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Bypass the OR: ECMO in the ED

Dr. Zach Shinar: If you can put in a central line or a dialysis catheter, you can place a patient on ECMO

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Second Gen. Laryngeal Mask Airway (LMA): Is It Time For You to Upgrade?

The laryngeal mask airway has revolutionized routine anesthesia and has become the default rescue airway for difficult intubation and difficult mask ventilation.

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Films and Scans: Foot Injury

She relates that she tripped and slid down about three wooden steps and now complains of severe pain in the right midfoot with inability to bear weight. You notice slight swelling and ecchymosis of the dorsal midfoot as well.

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40-Year-Old Female With Severe “Gas Pains”

What part of the body is each image from, and what does it show? Is your suspicion supported? What should be your next move, and what other test results do you need to wait for before proceeding?

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Under Pressure

An assault to the face leaves your patient in need of an emergency lateral canthotomy to relieve the pressure and preserve vision. Here is a step-by-step pictorial guide, in case ophthalmology isn’t immediately available.

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Decisions, Decisions

In a democratic emergency medicine group, there are many ways to arrive at decisions, from command-and-control to consensus-building. What works best will depend on the character of your group, and what you hope to achieve.

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Dr. John McGoff: Former Coroner Seeks Open Seat as Indiana Rep.

Dr. L. Anthony Cirillo talks to Dr. John McGoff about the top issues to face the nation in the coming years.

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White Coat's Call Room
Two interesting studies were published recently. First was a study in NEJM showing that the beloved ZeePack that so many people think will clear their boogers and resolve their cough instead increases the risk of death. During the 5 days that they took... Read more
 
White Coat's Call Room
Very poignant story about how a daughter is dealing with the health problems of her elderly father. Not Watching My Goldfish Die. Read it. Gatorade and Powerade are going to hate this study. Bananas are just as good as energy drinks as a source of ener... Read more
 
White Coat's Call Room
So I happened to be looking through my blog stats to see which posts are most interesting to you all lately. One of the stats on the blog is search terms that cause people to end up on my blog. Some of them are amusing, such as "How do I disimpact myse... Read more
 
Current Features

altDid you know that the macrolide group of antibiotics (erythromycin and all its cousins) could kill you? Drop dead – sudden death. Well there is a growing body of literature saying just that.

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White Coat's Call Room
I decided to stop posting Healthcare Updates every Monday. For one, if I get overwhelmed on a Monday (like what has happened a couple of times in the past month) and can't get everything out into a post, then it doesn't get published. Plus, there's a dela... Read more
 
White Coat's Call Room
Going green may make you feel blue. Reusable grocery bag cited as cause for norovirus outbreak. Member of girls soccer team became sick in bathroom where bag was sitting, later passed bag around to other players who ate cookies contained in the bag. The f... Read more
 
White Coat's Call Room
Two days later than I planned on posting. First of all, you all crack me up about the unemployment post. You can't imagine all the e-mails I got about this. I'm not going anywhere. But it is nice to know that my ramblings are modestly interesting to mo... Read more
 
Current Features

“I am not sure that any research should be performed in emergency department settings, and I suspect that many grant review study sections feel the same way. Patients come to the ED with an acute problem and they need clinical care, not research protocols and consent forms.”

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Night Shift

altOne of the primary expectations from the passage of the Affordable Care Act was that fewer people would go to the nation’s emergency departments rather than their primary physicians, thereby reducing the overall cost of health care.

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EM:RAP

altWe just finished a two-part series with one of our former Chief Residents, Dr. Zachary Shinar. Zach has been working in San Diego at Sharp Memorial Hospital and more recently at UC San Diego. What he has been up to down there is nothing short of incredible.

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Current Features

altOn March 22, the U.S. House of Representatives passed HR-5 – the Protecting Access to Healthcare Act – by a vote of 234-173. The Act, which went strongly down the party line (only 11 democrats voted for the bill) had broad support from ACEP as well as the AMA and a range of other medical organizations.

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Management

Dear Director,
Our physician assistants are fantastic and have functioned independently for a long time, but recently we had a bad outcome and now the hospital wants us to supervise all PA cases. This seems like a waste of time and it will slow down our docs. What do we do?

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