In the Spring of 2011, surgeon Cristiana Bertocchi finished a stint in Côte d’Ivoire–Ivory Coast–working with Médecins Sans Frontières (MSF). She served in the Abobo Sud neighborhood of Abidjan, one of the main flash points in the country’s widespread violence. At the time of her visit, the Ministry of Health hospital in Abobo Sud was the area’s only fully-functioning hospital and one of the few in the city. Medical teams there treated hundreds of emergency patients, most of whom had bullet wounds.

When emergency physician Ken Mwatha fell asleep after a shift, he set in motion a chain of events that would change his life – and his practice of emergency medicine – forever.

I want to save victims from cardiac arrest. I want to apply good CPR, use the right tools to improve outcomes, and use only the medications and processes that improve long-term restoration of neurologic function. Unfortunately, as Jimmy Buffett would say, “I arrived a little too late”.

altSpontaneous bacterial peritonitis (SBP) is a well-recognized, severe complication in cirrhotic patients presenting to the emergency department (ED) with ascites. The prevalence of this disease varies widely among study populations, with a range of 10% to 30% in hospitalized patients with ascites, compared to 0% to 3.5% among asymptomatic outpatient clinic populations.

Should the Joint Commission mandate all hospital employees get the flu shot?

altWith or without fiberoptic assistance, nasal intubation remains a valuable technique in some emergency airway situations, despite its overall decline in use. It is best in patients who are not critically hypoxic and in whom there is obvious oral pathology making intubation and ventilation through the mouth problematic.

In this series, much space has been dedicated to explaining the changes coming to emergency medicine as hospitals try to qualify for federal stimulus dollars, by demonstrating meaningful use of electronic health records. But as these changes unfold, another tech revolution is taking place in health care – the way patients interact with each other, and with health organizations, using social media. 

“It’s like a drug. First, it makes you feel better even though your situation isn’t any different. Second, and worse, it’s addicting.” Chuck Shufflebarger, MD, said this to me about ambulance diversion last summer as I was preparing a talk about concepts in patient flow.

The emergency department is undoubtedly the area of the hospital that most frequently requires the services of interpreters. As of January 1, 2011, the Joint Commission requires the use of “qualified translators” in the emergency department 24/7.

altIn this installment of "Rick's Picks" Rick Bukata discusses a couple law suits resulting from excessive emergency department wait times. Should the Joint Commission step in? 

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