tag:blogger.com,1999:blog-329850892024-03-17T02:53:09.860+08:00Emergency Medicine Blogcksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.comBlogger174125tag:blogger.com,1999:blog-32985089.post-84704823157394657372023-04-04T11:19:00.001+08:002023-04-04T11:19:07.360+08:00Formula for Hypernatremia Correction: How to Derive it?Do you find it difficult to grasp the concept of hypernatremia
correction and how to calculate the amount of water deficit in patients? This video breaks down the formula using a simple and relatable analogy
– diluting a bowl of salty soup! Just as diluting a bowl of overly
salty soup with water helps make it more palatable, correcting
hypernatremia involves adjusting the body's water cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-56230211705056330492023-03-18T14:00:00.004+08:002023-03-18T14:01:17.444+08:00Building Effective Healthcare Leadership: Five Key Shifts You Need to Know Image from pexels.com Leadership is a skill that anyone can learn. It's not something that people are born with, but rather something that can be developed through the right mindset and observable behaviors that lead to measurable outcomes. Unfortunately, a significant number of American workers report that their boss is toxic, and dealing with their manager is the most stressful cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-12262407238492675892023-03-18T11:48:00.002+08:002023-03-18T11:48:34.195+08:00AI and Snake Envenomation: A Game-Changer for Medical Treatment and Conservation Photo by Pixabay: https://www.pexels.com/photo/blue-bright-lights-373543/ Photo from pexels.comArtificial intelligence (AI) is revolutionizing various industries, including healthcare. The use of AI capabilities, such as natural-language generation, computer vision, and robotic process automation, is growing exponentially. In a recent McKinsey report for example, it has been showncksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-57109208438857138802023-03-03T21:23:00.003+08:002023-03-03T21:45:40.865+08:00ChatGPT Prompts to Enhance Research Proposal WritingBefore deep diving into the specific prompts that can be used to enhance research proposal writing, let me start this post by repeatingly remind each other as acdemicians and professionals, to use ChatGPT responsibly and ethically.
Whilst ChatGPT can be very useful in many aspects of research proposal writing,
the onus still falls on the researchers to evaluate and verify the accuracy of
cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-87664133620970318342019-05-26T01:54:00.001+08:002019-05-26T01:54:04.991+08:00Top five mistakes made by medical students during ACLS megacode exam
1. Unable to recognize ventricular
fibrillation or ventricular tachycardia
There are some students who cannot
differentiate VF from PEA. This is a
potentially fatal mistake because for VF, the one intervention besides CPR that
is proven to increase survival to hospital discharge is defibrillation (but not
for PEA).
AHA CPR Guideline 2015:
In addition to high-quality CPR, cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-64117880318709993062018-10-11T15:19:00.004+08:002018-10-11T15:37:16.089+08:00Beware of predatory or potentially predatory journals
Predatory journals from Chew Keng Sheng
This slide set is the presentation that I gave at the Faculty of Medicine and Health Sciences of Universiti Malaysia Sarawak on the issue of predatory or potentially predatory journals. “Predatory journals” refers to entities that prey on academicians for financial profit via article processing charges (APC) for open access articles, without cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-22218152721862569252017-11-15T16:14:00.000+08:002017-11-15T16:14:17.601+08:00The modern Physcian's Pledge to replace Hippocratic Oath?
One of the oldest professional oaths is the Hippocratic Oath, which is now as old as 2400 years old.
The practice pledging this oath begans at the
University of Wittenberg in Germany in 1508.
The contents of the oath are still relevant, although pledging in the name of long forgotten medieval Greek gods is probably what makes it out-dated.
A new modern version of the oath, known as ‘The cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-45459408978461969612017-10-09T09:54:00.002+08:002017-10-09T10:01:08.296+08:00Doctor-Patient Communication
The slide deck of a short sharing I gave to a group of first year medical students of Universiti Malaysia Sarawak (UNIMAS). It is indeed a good move to talk about doctor-patient communication early in their medical studies, to expose them to the intricacies, the skill and the art of communicating with patients, including how to break bad news.
