Emergency Medicine/Guide to the OCTEM

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Emergency Medicine
Symptoms and Presentations | Diseases | Tests
Treatment | Special Populations | Practice and Administration | Knowledge and Communication

The Open-Content Textbook of Emergency Medicine (OCTEM) has been launched. Open-content means that anyone - doctor, nurse, PA, EMT or interested layperson - can write chapters, edit existing chapters, and even re-organize the text. I am writing to you today to invite you to take part: jump right in and write or edit a chapter today.


You might be thinking, “this open-source formula might sound like chaos, like a disaster . . . “. Read on to find out why it won’t be.

The OCTEM is based upon the same system used to create the Wikipedia. From its inception in 2001 the Wikipedia has outgrown establishment encyclopedias such as Encarta, Brittanica and Merriam Webster. It has more entries, and also receives more traffic. Here’s why:

On the internet, for the most part, readers struggle with bad information crowding out good information. You might think this would be a real problem on Wikipedia, where anyone can create and edit entries. But in practice good information usually drives out bad on the Wikipedia. Inaccuracies, gross bias and other problems are picked up by a large and interested body of readers who are also editors. For every one person who might introduce an innaccuracy one some topic, there are many more people who are passionately interested in that topic, who are ready to find and remedy errors, inaccuracies and vandalism. Note that the “Wiki” model takes some pressure off authors. Chapters don’t have to be completely finished when they’re first put online. Sections can be missing, citations incomplete. In other words, works-in-progress are placed on the site. While you’re working on a chapter, you may find someone else working alongside you, adding and revising as you go. It’s an unusual form of collaboration, and it bears unusual fruit.

Of course, it can be unsettling to work this way. You have to get used to the idea that someone else can revise your work, or add to it, at any time. No-one “owns” the content. However, if you’re the first to start writing on a topic, or you contribute the bulk of the writing, you certainly can claim authorial credit.

In order to write and edit chapters you have to be able to do some basic things: create headings, lists, footnotes. The Wiki system is designed so that computer numbskulls pick it up almost instantly. About fifteen minutes is enough to know how to do these basic things. I have summarized some of them below, and have provided a link for people who want to learn more.

Please contact me with any questions. And please email your friends in medicine and related fields who might have something to contribute to this textbook. Thank you,

Paris Lovett

Here is a quick guide to contributing to the OCTEM:[edit]

Getting Started, Editing and Creating Chapters:[edit]

  1. To get started, visit Emergency Medicine
  2. Look for your topic on the home page, in the appropriate subheading. If something has already been written, it will appear in blue or purple, if nothing has been written it will appear in red.
  3. To start a new chapter, click on a red link. That's all it takes. You can start writing your chapter right away.
  4. If a chapter has already been begun, clicking on the link will allow you to start editing it.
  5. If you want to write a chapter that doesn't yet appear as a link, create a link by editing the home page (please be careful when doing this!). Paste in a new link under the appropriate subheading. For instance, to create a new chapter on Chest Tube, paste a line under the subheading "Treatment" which looks like this:
    [[Emergency Medicine/Chest Tube| Chest Tube]],
    Submit the edit to the home page. Then follow the new link you created. Presto! you have a new chapter.
  6. A nice feature of the Wiki system is that you can view all previous versions of a page. And you can hold discussions attached to each page. For instance, when controversy exists, you can click on the “Discuss this page” link and type in your thoughts. Others will respond. It becomes a forum for creatively engaging differences of opinion and reaching consensus on how to present those differences in the actual chapter. Look for plenty of such discussion on such topics as NEXUS versus Canadian C-spine rule!
  7. This page offers more help on this topic: Help:Starting a new page or book
  8. I have created a template for chapters. You are free to use this or not use this. It has subheadings such as symptoms, signs, investigations, etc.
  9. Wherever possible, please include evidence (EBM) on the performance of symptoms, signs, labs, treatments. Likelihood ratios, where known, are particularly valuable, as are number-needed-to-treat and other information.

The Wiki Format:[edit]

  1. Wikibooks have only a few special tips for formatting. It’s kept simple on purpose. You can basically enter normal text and add just a few characters here and there for formatting.
  2. Here’s how to create headings and subheadings:
    1. To create a heading, add = signs like this:
      == Management ==
    2. To create a sub-headings, and sub-sub headings, use more = signs like this:
      === Cardioversion ===
      ==== Emergency Cardioversion ====
  3. To create lists:
    1. Bullet lists
      *Lists are easy to do:
      ** start every line with a star
      *** more stars means deeper levels
    2. Numbered lists
      # Numbered lists are also good
      ## very organized
      ## easy to follow
  4. To add footnotes/references/links to documents on the web (not in the OCTEM):
    1. To add a footnote to a document on the web (not in the OCTEM), just enclose the URL in square brackets like this [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15635313] and it will be converted to a footnote [1].
    2. Actually, in the above example, for PubMed references, it's even simpler. Just type in PMID 15635313 and you'll get a link that looks like this: PMID 15635313 .
    3. To add a link to a document on the web, and have it appear as a link, not a footnote, do the same think as in (a) but after the URL put a space and then type in a name for the link. For instance [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15635313 The Vexatious Vital]. This will appear as “The Vexatious Vital” underlined, and linking to the PubMed URL.
    4. You are encouraged to use links to the NLM/PubMed whenever possible.
  5. To add a link to another chapter/page in the OCTEM
    1. Here is an example: [[Emergency Medicine/Cardioversion| chapter on cardioversion]]
    2. In the example in above the link will be to a page called Cardioversion. It doesn’t even matter if the page has been created or not yet. If the page has been created, it will link there. If the page has not been created, anyone who follows the link will have the opportunity to create it.
    3. Basically, the words between the / and the | refer to the actual page/chapter name you’re linking to. And the words after the | determine how the link will look. So in the example in (a) you’ll get the words “ chapter on cardioversion” underlined as a link to the chapter called “Cardioversion”. And it doesn’t even matter whether or not someone has created that chapter yet!
  6. Here’s how to make big text or small text
    1. <big> Remember to order a CXR after placing the central line</big>
    2. <small> The material in this textbook has not been checked for accuracy or safety </small>
  7. You need an empty line between paragraphs. So hit the enter button twice.
  8. Indent: use a colon : at the beginning of the paragraph
  9. Images:
    1. You have to choose a name for your image such as steakknifeinheart.jpg
    2. Make sure that no-one has already uploaded an image with the same name, so you don’t erase it. You can search at this page: Special:Imagelist
    3. once you’ve picked a name for your image, you can upload images at the following link: Upload an image to Wikimedia Commons
    4. you can then display those images by including the following line in your page/chapter: [[image:steakknifeinheart.jpg]]
    5. For more details look at Help:Editing

You can usually learn what you need to do by looking at existing pages (in the OCTEM or in other wikibooks or on Wikipedia) and clicking the “edit” link. That will show you how people created lists, formatted text, placed images, and so on.