Cellulitis is commonly treated in the emergency department. Patients who present with cellulitis incur significant health care costs and may be over-treated with antibiotics. For our August journal club, we selected articles that would help providers avoid treatment errors that lead to high costs, unwanted side effects, overuse of antibiotics and unnecessary admissions.
Read MoreIt's 3 AM and EMS brings in a patient with altered mental status found down in the local park. His glucose and vital signs are normal and there is no clear etiology on his exam. As part of your work up, you order a CT brain to evaluate for a neurologic case. Unfortunately, teleradiology has been taking up to 90 minutes to give an interpretation on your CT's. As the patient is taken off the scanning table, you quickly peruse his CT and wonder. . . will I be able to identify an emergent diagnosis before my friendly "neighborhood" radiologist?
Read MoreEvery month we summarize our simulation cases. No deep dive here, just the top 5 takeaways from each case. This month's cases included anaphylaxis, PCP pneumonia, neutropenic fever, Giant Cell arteritis and Polymalgia Rheumatica.
Read MoreHematoma blocks are a great adjunct to assist with the reduction of long bone fractures. Dr. George "Bud" Higgins shares with us some tricks of the trade in how to perform this procedure via ultrasound or landmark technique.
Read MoreIn this issue of Tox Talk with Tammi, Dr. Tammi Schaeffer discusses common issues regarding the diagnosis and treatment of acetaminophen toxicity: select vs universal acetaminophen toxicity screening, the utility of the sub-four hour acetaminophen level, the decreasing repeat acetaminophen level, and using NAC for the patient with an undetectable acetaminophen level.
Read MoreOur very own Irish George Clooney shares some pediatric pearls as he discusses the pros and cons of testing for and treating streptococcal pharyngitis including: using the centor criteria in children, test characteristics of the rapid antigen detection test, risks, complications and potential benefits of treating versus not treating and how to discuss these issues with parents.
Read MoreWith nearly 1 million US emergency department (ED) visits attributed to acute heart failure (AHF) annually, heart failure is a serious illness frequently managed by emergency physicians. More than 80% of visits result in hospital admission, and readmission rates may range from 30-60% within 3 to 6 months of initial discharge. ED visits related to AHF are expected to continue to rise with the aging population and improved survival rates in patients with chronic heart failure and acute coronary syndromes. One critical issue facing emergency physicians caring for AHF patients is deciding upon disposition: admission (with or without monitoring) or discharge (with or without early follow-up). Consensus guidelines are available to support decision-making around diagnosis and treatment; however, no current guidelines provide an evidence-based approach to disposition. For this month’s journal club, we reviewed three papers examining decision aids developed to assist emergency physicians in determining risk in AHF patients.
Read MoreDizziness accounts for 4-5% of all emergency department (ED) chief complaints and 26% of ED patients endorse dizziness in their review of systems. Although most presentations for dizziness are benign, nearly 200,000 strokes present with dizziness each year in the United States (Edlow et al. 2008). Misdiagnosis of vertebrobasilar strokes is common, as symptoms may be minimal and patients often change how they characterize their symptoms. In the video below, Dr. Siket covers a systematic and evidence based approach to guide your workup of this all too common patient.
Read MoreYou stuck what where?!?! Dr. George "Bud" Higgins shares with us some tricks of the trade regarding evaluating and removing intra-nasal foreign bodies. He discusses some well known maneuvers ("parent's kiss," passing a foley catheter, bayonette forceps) and a more novel approach using intranasal positive pressure gas flow.
Read MoreEvery month we summarize our simulation cases. No deep dive here, just the top 5 takeaways from each case. This month's cases included death notification, elder abuse, leaving against medical advice.
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