Emergency medicine

2,327 articles · Since 2004

Articles, page 29

A mysterious case of seizures in the ER

April 25, 2019Apr 25, 2019

Alex and Edward Santos have just returned from a weekend away at their aunt and uncle’s place. They love it there. The couple is in their 20s and spoil the boys with late bedtimes, movies and video games, and home-made cupcakes with chocolate icing and sprinkles. It’s been a long break for Alex, who’s 15, and has been off school for a week. Now, his vacation is almost over, he …

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A mysterious case of seizures in the ER

Health policy

Change the approach to triage to alleviate ER overcrowding

Stephen P. Wood, ACNP-BC

April 15, 2019Apr 15, 20198

“Triage” is French for “to sort.” It developed as a concept on the battlefield as a way to address injured soldiers and ensure that care was provided to those most in need. In the emergency department, triage is usually the responsibility of a trained, experienced nurse. Patients present to the emergency department, the nurse obtains a history and may perform a cursory …

Physician voices

Fleece pajama bottoms in the ER

StorytellERdoc, MD

April 12, 2019Apr 12, 20194

Can someone please tell me the exact moment when fleece pajama bottoms became the fashion sensibility of America? I can't pinpoint the moment exactly, but several years ago I began to notice that many of our ER patients were presenting…

Can someone please tell me the exact moment when fleece pajama bottoms became the fashion sensibility of America?

I can’t pinpoint the moment exactly, but several years ago I began to notice that many of our ER patients were presenting for treatment wearing nice fluffy fleece bottoms. Men. Women. Old. Young. These fleece bottoms seemed to be enjoyed by a variety of the population. Most of these earlier bottoms for the …

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Fleece pajama bottoms in the ER

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Health technology

Could patients be their own scribes?

Efficient MD

April 11, 2019Apr 11, 20197

One day while on shift in the emergency department, I looked out into the waiting room at the dozens of people waiting to be seen. Many had been waiting for hours. Some looked bored. Others appeared agitated by the long wait time. One thing that nearly all of them had in common, though, was the presence of a smartphone within arms reach. I wondered, rather than spending their time mindlessly …

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Could patients be their own scribes?

Conditions and diseases

Important new information in the tragic cases of child abuse

Christopher Johnson, MD

April 9, 2019Apr 9, 2019

Like many pediatric intensivists, I care from time to time for victims of child abuse in the form of what is often called “shaken baby syndrome.” This syndrome is a characteristic constellation of finds that happen when a strong person grasps a child around the chest and aggressively shakes the infant. It was first described by Caffey, a pediatric radiologist, fifty years ago. The baby may have …

Physician voices

How Grey’s Anatomy made this physician into a better doctor

Monique Rainford, MD

April 9, 2019Apr 9, 2019

I am an obstetrician-gynecologist, and my favorite show is Grey’s Anatomy. I dare say I have not missed an episode since I started watching in 2006 (as a busy obstetrician, multiple shows are watched on DVR). I fell in love…

I fell in love with the show when, at random, I ended up watching the final episode of the second season when Izzie (a physician character from the earlier seasons) fell in love with Denny, …

Physician voices

Should medical residents appear in reality TV shows?

Skeptical Scalpel, MD

April 6, 2019Apr 6, 20193

This notice appeared on a general surgery news website in early February. I don’t know who has been long anticipating this, but I’m pretty sure it’s not people on medical Twitter. My informal, nonscientific Twitter poll garnered 707 votes with…

This notice appeared on a general surgery news website in early February.

I don’t know who has been long anticipating this, but I’m pretty sure it’s not people on medical Twitter. My informal, nonscientific Twitter poll garnered 707 votes with 87 percent of those responding saying they would not allow their residents to participate in a reality television show.

Many of those who …

Conditions and diseases

Being a nurse: the hardest and the best job of all

Rachel Basham, RN, CCRN

April 4, 2019Apr 4, 2019

I became a nurse at the age of 23. I was pregnant with my first son and dove into nursing headfirst, accepting a job in the pediatric ICU of the hospital where I worked. I still remember the call when I received the job offer. I hung up and jumped up and down, screaming in excitement. I couldn’t believe that I got my dream job, the job that wove my …

Health policy

Patient satisfaction should not be driven by poorly-designed surveys

Stephen P. Wood, ACNP-BC

April 3, 2019Apr 3, 20199

A young male patient checks into the emergency department (ED) and is brought back to a room for an ankle injury he suffered the day before. He states that he twisted it while doing some indoor rock climbing and tells the triage nurse that it is swollen and tender, but that he can walk on it. His vital signs are registered, and he is brought back to a room where …

Physician voices

Can you put me to sleep? Why ER physicians have to say no.

Rada Jones, MD

April 2, 2019Apr 2, 20198

The heavy young man curled on his left side is in the ER for a pain in his backside. The sweaty blue dragon on his chest smells like fear. “It’s an abscess. I’ll have to open it. It’s gonna hurt.”…

The heavy young man curled on his left side is in the ER for a pain in his backside. The sweaty blue dragon on his chest smells like fear.

“It’s an abscess. I’ll have to open it. It’s gonna hurt.”

“Can you put me to sleep? I hate pain.”

I can. Should I? Remember Michael Jackson? I do.

