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