The April 2013 Boston Marathon bombings brought the sobering reality of
domestic terrorism back to the United States. Yet amidst the carnage and
chaos that followed the explosions emerged a superb response by the
Boston EMS system and the emergency medicine community.
The routine use of contrast (both oral and IV, and certainly rectal) is
unnecessary for the majority of abdominal CT scans performed in the ED.
At least that is what the literature says over and over.
Merely utter the term “patient satisfaction” among most emergency
physicians and you’ll quickly see us retreat into a world of skepticism
and exasperation. The term has become symbolic of a never-ending battle
over flawed data and an inaccurate evaluation of our performance.
In room six sat a typical 78-year-old nursing home patient with the
history of a cough and low grade fever. She was pleasantly confused but
followed instructions; grey and wrinkled but otherwise she looked better
than most. Her vitals were normal. We found no fever at the time of
triage and she had received no antipyretics.
I occasionally enjoy intellectual jousting, especially with other airway
enthusiasts, and its fun to prognosticate about the future of our
practice. So let me give you my controversial take on the future of
airway management. As I see it, the future of oxygenation in emergency
airways is through the nose, not the mouth.
Are Tasers a safe alternative to lethal force, or are they dangerous weapons associated with dysrhythmia and sudden cardiac death? Everything you need to know to treat the taser victim in the ED.
Burning belly pain awakens Marcus at 2 AM. Having it multiple times
before, he’s tired of waking up and having to walk until it goes away.
‘No more,’ he declares, ‘I’m going to the ER to get some relief.’
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.
Emergency 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.