Figure: transformation into a company of EM, app, CMG, Take Medicine Back Figure Figure To say that emergency medicine is worried about corporate consolidation would be an understatement. The American Academy of Emergency Medicine and the American College of Emergency Physicians have written position statements, and many emergency physicians, prompted by Take Medicine Back, have […]
Figure: prophylactic antiemetics, IV opioids, opioid-induced vomiting Figure Are you administering a dose of an antiemetic drug at the same time as IV opioids? This theory seems logical given the nauseating effects that opioids have on some patients. Three studies using metoclopramide 10 mg IV showed that this antiemetic did not reduce the need […]
Figure: DEI, well-being, health equity, burnout Figure Burgeoning wellness and burnout crises in medicine have accelerated during the pandemic, with several pre-existing conditions contributing to the current mental health crisis being felt by many medical professionals. These crises are particularly palpable among front-line doctors. Emergency physicians receive disaster preparedness and rapid response training for […]
Figure: EP life, burn-out, moral damage, well-being in EM Figure Figure I fight, but I am not exhausted. I enjoy taking care of my patients and doing clinical work. It’s all that bothers me that I find intolerable. —Anonymous doctor Almost all of our colleagues experience some level of distress, but most refuse […]
Figure: fanny pack, intravenous hydration, alcohol use disorder, acute alcohol intoxication Figure Intravenous hydration clinics are the latest thing, with real doctors touting the therapy as a way to relieve hangovers, build athletic endurance, lose weight and prevent burnout. Apparently, it’s such a booming business that even emergency care is getting into it. We’re […]
Growing up in Southern California, Linda Nguyen, MD, considered several career choices: marine biologist; astronaut; doctor. Luckily for the thousands of patients she has treated over her career, she chose the latter. This year, she was selected to receive the Stanford Medicine Master Clinician Award, which honors a physician in the Department of Medicine for […]
There are a significant number of residents, fellows, and new physicians who have accumulated significant medical education debt. In 2016, the median amount of student loan debt carried by graduates of medical schools was $190,000. There is one category of student loans known as medical education loans. They might have interest rates that are lower […]
Figure: medical misinformation, social media Figure We may disagree on the medical details, but we can all agree that the best way to treat the disease is to watch random posts on Facebook and Twitter. OK, maybe not, but we know that the onslaught of overconfident misinformation whistleblowers has grown exponentially since social media entered […]
Figure: C-reactive protein, CRP, erythrocyte sedimentation rate, ESR, septic arthritis Figure A pervasive myth perpetuated in ED is the false power given to inflammatory markers. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are routinely prescribed as part of septic arthritis assessments in adults, but do they really change management? The absence of septic […]
Figure: COVID-19, EP life, vaccination Positive. Certainly not. I tested positive. I had woken up that day with a little congestion, but otherwise felt fine. I had poured a cup of coffee before leaving the house that morning, and thought my wife must have made the pot; she uses one spoon and I use two. […]
Figure: gun safety, violence prevention, mental health Figure Figure America’s health care safety net is growing even as it continues to fray. Emergency departments have become one-stop-shops for all health crises, but what defines an emergency is subjective, and what contributes to a patient’s presentation to emergency departments is even more varied. The social […]
Figure: opioid crisis, substance use disorder, electronic referrals Figure Figure Figure The US Department of Health and Human Services, after declaring the opioid crisis a public health emergency in 2017, released a five-point strategy to prioritize improving access to prevention, treatment and recovery aids. The plan also targeted the availability and distribution of drugs to […]
Figure: Match Day, Preference Signaling, EM Jobs Figure Emergency medicine took a beating in the 2022 game, but it was the best result for our specialty at the most critical inflection point in our history. We needed something to slow the accelerating growth of residency positions. Like the Federal Reserve raising interest rates to cool […]
BY EMEDHOME.COM Following blunt abdominal trauma, peritoneal fluid on a CT scan with no evidence of solid organ damage can be a major diagnostic dilemma. Bladder rupture should be considered if nonhemorrhagic fluid is present in the abdomen on CT with no evidence of solid organ damage, after ruling out preexisting conditions such as […]
