You are working in a rural ER in a mountain resort town. A family of
four is brought in because they have headache, nausea and malaise
without syncope or chest pain. Following a thorough history and physical
examination you quickly note the cause of the illness is carbon
monoxide (CO) poisoning from a faulty heat generator. The closest HBO
chamber is 300 miles away.
Another extremely busy day, but you feel a small sense of achievement as
you prepare to discharge an 87-year old man with mild lower leg
cellulitis. Your euphoria quickly evaporates as the nurse tells you that
several family members are concerned that the patient has recently been
demonstrating increasing signs of cognitive dysfunction.
A helpful application of the Canadian C-Spine Decision Rule, or an onerous malpractice risk?
You recently read a debate on the new American Heart Association
guidelines for CPR on the blog WhiteCoat’s Call Room. Not long after,
your local EMS director asks for your opinion about the evidence
supporting compression-only CPR (COCPR) for witnessed cardiac arrest
victims outside the hospital.
As you polish off the documentation on your last five patients, the
nurse for the closed femur fracture patient asks if you are ready for
the pending reduction. Orthopedic surgery is patiently waiting, and the
nurse has the Propofol that you requested at the bedside.