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.

altDid you know that the macrolide group of antibiotics (erythromycin and all its cousins) could kill you? Drop dead – sudden death. Well there is a growing body of literature saying just that.

“I am not sure that any research should be performed in emergency department settings, and I suspect that many grant review study sections feel the same way. Patients come to the ED with an acute problem and they need clinical care, not research protocols and consent forms.”

altOn March 22, the U.S. House of Representatives passed HR-5 – the Protecting Access to Healthcare Act – by a vote of 234-173. The Act, which went strongly down the party line (only 11 democrats voted for the bill) had broad support from ACEP as well as the AMA and a range of other medical organizations.

As an emergency medicine (EM) practice management consultant I”m frequently asked “How can we determine what’s fair to pay for physician administrative duties?”  It’s an emotional subject in every group because it involves the discussion of each member’s relative value to the business enterprise side of the practice.

altWhat practice-changing medical research have you come across on Facebook? What amazing EM career opportunities did you discover on LinkedIn? What enlightening medical conversations have you had on Twitter? There’s a good chance the answers are none, none and none. When it comes to meaningful physician-physician interaction, online social networking has yet to really take off.

altThe laryngeal mask airway has revolutionized routine anesthesia and has become the default rescue airway for difficult intubation and difficult mask ventilation. The King LT and Combitube have advantages for prehospital and tactical use, but they are not effective conduits for tracheal intubation.

Although we used to have any drug we needed at our fingertips (regulatory interference notwithstanding) today we don’t. So, what has changed? Have they run out of the rare “zine” compound that is needed to make Compazine, or the “tron” in ondansetron? Hardly! We can only order what the pharmaceutical companies are willing and able to produce.

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