The Emergency Department, by its nature, is interruption driven given it is “uncontrolled and unpredictable and punctuated by intermittent time-critical activities (Chisholm 2000). On average, each Emergency Physician is interrupted 6.6 times per hour while at work; 11 percent of all tasks were interrupted, 3.3 percent of them more than once (Westbrook 2010). One study (Westbrook 2010) calculated that physicians were multitasking 12.8 percent of the time,
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Journal Review
Value of EKG Machine Interpretation
Core
Hip Dislocation
This post discusses the diagnosis, classification and management of hip dislocations in the ED.
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FeminEM at SMACCDub
Over the last year, the SMACC group has released some absolutely amazing talks from SMACCDub in Dublin in June of 2016. In the true spirit of FOAM, all of the content is free for use and reuse. Among the many amazing talks was this one from the FeminEM crew. For all the SMACC talks,
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Core
Surviving Sepsis 2017 Guidelines Overview
This post review the updates in the new surviving sepsis 2017 guidelines.
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Journal Review
Age-Adjusted D-dimer (Using D-dimer Units)
Risk stratification tools like the Well’s and Geneva scores are useful for identifying patients in whom a venous thromboembolism (VTE) can be excluded with a negative D-dimer. This allows for decreased utilization of computed tomographic pulmonary angiography, V/Q scans and lower limb ultrasounds. However, the poor specificity of the D-dimer is associated with more patients getting imaged and the increased identification of sub-segmental clots of questionable significance.
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Post-It Pearls 7.0
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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Journal Review
Effectiveness of Diazepam Adjunct Therapy in Acute Low Back Pain
Thanks to Salim Rezaie for the peer review. This post is cross-posted at REBEL EM.
Low back pain is an extremely common presentation to US Emergency Departments (EDs) representing 2.4% or 2.7 million visits annually. The vast majority of presentations are benign in etiology but can be time consuming and frustrating for both patients and physicians.
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