It is a busy Friday evening in the emergency department when you get called to the resuscitation bay for a 14-year-old female who was the restrained back seat passenger in a rollover motor vehicle crash. After a thorough initial inspection you find that the patient has a large laceration to the lateral side of her left ankle, and swelling that suggests either a fracture or a severe sprain or dislocation.

I believe that every physician, nurse, PA, NP, tech and clerk who works in an ED should periodically have an organ removed. We have lots of organs that will only get us into trouble, so let’s remove them before that happens. Hey, we don’t need that appendix or gall bladder, and the ladies can get rid of that bothersome uterus once they hit the menopause.

When the Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010, the year 2014 seemed a long way off. Now that we are on the down side of 2013, the “big” changes of the ACA are fast approaching. Some are good, some are bad, and some are just plain ugly.

altThis month EPM asked 17,003 emergency physicians how they felt about tPA and stroke.
1,333 physicians (7.8%) responded. Here’s what you told us:

altThe jury is still out among EPs as to whether tPA helps more than it hurts, yet ACEP has forged ahead with clinical guidelines which seem to ignore controversial findings. 

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 June edition of Emergency Physicians Monthly. Questions about the test? Talk back on Twitter @epmonthly.

In this age of budget cuts and health care reform it is becoming increasingly important for each medical specialty to prove its value, and back those assertions up with real data. It is not uncommon in these discussions for emergency medicine to come under attack as cost-cutting policies hone in on reducing ED visits for non-urgent care.

altIn her inaugural issue, we take a few minutes to learn a little bit about what makes this textbook author and world-renowned educator tick.

In 2001, Bernard et al published a piece in the New England Journal of Medicine that changed the way physicians treated severe sepsis. PROWESS asked whether, among patients with severe sepsis, activated protein C might improve survival. The study was so successful, according to researchers, that it was halted early.

altA 31-year-old male was brought in by ambulance after attempting to hang himself. He was found hanging from a tow rope in the back yard by his brother who immediately cut him down. He was unconscious when he was cut down and had been hanging for an unknown amount of time.

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