Figure: ECG, cardiology, diagnosis Figure A man in his mid-80s with a medical history of diabetes and stage 5 chronic kidney disease was taken to hospital by doctors with two days of nausea, vomiting and generalized weakness. He said he had no chest pain, difficulty breathing, fever, chills, abdominal pain, diarrhea, melena or other symptoms. […]
Figure: whole body donation, corpse journey, EP life Figure The villains aren’t just the villains of literature. These are the characters whose actions stem from motivations to serve themselves rather than others. They are driven by their inextinguishable ego, happy to ravage others in their quest for self-advancement. Heroes, on the other hand, are those […]
Figure: well-being in EM, self-acceptance, self-esteem Figure Figure Figure What makes people worthy? Is it the mastery of their career or the amount of charity work they do? Is it the number of extra shifts they take or agree to sit on all the committees? These can bring value to the world, but our value […]
ultrasound, subclavian, supraclavicular, subclavicular lines: Placement of the transducer for a supraclavicular approach. Some tilting of the transducer toward the collarbone (forward tilt) will be required in most patients. Figure I’ve written before about using ultrasound for subclavian lines, both the standard infraclavicular approach and my favorite, the supraclavicular approach. (REM. 2017;39[6]:1; https://bit.ly/3wkjmGs; REM. 2013;35[7]:8; […]
Figure: cyanosis, hypoxia, diagnosis Figure A 44-year-old woman presented with shortness of breath, fatigue, and bilateral lower extremity edema. She was 85% hypoxic on room air with pale skin, cyanotic lips, and anasarca. The patient was consistently 85% hypoxic despite being placed on a 15 L ventilator. She had recently been admitted to another […]
The education program helps address the complexities that determine rates of sexually transmitted and blood-borne infections (STBBIs) in Saskatchewan and their impact on patient care. Content will include clinical treatment and infection management and will feature the involvement of experienced HIV/HCV care providers, organizations and community members to create made-in-Saskatchewan solutions to the environment and […]
The antimicrobial capacity against S. mutans biofilms was investigated using a Calgary biofilm device coated with collagen (CFU and Live/Dead Confocal). Collagenases from Clostridium histolyticum, Porphyromonas gingivalis and S. mutants were used to assess anti-collagenolytic activity. The biocompatibility of the two compounds with human dental pulp stromal cells (HDPSC) was studied in 3 different donors […]
Stanford awards for 2021-22 academic year include many DOM faculty and residents Congratulations to over 40 recipients of awards for excellence in teaching, patient care, etc., recently presented by Stanford Medicine in recognition of their outstanding contributions during the 2021-2022 academic year. See the partial list (including several of our DOM colleagues) below. Tracy RydelMD, […]
When Jesse Schmidt (Psychology ’21, MIB ’22) enrolled in a fall 2019 course on spirituality and health care, she had no idea how powerful the connection between the two could be. She would soon find out firsthand. Schmidt has worked for a “telephone friends” service, speaking with people across the country struggling with debilitating illnesses […]
NEW DELHI: In what appears to be a miracle and a “first in history”, a small clinical trial has revealed that every rectal cancer patient who received experimental treatment found that their cancer had disappeared. According to the New York Times, in the small clinical trial run by Memorial Sloan Kettering Cancer Center, 18 patients […]
Summer is here and North Carolina is feeling the heat. With rising temperatures and humidity, Steve MarksAssociate Dean and Director of Veterinary Medical Services at NC State College of Veterinary Medicine and Veterinary Hospital, does not want your outdoor activity to include an emergency visit to the veterinarian. “Pets can suffer from heatstroke, dehydration, and […]
Figure: gender bias, women in EM, gender equality Figure I went from tourist mode to EP mode when my son collapsed in the Eiffel Tower. We watched the man at the macaron counter arrange a rainbow of sweets while we waited for his sign to say “open”. My bored teenagers started bickering, and an […]
Figure: loss of vision, headache Figure Figure A 40-year-old man presented with peripheral vision loss. A severe headache three days earlier had woken him up, but his pain had eased with ibuprofen. His headache was completely gone, but he continued to have vision loss and was bumping into things on his right side. His […]
Figure: Percheron’s artery, stroke BY EMEDHOME.COM Percheron’s artery is a variant of the arterial supply to the thalamus in which a single artery supplies both sides of the thalamus and the midbrain. Occlusion of this artery can lead to a bilateral thalamic stroke. Knowledge of the PDO and its occlusion is crucial for […]
