You’re having a rough shift: The ED is out of metoclopramide and
prochlorperazine, so you worry that you’ve been turning migraineurs into
drug-seekers by treating them with promethazine and hydromorphone. You
know that sodium bicarbonate is running low, so you hope that you don’t
see a bad tricyclic overdose any time soon.
The Society for Academic Emergency Medicine’s Annual Meeting was held
May 9-12, 2012 in Chicago, Illinois. The Research Forum featured 746
Abstracts, and 37 Innovations in Emergency Medicine education
presentations. We selected the 10 we thought had the most potential to
impact the practice of emergency physicians.
Part 1 in a series about the cold, hard numbers behind some of our most common ED practices
This is the third in a series of columns dealing with non-allergic,
potentially serious reactions caused by antibiotics. In the column
dealing with macrolides, the increased risk of sudden death was noted.
Clearly, the absolute numbers of deaths associated with macrolides has
to be small, but it makes sense to take this fact into consideration
when prescribing these antibiotics to those prone to arrhythmias (such
as patients with congestive heart failure).
If you are an emergency physician and you Google yourself, you’ll find a
host of companies offering the world a chance to “rate” you as a
doctor. On a scale of 1 to 5 stars, “How would you rate your overall
experience?” asks eHealthScores. “Does the provider listen to you and
answer your questions?” asks HealthGrades. The internet is replete with
these sites, and now even mega-review sites like Yelp have gotten in the
mix, stacking physician reviews right next to write-ups on bars and
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.”