Patients who undergo elective abortions may present to the emergency department for various symptoms and complications due to their recent procedures. This is a brief article of the complications of elective abortion. Workup and management of these complications are also reviewed.
Recent Elective Abortion Read More »
Intubation, especially in the septic and critically ill patient, can, by itself, cause hemodynamic abnormalities and/or hypoxemia and hypercapnea. In some situations, it may be important to make sure that the patient is adequately prepared for intubation, both from hemodynamic and pre-oxygenation standpoints. This is a brief review of some suggestions when intubating the very ill patient in the emergency department.
Unstable Sepsis: Airway First? Not Always Read More »
Pulmonary embolism (PE) is classically a life-threatening diagnosis, often considered in the work-up of patients with chest pain or dyspnea. Initial mortality rates of missed, untreated PE has been quoted as high as 26%, based on a 1960 study. This disease is common, with 400,000 patients affected with nonfatal PE and another 200,000 patients in the U.S. dying each year from this disease. PE is the third most common cause of death in cardiovascular disease after myocardial infarction and stroke.
Struggling to decide if your patient requires a RBC transfusion? Read on: we’ll review the most recent studies and evidence-based guidelines to aid in your clinical decision-making.
RBC Transfusion in the Emergency Department Read More »
Based on the available data, it does not appear that cervical collars have any appreciable positive effect on patient care. However, at this point in time, they are the recommended treatment option. Hopefully this knowledge will help your daily practice by understanding the effects of cervical immobilization.
Cervical Collars for C-Spine Trauma: The Facts Read More »
There are often multiple roadblocks to incorporating a CDR into clinical practice. These can be broken into the 1) individual provider and 2) the institution.
1. Emergency physicians are a rare breed, and many of us do not appreciate suggestions on how to practice. Individual providers vary in many regards: training, knowledge, experience, and gestalt. Workups and treatments can significantly differ among providers. With CDRs, physicians may be hesitant to apply these rules to their own practice. They may feel the rules are too complex, too difficult to remember, or detract valuable time from patient care. Providers often feel that gestalt or experience is better than rules.
2. Institutions may have habits or a culture for particular conditions that may make it difficult to apply a rule. Tradition or consultant availability may color the use of CDRs. Unfortunately, the medico-legal environment or funding can also play a large role in the use, or lack thereof, for CDRs.
Clinical Decision Rules Series Part 2: CDR Implementation Read More »
Alcohol use is extremely widespread throughout developed countries. It is estimated that 8 million people in the US are alcohol dependent. Approximately 20% of men and 10% of women will at some point in their lives have an alcohol-use disorder. About half of people with alcohol-use disorders will have symptoms of withdrawal when they cut down or stop their alcohol consumption. Extreme complications, including seizures and/or delirium tremens, will occur in 3-5% of these people.
Alcohol Withdrawal: Pearls and Pitfalls Read More »
To the Class of 2016 – Congratulations!! You’ve made it. After at least 11 years of post-high school education, you have finally reached that proverbial finish line and are ready to transition from resident to attending. What I would like to share with you is some advice about what life is like on the other side. Now that you have finished residency, it’s safe to say that you know the medicine really well. But, I have come to find that your learning about life as a professional is just beginning.
One Physician’s Advice to the New Grad Read More »
Is it possible to teach in the ED? What about all of the critically ill patients and full waiting room? It is possible to balance great education and patient care: this post contains keys to success for teaching in the busy ED.
Teaching When There is No Time Read More »
A commonly ordered test in the ED is the coagulation panel. What does this panel entail? Is there any evidence behind it for ED use? When should it be ordered? This post provides these answers and more.
When should you obtain coagulation tests in the emergency department? Read More »