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Issue 2 - Progress, developing a lecture, Pulsenotes LIVE & more...

Hey guys, Welcome to our weekly instalment. Things have been particularly busy for the three of us th
Issue 2 - Progress, developing a lecture, Pulsenotes LIVE & more...
By Pulsenotes • Issue #2 • View online
Hey guys,
Welcome to our weekly instalment. Things have been particularly busy for the three of us this week, balancing clinical work and pulsenotes. We’ve seen a really nice surge in traffic to the website and we have big plans on how to develop the service further!
This week, I’m going to take you through how we develop a lecture from conception of an idea to final delivery. Sam’s going to run through what’s new this week and Norton’s got some more medical tips - enjoy!!

Developing a lecture…
Conception
This week I created a lecture on Skin Cancer. Well, after about ten minutes of thinking this was hastily redefined to Non-melanoma skin cancers (essentially BCC and SCC). All skin cancers would be WAY too much. The first point is to be realistic in what you want to teach. Too much content and people will switch off… 
Next, I like to broadly draft out the sections I wish to cover, or that I think are most relevant. For this I usually divide an A4-page into four. Then you can begin to fill each section. Once you have this overall plan you’re good to go.
Content creation
Things are a little easier for us at pulsenotes. We usually start with one of our presentation templates. We have all been teaching for many years and have a wealth of graphics and assets to fall back on. Our program of choice is Apple Keynote - yes, you guessed it we’re all massive Mac fanboys (including Norton, who reluctantly surrendered his windows laptop in our fourth year of med school).
Diagrams are BY FAR the most time-consuming part of content creation. Thankfully, I am not alone in this endeavour; both myself and Sam are now relatively proficient in both Adobe Illustrator and Photoshop - however, a good diagram still can take upwards of 5 hours to produce. But as they say, a really nice vector diagram is worth a thousand words.
Many, many hours later...
Many, many hours later...
Bringing it all together
I always see a lecture as trying to tell a story. Content needs to flow in a coherent and easy-to-follow manner. Here, sign-posting is key - both visually and verbally (when we finally deliver these lectures). You may have noticed that on each slide, generally speaking, you can immediately tell which topic we’re on and what we’re discussing. We also like to summarise. Each lecture always ends in a number of summary slides. Literally, my thought process here is ‘if you completely switched off from the lecture up until this moment, at least you would take away these salient points’
Lastly, focus not only on content, but how it is delivered. I probably spend longer working out how to deliver a piece of information than actually researching it in the first place. Remember, content delivery, not content, is KING.
Benjamin Smeeton (@plasticsreg)
New stuff...
Pulsenotes LIVE
As most of you are aware we recently launched Pulsenotes LIVE. This week we live-streamed three lectures: tumour lysis syndrome, acute pancreatitis and non-melanoma skin cancer (the later in association with SMILE had an audience of over 700!).
The lectures were also live-streamed directly to our website in a BETA trial of a service that we hope to be launching soon… Except one or two minor hiccups it was a great success. Even better, all three recordings are now available to watch via the website!
Ben's Skin Cancer LIVE lecture is available to watch NOW...
Ben's Skin Cancer LIVE lecture is available to watch NOW...
UPCOMING EVENTS - what we’ve got lined up…
  1. Sunday 10th May 14:00 - Microbiology by Norton (in association with SMILE, 1000 spaces - see Facebook)
  2. Tuesday 12th May 14:00 - Melanoma by Ben (in association with SMILE, 1000 spaces - see Facebook)
  3. Saturday 16th 19:00 - Q&A with Pulsenotes (we’re here to tackle any queries about medical / surgery training, work-life balance, running a business and any other questions you may have - not to be missed!)
Remember that all events will be LIVE-streamed to the Pulsenotes website, plus recordings will be available for those that aren’t able to make it!
UPDATES - Medicine isn’t static and neither is Pulsenotes.
The notes on abdominal aortic aneurysm have been updated to reflect the latest NICE guidelines (CG 156). The guidance published in March 2020 represents a significant shift away from EVAR and towards open surgery. It’s a must read for any budding vascular surgeons!
We have also updated and separated our Stroke and TIA notes. One major change reflects the removal of the ABCD2 score from the TIA referral pathway based on recent NICE guidance.
Finally we have been hard at work creating questions, adding around 70 in the last week - so if you’re feeling like a challenge, go ahead and test yourself!
Norton's Corner
ECG with Left bundle branch block, easy… ‘WiLLiaM’ pattern, I mean ‘MaRRoW’, I mean, which one is it again?!
First off, let’s be honest, ECGs are hard. A lot of doctors would describe their ECG skills as ‘below parr’. 
There is no magic answer to learning ECGs apart from looking at hundreds and developing some pattern recognition. But here’s a quick tip for deciding if an ECG is Left bundle branch block (LBBB) or right bundle branch block (RBBB) without the faff. 
Firstly, look at the ECG.
  1. Is the QRS broad? (i.e. is it greater than 3 small squares or 120 ms)? Yes? Move on.
  2. Next, look at V1 (the first chest lead). If the QRS complex has a predominantly positive deflection, in other words the R wave is pointing up, it is a RBBB. If the QRS complex has a predominantly negative deflection, in other words there is mainly an S wave pointing down, it is LBBB. Simples
Just remember this method assumes other causes of a broad QRS (ventricular tachycardia, ectopic beats, escape rhythms) have been excluded.
Want something covered next week? - send me a tweet @pulse_notes

Final words
Remember to get in contact with any questions, suggestions, or topics that you wish to be covered!
Thanks for reading, see you in a week!
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