Figure: substance use disorder, misinformation Figure We have all been taught to be wary of popular press reports about the effects of new illicit drugs. More often than not, they are sensational and unsupported by scientific data. A kerfuffle broke out a few years ago over krokodil, the homemade designer opioid originating in Russia […]
Figure: gun tips, gun safety, injury prevention Figure I recently saw a patient who had intentionally overdosed, a common occurrence in the daily work of an emergency physician. I spoke to him after a psychiatric guard was signed by law enforcement. She had overdosed on ibuprofen, which had minimal adverse effects at the dose […]
International EM, first responder: The scene of a motorcycle collision where Dr. Jedick provided treatment. Figure As a young Air Force flight surgeon, I despised nothing more than drill week. I was stationed in the Republic of Korea, which meant 24-hour war games for a week. These drills were very high fidelity. We doctors […]
Figure: Ukrainian war, medical volunteering Figure Dusk came quickly and it started to rain again. The cold, damp air soaked through all my layers of clothing, sending shivers down my spine. It was our last day at the border and we had just said goodbye. The orange vests we wore all week had been […]
Figure: contract management, healthcare costs Figure The COVID-19 outbreak has thrust emergency physicians into the media spotlight, showing them saving countless lives from a highly contagious virus through hands-on frontline care. Emergency doctors intubated infectious patients without hesitation moments before their last breath of air, performed CPR on those arrested in the emergency department, and […]
In the spotlight CVM Class of 2022 celebrates hard-earned oath and balaclava moment When the Class of 2022 showed up for the first day of classes, little did they know a global pandemic would upend their path to a veterinary degree. Having endured COVID testing, distance learning, social distancing, mandatory masks and more, 101 DVM […]
Paige Daubenfeld has dreamed of becoming a doctor since she was a child. This dream led her to enroll in health studies at the University of Saskatchewan (USask), a program that examines health and well-being from a variety of perspectives, including the influence of biological contexts. , cultural, social and environmental on the health and […]
We are delighted to announce the launch of the new Stanford Master of Science in Translational Research and Applied Medicine (M-TRAM) starting in September 2022. This new graduate program will provide formalized training in the sciences of translational medicine, basic sciences to clinical investigation. The program will focus on developing new therapies designed to help […]
A North Carolina State undergraduate student majoring in animal science, a recent master’s degree graduate, and a burgeoning third-year student at the North Carolina State College of Veterinary Medicine work among the wildlife in South Africa this month, thanks to a North Carolina State Internationalization Seed Grant awarded to help broaden the participation of minority […]
Wayne State University School of Medicine’s Office of Higher Medical Education held its 11th annual online Quality Improvement Research Day, in conjunction with its lead clinical partner, Ascension Providence Rochester Hospital, the May 10, to showcase resident-led quality improvement projects in the Internal Medicine, Family Medicine and Transition Year Hospital Programs. Anne Messman, MD, Associate […]
As recently selected American Fulbright Scholar for the academic year 2022-2023, Latha Palaniappan MD, MSwill travel to Australia to further his research in precision health. Fulbright Scholar Fellowships are esteemed fellowships that involve a rigorous application process and provide a unique opportunity for scholars to teach or conduct research overseas. Past recipients include numerous Nobel […]
Sarah Talamantes, MD Sarah earned her bachelor’s degree in biopsychology from Cornell University in 2015, where in addition to being a college star, she was a shooting guard for Cornell’s Division I NCAA basketball team. In addition to this, she also spent 3 summers working with the University of Colorado Cancer Center as a clinical […]
I was so proud of the work of the staff and managers in our department. Once again, it reminds me how our investment in great people has a ripple effect not just here at Stanford, but across the country. Ultimately, as Zeng explains, the interest generated by the three projects was “quite a testament to […]
Since 1989, Feinberg has offered seminars in the arts and humanities as part of its medical program, allowing students to approach the world of medicine and health care from different perspectives and with new skills. Today, every Feinberg medical student takes two seminars during their medical school career—one in the winter term of their freshman […]
Figure: gun safety, gun violence, violence prevention Figure Figure People undoubtedly respected medical professionals. This respect still prevails today, but new influences are undermining patient-physician trust. Sensationalist media, political ideologies, inconsistent CDC guidelines, Google-driven anticipation and “individual research,” impossible insurance plans, and the role of health care in the opioid epidemic, among other effects , […]
