Be yourself; Everyone else is already taken.

— Oscar Wilde.

Welcome to Dr. Adrian Cohen’s blog! Check back for updates soon!

Questions For Managers To Ask Potential Employees

Preparation is of the utmost importance when preparing for a job interview. This doesn’t just go for the potential employee though – this also stands for the person who is conducting the interview. In order to get a true sense of if the person you’re interviewing is the right fit for your organization, there are certain questions you’ll want to think about asking them. Here are a few great questions that any manager should consider asking potential employees during an interview.

Can you tell me about a time you overcame a challenge?

Most potential employees dread this question, but it’s a great way to get a better understanding of their experience and how they react in tough situations. Starting a new job is never easy and practically every new employee runs into issues so this is a good opportunity to gauge how they will react and hopefully overcome those issues.

Why are you leaving your current employer?

Another question that is undesirable by many interviewees, but still important to ask. If hired, interviewees will be leaving their current employer to come work for you. There can be a number of reasons as to why they’re choosing to do this – it could be money-based, unhappiness with their current employer, unhappiness with what they’re currently doing, or the desire to try something new, to name a few different reasons. Asking this question gives you a better idea of what their professional history is like, and can raise possible red flags that might tell you this person isn’t the best fit for the role.

What’s A Skill You’d Like To Improve And How Do You Plan On Doing So?

A great way to gauge a potential employee is to ask them if there is a skill they’d like to improve on, as well as their means of doing so. This is similar to the typical question of “what’s your biggest weakness” but turns the question on its head a little bit. The employees you hire should be aware of their weaknesses and be actively working on improving them and the second part of the question allows them to explain to you how they’re going to go about it.

This article was originally published on DrAdrianCohen.org

Differences Between A Leader And A Manager

While almost anyone can become a manager in a business, this doesn’t necessarily mean that they’re also a leader. Many distinct differences exist between the two phrases, and in order to be good at either role, you must understand those differences. Here are a few of the major differences commonly found between managers and leaders. 

Vision vs Goal

Leaders are all about vision. They look at their team while engaging and inspiring them to turn a vision into reality. Leaders understand that when providing a vision to a group of people, that group can come together to achieve great things. Managers, on the other hand, focus more on individuals. Managers are all about setting goals with each member of their team, doing their best to control situations that allow individuals to reach or exceed their objectives.

Long Term vs Short Term

This relates to the difference between a vision and a goal. Managers think more in the short term. They focus on what they can do to accomplish different tasks within their organization. A leader, on the other hand, is in it for the long haul. They understand that what they’re working towards isn’t something that will be accomplished in a month, or 6 months, or even a year. They have to stay motivated, likely without any compensation, for long periods of time.

Relationships vs Structure

People and the relationships they form with them is a core aspect of being a leader. In order for a leader’s vision to be reached, they understand that they have to focus on the people involved in making that vision a reality. By doing this they end up building a sense of loyalty and trust with their team. On the other hand, managers focus more on the structures they need in order to set and achieve goals, making sure systems exist to attain desired outcomes.

Coaching vs Directing

Leaders have the utmost faith in their team. They understand that the people they work with are confident and are able to find the answers they seek if they don’t already have them. Leaders do everything they can to avoid telling their team what to do. On the flip side, managers tend to assign their team with tasks, giving each individual guidance on how to get the best results.

This article was originally published on DrAdrianCohen.org

Tips For Ultrasound Guided IV Placement

When working in a hospital you’ll occasionally encounter an unstable dialysis patient whose providers are struggling to give venous access to. At this point, many healthcare providers will use an ultrasound to find the vein they’re looking for, hopefully making things a little easier and allowing proper care to be provided. Struggling with venous access can also frustrate the patient, which ends up causing many healthcare providers to resent this task altogether. Luckily, an ultrasound-guided IV can decrease complications and improve the chances of success. Here are a few tips to help improve the odds of success and avoid any potential risks.

