June marks graduation for thousands of medical residents around the country. This is a special time for residents and educators alike as it marks a major transition point. It’s a good time to reflect on who we are, what we do and, where we are going. Every year, Dr. Lewis Goldfrank gives an address to the residents,
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Fever without source in infants less than three months old presents a difficult diagnostic dilemma for ED physicians. Over the past 25 years several algorithms have been developed to help guide clinicians, most notably the Rochester, Philadelphia and Boston Criteria, in determining which infants require admission vs. outpatient management. These studies were designed published between 1992 and 1994 prior to the wide spread use of HiB and pneumococcal vaccines in children,
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Severe hyperthermia is life-threatening but easily managed if it is identified rapidly and the patient is aggressively cooled.
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Within the US, chest pain is the most common etiology for observation and short inpatient stays. Patients are admitted to assess for the presence of serious pathology including acute coronary syndrome (ACS). To decrease short inpatient stays, institutions have transitioned to observational status and those patients are considered outpatients. The impact of this change on resource utilization and patient outcomes continues to be unclear.
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Teaching on a clinical shift can sometimes be difficult: it’s busy, everyone’s running around and it’s hard to capture a trainees attention. Recently, on twitter, Amal Mattu (@amalmattu) has been posting pictures of his white board teaching: discrete pearls written down and shared with anyone who walks by. The pearls are often prompted by patients presenting during that shift but they don’t have to be.
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This post is cross posted on REBEL EM.
Intubation and mechanical ventilation are commonly performed ED interventions and although patients optimally go to an ICU level of care afterwards, many of them remain in the ED for prolonged periods of time. It is widely accepted that the utilization of lung-protective ventilation reduces ventilator-associated complications including acute respiratory distress syndrome (ARDS).
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This posts reviews diagnostic and management considerations in ectopic pregnancy.
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