His neck would make a Hereford bull proud; he’s missing a chin but he’s got a …

Conditions and diseases

An emergency physician does a tooth extraction

Edwin Leap, MD

April 2, 2019Apr 2, 2019

I was working a few days ago and pulled a tooth. Mind you, it’s not something I do with any regularity. However, it was a very sweet little lady who was too weak and ill to get to the dentist…

I was working a few days ago and pulled a tooth. Mind you, it’s not something I do with any regularity. However, it was a very sweet little lady who was too weak and ill to get to the dentist and had other issues. That lower incisor was loose, and constantly in the way. Furthermore, it was painful.

I had seen her for something else in the emergency department. I took …

Physician voices

A tragic Fentanyl story without redemption

Marcia Glass, MD

April 1, 2019Apr 1, 201918

Matt was 40, my sister’s age. He was training for a marathon and trying to talk his many friends into joining. He lay in bed with his three-year-old son every night to help him fall asleep. It’s hard to sleep train a toddler with a newborn to nurture at the same time, but he loved spending this time with his two kids and being the dad everyone counted on.

Matt’s best …

Physician voices

A physician’s empathy in urgent care makes a big difference

Alexander Rakowsky, MD

March 29, 2019Mar 29, 2019

While winter is traditionally the busiest time of year for pediatricians, this winter has been particularly difficult in the Midwest with not only a larger number of ill visits, but a late and heavy flu epidemic hitting at a point where most of us were already wearing out. With this flu epidemic, our urgent cares, same day sick clinics and ERs have been setting all-time highs for any particular calendar …

Drugs and prescribing

Take the naloxone challenge

Matthew Zuckerman, MD

March 26, 2019Mar 26, 2019

Last week I took the naloxone challenge. I walked up to a pharmacy window, waited in line, and requested naloxone from the pharmacist. She showed a supportive but knowing look, and I became acutely aware of the four people in line behind me. After giving her my name and date of birth, she was able to pull my insurance info from prior visits, and I left with a dose of …

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Take the naloxone challenge

Physician voices

An image that reminds us what life versus death looks like

Amy Faith Ho, MD

March 24, 2019Mar 24, 2019

This is what life versus death looks like. This is what medicine verses mortality looks like. This is what science verses humanity looks like. After a thoracotomy, a fellow ER doctor Dr. Mitch Li snapped this picture of the spilled…

This is what life versus death looks like.

This is what medicine verses mortality looks like.

This is what science verses humanity looks like.

After a thoracotomy, a fellow ER doctor Dr. Mitch Li snapped this picture of the spilled blood and Propofol on the trauma bay floor.

Blood courses through every one of our veins to sustain life.

Propofol courses through our veins only when we’re on the brink of death.

Ever since I’ve seen …

Conditions and diseases

Hope is essential in every field of medicine

Shannon Casey, PA-C

March 22, 2019Mar 22, 2019

A man in his fifties is wheeled into the emergency department on a gurney hoping he’ll still be around to cheer from the sidelines at his daughter’s next soccer game. A little girl on the pediatric floor upstairs simply hopes her tummy stops hurting. A woman in the clinic explains her puzzling symptoms and hopes that this is the specialist who will finally be able to ascertain why she hasn’t …

Health policy

Why are we hemorrhaging emergency nurses?

Rada Jones, MD

March 20, 2019Mar 20, 201918

I started my medical career late. Really late. By that time, I’d lived a few lives. I’d earned a boatload of initials. I’d changed husbands, languages, and continents. I’d written a useless novel, and I’d been a Mary Kay lady.…

One day over lunch as I was looking for something to do with myself, my husband suggested medicine. I spent the next nine years immersed in my medical training, feeling guilty …

Physician voices

Emergency medicine and the inevitability of death

Joe Bocka, MD

March 19, 2019Mar 19, 2019

Though many are not thrilled about the April 15th deadline, death is an even more inevitable part of life than taxes. Sometimes we try to lessen the impact of death through our words: bit the dust, bought the farm, kicked…

Though many are not thrilled about the April 15th deadline, death is an even more inevitable part of life than taxes.

Sometimes we try to lessen the impact of death through our words: bit the dust, bought the farm, kicked the bucket, flat-lined, passed on, checked out, gave up the ghost, met his maker, paid the piper, put out of his misery, laid to rest, six feet under, pushing up daisies, …

Physician voices

Clear and concise communication is key while delivering bad news

Shubham Bakshi, MD

March 19, 2019Mar 19, 2019

“Guys, are you alright in there?” I ask casually while taking the first bite of my dinner on a 24-hour PICU shift. No answer. “What is going on? Why is she beeping so much? Is her tube blocked?” My voice…

“Guys, are you alright in there?” I ask casually while taking the first bite of my dinner on a 24-hour PICU shift.

No answer.

“What is going on? Why is she beeping so much? Is her tube blocked?” My voice gets louder.

Complete human silence. Except for the deafening hypoxia monitor going to 30s. Heart rate monitor dipping to below 60s. All this beeping was coming from a six-month-old girl with a history …

Physician voices

49 ways to stay out of my ER

Rada Jones, MD

March 13, 2019Mar 13, 20198

I’m an ER doc. I care for patients. All patients: Those who need to be in the ER; those who don’t; those who wouldn’t be there if they knew better. For them, for you and for fun, I’ve got some…

1. Never, ever say “hold my beer and watch this!” Besides “I do!” they are the most dangerous words …

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49 ways to stay out of my ER

Emergency medicine

Articles, page 29

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