12 years 100 
Normal Respiratory Rate in Children
  • under 1 month 40-60 RR
  • 1-6 months 30-50 RR
  • 6 mo – 1 year 20-40 RR
  • 2 yr – 4 yr 20-30 RR
  • 5 years 18-24 RR
Orthopedics
Carpal bones in 30 secs…
Trapezium’s beneath the thumb, Scaphoid then Lunate
Triquetrum joins them up, to make it a U base 
Pisi’sunder pinky, Hamate and Capitate 
Trapezoid points to Scaphoid, that away!
What are the carpal bones?
Trapezium, Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid
Neurology - Seizures
Neurology
The inspiration for this song, came from a young woman that presented to the ED with Bell’s Palsy. It turns out that the facial nerve is responsible for a lot of functions, including motor function to the face, taste, and tears and salivation.  The 7 faces in the crowd are drinking seven up, because the 7th cranial nerve, aka Facial nerve, is responsible for taste. 
  1. Motor sensation includes muscles of facial expression.
  2. Parasympathetic functions include tears and salivation via petrosal nerve to pterygopalatine ganglion to lacrimal nerve.
  3. Taste via the lingual nerve, chorda tympani, solitary nucleus, thalamic VPM, to the gustatory taste center.
Video

In this song, I use basketball players as a metaphor for vasopressors and inotropes used in critical care medicine. Their jersey numbers reflect their maximum dose. Their position reflects how they should be administered, central vs. peripheral. The song is filled with many homonyms, so that each time you listen you may discover something new. On the right side of the screen, I reveal these meanings as the song progresses.

Toxicology

This song highlights the sources, pathophysiology, clinical presentation, and management of cyanide. Special thanks to Dr. Rana Biary and Toxicologists from the New York Poison Control Center.

Article

“He worked with two doctors and a dentist in Iraq who took him under their wing and convinced him that he was smart enough to be a physician himself. So, he enrolled in a community college in San Diego County, transferred to UC Berkeley and did post-bachelor’s work in physiology after graduating from Cal.”

Read the full article here!