Doctor-Patient Communication Skill from Chewcksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-72241801179410106312016-08-29T01:08:00.003+08:002016-08-29T08:47:27.142+08:00Life Threatening Electrolytes
Slide deck (in pdf) for the above presentation:
Life threatening electrolyte abnormalities from Chew Keng Sheng
Perhaps one thing which I did not make clear in the video and the slide is the use of 3% hypertonic saline:
As 1g of Na = 17 mmol
therefore,
3% NaCl means
3 g in 100 ml
or
30 g in 1000 ml (1 L)
= (30 * 17) mmol in 1 L [since 1 cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-32761433762879071082016-07-27T00:23:00.001+08:002016-07-27T00:24:28.224+08:00Discussion on the dilemma in bioethics using the various ethical theories
We often discuss bioethical principles using Beauchamp and Childress (2008)'s four bioethical principles (some people would say that there are more than four) but seldom do we teach or guide students through some of these bioethical dilemma (which we often face in real clinical practice) using the various ethical or moral theories in philosophy.
This short video starts with a case cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-13133127277312784412016-05-03T11:37:00.000+08:002016-05-03T11:37:59.294+08:00Spinal immobilization including cervical immobilization is no longer widely recommended for ALL trauma patients
Spinal immobilization including cervical immobilization is no longer widely recommended for ALL trauma patients.
In fact, the American College of Emergency Physicians (ACEP) has come out with a new statement that is against the use of long backboards by EMS (click here to access):
“Backboards should not be used as a therapeutic intervention or as a precautionary measure either inside or cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-90464777316728640342016-01-25T18:42:00.002+08:002016-01-25T18:43:57.478+08:00Sensitivity, specificity and likelihood ratios
A short tutorial on sensitivity, specificty and likelihood ratios. A few good tutorials in YouTube are linked below as well.
Sensitivity, specificity and likelihood ratios from Chew Keng Sheng
A good series of 6 short videos on sensitivity, specificity, ROC curve and the concept of the trade-off between sensitivity and specificity:
A short tutorial on likelihood ratios:
cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-29971844388330185142016-01-17T23:19:00.000+08:002016-03-03T12:10:25.881+08:00Damage Control Resuscitation
Damage control resuscitation (DCR)
Historically, first described by Rotondo et al in 1993. In that study, although no significant differences were identified between the 22 patients with definitive laparotomy (DL) vs 24 damage control surgery (DC) (with actual survival rates were similar, ~ 55% DC vs. 58% DL), in a subset of 22 patients with major vascular injury and two or more visceral cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-27200706176056787562015-11-22T00:06:00.002+08:002015-11-22T11:46:09.302+08:00BLS and ACLS Updates 2015 - The Malaysian Perspective
A talk that I presented during the Kelantan Resuscitation Updates 2015 (22 Nov 2015) based on the new AHA/ILCOR guidelines. However, I have put in some emphasis on certain aspects which are relevant in the Malaysian setting (for both major referral hospitals as well as smaller, lesser-equipped hospitals/clinics). Basically however, there are no major changes in this year 2015 updates. If you cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-65798876016618250772015-09-27T00:35:00.001+08:002015-09-27T00:38:33.687+08:00Mechanical Ventilation in ED - A Practical Approach
This post is created using padlet. Padlet is like a huge digital notice board where the owner as well as other collaborators can "pin" up notes by simply clicking on the board.
Created with Padlet
cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-2267623595737255192015-09-21T08:06:00.001+08:002015-09-21T08:06:55.587+08:00An Approach To Chest Pain In Emergency Medicine - Introductory Level Resource
Another set of my learning materials developed using storify - a platform that allows me to curate contents (almost always the free ones) by simply drag and drop that content into the story timeline. The good thing about storify is that as all contents belong to their respective owners, I simply do not own them, just linking them here. All copyrights belong to the respective original authors.
cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-84299437455769572662015-09-15T09:10:00.001+08:002015-09-15T09:10:48.553+08:00Pathophysiology of Sepsis
My learning materials developed for first year postgraduate emergency medicine candidates on the concept in the pathophysiology of sepsis using storify.com.
[View the story "Pathophysiology of sepsis" on Storify]
cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-74791428230023276442015-09-09T13:13:00.000+08:002015-09-21T21:37:21.308+08:00Relative bradycardia and constipation in typhoid fever
Two of the buzzwords in typhoid that are oft-mentioned in clinical setting as well as in many literature are 1) relative bradycardia and 2) constipation.
Relative bradycardia (Faget sign):
But what exactly is relative bradycardia?
