Mr. B presented to the ED acutely septic, likely secondary to an underlying pneumonia. He had advanced dementia and was functionally and cognitively declining at home. His recent life had been punctuated by trips back and forth to the hospital

In the name of high quality, cost-conscious care, ACEP has revised its stance on the Choosing Wisely campaign, voting to join the initiative in the fight against low value care.

altEmergency medicine education is an evolving art. As educators and learners, emergency physicians are quick to integrate new technologies into our educational armamentarium. It’s now the norm to glean pearls from podcasters while running on the treadmill, keep up with EM conference lectures via tweets, and use a variety of handheld apps to improve bedside care.

altDrug shortages are an all-too-common problem in the United States. Emergency physicians are more aware of the severity of the issue than most, as we use such a wide variety of medications. While the causes of drug shortages are multi-faceted, there is one contributing factor that’s been flying under the radar: “pay for delay.”

altA recent Time Magazine cover article is the latest in a series of eye-opening reports about runaway hospital charges. Here we break down some of the critical numbers to know.

altLast month marked the end of India’s Kumbh Mela, a Hindu festival billed as the world’s largest human gathering. Over the course of the 55-day festival, as many as 100 million ascetics and pilgrims traveled by train, car and foot to perform a bathing ritual in the Ganges river in the city of Allahabad. Some came for a single dip while others settled for weeks, inhabiting a temporary tent camp that is arguably the largest pop-up mega city ever erected.

In writing about medical errors, health policy researcher Robert Wears, MD, breaks down a common problem in how we view mistakes in general. We often choose to view the error or mistake a person makes as a linear process and assign blame to that individual, but it’s rarely that simple. A medical error (or any mistake for that matter)  is usually the result of a confluence of many different occurrences. The error or mistake is not the cause, but the result.

titleThe elegantly (and deliciously) simple Mediterranean diet is among the most life-saving post-MI interventions. Look beyond statins and bring on the olive oil!

altThe debate surrounding the use of etomidate in sepsis has been going on since the 1980s and continues to plague contemporary literature. Those muddy waters were recently stirred when a meta-analysis in Critical Care Medicine concluded higher rates of adrenal insufficiency and increased mortality associated with its use1. This is not the first meta-analysis to have made such a claim2. We could spend our time debating the statistical merits of a meta-analysis, but we’d be missing the forest for the trees.

altThose concerned about the use of etomidate in septic patients seem to focus on two primary issues. First, that etomidate results in adrenocortical suppression. Second, that suppression is associated with increased mortality.

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