24 year old male presents with laceration to the right elbow after
rollover MVC. He has stable vital signs and no other injuries. Plain
films reveal no fracture or dislocation and no foreign bodies. He has
full ROM and is neurovascularly intact. Your intern suggests local
infiltration of Lidocaine for analgesia, copious irrigation and primary
Did you know that the macrolide group of antibiotics (erythromycin and
all its cousins) could kill you? Drop dead – sudden death. Well there is
a growing body of literature saying just that.
“I am not sure that any research should be performed in emergency
department settings, and I suspect that many grant review study sections
feel the same way. Patients come to the ED with an acute problem and
they need clinical care, not research protocols and consent forms.”
On March 22, the U.S. House of Representatives passed HR-5 – the
Protecting Access to Healthcare Act – by a vote of 234-173. The Act,
which went strongly down the party line (only 11 democrats voted for the
bill) had broad support from ACEP as well as the AMA and a range of
other medical organizations.
As an emergency medicine (EM) practice management consultant I”m
frequently asked “How can we determine what’s fair to pay for physician
administrative duties?” It’s an emotional subject in every group
because it involves the discussion of each member’s relative value to
the business enterprise side of the practice.
What practice-changing medical research have you come across on
Facebook? What amazing EM career opportunities did you discover on
LinkedIn? What enlightening medical conversations have you had on
Twitter? There’s a good chance the answers are none, none and none. When
it comes to meaningful physician-physician interaction, online social
networking has yet to really take off.
The laryngeal mask airway has revolutionized routine anesthesia and has
become the default rescue airway for difficult intubation and difficult
mask ventilation. The King LT and Combitube have advantages for
prehospital and tactical use, but they are not effective conduits for
Although we used to have any drug we needed at our fingertips
(regulatory interference notwithstanding) today we don’t. So, what has
changed? Have they run out of the rare “zine” compound that is needed to
make Compazine, or the “tron” in ondansetron? Hardly! We can only order
what the pharmaceutical companies are willing and able to produce.
Privacy advocates are pushing electronic record vendors to create a new class of “sequestered” health information, which could hide critical data from emergency physicians when they need it most.
Expansion of the Medicaid rolls under the Affordable Care Act has caused
more than one state to look at ways to cut healthcare spending. In
Washington State, the result has been a clash between physician groups
and state health agencies that could to be a sign of battles to come.