Are you guilty of anchoring bias?
As doctors, we have all been guilty of anchoring bias, which means we put too much weight on the first complaint. When a patient presents to the clinic with a complaint that sounds vaguely like a headache due to a sinus infection, we whip out the script pad and write a script for Augmentin. WeRead more …Are you guilty of anchoring bias? originally appeared inKevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 30, 2022 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/post-author/janet-tamaren" rel="tag" data-wpel-link="internal" > Janet Tamaren, MD < /a > < /span > Tags: Physician Gastroenterology Primary Care Source Type: blogs
Properly Naming the Sinusitis-Otitis-Conjunctivitis Syndrome
One of our nonphysician providers recently announced, “This kid has that double-sickening thing you talk about all the time." She was referring to the sudden worsening of signs and symptoms (e.g., onset of fever) in a patient who had had an upper respiratory tract infection for several days.The majority of links in a Google search for “double-sickening" are references for sinusitis, but new-onset pneumonia is another double-sickening event. The Infectious Diseases Society of America guidelines for sinusitis acknowledge double-sickening and concur that pneumonia can present similarly. I investigate for sinusit...
Source: M2E Too! Mellick's Multimedia EduBlog - November 1, 2021 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
(Maybe) I Got Bit by a Snake
I saw my hand by the morning light streaming through my blinds and felt like I was looking at something that wasn ’t a part of me. A crimson, half-inch lesion rose above the right side of my right hand like Mary’s Rock. Swelling puffed up the skin like a balloon, leaving me with one apparent knuckle. I flipped my arm over. Red streaks crawled up it like fingers stretching to grasp my heart.My instinct was to call my dermatologist. “Good morning, I’d like to schedule an appointment.”“If this is for body sculpting, I’ll transfer you to that receptionist.”Nope. I rapid-fired my problem: yesterday afternoon, I ...
Source: cancerslayerblog - June 7, 2019 Category: Cancer & Oncology Tags: a day in my life animals death Source Type: blogs
Pediatric Conjunctivitis a Simple Diagnosis Until It Isn’t
Conjunctivitis is a common condition and easy enough to treat, but several uncommon conjunctivitis syndromes require more care and should not be missed.Conjunctivitis is either infectious (viral or bacterial) or noninfectious (allergic or nonallergic). Viral infections are more common in adults, bacterial ones in children, usually caused by Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Adults tend to have more S. aureus infections, while the other pathogens are more common in children. An adenovirus is typically responsible for viral-associated infections in conjunct...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Do you really have a penicillin allergy?
Chances are, you or someone you know is one of the 10% of Americans with a documented penicillin allergy. But just because you were told you had a penicillin allergy, or had one in the past, does not mean you have one now. People with a penicillin allergy history have their allergy disproved with allergy testing more than 90% of the time.
Penicillin: a primer
Penicillin is part of a larger drug class called beta-lactam antibiotics, which include the common penicillins and cephalosporins.
Common penicillins include ampicillin, amoxicillin, and Augmentin. Among other uses, penicillins are often used to treat ear infections, ...
Source: Harvard Health Blog - February 26, 2019 Category: Consumer Health News Authors: Kimberly Blumenthal, MD, MSc Tags: Allergies Health Tests and procedures Source Type: blogs
Distinguishing between Orbital and Preseptal Cellulitis
Some medical conditions have signs and symptoms that significantly overlap, making a diagnosis a little more difficult. Epididymitis, testicular torsion, and torsion of the testicular appendage are examples, but orbital and preseptal cellulitis are others that can cause significant diagnostic confusion.Both conditions are more common in children than in adults, and preseptal or periorbital cellulitis is more common in children under 5. The preseptal and orbital spaces are separated by only a thin membranous septum that originates in the orbital periosteum and inserts into the tarsal plates. It is only this thin septum t...
Source: M2E Too! Mellick's Multimedia EduBlog - December 31, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
If I were writing sore throat guidelines
Several tweets asked me to answer this question. How would I rewrite sore throat guidelines? Obviously I am biased. So this is my opinion and I am sticking to it!