Figure: medical school, COVID-19, workforce Figure One of the most interesting changes in healthcare during the COVID-19 pandemic has been the effect on the number of applicants to medical school. These are on the rise. These applications have increased by the highest percentage since 1980, and we have seen a significant increase in applications […]
Dr. Janet Tootoosis (MD) will act as Acting Associate Dean of Indigenous Health to advance work in the portfolio while a search for a permanent Associate Dean is underway. She was hired for a one-year term, starting June 1, 2022, with the expectation that the search will be completed and the position will be filled […]
Figure: CT, dizziness, diagnosis Figure Few conditions present in the ER that make the average ER doctor hesitate. We tackle everything from cardiac arrest and trauma to strokes and foreign bodies in every orifice, but we choose to let someone else see a patient who presents with vertigo. Why? One of the reasons is […]
Figure: bilateral ptosis, diplopia Figure A previously healthy 8-year-old girl presented with bilateral ptosis and impaired superior gaze. She was transferred from an urgent care center to the emergency department for advanced brain imaging after abnormal extraocular movements were detected by the doctor. The patient’s father said he had noticed that his daughter had […]
lactic acidosis, metabolic acidosis: Thiamine is an essential cofactor in the metabolism of pyruvate to lactate. This metabolic pathway is blocked in thiamine deficiency and pyruvate is diverted into another pathway which converts it to lactate. Figure Determining the underlying cause of lactic acidosis often comes down to two choices. Type A lactic acidosis […]
Figure: perfectionism, well-being, mental health Figure Figure Figure Doctors should be perfectionists, right? It really depends on the kind of perfectionist. Adaptive perfectionists, who we call high achievers, have high standards, set ambitious goals, and work tirelessly to achieve those goals. They are success-oriented but flexible enough to allow for occasional mistakes. Misfit […]
Figure: medical school, knowledge Figure Every time I listen to a continuing medical education podcast or talk at a conference, I come away shaking my head. I’m always moved by how much information we’re supposed to withhold, how quickly new data and therapies emerge (and old ones get pushed aside) and, of course, the absolute […]
International EM, rural EM, humor: Orf causes scab-like lesions, left, and raised fluid-filled vesicular lesions. Figure Working in a rural New Zealand hospital for six months was remarkably similar to working in a major American city. Oops, wait. My computer crashed for a second. Just go back and change the words ‘remarkably similar’ to ‘breathtakingly, […]
Figure: ECG, cardiology, hypokalaemia Figure Figure An elderly woman presented to the emergency department with generalized weakness. She and her family said she did not have a fever, but had a history of frequent UTIs. They also said she had no syncope, palpitations, pain, shortness of breath, cough or other symptoms. His vital signs […]
Figure: operational risk management, burn-out Figure Am I the same doctor at the end of a busy shift as when I first walked through the doors 12 hours earlier? Does my last patient on a busy shift have the same knowledgeable physician and similar exam as the first patient I saw? I wish I […]
Figure: cerebral infarction, cerebral imaging, cerebrovascular accident BY EMEDHOME.COM Hidden cerebral infarcts are focal lesions detected on brain imaging consistent with ischemia in the absence of a history of overt stroke or neurological dysfunction. These infarcts are the most common incidental finding in brain imaging and are associated with an increased risk of future […]
Figure: opioids, opioid epidemic, drug disposal Figure My stepfather passed away in January after a long illness. Like millions of patients with metastatic cancer, he was receiving aggressive pain management that included high doses of multiple opioids toward the end of his life. Within days of his passing, my wife, her siblings and I attempted […]
emphysema, pneumothorax: CT scans show extensive pneumothorax, emphysematous bullae, and diffuse subcutaneous emphysema. A 55-year-old man was brought to the emergency room by EMS after being found outside with breathing difficulties. Prehospital providers feared an anaphylactic reaction and administered 0.3 mg intramuscular epinephrine (1:1000). The patient was dyspneic, leaning on his right side and […]
Figure: tears, physiology, anatomy Figure It is said that there are three main types of tears. Not long ago I saw a series of patients with all three within hours of each other in the ER, and I thought there was a column in there. Before breaking down this triumvirate of epiphoras, let’s take […]
