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New: Push Me(ds), Pull Me: Emergency Medicine News

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 […]

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Goddess of emergencies: bailing out the COVID-19 tidal wave : Emergency Medicine News

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 […]

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Diversity matters: How to address health disparities… : Emergency medicine news

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. […]

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Standing AFFIRM: Placing the “public” in public health : Emergency Medicine News

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 […]

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POV: Titanic sinks without nurses : Emergency Medicine News

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 […]

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Viewpoint: Government can do better with COVID-19 : Emergency Medicine News

Figure: public health policy, COVID-19, government I often ruminate on the first patient I lost to COVID-19. What was different about her, besides being young and pregnant, was that she was my first. We knew so little in the spring of 2020 and we had so few tools to fight the virus. These losses sometimes […]

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Diversity matters: Exposing the blind spots of equity with ethnic identity… : Emergency Medicine News

Figure: Social MI, health equity, ethnic identifiers, DEI, diversity Figure A concrete step towards health equity is the active and accurate collection of ethnic identifiers. This has been a controversial subject for years. One school of thought believes ethnicity information has no place in medical records, while another suggests added value. A health equity stance […]

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NUMBERS: Opportunity cost as a proxy for empowerment : Protec… : Emergency Medicine News

Figure: opportunity cost, employee power, BATNA Figure I used a computerized survey of nearly 500 emergency physicians in my last two articles (http://bit.ly/EMN-numbERs) to examine general opportunity costs – the cost of pursuing one option versus your next best alternative – and related them to pursuing an education in the stock market. But what about […]

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ER Goddess: My Stupid Heart Belongs to Medicine : Emergency Medicine News

Figure: EP life, first person, narrative medicine Figure I’ve been writing this column since 2015. I’ve poured out my frustrations and revelations related to our crazy specialty in an article every month for over six years. This month, as I sit down to write my 75th article for REM, I’m having a little trouble finding […]

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POV: Overworked nurses need relief : Emergency Medicine News

Figure: nursing, EM workforce, nurse-patient ratio Nurses are the primary patient-facing members of most healthcare organizations and often the first point of contact for many people seeking medical care. They initiate screening exams, draw blood, administer medications, provide education and counseling, and are often the customer service side of any facility. My hospital once ran […]

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Diversity Matters: Simulation Cases Exploring Racial Equity… : Emergency Medicine News

Figure: simulation, racial equity, social MI Figure Simulation has become an educational reference in emergency medicine. The beauty of this is that EPs benefit from the full Danger Room experience, an unbridled opportunity to practice critical skill sets in a low-impact environment. EPs can gain confidence through repetition and bouts of constructive feedback for everything […]

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Diversity Matters: A Simulation Case Exploring Racial Equity …: Emergency Medicine News

Figure: simulation, racial equity, social EM Figure Simulation has become an educational gold standard in emergency medicine. The beauty of it is that EPs get the full Danger Room experience, an unbridled opportunity to rehearse critical skill sets in a low impact environment. PEs can gain confidence through repetition and episodes of constructive commentary for […]

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What’s Below: An Ode To Droperidol: Emergency Medicine News

Figure: droperidol, sedation Figure Few drugs blackmail me like droperidol. It is a superb and unmatched tool in our pharmaceutical hangar. It’s a sophisticated instrument, a targeted dart, a brilliant medicine to take control of a patient with agitated delirium. The sedation of very excited and dangerous patients is always heavy. As a procedure, it […]

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News: EP blocked when insurer goes bankrupt: Emergency Medicine News

Figure: malpractice insurance, bankruptcy Connecticut emergency physician Eric Salk, MD, MPH, received a distressing notification in March 2021. The Emergency Physicians Insurance Exchange Risk Retention Group (EPIX RRG) had been placed in rehab in Vermont where he was domiciled. (https://epixrrg.com.) The 60-year-old emergency physician, who served as medical director and president of his emergency department […]

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Quick consultation: Symptoms: Confusion and urinary retention: Emergency medicine news

Figure: urinary retention, diagnosis, AUS Figure Figure Figure A 53-year-old man presented to the emergency department with major complaints of progressive weakness and confusion. He had a medical history of prostate cancer and a radiation prostatectomy complicated by post-prostatectomy incontinence that resulted in the insertion of an artificial urethral sphincter (AUUS). The patient had to […]

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What About This ?: Could Regeneron Therapy Be Beneficial Amid …: Emergency Medicine News

Figure: Regeneron, COVID-19, therapeutic Figure I recently decided to look at the evidence for monoclonal antibodies to treat COVID-19, in part because I provide medical surveillance to EMS companies that have started infusing them at home, and immediately a video surfaced. “Hello, maybe you recognize me. He’s your favorite president, ”said Donald Trump, standing in […]

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Brandt’s Rants: Doctor: Be careful what you document …: Emergency Medicine News

Figure: communication, dictation, humor in EM Figure Communication is essential in the emergency department, not only when speaking to our colleagues and patients, but also in writing. Our documentation should clearly show what we have done and what our thought process has been. The notes must convey our reasoning and our reason for being. We’ve […]

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NUMBERS: Are the scholarships worth it? Not really: the news of emergency medicine

Figure: EM grants, opportunity costs, jobs Figure Opportunity costs and incentives affect our decisions and their outcomes for a career in emergency medicine. As I wrote in October, there are many great entities shaping the fate of emergency medicine, all of which have vast repositories of valuable data. Making the right data public to all […]

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Toxicology Rounds: The Truth About High-Dose Insulin : Emergency Medicine News

