What Does a Rhonchi Sound Like Anyway?

Before I hit my clinical rotations I wasn't really sure what a crackle or a rhonchi sounded like through a stethoscope. I have since gotten much better being on a geriatric floor riddled with COPD, CHF, pneumonia, interstitial lung disease, bronchiectasis, and TB - but it took hearing the abnormal sounds a few times before they really sunk in. I recently came across this site - and I wish that I had had it during my first year when I was trying to learn all of this. On the left side of the screen there is a menu with lung and heart sounds which are very realistic. It also has a "presentation" section that shows a stick figure inhaling and exhaling and shows dots where you'd expect to hear the defect. Pretty cool. Stethographics

UPDATE: These 2 sites were recommended via comment as newer alternatives to this pulmonary auscultation website: Practical Clinical Skills and Easy Auscultation

Wound VAC

A wound VAC, or a Neg Pressure Therapy, is a machine used to treat advanced wounds.  It uses a pump to suction fluids from the wounds that are difficult to heal on their own.  I had only ever seen them completely sealed up and hadn't the faintest how to do one from scratch. This youtube video was a big help. I think I may have the opportunity to do my first one tomorrow....

Shared Decision Making + PA Education

It's no secret that I am big into the shared decision making (SDM) model as it applies to the delivery of health care. I think it is incredibly important and I truly wish that it were part of every PA program's educational requirement. I recently had the fortune of writing an article about SDM for the PA Professional, which is the AAPA's monthly magazine. Check it out!  Here is the link (page 37).

Internal Medicine Pocket Resource

The attending that I am currently working with on my internal medicine rotation recommended Practical Guide to the Care Ofthe Medical Patient (Mosby's Practical Guides) [Spiral-bound] above all of the other "medicine manuals" out there. She recommended this particular book for the following reasons:

1) it has detailed information on multiple diagnoses - she said that it a great resource for a med/PA students and new residents because we don't yet have a detailed, working knowledge of a lot of the diagnoses (since we are still learning!). Many of the other pocket guides are brief "reminders" of diagnoses and are better suited for providers with more experience treating these illnesses.

2) it actually fits in your pocket - the Washington Manual does not fit in your pocket.

Her copy is well-worn and she claims that it was her most used book during her residency and for years after. The best part is that you can get a brand new copy for under $5. I just purchased a like-new used copy for 1 cent. I'll let you know my thoughts once I have a chance to use it.

UPDATE:
So I rec'd this book in the mail and LOVE it. I honestly use it daily and it has been a great resource. It also has a lab results section so now I don't have to carry around a separate book for lab values. It also has a differential section and a drug dosage section. I'd recommend it highly and its really inexpensive - perfect for the student budget. 

Free Pocket Resources for the ED

Short post to plug an AWESOME Emergency Medicine Blog that I've been following for months now: Academic Life In Emergency Medicine Dr. Michelle Lin has 2 sections to her blog that are tremendously helpful.

1) Tips and Tricks - new post every Tuesday
2) PV (Paucis Verbis) cards - new post every Friday

I have printed out almost all of the 6"x 4"PV cards that she made - I punched a hole in them and put them on a key ring. They fit perfectly in a lab coat pocket and are ridiculously useful. I also love that she puts the references of her sources on the card (I like to know where my medical knowledge is coming from). Happy printing.