Building a team is one of the most important components of a medical director’s job, and it starts with finding the right people. Many factors come into play in this process, but in many ways it starts with timing.

Dr. Adam Levine, an assistant professor at Brown University Medical School, traveled to Libya with International Medical Corps (IMC) during August, just as rebels were beginning to overthrow the Gaddafi regime. The following are excerpts from his travel blog, which first appeared on www.epijournal.com .

Pain is the most common symptom prompting one to seek emergency care. Over the past two decades numerous studies have addressed the inadequacy of pain management provided by the medical community. In 2005, approximately 10 million Americans were being treated on long term opioid therapy for non cancer related pain.

I’m a believer that if an adult patient presents to the ED with chest pain, unless you are very, very positive the diagnosis is not cardiac, you owe it to the patient to pursue a cardiac work-up. Sounds pretty straight forward to me – but many would disagree.

Are you ready for an acute inflammatory mediator for sepsis that is consistent and works just as we’d expect it to? Well, it’s here: procalcitonin. Or is it? It can certainly claim that it works just as well as former acute phase reactants and inflammatory mediators. But these predecessors all suffer from a similar, critical problem - they are somewhat sensitive but not very specific. 

The first 24 hours for a patient with early signs of sepsis are critical. The first hour after this patient arrives in the emergency department is equivalent to the “golden” hour of trauma. The initial evaluation, with particular emphasis on the laboratory findings are vital in the effective management of a septic patient. 

“Set phasers to full body scan!” Radar gun technology similar to that used by police to catch speeding cars may someday be used to monitor vital signs in your emergency department.

A Swedish EP on an observership in New York City reflects on the differences in care between the two developed nations.

More than just intubation, a short fiberoptic scope can check for edema, infection, burns, or foreign bodies. And single use and sheathed scopes are bringing the usefulness of this technology back into the ED.

On January 28, 2011, 28-year-old single mom Courtney Capps brought her 5-year-old child to the emergency department at Huguley Medical Center in Burleson, TX for evaluation of paronychia. According to Ms. Capps, the emergency physician asked about the child’s race, and, when told that the child was bi-racial, grunted, then asked, “What does your family think about that?”

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