If You Can’t See Any Good Veins, Look Distally

In most situations, healthcare providers will scan proximal to the antecubital fossa when trying out ultrasound-guided access. It’s suggested that you should think about looking distally while utilizing a shorter and smaller gauge needle. Doing this helps you avoid injuring more proximal veins and allows for vessel preservation. Radial veins are a good candidate for IV placement in most patients but are often discounted due to their size and proximity to the radial artery. On the contrary, the radius stabilizes these vessels and can make them less likely to roll or dislodge the catheter. It’s also possible to use the “intern vein” if needed.

If You Only See Tiny Veins, Look For A Y-Shaped Junction Between Veins

Don’t fret if you’re only finding small veins. Even these can be cannulated successfully by looking for a Y-shaped junction where two veins merge. Approaching this venous junction allows the needle to puncture perpendicularly against the vessel wall while remaining parallel to the overall vessel course. In order to do this, you must first mark the location of the junction on the skin as well as the direction of each branch distally and proximally. After, puncture the skin between the distal branches 1 – 2 cm distal to the junction. You’ll want to advance the needle and maintain it between the two distal branches until they converge, continuing towards the junction until the needly is visible in the larger and more proximal vein.

If The Vein Rolls Away As Soon As You Get Close, Try Approaching From the Side

Veins can collapse easily or fade behind artifact as the needle approaches, especially in patients with sclerosed vasculature or that are dehydrated. When this happens, a great alternative is to approach the vein from the side as opposed to from above. In order to do this, you’ll want to intentionally pierce the skin lateral or medial to the vessel, followed by advancing the needle approximately 1cm until it lies alongside the vein. You’ll want to then aim for the vessel from beside it. This technique makes it so needle artifacts don’t obstruct visualization of the vessel.

This article was originally published on DrAdrianCohen.com.au

A Brief Guide to Procedural Sedation

Being a pro at procedural sedation is a great skill to have. It helps make your job safer and more efficient while also making your patients more comfortable with the process. There’s a lot to know about sedation though, so here’s a brief guide to help you make sure you’re doing everything properly for both yourself and your patients.

The first thing to know is that sedation has multiple definitions. These are defined by the responsiveness and ventilation pattern of the patient and are known as dissociative, moderate and deep sedation. Dissociative sedation is defined by a trance separation with retained airway reflexes and ventilation. Moderate sedation involves depressed consciousness with responses to commands or touch, with no ventilation changes. In deep sedation, patients are aroused by pain and ventilation may be irregular but is intended to be adequate.

What Do You Need?

In order to properly go through with the sedation, you’ll want to make sure you have respiratory therapy, nursing and a second provider if possible. A sedation certified nurse can help push medications at the direction of the physician, making things easier for them, while having another provider present – one for the sedation and one for the procedure – also makes things easier. If alone, make sure you’ll be able to stop the procedure and resuscitate if the need arises.

When preparing for the sedation, do your best to keep everything organized. You’ll want to have the blood pressure cuff on the opposite arm of the IV as well as opening up your fluids. Be sure that the IV flows well before starting as well. Another good tip is to draw up more medications than you expect to use, just in case. 


When choosing your medications of choice, be sure to consider your goal depth and duration as well as the characteristics of the patient. While every provider has their own preferences when it comes to medication, it’s always good to be comfortable with multiple options in order to play it safe. The dose you’ll need for a specific level of sedation will be different for every patient, and it should be based on the desired depth of sedation. There are many medications you can use, all with their own suggested doses and concerns to be aware of.

This article was originally published on DrAdrianCohen.net.au

Tips For Managers To Form Meaningful Relationships With Their Employees

More than anything, human beings strive to form meaningful relationships with those around them. Having those meaningful relationships creates an idea of belonging to something. This can be extremely important in the workplace, especially since research shows that people in the workforce spend more overall time with their coworkers than they do with their own families. Just like with a sports team, having a meaningful relationship with your employees encourages them to want to work harder, or to help their peers out more often. It’s also important that not only do employees form meaningful relationships with one another but that managers are able to do it with their employees as well. By forming meaningful relationships with their team they can develop a better understanding of what makes each employee tick, the goals they’re striving for in their career and in life, and how to approach each situation in a way that works best for that employee. Here are a few ways managers can begin to form meaningful relationships with their team.

