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In My Opinion

Two years ago I called into question the use of the sepsis bundle of therapies defined by the “Surviving Sepsis” campaign (EPM, March 2010) Although aggressively managing sepsis is a good thing, and the mere focus on the rapid identification and application of appropriate management strategies for sepsis is essential to good patient outcomes, it appears that EGDT and the research it was based on may have promised more than it could deliver.

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altDespite popular belief and common practice, due process for EPs is a right, not merely a privilege. Dr. Larry Weiss offers a counterpoint to “Due Process in Due Time,” from EPM’s February issue.

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altYou rarely hear of problems with the old standby, TMP-SMZ, but there is a growing body of literature suggesting that physicians need to be wary of the drug’s potentially serious side effects.

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A study published in last month’s Archives of Internal Medicine has reignited the patient sat survey debate, correlating high patient satisfaction with several negative indicators, including higher patient death rates.

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altThe cost of running a high-quality CME event has gone up, but physicians aren’t willing to cover the tab. That tension has put the squeeze on medical education, bringing into focus the role of industry in the future of CME.

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With a wave of new articles published every day, how is an emergency physician to know how to keep up to date? One EP’s fight against biased literature reviews, followed by an admittedly-biased endorsement

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Emergency physicians need to lead the charge on halting unnecessary urinary catheterizations, for the sake of patient safety and the bottom line.

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altThe trend of voluminous, exhaustive discharge instructions puts the pressure on patients to understand and identify complex risk factors, like infection. According to the research, this is probably a bad idea.

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One of the trickiest diagnoses in emergency medicine is pulmonary embolism. The problem is not a lack of information; the amount of literature on this topic is truly staggering. The problem with making the PE diagnosis is that ordering the definitive test, a CT pulmonary angiogram, is a big deal.

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It gets a little tiring, and certainly frustrating, to be on the receiving end of recurring mandates from “the experts” regarding the care provide by physicians and nurses. It seems that CMS and its watch dog, the Joint Commission (JC), relish adding more and more requirements onto healthcare staff because, obviously, we just don’t seem to understand the importance of initiating these behaviors on our own.

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