Cunha (2000) commented that this term has been vaguely described in a variety of literature and by many healthcare professionals leading to confusion.
cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-44583567094032849602015-09-05T22:09:00.001+08:002015-09-05T22:12:32.170+08:00Flipped Learning in Adult Supervision
Note: This post is published simultaneously in the Malaysian College of Emergency Physicians website
A REPORT ON FLIPPED LEARNING IN ADULT SUPERVISION WORKSHOP
Date: 01 SEPTEMBER 2015
Venue: Trauma and Emergency Medicine Building, School of Medical Sciences, Universiti Sains Malaysia
The workshop started off with Prof Abd Karim bin Alias explaining the relevance of flipped cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-80265318191578189892015-08-16T11:47:00.000+08:002015-09-21T16:08:16.504+08:00Life Threatening Asthma - Some Pearls and Pitfalls
My talk on Life Threatening Asthma talk in 2nd NECCS Ipoh
Life Threatening Asthma - Some Pearls and Pitfalls from Chew Keng Sheng
Some may not agree with the ventilation strategy I borrowed from Scott Weingart's, i.e., a PEEP of 0 or zEEP. I guess if you are familiar on how to play around with the PEEP in severe airway obstruction without causing a disaster in barotrauma, thencksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-39465168078288756962015-08-08T15:08:00.003+08:002015-08-08T15:18:04.186+08:00Five Compelling Reasons Why New or Presumed New LBBB (without any other qualification such as Sgarbossa’s or Smith’s criteria) Should NOT be treated as STEMI
My presentation (contra-argument) during the "debate" with Prof Dr. Rashidi Ahmad from UMMC during the 2nd National Emergency and Critical Care Symposium 2015 in Ipoh (08 August 2015)
New or Presumed New LBBB To Be Treated As a STEMI Equivalent? A Debate from Chew Keng Sheng
The 6-page companion notes below can also be downloaded at: http://tinyurl.com/pern38t OR at the cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-50700828219440058802015-06-16T10:38:00.002+08:002015-06-16T10:42:12.765+08:00Giving Oxygen in COPD - A Goldilocks Principle Is Required
Effects of hypoxia in COPD
The most dangerous effects of hypoxia in COPD are sudden cardiac arrest and irreversible damage to the vital organs. Significant hypoxia for more than 4 - 6 minutes is already enough to cause sudden cardiac arrest. (Murphy et al, 2001)
A number of studies recommend keeping a PaO2 of 50 mmHg in COPD to prevent sudden death of hypoxia (Hutchison et al, 1964; Smith et cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-60091542189834107462015-05-14T12:55:00.000+08:002015-05-14T12:55:24.445+08:00Recommended Web Educational Resources Related to Emergency Medicine - To Get You Started!
Recommended resources from Chew Keng Sheng
In today's hyper-connected world, content is almost a non-issue. When we
click on the web, tons of educational resources can be found in
websites, blogs, YouTube and in medical education, a recent
crowd-sourcing, crowd-sharing concept has emerged - FOAM (Free Online
Access Meducation). In recent years, I've got caught up with the FOAM
virus cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-17415171345964510652015-04-30T09:08:00.001+08:002015-04-30T09:08:05.256+08:00The Use Of adrenaline in anaphylaxis
IM vs SC - which is preferred? According to the AHA 2005 on CPR & ERC, it says:"Absorption
and subsequent achievement of maximum plasma concentration after
subcutaneous administration is slower and may be significantly delayed
with shock. Thus, intramuscular (IM) administration is favored."Thus, although it does not mention that SC route cannot be used, this is not the preferred route.IV cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0tag:blogger.com,1999:blog-32985089.post-66926694220588097672015-04-22T15:09:00.002+08:002015-04-22T16:23:17.097+08:00Mechanical CPR Devices - What is the scientific evidence so far with regards to its effectiveness in real life clinical settings?
There are two types of CPR devices:
1. Load-distributing band CPR devices (LDB)
Provide circumferential thoracic compression
2. Piston-driven CPR device (PD)
Provide sternal compressions
In preclinical settings, CPR devices improve coronary perfusion, cardiac output, ROSC.
But how effective are these in real-life clinical settings? What’s the evidence so far?
Let's look at three latest cksheng74http://www.blogger.com/profile/06036082043676928460noreply@blogger.com0