If that coughing and wheezing febrile premee is a boy he is at greater risk for a bad outcome due to his prenatal testosterone causing a delay in his lung maturity. If the patient with afib is a woman, she is at higher risk to stroke out and her stroke is more likely to be hemorrhagic. In addition, she is at a greater risk for developing both a prolonged Qtc from certain anti-arrhythmics, and for digoxin toxicity plus she will require smaller amounts of warfarin to become therapeutic.

altEP Monthly has highlighted the issue of practice heterogeneity over the last four years, but the universe of emergency medicine has largerly resisted efforts to admit and address this problem. Why? Do we not believe it to be true? Do we assume that it is unavoidable?

altAs the director of a single-coverage community ED with about 22,000 visits a year and about 20% admissions, I’ve been fortunate to be left alone by the administration. The nursing director and I – along with a team of scribes, advance practice clinicians and staff, have largely been free to do whatever we could to improve throughput in the ED.

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

Oils on the black pavement are freshly released as the cool rain drizzles upon it. Typical morning rush hour traffic as drivers vie for position. She slams on her brakes to avoid a passing car. At 55 mph, her sedan spins out of control. Miraculously avoiding other vehicles, the sedan comes to a stop by sideswiping the median. The driver, Mary S., unbuckles her restraints and runs from the vehicle. One case presentation. Two distinct courses of action. You judge which is right.

altDr. Wayne Barry had a heart attack this year and was forced to leave the practice of emergency medicine. A few months later he had retooled his trajectory and was enjoying life more than he ever could have imagined.

altA series about the cold, hard numbers behind some of our most common ED practices
Does it help to use prophylactic antibiotics during management of gastrointestinal bleeding in cirrhotic patients? 

altThere is still a marked disparity between the number of women in emergency medicine and the percentage of female leaders. This is damaging both to female physicians and to the specialty as a whole.

altLast month, New York City mayor Michael Bloomberg cut the proverbial ribbon on a plan aimed at combatting opioid prescription drug abuse in the big apple. The guidelines, which will be rolled out in all 11 of the City’s public hospitals, state that the emergency departments will not prescribe long-acting opioid painkillers; can only prescribe up to a three-day supply of opioids

When people learn I work in the emergency department they usually ask, “How do you do it?” Or they say, “Wow, I bet you see a lot of crazy things.” My answer aloud: “It’s never dull.” My answer in my head: “You have no idea.”

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