I would not change anything about pre-adolescents. Group A strep is the most important bacterial infection and using rapid tests with backup cultures makes sense.I would change the guidelines for adolescents and young adults. I would treat patients having Centor scores of 3 or 4 with either penicillin or amoxicillin (augmentin would be fine). I would probably treat some 2s if they looked very ill. I would never use macrolides. If the patient is truly penicilli...
Source: DB's Medical Rants - December 29, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Nailed It!
What do you do for a nail from a nail gun in the hand? This procedure is simple, but you have to worry about the aftermath. Complicated issues may arise post-procedure in the days to weeks after extraction, including retained foreign bodies, infection, fractures, disability, pain, nerve damage, tendon rupture, and cosmetic concerns.Removing the nail is only half the battle. Proper removal, treatment, and follow-up should be considered with all foreign bodies in the skin, especially the hand. Being prepared for the possible aftershocks will help your patient have a successful recovery.A 23-year-old man with a nail fro...
Source: The Procedural Pause - June 1, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Oldie but Goodie Pediatric Clinical Concepts
A number of older clinical concepts may be unfamiliar to younger clinicians, but these clinical concepts are useful in pediatric medicine. Some of these concepts showed up in the medical literature for the first time nearly a century ago. Physicians should feel free to question the potential value and validity of older clinical concepts that aren't at the forefront of medical education, but my experience of more than 30 years practicing pediatrics and emergency medicine has repeatedly affirmed to me that these are valuable in emergency medicine.Parenteral DiarrheaThe concept of parenteral diarrhea has been around for...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Oldie but Goodie Pediatric Clinical Concepts
A number of older clinical concepts may be unfamiliar to younger clinicians, but these clinical concepts are useful in pediatric medicine. Some of these concepts showed up in the medical literature for the first time nearly a century ago. Physicians should feel free to question the potential value and validity of older clinical concepts that aren't at the forefront of medical education, but my experience of more than 30 years practicing pediatrics and emergency medicine has repeatedly affirmed to me that these are valuable in emergency medicine.Parenteral DiarrheaThe concept of parenteral diarrhea has been around for...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Ultrasound: Foreign Body Removal
Part 2 in a SeriesAre you ready for summer? That means more bare feet, flip-flops, and the potential for foreign bodies of the foot and toe. We will continue to highlight tools and tricks to help you master soft tissue foreign body removal in the emergency department. A refresher on the basics of ultrasound is available in our blog post from last month: http://emn.online/1UGtduz.Foreign bodies of the toe or foot are common presentations in emergency departments, and one way to determine the size and shape of retained superficial foreign bodies is to use ultrasound and the linear probe. This simple technique may hel...
Source: The Procedural Pause - April 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Beware of predatory journals when it comes to homeopathy studies
An August, 2015 study in Multidisciplinary Respiratory Medicine is being touted as evidence that homeopathy is as effective as antibiotics for respiratory infections in children. It doesn’t show that at all — in fact, it doesn’t show anything, except that crappy studies in crappy journals can nonetheless be used to manipulate opinion. Beware.
First, the study itself. Researchers in Italy looked at about 90 children with ordinary colds. All of them were given a homeopathic product that the authors claimed had already been shown to be effective for cough (that’s not actually true, but let’s let it slide for now...
Source: Kevin, M.D. - Medical Weblog - November 9, 2015 Category: Journals (General) Authors: Roy Benaroch, MD Tags: Meds Infectious disease Pediatrics Source Type: blogs
Dabbling in Dentistry
Most people will experience dental pain or a dental complication at some point in their lives. Dental pain is an incredibly common complaint by people of all ages, especially those who lack dental insurance and suitable hygiene habits. Sometimes, though, poor dentition or injury is simply a result of bad luck. Patients often present to the ED hoping to find a dentist and an answer to their problems.
Your first thought? “I am not a dentist. What am I going to do?” You’re right to an extent. We are not dentists, and often feel we have little to offer patients for acute issues that require equipment we don’t have...
Source: The Procedural Pause - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
