Technical Skills

The steps are:

1. Conceptualization

2. Visualization

3. Verbalization

4. Guided Practice

5. Feedback

6. Skill Mastery

7. Autonomy

Technical skills learning should be prepared for by completing steps 1-3 at home prior to the skills sessions. Some resources for this will be provided below. Steps 4 and 5 will occur in the simulation center during skills labs. Steps 6 and 7 occur throughout a career in EM and are not the objective of the skills labs.

The 2-year repeating curriculum is as follows:

July 2022: Airway lab

Conceptualization: Pediatric Airway Screencast

Visualization: Pediatric Intubation POV LMA Insertion

Verbalization: BVM PEMOSATS, LMA PEMOSATS

Aug 2022: Direct Laryngoscopy/Bougie PEMOSATS

Preparation for Intubation PEMOSATS

Direct Laryngoscopy PEMOSATS

Sep 2022: Video Laryngoscopy: Glidescope and CMAC/fiberoptic PEMOSATS

Conceptualization: Roberts and Hedges VL Chapter

Visualization: 

Glidescope 4-Step Technique 

C-MAC Intubation POV Video

Dr. Gallagher's Fiberoptic Intubation Youtube Video

Fiberoptic intubation with split screen

Flip-flop maneuver close-up

ETT position check with fiberoptic

Verbalization: Glidescope PEMOSATS

Oct 2022: IO PEMOSATS

Conceptualization: Roberts and Hedges "Intraosseous Infusion" Chapter

Visualization: Pediatric IO Placement POV Video

Verbalization: IO Placement PEMOSATS

Nov 2022: Emergency Umbilical Catheter

Conceptualization: 

• Roberts and Hedges Chapter 

• King Chapter

Visualization: Pocket Procedures

Verbalization: PEMOSATS

Ultrasound #1 (Cardiac, Lung and eFAST, bladder)

Conceptualization/Visualization:

Sonosite M-Turbo Knobology Videos (4 videos totaling 20 minutes that review how to use our Sonosite machine)

Pulmonary, Cardiac, and eFAST videos from 5minsono.com

TTE Standard Views from University of Toronto (3-D Animation to help you visualize views - focus on parasternal long axis, parasternal short axis at LV mid level, apical four-chamber, and subcostal four chamber)

Vi Dinh's eFAST screencast

Dec 2022: Faculty House, Suture Skills lab

Conceptualization: Duke Suture Skills Video

Visualization: ALiEM Wound Closure Video Series

Verbalization:

Jan 2023: Ultrasound-guided LP

Later Month: CVL microskills lab, Central Line PEMOSATS

Conceptualization: emcrit.org CVL Microskills

Visualization: 

Microskills POV Video

emcrit.org Full Sterile Preparation video

Verbalization: CVL Microskills Checklist

Feb 2023: Ophtho skills lab

(Slit Lamp, panoptic, FB removal, Morgan lens irrigation, ph check, fluorescein stain)

Conceptualization:

Roberts and Hedges Ophthalmologic procedures chapter

Visualization:

Using a slit lamp

Removing an ocular foreign body: Video 1 and Video 2

Using a panoptic

Using a tonopen

Verbalization:

Mar 2023: In-situ sim in Peds ED

April 2023: Foreign bodies

Team leadership (TEAMSTEPPS and CRM) animated lecture

Conceptualization:

Visualization:

Verbalization:

May 2023: Inter-disciplinary Simulation cases

Conceptualization:

Visualization: Youtube video: The Ideal Pediatric Resuscitation

Verbalization:

June 2023: Faculty House, Ortho reductions, compartment check with stryker and splinting

Conceptualization: 

EMRA splinting guide

ALiEM common splints

Visualization:

ERcast Splint Like a Pro videos

Verbalization:

July 2023: None

Airway Lab,Direct Laryngoscopy/Bougie PEMOSATS

Conceptualization: Pediatric Airway Screencast

Visualization: Pediatric Intubation POV LMA Insertion

Verbalization: BVM PEMOSATS, LMA PEMOSATS Preparation for Intubation PEMOSATS Direct Laryngoscopy PEMOSATS

Aug 2023: CVL microskills lab and Central Line PEMOSATS

CVL microskills list

Pericardiocentesis PEMOSATS

Conceptualization: Roberts and Hedges Chapter

Visualization: NEJM video Ultrasound Podcast

Verbalization:

Sep 2023: Team leadership (TEAMSTEPPS and CRM) 

Conceptualization:  

TeamSTEPPS Pocket Guide

Life in the Fastlane CRM

Debriefing in the ED

Visualization: The Ideal Paediatric Resuscitation

Verbalization: Team Leadership PEMOSATS

Oct 2023: Immersive Sim cases with nursing

Nov 2023: None

Dec 2023: Faculty House, Suture skills lab

Feb 2024: iCare and Lateral Canthotomy

Mar 2024: Umbilical Lines

April 2024: Traditional Chest Tube/Seldinger Chest Tube/needle thoracostomy

Conceptualization: Roberts and Hedges Chapter

Visualization: Trauma Professional's Blog EM:RAP HD

Verbalization: PEMOSATS

May 2024: APE

June 2024: Sim Cases in Sim Center?

Emergency vaginal delivery

Conceptualization/Visualization:

Roberts and Hedges Emergency Childbirth Chapter

https://first10em.com/2015/03/07/precipitous-delivery-in-the-ed/

https://first10em.com/2015/03/07/the-difficult-delivery-shoulder-dystocia/

https://first10em.com/2015/03/07/the-difficult-delivery-breech-presentation/

https://first10em.com/2015/03/07/the-difficult-delivery-umbilical-cord-prolapse/

http://emcrit.org/wee/peri-mortem-c-section/

https://vimeo.com/59516684

Verbalization: PEMOSATS

Ultrasound #2 

Procedural:MSK [tendon, reduction]/soft tissue [abscess, nec fasc, water bath]/LP

Team Leadership

Inter-disciplinary Sim

Medication Administration

Later Month: CVL microskills lab, Central Line PEMOSATS

Conceptualization: emcrit.org CVL Microskills

Visualization: 

Microskills POV Video

emcrit.org Full Sterile Preparation video

Verbalization: CVL Microskills Checklist

Other: emergency/complicated delivery, respiratory therapy, medication administration, airway drills

Games for first Wed: Dental Bowl (Dental splinting and PTA drainage), Cardiac Bowl, Ortho Bowl, Ophtho Bowl