For the third time this week Ms. A, a 49 year old with a history of alcohol dependence and untreated bipolar disorder presents to your emergency department (ED) for suicidal ideations. Of course it is Friday night, or rather, Saturday morning, your department is over capacity and Ms. A is being uncooperative with both the triage nurse and the security staff attempting to maintain order.

altDecompression Sickness (DCS) is a condition caused by the change in absorbed gas volume upon depressurization that releases gas bubbles into tissue and vasculature (1). This process can occur in divers who quickly arise from depth or who perform repetitive dives. The most common presentation of DCS in shallow dives is referred to as DCS Type 1 and is characterized by localized deep joint pain.

An entitlement culture is one which says, “you owe me” because of who I am or what status group I belong to. While some have argued that such a mentality has been on display in the Occupy Wall Street movement – young people believing that they are “owed” a job because a small percentage of the population earns a lot of money – they are certainly not alone.

Why should we care about benchmarks? They are a way to be proactive in evaluating and improving your practice before you get criticized, fired, or have your compensation reduced.

Rolling in like a Trojan horse, CMS is proclaiming that its new ramped up benchmarking efforts are primarily motivated by efforts to improve quality. In reality, they are really focused on cost-reduction.

altAs part of EPM’s commitment to encouraging emergency physicians to become more effective advocates for our patients and our specialty, we’ll be running a series of interviews with the emergency physicians who will be candidates for congressional office in 2012.

altSenator John Barrasso was “Doctor” Barrasso, an orthopedic surgeon from Casper, Wyoming, long before he came to Washington. So, after the passage of broadsweeping healthcare reform, it came very naturally for him to offer a physician’s perspective on the floor of the Senate. Since then, he’s given these “second opinions” about the unintended consequences of healthcare reform nearly every week.

altMedGadget.com presents the top 10 smartphone applications that can save a patient’s life … before they get to the emergency department.

A physician recently emailed me with a question (paraphrasing): “Our lab recently switched over to using the new highly sensitive troponins’ and we’re confused. What do we do with a positive troponin?”

Next November, when Americans enter the polling booths, there will be five emergency physicians who are either seeking re-election or running for a seat in the US House of Representatives.

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