Figure: epistemology, professions, misinformation Figure Ivermectin is symbolic. If a large, multicenter, randomized, placebo-controlled trial with no conflicts of interest were published in a peer-reviewed journal with sound methodology and statistics concluding that it was beneficial for COVID-19, that would not change the symbolic role and social behavior that existed before such a study. […]
Mintu Turakhia MD, MASprofessor of medicine (cardiovascular medicine), will take a planned leave of absence from Stanford to join iRhythm Technologies, Inc. as the new Chief Medical Officer and Chief Scientific Officer. One of the earliest and most successful companies spun off from the Stanford Biodesign program, iRhythm is perhaps best known for its heart […]
A sequel to “Class of 2022: In Search of More” Lots of changes between the time you receive your acceptance letter to vet school and the time you enter the final weeks of your clinical rotations. I remember being interviewed for an online feature about incoming students in 2018, being asked about my background, which […]
We are pleased to announce the appointments of Andrew Padmos as Director of Medical School Institution and Marcia Moshe as Senior Advisor to the Provost and Vice Provost Academic, MD Proposal Development of the Ryerson University School of Medicine, effective April 1, 2022 Both Andrew and Marcia have shown incredible commitment to creating an innovative […]
The specialist hospital offers a unique range of orthopedic and neuro-spinal treatments in line with world standards Published: Fri 22 April 2022, 09:00 Alarming levels of vitamin D deficiency among UAE citizens and residents, augmented by their sedentary work routines and physically inactive lifestyles, have catapulted the prevalence of arthritis and degenerative bone, joint and […]
An exciting opportunity has arisen at Mansfield Town Football Club for an enthusiastic, proactive and knowledgeable individual to join the Academy’s Department of Sports Science and Medicine as Head of Academy Science and sports medicine. Based at: HR Academy, Pleasley, NG19 7RT Salary: Depending on experience (to be discussed during the interview)Type of employment: […]
Just outside the back doors of the NC State College of Veterinary Medicine, where classrooms, labs and lockers line the hallways, 80 scenic acres are home to pigs, chickens, sheep, goats and cattle and a learning laboratory for veterinary students. The Animal Teaching Unit, as the working farm is called, is a dynamic space for […]
As spring arrives and the weather warms up, we will start going out more with our dogs and maybe do some gardening. This is also the time of year when many people celebrate Easter. Steve Marks, Associate Dean and Director of Veterinary Medical Services at NC State Veterinary Hospital, shares some important tips for keeping […]
33 Stanford researchers named Chan Zuckerberg Biohub investigators Congratulation to the 33 Stanford researchers (including several of our DOM colleagues) recently named as the latest cohort of Chan Zuckerberg BioHub investigators. Successful applicants receive $1 million in unrestricted donations over a non-renewable 5-year term ($200,000 per year), with a start date of March 1, 2022. […]
Figure: COVID-19, nursing shortage, lack of beds Figure I had to beg for my patient in his twenties, dying and previously healthy, to get the care he needed. Beg! Not because no one wanted to help, but because the latest wave of coronavirus had brought our healthcare system to its knees. As of mid-January, no […]
Figure: medical data, computers Figure Aiden Sims was a 9 day old who presented with congestion and fever. He had only been sick for a day, but he had declined rapidly. Slightly hypoxic, he growled and retracted during my examination. Unfortunately, Aiden never improved. Indeed, Aiden is not a person but an artificially generated […]
Figure: substance use disorder, drug withdrawal, opioids Figure One of the things I love most about medicine is that it is constantly changing and improving, especially as new evidence sheds more light on a subject. I have doctors in my group who have been trained in diagnostic peritoneal lavage, but that was just a historical […]
Figure: cardiology, pulmonary embolism, myocardial infarction Figure Figure A woman in her 70s with asthma, diabetes mellitus, hypertension and a pacemaker came to hospital with shortness of breath and chest tightness lasting two hours. She had had a similar episode the day before which was milder and resolved with albuterol. She had a cough […]
Editor: Mark Mosley, MD has made an impassioned call for physicians to unite with one voice to create a clear message for patients regarding COVID-19. (REM. 2021;43[12]:26; https://bit.ly/3Dc0LN1.) He suggested that science strongly supports the effectiveness of masks and the safety and effectiveness of vaccines, but has no evidence to support current therapeutics. […]
