altThe department was packed and I was counting down the seconds until I would board a plane for the Ivory Coast. I snapped back out of my haze to realize that I had 18 patients on the board. It was a pretty good day, all in all, yet somehow after admitting and discharging scores of patients, the board was still overflowing.

The Detroit News and the Free Press reported that an emergency physician was stabbed in the neck by a patient at Lansing, MI, Sparrow Hospital near midnight May 4, 2012. Assaults on healthcare workers are becoming all too common.

You’re having a rough shift: The ED is out of metoclopramide and prochlorperazine, so you worry that you’ve been turning migraineurs into drug-seekers by treating them with promethazine and hydromorphone. You know that sodium bicarbonate is running low, so you hope that you don’t see a bad tricyclic overdose any time soon.

The Society for Academic Emergency Medicine’s Annual Meeting was held May 9-12, 2012 in Chicago, Illinois.  The Research Forum featured 746 Abstracts, and 37 Innovations in Emergency Medicine education presentations.  We selected the 10 we thought had the most potential to impact the practice of emergency physicians.

Part 1 in a series about the cold, hard numbers behind some of our most common ED practices

This is the third in a series of columns dealing with non-allergic, potentially serious reactions caused by antibiotics. In the column dealing with macrolides, the increased risk of sudden death was noted. Clearly, the absolute numbers of deaths associated with macrolides has to be small, but it makes sense to take this fact into consideration when prescribing these antibiotics to those prone to arrhythmias (such as patients with congestive heart failure).

If you are an emergency physician and you Google yourself, you’ll find a host of companies offering the world a chance to “rate” you as a doctor. On a scale of 1 to 5 stars, “How would you rate your overall experience?” asks eHealthScores. “Does the provider listen to you and answer your questions?” asks HealthGrades. The internet is replete with these sites, and now even mega-review sites like Yelp have gotten in the mix, stacking physician reviews right next to write-ups on bars and nightclubs.

While travelling along the interstate between who-knows-where and woebegone—a long way from any EMS services—you come across a rollover accident that has just occurred. For some reason you’re not carrying any medical equipment. (Why not?) One of the van’s former occupants is in respiratory distress from a chest injury and needs a chest tube. When you ask, a trucker who has also stopped says that he has some tubing in his truck. So, now you need a scalpel.

CASE STUDY: Clearing Athletes for Return to Play
New legislation in Pennsylvania has mandated greater scrutiny of student athletes who suffer on-field concussions. An interview with Dr. Michael Garfinkel

alt24 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 closure.

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