Figure: high dose insulin, calcium channel blocker poisoning, amlodipine Figure The causative agent when our poison control center is consulted for cases of calcium channel blocker poisoning (CHB) is almost always amlodipine. Quite often the clinical team will be looking for high dose insulin (HDI) as they call us. After all, HDI is often considered […]

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Same shift, different day : High-intensity interval medicine… : Emergency medicine news

well-being, burnout: Dr. Harmon and his friend Atlas’ dog on the Pismo Dunes. Figure About 10 years ago, my wife and I followed our daughters’ high school football team to the Pismo Dunes. They were going to run in the sand to condition themselves. Afterwards, we decided we could go there periodically to run a […]

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Words of Healing: Drivers of the COVID-19 Story : Emergency Medicine News

Figure: COVID-19, medical crisis, pandemic Figure But it is, when not duly considered against, an almost irresistible tendency of the human mind to become a slave to its own assumptions; and when he has once become accustomed to reasoning, feeling, and conceiving, under certain arbitrary conditions, he ends by confusing these conditions with the laws […]

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News: Food as Medicine: Nutrition Prescriptions in the ED : Emergency Medicine News

Figure: lifestyle medicine, nutrition, diet Figure Adding the principles of lifestyle medicine to a busy emergency department is daunting. I always find it difficult to decide when to talk about it and who will be interested in listening. I finally learned to use the same approach that I take with my patients with substance use […]

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Standing AFFIRM: Compassion Matters, Now More Than Ever : Emergency Medicine News

Figure: gunshot wound, compassion, violence prevention Figure Figure AFFIRM’s firearm injury reduction mission at the Aspen Institute is rooted in compassion for others, not only for victims of firearm injuries, but also for those at risk of becoming its victims. authors. One of AFFIRM’s explicit goals is to employ evidence-based practices, and we think this […]

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Diversity matters: Social determinants of health are in EPs… : Emergency Medicine News

Figure: social determinants of health, social justice, equality in SE Figure The role of an emergency physician has evolved significantly over the past 30 years, partly due to patient demand, but also to changing patient needs. Our day-to-day responsibilities as outward-looking suppliers have also become more sophisticated. We interact with diverse patients and family members […]

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POV: Just wear a mask! : Emergency medicine news

Figure: COVID-19, mask I have always admired the patients I see who are in the military because they are, without exception, respectful and obedient. They are people with a unique background. They understand that the mission is bigger than them. They understand that a call to protect and serve Americans abides by a different set […]

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Viewpoint: Tackling the mental health pandemic requires society… : Emergency Medicine News

Figure: mental health, COVID-19, quarantine Many publications, including Psychiatric time and American scientist, have published articles over the past year about the mental health pandemic accompanying the COVID-19 pandemic. This terminology got me thinking. I wondered if there really was a mental health pandemic or if people rightly felt more overwhelmed by an international public […]

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Viewpoint: The Rise and Fall of Emergency Medicine : Emergency Medicine News

Figure: EM history, ED management, EM jobs Doctors had few useful treatments centuries ago. They could do a few things, but most importantly they understood the path of illness, predicted the outcome of a problem, and summoned friendly spirits, such as leeches, and sometimes a herbal remedy to help those in pain. A doctor couldn’t […]

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News : CONS: HINTS exam not ready for prime time : Emergency Medicine News

Figure: TIPS, vertigo Figure The HINTS exam, first reported in 2009, has been touted as a tool that can help us identify patients with central vertigo without the need for advanced imaging. (Stroke. 2009;40[11]:3504; https://bit.ly/3jGxQc2.) The results of this study seemed promising at first glance, but closer examination revealed concerns about the applicability of this […]

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Emergentology: Depersonalization, Emotional Exhaustion, Burning…: Emergency medicine news

Figure: EP life, mental health, well-being Figure About 20 minutes into my shift, I struggled to find a place to sit and place orders. Or even stand up and place orders. The emergency room was crowded. The hospital upstairs was completely full. PE colleagues stayed after their shifts ended, recording and summarizing, disconnecting and arranging […]

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POV: Give me regular procedure, not bottled water : Emergency Medicine News

Figure: contract management, ACEP I first heard of the American College of Emergency Physicians as an emergency medicine resident nearly 30 years ago. The organization has been and still is extremely helpful in establishing emergency medicine as a specialty, providing policies and guidelines to improve and standardize the way it is practiced. I also enjoyed […]

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Emergentology: Goodbye for now : Emergency Medicine News

Figure: EP life, COVID-19, burnout Figure I’m eight days late writing this column. I don’t have much to say at the moment. (Strike that out. I have a lot to say, ask my colleagues.) But none of this is more productive. I’ve been writing this column for 10 years, if you can believe it. […]

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ER Goddess: The Trauma Emperor Has No Clothes : Emergency Medicine News

Figure: trauma centers, for-profit hospitals, reimbursement Figure It’s 6:45 a.m. You click frantically to complete a patient’s discharge paperwork while you wait for the hospitalist to call you back so you can admit another. You’ve been too busy to check if your other four patients’ scans and labs are back. There’s no way you’ll be […]

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Stand up AFFIRM: Enough already! Ending Workplace Violence: Emergency Medicine News

EP safety, workplace violence, emergency management: Chris Coyne, MD, who consented to the publication of this photo, was assaulted by a patient. Figure Every act of violence against an emergency health care provider is a sentinel event, and it deserves the same robust response that hospitals apply to other negative health outcomes, such as patient […]

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Brandt’s Rants: Why I moved to New Zealand : Emergency Medicine News

EP life, global EM, health care: Nugget Point on the Catlins Coast in New Zealand. Figure The year was 2020 and I was working in my busy Michigan emergency department with great staff. I felt some frustration, however; health care was after me. I have had patients with constricting chest pain leave the AMA […]