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CASE PRESENTATION: A 32-year-old man with a history of hemophilia A presented to the emergency department with right shoulder pain, swelling, and decreased range of motion. DISCUSSION: Emergency physicians can use ultrasound to quickly and accurately identify hemarthrosis at the bedside.
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Acute pain is one of the most frequent, and yet one of the most challenging, complaints physicians encounter in the emergency department (ED). Currently, opioids are one of several pain medications given for acute pain, but given the long-term side effects and potential for abuse, alternative pain regimens are sought. Ultrasound-guided nerve blocks (UGNB) can provide quick and sufficient pain control and therefore can be considered a component of a physician's multimodal pain plan in the ED. As UGNB are more widely implemented at the point of care, guidelines are needed to assist emergency providers to acquire the skill necessary to incorporate them into their acute pain management.
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OBJECTIVES: We set out to develop and implement a critical race theory (CRT) curriculum to address an identified gap in emergency medicine education. Sessions explored concepts of CRT and issues of racism as they relate to the clinical and extraclinical environments. METHODS: We developed a series of five virtual workshop sessions in 2019 that were held over Zoom in June and July 2020 in the setting of the COVID-19 pandemic. Eight learners completed the curriculum. Prior to each session, learners were provided presession materials including podcasts, recorded lectures, and readings. Thought-provoking questions were also provided with presession materials to facilitate discussion during sessions. Materials were curated to provide foundational knowledge on CRT and U.S. history as well as local history of the San Francisco Bay Area. RESULTS: Participants found the curriculum useful, reported increased familiarity with CRT, and were more likely to have an analytic framework for topics of race and racism. Participants also reported that their perspective had been changed after completing the curriculum. CONCLUSIONS: Our curriculum promoted effective engagement with topics of race and racism by learners. Opt-in participation contributed to an engaged cohort and the small cohort size encouraged participation by all learners. Semistructured facilitation allowed participants to guide conversations to their own topics of interest while also addressing specific topics at hand. Independent guided presession work allowed participants to gather knowledge at their own pace prior to each session, which likely contributed to more active and in-depth participation.
