Although the technology is fascinating, caution must be exercised when
applying coronary computed tomography angiography (CCTA) to emergency
department chest pain patients. The only way this diagnostic modality
will help us, and our patients, is if it guides us with risk
stratification, showing a clear path to discharge for patients we
currently don’t know what to do with.
Should antibiotics be used in conjunction with incision and drainage of a
simple abscess? Recent studies suggest not, yet they leave room for
physician discretion at the bedside.
The College’s new policy lacks a comprehensive perspective and too readily discourages the use of opioids. The dearth of valid evidence should lead EPs to a balanced approach on pain, rather than a restrictive one.
Last month, Dr. Kevin Klauer suggested that emergency physicians “unbundle the sepsis bundle.”
This month, Dr. Emanuel Rivers offers his rebuttal, explaining why EGDT greatly improves sepsis outcomes.
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