Figure: ondansetron, migraine Figure My patient was a preteen girl who could usually manage her acute migraines with acetaminophen, ibuprofen, and intranasal sumatriptan, but it didn’t work this time. Her mother had called the pediatric neurologist to see if they could try something else at home, but the neurologist suspected the patient needed medication and […]
Figure: gunshot wound, trauma, diagnosis Figure Figure A 50-year-old man was rushed to a Level I trauma center about an hour after being shot in the legs with a shotgun at close range. He had normal vital signs on arrival and reported pain at the injury site. Numerous haemostatic penetrating wounds were observed throughout […]
Figure: misinformation, cults, COVID-19 Figure I have a friend whose marriage is failing due to a misinformation addiction. She and her husband have always had differing political views, but their yin and yang were endearing intellectual fodder for respectful and playful debate. But things have changed dramatically in this new world we live in. […]
Figure: medical toxicology, good practices Figure Effective medical toxicologists develop habits that minimize the risk of overlooking minor but crucial aspects of poisoning case management. Two of them stand out and can also help emergency doctors in the care they provide. Know the units Units count. Just ask the NASA folks. The Mars […]
Figure: viscous lidocaine, medicated, gastrointestinal Figure One of my professors of pharmacology in medical school often joked, “Doctors would think twice about giving some questionable drugs if they took them themselves.” There is no better example of this than viscous lidocaine. It may be one of the most nasty drugs ever invented. Ask the […]
Figure: DEI, community engagement, social MI Figure A common saying in emergency medicine is that we are an extension of our surrounding community. Its members come to us out of necessity, often at their worst, as a last resort, and as the only option in some cases. EPs strive to meet all patients where […]
Figure: courage, resilience, well-being Figure Resilience is the buzzword everyone in the wellness world seems to be using. It’s something everyone has in varying amounts and is essential for well-being. We talk and talk about ways to build resilience and even make it part of wellness models for health systems because, well, burnout is out […]
Figure: trauma management, writing Figure Lewis Carroll cryptically asked his Mad Hatter, “What’s the difference between a crow and a desk?” The answer to the riddle is, to this day, unknown. But that hasn’t stopped generations of people from making fanciful connections between the two, some of which even make a bit of sense. […]
Figure: EM manpower, EM staffing In addition to shouting: “We are sinking!” from the bridge of the ED, how are we going to practice emergency medicine in 2022 without nurses and other essential personnel? I offer these suggestions with terrifying trepidation, knowing that the difference between malpractice and lifeboat ethics may depend on the situation […]
Figure: Emergency department documentation, chart label, patient records Figure Figure The 21st Century Cures Act allowed patients to view their medical records, including the entire emergency department documentation. This means that patients can read anything written in a doctor’s emergency note. And that means chart etiquette has a new importance in emergency medicine. Comments […]
On this year’s Transgender Visibility Day, we should be celebrating accomplishments, honoring resilience, and loudly advocating for the rights of trans people. Yet the growing onslaught of anti-trans legislation targeting the healthcare decisions families make with their doctors threatens to cast a shadow over this day. About a year ago I lost a family member […]
Duncan Lascelles, internationally renowned pain expert, professor of translational pain research and management at NC State College of Veterinary Medicine, will be the recipient of the Dr. J. McNeely and Lynne K. DuBose Professor Emeritus Chair in Health musculoskeletal. He is director of the Comparative Pain Research and Education Center at NC State. He will […]
Broadband and the heart Ashley, a self-proclaimed “tech geek”, was drawn to medicine as the child of a doctor and a midwife. At 16, he became fascinated with genetics while reading Richard Dawkins’ book The selfish gene. After completing medical school at the University of Glasgow and a medical residency and doctorate in molecular physiology […]
Classmates show off the stethoscope and pledge they received during the clinicians ceremony. Wayne State University School of Medicine’s Class of 2024 began medical school in 2020, just four months after the COVID-19 pandemic began. The pandemic has forced the cancellation of all in-person teachings and events, including the traditional White Coat Ceremony usually held […]
Figure Figure Residency is a time of excitement, optimism, ideas for the future and connection, a time when we contemplate change and potential possibilities. My residency class consisted of eight incredible individuals, two females and six males. We had people from all stages of life: single and married, some in their second careers, others […]
