stack-web-prevAt the recently concluded Annual Meeting of the AMA House of Delegates, by far the best and most significant news was that our very own Steve Stack, an emergency physician from Kentucky, was elected President-elect of the AMA. He is the first emergency physician to be elected to this position and will be the youngest AMA president in more than 100 years. We indeed have come a long way. As usual, there were a plethora of resolutions ranging from e-tobacco initiatives to condom use in sex films. Here are the highlights.

gag-order-prevGreg Henry seldom fails to deliver on a promise. But this time, it looks like it’s out of his control. Earlier this year in the pages of Emergency Physicians Monthly, Dr. Henry outlined what he saw as some of the most important issues confronting our specialty to be addressed by our
representatives on the ACEP Council. In his column he promised to conduct objective, but pointed interviews with each Council candidate so that the membership could hear their views on these important issues.

ep4-prevThis is the 4th episode of “The Night Shift” that I’ve endured watched. If you’ve seen it and you work in an ED you most likely know how I feel. I started off trying to find it’s redeeming qualities but its been tough.

pie-chart-prevIt is the processing of the sickest patients, the ones who are admitted to the hospital or transferred for admission at another hospital, that determine the overall flow rate of the emergency department. As a result, less sick patients – those who can be treated and released – benefit from the rapid flow processing of the sicker set.

ep-3-orig1-prevEpisode three of Night Shift is over and out. Here’s the recap: attractively psychologically broken, yet fiercely ethical, and super sexy night shift staff continue their drama this week. We’ve got war flashbacks, UFC style fighting between friends, hand-eating hogs and drunk hunters on a rampage, and new girlfriends and boyfriends barely missing awkward encounters with old girlfriends and boyfriends. Heck, you’ve even got “Big Todd” (don’t ask).

NS-prevNick Genes is probably the nicest man in the entire world. No one else would be as kind to the new NBC show "The Night Shift" than somebody who has an unending ability to forgive mistakes. Let me assure you, I’m not the nicest man in the world. Having now watched the first two episodes, the only thing I can honestly do is beat my head into a wall and vomit.

dollahz-prevIt’s been nearly three decades since Congress enacted the landmark Emergency Medical Treatment and Active Labor Act (EMTALA), changing the field of emergency medicine forever. One the byproducts of EMTALA was the “Prudent Layperson Standard (PLP),” which was codified in 1998 in response to a critical payer issue of the day — payment denials for the lack of prior authorization. Under the PLP standard, if the patient reasonably thinks he or she has an emergency medical condition, then the service is covered, even if it turns out to not be an emergency. This system worked for years, but now, thanks to the Affordable Care Act, the idea of what a “prudent” person is likely to do is fundamentally shifting, which brings the PLP standard into question.

lqt-prevA nine-year-old healthy girl at summer camp, running up a hill to chase her friend, collapses and fractures her left arm. She is seen in the local emergency department where she is diagnosed with a supracondylar fracture and dehydration. Three months later her brother is found dead in his bed in the morning.

monurol-previewYou may want to consider this old stand-by now to cover drug-resistant bacteria.


rsz lobster cutout clawComputed Tomography (CT) scan using radiocontrast is one of the most common imaging modalities used in emergency departments today. Several studies and my own anecdotal experiences indicate that both physicians and patients believe that iodine allergies are linked to seafood allergies, and that both are related to a disproportionate increased risk of “allergic” reactions to radiocontrast agents. But is iodine allergy fact or fiction?

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