Be Authentic, Informal, and Frequent with Communication

When trying to form a relationship with your employees, it’s important that you don’t always come off as only their boss. You’re human, just like them, and it can be easy for employees to forget that. In order to ensure your employees don’t see you as a robot, make an attempt to truly get to know them. Engage in casual conversation with them by asking them how their weekend was or seeing if you have similar interests. Make sure this is something you do often as well, as only doing it once in a blue moon may throw employees off guard. Trust levels between managers and employees will grow more when employees see the human side of you, making it easier to form a relationship with them.

Reach Out To New Hire/Team Members

When a new employee joins the office, or your team gets a new team member out of an existing employee, it’s imperative you begin the relationship-building phase right away. You don’t need to necessarily wait until they’ve actually joined the team other. Once things are finalized and you know they’ll be joining, reach out in an informal manner. Some managers or team members will send welcome emails to new hires before they join, or they may choose to invite a new incoming team member to a team lunch. This is a great way to introduce them to their managers and other new team members in an informal setting.

Celebrate Employee Milestones

Managers can also form relationships by celebrating the milestones of their employees, both in and out of work. If someone is having a baby or got an award, be sure to get the team together to celebrate it. This can help employees be their whole selves in the workplace and give them the sense that they can share their personal lives with people who care, fostering an overall greater feeling of inclusion. The people you work with often come from all walks of life and it’s important to recognize that.

This article was originally published on DrAdrianCohen.org

Tips For Giving Negative Feedback To Employees

One of the most difficult aspects of being a manager is having to provide them with negative feedback. No employee is perfect and there is always room for improvement but sometimes you’ll have an employee who is struggling more than others. As a manager, it’s your job to guide them and help where you can so they can become the thriving employee they’re meant to be, but that usually involves telling them where they might be failing in the job. While this can be a difficult task, there are plenty of ways you can approach it in order to ensure employees understand where you’re coming from and that you’re trying to help them. Here are a few tips to help you give your employees negative feedback. 

Create A Comfortable Environment

The first thing you want to do when looking to provide an employee with negative feedback is to make sure they’re in a comfortable environment. It’s important to find a quiet place away from prying eyes in order for both of you to speak freely about the feedback, otherwise, they’re more likely to shut down and not talk to you about the what you’re telling them. Employees are more receptive when they feel comfortable and safe, whereas being scolded for something in front of their peers may make them defensive. You’ll also want to make sure you don’t come off as threatening unless it’ a more dire situation. The language you use when addressing an employee can change the way they react, so avoid using phrases such as “you need to…” or “you didn’t do…”. 

Try To See Their Perspective

As previously mentioned, employees will occasionally shut down or become defensive when they’re given negative feedback. One way to avoid this is to do your best to see their side of things. As a manager, you should ask them how they thought they handled a situation or why they approached a task the way they did. Giving your employees the opportunity to explain themselves and share their views is important in understanding where a misunderstanding or challenge may have occurred. While you may be giving an employee constructive criticism, you also want to be sure that the conversation isn’t one-sided. This also helps managers build relationships with their employees, getting a better understanding of things in their life that may be affecting their job performance.

Make Giving Feedback Normal

While giving negative feedback is of great importance in any workplace, it’s important to provide positive feedback as well. By providing both forms of feedback, it helps create a culture of feedback where both management and employees feel they can be open and honest with one another about issues in the workplace, whether they be about structure, culture, or just the work the employee or manager is doing. Make sure feedback is continuous within the workplace, and not something that happens once in a blue moon. This encourages employees to be open about the way they’re feeling and helps both management and employees understand what is expected of them.