KYIV, Ukraine – The temperature was below freezing and the pharmacy queue was way outside the door. But Tetyana Dagadaeva could not be deterred. For days, she and her 11-year-old son, Oleksiy, had been desperately seeking the insulin he needed to survive. With his home supply dwindling, they will soon have no choice but to […]
Figure: sedation, best practices, single blanket Figure I’m unabashedly proud of how good EPs are at multitasking and task switching (we fight a lot about how we can get out of a code and into the next room without a break), but I never feel this more intensely than when doing a sedation procedure on […]
Adidas unveils new retro Penguins ‘Team Classics’ jerseyAdidas has released a new Penguins throwback jersey – and for Pittsburgh hockey fans, it will be a trip down memory lane. 2 hours ago KDKA-TV Afternoon Forecast (3/1)Stay on top of local weather with meteorologist Kristin Emery’s 7-day forecast! 2 hours ago Duquesne University Inaugurates Future College […]
Figure: URM, GME, equity in emerging markets Figure Health care facilities create or expand diversity programs to address gender, ethnicity, and sexual orientation gaps. Higher medical education has a particular interest in recruiting underrepresented minorities (URMs). This effort is more complex than I can cover in this space. Centuries of racial oppression are hard to […]
Post-it beads Phenobarbital for alcohol withdrawal symptoms Lin, Michelle MD doi: 10.1097/01.EEM.0000824164.73418.8a Metric Figure: alcohol withdrawal, phenobarbital, best practices Figure Does your patient have more than a mild case of alcohol withdrawal symptoms? Consider giving IV phenobarbital as a first-line agent instead of a benzodiazepine. The initial dose is usually 130 to 260 […]
Figure: buprenorphine, opioid withdrawal, substance use disorder BY EMEDHOME.COM Buprenorphine-precipitated opioid withdrawal is seen in physically opioid-dependent patients who have recently taken full agonist opioids and are subsequently receiving buprenorphine. (J Addict Med. 2021 Nov 16. doi:10.1097/ADM.0000000000000929.) Withdrawal intensity can range from mild to life-threatening. (J Addict Med. 2021 Nov 16. doi:10.1097/ADM.0000000000000929; Cardiovascular toxicol. […]
Editor: What about the sensational stories on the front page of the January issue? While I agree with the spirit that EPs that spread misinformation should lose board certification, who gets to decide? This year’s misinformation could be next year’s standard of care. Should doctors who were against solumedrol for spinal cord injury (heresy […]
Figure: cardiology, ECG Figure Doctors were called to a private residence by the family of a woman in her 80s with ESRD, hypertension and diabetes who could not be fully awakened from a nap. Her husband said it was like the lights were on, but no one was home. She had missed dialysis the […]
Figure: AAEM, Envision, company medicine When Placentia-Linda Hospital, a Tenet-owned facility in Placentia, California, awarded a contract to manage and staff its emergency department to Glass Beach Medical Services, a company controlled by Envision Physician Services , Placentia Linda Emergency Physicians (PLEP) and the American Academy of Emergency Medicine Physicians Group, Inc., (AAEM-PG), which provided […]
Figure: COVID-19, pandemic outbreak Figure It’s Christmas Day. I sent my fiancé Matt to work with Bojangles fried chicken and chocolate cake, but our brief afternoon phone conversation made it clear that none of his ER workers will have time to eat it. “Sandy, people are coming in carloads. I just had a family of […]
Figure: COVID-19, equity in emerging markets, health disparities Figure We have seen an unprecedented increase in demand for emergency services throughout the pandemic. Many emergency departments receive patients who otherwise (pre-pandemic) would never have entered the medical system. This interaction between constants (staff, space, resources) and variables (volume of patients, patient acuity, seasonality) changes daily. […]
Figure: ultrasound, right eye pain, laceration, asteroid hyalosis Figure A 55-year-old man complained of pain in his right eye. He reported that the pain started after he hit his head against a door. He noted floaters in that eye, but said they had been there for several years. He had a history of […]
Figure: public health, armed violence, violence prevention Figure Americans come together in grief over every gun tragedy and senseless loss of life. We share our astonishment that the people closest to the attacker did not recognize the warning signs and appropriate precautions were not taken when strong risk factors are identified from dangerous people with […]
Figure: nursing, understaffed, EM workforce The shortage of nurses in the emergency department has been a beleaguered issue for years in which the staffing grid has never quite matched the help in the field due to calls, mentorship, management or of a handful of other shell game explanations that makes an ED feel fully staffed […]