Are you in the 700 club? Most emergency physicians are. If
you trained in emergency medicine you learned that the work-up of a
potentially dangerous headache isn’t finished until the CSF is back. In
this month’s SMART EM (www.smartem.org) we flesh out our educational
session from ACEP 2012, a talk which asked how many LPs it takes to find
one aneurysmal subarachnoid hemorrhage—and what the fallout is.
Hurricane Sandy may have had an androgynous name, but there was nothing
ambiguous about the impact this “superstorm” had on New York City, where
I live and work. As I pen this article 10 days after the storm, it is
shocking to realized that Beth Israel, where I work as an emergency
physician, still isn’t back to normal.
Big pharma is paying the price for pushing off-label applications and putting inappropriate pressure on medical education, but is it too little too late? Industry influence runs deeper than you might imagine.
A 39-year-old-male presented to the emergency department with a chief
complaint of one day of left-sided facial swelling and weakness. He
denied facial pain, rash, vision changes, fever or chills. He had
recently returned from a trip to the mountains but denied any
A 40-year-old man is brought in by ambulance after sustaining a single
stab wound to the left lower abdomen. The patient is asymptomatic with
stable vitals, a negative FAST exam, no obvious evisceration and no
clinical evidence of peritonitis on exam. On local wound exploration
with the trauma surgery team, the wound violates the peritoneum.
Last January, emergency medicine icon Raed Arafat resigned from his post
in the Romanian Ministry of Health, sparking unprecedented public
protests in defense of Romania’s emergency care system.
Health Care Providers (HCPs) are trained to recognize victims of elder
abuse, child abuse and general domestic violence. When it comes to
identifying victims of sex trafficking, however – an area where clues
can be very subtle – there is a marked lack of practical education. A
study by Barrows and Finger in 2008 demonstrated that only 13% of HCPs
felt confident they could identify a trafficked victim, and only 3% of
medical personnel had received any training on identifying victims.
No mistakes! That’s the mantra these days for medical care in the United
States. Another term for reducing error rates to near zero is “Six
Sigma” a business strategy developed by Motorola back in the ‘80s, and
popularized by Jack Welch at General Electric in the mid-‘90s. Six Sigma
is about removing the causes for errors by minimizing the variation in
how specific tasks get done.
Jesse Pines sits down with executive editor Mark Plaster to discuss upcoming books, goals concerning publication, myths, examples of admission decisions, urgent matters, Affordable Care Act and lowering healthcare costs.
Dave Packo sits down with Greg Henry to discuss controversy of staffing, issue of funding, staff roles moving on, residency training and the future of contraction medicare.