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
24 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
Did 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.”
On 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.
What 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.
The 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
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.