This article was originally published on DrAdrianCohen.org

A Brief Guide To Evaluating Syncope

Syncope, or fainting as it’s more commonly referred to, is a temporary loss of consciousness that typically involves an insufficient flow of blood to the brain. Having blood pressure that is too low is the most common reason it happens, but there can be various reasons as to why it occurs, with some having the possibility of having an underlying medical condition. In the field of emergency medicine, it’s important that a healthcare provider is able to recognize whether or not someone is suffering from syncope, and how to go about treating it. Read on for a brief guide to evaluating syncope.

Step 1: Ensure it’s Syncope

If a patient is stable after waking up from a loss of consciousness, you’ll want to make sure it’s actually syncope versus what could possibly be a seizure, mechanical fall, or something else entirely. This is important because syncope shares many commonly cited symptoms with other health issues, such as myoclonic jerks which bystanders may view as a seizure, or bladder incontinence which can occur during seizures, severe head trauma or syncope. Tongue biting is also common in syncope, seizures and mechanical falls. A good way to determine if it was a seizure is if they have lateral tongue biting or postical confusion, whereas for a mechanical fall you’ll want to as about prodrome because a preceding prodrome is more likely with syncope. 

Step 2: True Vs Symptom Syncope

Now it’s time to figure out if it’s true syncope or symptom syncope. Patients with true syncope typically lack any symptoms and after the syncope occurs. If there are other symptoms to go along with the syncope, it’s instead syncope secondary to another health problem and should be evaluated for the disease that’s associated with the symptoms they’re displaying. For example, if they have abdominal pain and syncope, they may be suffering from a rupturing abdominal aortic aneurysm with syncope as a high-risk symptom. Syncope can occur from practically any dangerous disease, making being able to distinguish between true and symptom syncope a vital skill.

Step 3: Risk Of Dysrhythmia

If a patient has true syncope, the final thing you’ll want to do is determine their risk for dysrhythmia. This usually involves performing an ECG. There are 6 factors that tend to increase the risk of adverse outcomes – family history, age, heart disease, exertion, hypotension, and abnormal ECG. If any of these factors are relevant to a patient, they should be admitted for telemetry monitoring and most likely an echocardiogram.

This article was originally published on DrAdrianCohen.net.au

Using A Sphenopalatine Ganglion Block For The Treatment Of Headaches

When it comes to migraines and other primary headache disorders, the autonomic nervous system is typically involved, with the trigeminal nerve being the main nerve involved in them. The sphenopalatine ganglion is a collection of nerve cells that are closely associated with the trigeminal nerve and has connections to the brainstem and meninges through this nerve. When inflammation and the opening of blood vessels around the meninges occur, they send pain impulses through the trigeminal nerve, and in the case of migraine and cluster headaches, these pain signals pass through the SPG. A common hypothesis is that by blocking the SPG, pain relief can be produced from primary headaches by modulating the autonomic fibres involved in headache disorders. These blocks have had many positive results, but there is only so much evidence for its use in the emergency department. 

When performing an SPG block, there are several methods you can perform. The most common approaches include transnasal, transoral, and lateral infratemporal, with the transnasal approach being the easiest and most practical way of performing the block in the emergency department. This approach has a few advantages over the others; it’s a fast and safe way of performing the block, it’s easy for patients to tolerate with little risk of complications, and it’s non-invasive compared to other methods due to avoiding the use of needles. 


Performing an SPG block in the emergency department typically uses supplies that can be found in any ED. You’ll want to begin by soaking a 10-centimetre cotton-tipped applicator in local anesthetic, typically either 1% to 4% lidocaine or 0.5% bupivacaine. Next, you’ll want to make sure the patient’s head is in a sniffing position and insert the soaked applicator into the naris, on the unilateral side of the patient’s headache. Make sure to apply firm and steady pressure along the superior border of the middle turbinate. Do this until you meet resistance at the posterior wall of the nasopharynx, which is when the anesthetic should contact the SPG and anesthetize the ganglion. You’ll then leave the applicator there for about 5-10 minutes, which should result in the patient experiencing a vast improvement or resolution of their headache.SPG blocks are a satisfactory option for patients suffering from primary headaches but more studies need to be performed before they’re considered standard first-line therapy for migraines and the like.

