commentThe use of lytics in stroke is perhaps the most controversial therapy in emergency medicine; too many EPs have evaluated the data, starting with the NINDS trial in 1995, to recent trials like IST-3, and decided that tPA is not worth the risk.

click-90If time is money, emergency medicine needs to take another look at electronic medical records which introduce inefficiencies into the medical system. A recent study brought this issue of ED efficiency – and its impact on revenue – into sharp focus. The study asks the question, “Just how long are physicians actually spending on the computer?”

binder-90Louis Binder: 1954-2014. The emergency medicine community recently lost a great physician, scientist and educator who made a lasting impact on our specialty. Louis S. Binder passed away on January 16, 3 months short of his 60th birthday.

In room 7 there is an 85-year-old puffing away on CPAP who was just discharged from the hospital two days ago and is back for worsening congestive heart failure (CHF). In room 8 there is an agitated advanced Alzheimer’s patient whose J-tube fell out at the nursing home. And in room 9 there is a cirrhotic, COPD hypotensive dialysis patient with pneumonia and a room air sat of 85%.

Jeremy-Brown-90Dr. Jeremy Brown, director of the new Office of Emergency Care Research, works to improve emergency medicine’s seat at the NIH research table   

Some people I know are very diplomatic and couch their opinions with soft words like “may,” “perhaps” or “could” in order to allow some wiggle room. Not David Newman. His recent column in the Huffington Post pulled no punches: “The News About Tamiflu: It Doesn’t Work.1”

research-90This Fall, a cover of The Economist boldly asserted that scientific research is all but broken. Their main assertions – that negative findings go underreported, study replication is rare, and dubious findings go unchallenged – are significant and damning.

You might assume there are only so many ways to teach the coagulation cascade or the brachial plexus. But if you think today’s medical students are learning the way you did, you need schooling. Sitting in a crowded lecture hall to hear a professor and scribble notes, then heading home or to the library to memorize the material, will soon seem as archaic as overhead projectors.

In November the AMA House of Delegates held its interim meeting in Washington DC. While the spread of resolutions debated was vast and varied, the greatest focus of energy and emotion surrounded the repeal of the SGR. Of course we’ve been here before. Like Charlie Brown optimistically hoping that this time Lucy will hold the football steady, we keep landing on our backs as Congress applies a Band Aid and pushes the “doc fix” back another year.

Emergency Physicians Monthly has teamed up with the board prep pros at Rosh Review to bring you a mini board review, so that you can test yourself on a regular basis and track your progress. The following is the test – and answers – from the January edition of Emergency Physicians Monthly. Questions about the test? Talk back on Twitter @epmonthly

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