The FDA-approved drug dabigatran is being marketed as a safe alternative
to Coumadin. But without a proven reversal agent available, it has the
potential to create a new set of complications, and send unsuspecting
patients right back to the ED.
I didn’t know what to expect. I was excited, curious, but also somewhat
apprehensive about being a woman in Saudi Arabia. The reason for my
visit was the ‘2nd Up to Date Emergency Medicine Practice’ conference,
sponsored by the King Fahad Medical City in Riyadh.
The emergency department (ED) is not an ideal place for patients with
depression to seek help. Waiting times, busy staff, and a greater
likelihood of a fleeting interaction with a physician coincide with the
reality that many emergency physicians do not receive training for
In a recent emergency medicine listserv exchange several posters
commented on the widespread abuse of emergency physicians made possible
by their lack of due process “rights.” Perfectly innocent emergency
physicians, nay even model citizens it was alleged, had been terminated
on the spot purely on the whim of some grumpy hospital administrator
with not a word of protest from the contract management group.
Abdominal pain is one of the most frequent complaints that present to
the emergency department. With every physical examination of the abdomen
we note if there is pain in the right lower quadrant (RLQ) over that
most famous of landmarks, McBurney’s point.
At the ACEP Scientific Assembly this year, I spoke to a group of
physician assistants and advanced practice nurses. I gained many
insights into the uniqueness of their role and their place in Emergency
Medicine. The first thing I learned was that terminology is evolving as
their training and scope of practice is evolving.
In 2010, Rep. Joe Heck became the first emergency physician (and first
osteopathic physician) elected to the US Congress. In addition to his
emergency physician skills, Rep. Heck brought to Washington a unique
skill set developed through years of military and specialized medical
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.
Decompression 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.