This article was originally published on DrAdrianCohen.com.au

Palliative Emergency Medicine – What Is It?

When working in the emergency department, the number one goal is usually to prolong life. Success is usually achieved by avoiding a patient’s death, but sometimes it’s not possible. Depending on what the patient is there for you may have to consider if you’re just prolonging the dying process, as opposed to the living. This is why palliative care principles have begun to arise in emergency medicine as of late. These care principles put the patient at the centre of care, taking into consideration their feelings, concerns and decisions so they can have a better experience and a stronger relationship with their physician. 

To put it simply, palliative care is defined as an approach that improves the quality of life of patients and their families who are facing problems associated with a life-threatening illness. Palliative care brings many benefits to patients in the emergency department. Since the emergency department typically acts as a “front door” for many conditions and injuries, it can similarly be a front door for palliative care as well. Introducing palliative care in the ED as opposed to later on when they’ve become an inpatient can improve satisfaction for patients and their families, improve system management, and can lessen the time spent in the intensive care unit, among other things. In fact, the length of stay for many ED patients has decreased by an average of 4 days.

Palliative care doesn’t need to benefit only the patients though. It can benefit emergency medical providers as well. Burnout is a serious problem in emergency medicine due to a large amount of emotional exhaustion and an overwhelming number of patients seeking medical attention. Palliative care can help EM providers avoid burnout by providing them with true empathetic engagement with their patients which in turn provides them with a greater sense of satisfaction from helping their patients. Burnout in emergency medicine is sometimes blamed on the fact that many hospitals have moved on from the bedside care aspect of the industry and instead focusing on efficiency, so they can treat as many patients as possible while still providing quality care. Many enter the medical field to help people and by moving towards palliative emergency medicine, physicians are more likely to move towards that. 

Having palliative care conversations with patients as soon as they enter the emergency department can be crucial to providing them with a comfortable experience during their time of need. There are many ways this can be handled, from the simpler task of having emergency department doctors provide the care to hiring a team that is there specifically to have these conversations with patients. However it may be done, it’s important that palliative care finds its way into the emergency department.

This article was originally published at DrAdrianCohen.co

How Failure Can Help Leaders Succeed

Leaders need many things in order to help them succeed. The greatest leaders will often display abilities such as excellent communication skills, critical thinking abilities and the ability to stay cool in a crisis, which has helped them get to where they are, but one of the most vital parts of being a successful leader is having experienced failure. Many of the most successful people on the planet failed time and time again before finding the success they have now. You might be wondering how that’s possible, so read on for a few ways in which failure can help you succeed as a leader.

Failure Gets You Out Of Your Comfort Zone

One of the worst things you can do as a leader is to become too comfortable. If things are going well in your business or organization, it can be rather easy to go with the flow and just let things happen. While this is an understandable feeling, it can also be detrimental to your leadership abilities and can stunt further growth. Think of leadership the way you would think of lifting weights. If you’re lifting weights and aren’t struggling to do so, you likely aren’t lifting enough. Leadership is similar, and we must constantly challenge ourselves if we want to grow at all.

Failure Makes You More Grateful

While failing is never a fun experience to have, it tends to help individuals be more grateful once they’ve actually succeeded. This is true not only of leaders but practically anyone who has experienced failure at one point or another. Having gratitude for the circumstances that brought you to your success, as well as the people who helped you get there helps you be a better person, which can help improve your leadership abilities by making you more motivated, amongst other things.

Failure Teaches You What Doesn’t Work

One of the hardest parts of being a leader is knowing what tactics do or do not work, whether they be for you specifically or for your business. You can often look at other people’s success and the failures they’ve experienced in order to give yourself an idea of what may or may not work for you, but you’ll never truly know if something works for you until you try it for yourself. Failure can help you realize that the great idea you had might not be working for you and that it’s time to try something new.

This article was originally published on DrAdrianCohen.org

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