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 a...
Source: The Procedural Pause - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Tips to avoid medical errors in the emergency department
Emergency medicine physicians: Could these be your cases?
A 35-year-old presents with shortness of breath and numbness to the legs. CXR and EKG are normal. She is discharged to see her doctor in two days, but is found dead at home. Autopsy reveals a dissecting aortic aneurysm.
A 15-month-old is triaged to fast track and seen by a physician assistant for fever, lethargy, and ear pain. Treatment includes Augmentin. The next day the patient is admitted with pneumococcal sepsis and meningitis with severe brain damage.
Continue reading ...
Your patients are rating you online: How to respond. Manage your online reputation: A ...
Source: Kevin, M.D. - Medical Weblog - May 12, 2015 Category: Journals (General) Authors: Roneet Lev, MD Tags: Physician Emergency Malpractice Source Type: blogs
Research and Reviews in the Fastlane 070
This study demonstrated a high sensitivity (86%) and very high specificity (97%) when looking for consolidations > 1 cm on US compared to chest X-ray as the standard. The study was done quickly (mean 7 minutes) and by non-experts (1 hour of training) increasing the likelihood that the findings can be generalized to non-study settings.Recommended by: Anand SwaminathanThe Best of the RestResuscitationOlaussen A, et al. Return of consciousness during ongoing Cardiopulmonary Resuscitation: A systematic review, Resuscitation 2014; 86: 44-48. PMID 25447435After introduction of mechanical CPR device CPR induced consciousnes...
Source: Life in the Fast Lane - February 11, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: Education Emergency Medicine Neurosurgery Pediatrics Resuscitation Trauma critical care examination Intensive Care R&R in the FASTLANE research and reviews Source Type: blogs
Research and Reviews in the Fastlane 040
In this study the role of a “1/2 dose” thrombolysis was evaluated for the reduction of pulmonary artery pressure in moderate PE. A total of 121 patients with moderate PE received either tissue plasminogen activator plus anticoagulation or anticoagulation alone with the primary end points of pulmonary hypertension and the composite end point of pulmonary hypertension and recurrent PE at 28 months. The results suggested that the ½ dose or “safe dose” thrombolysis was safe and effective in the treatment of moderate PE, with a significant immediate reduction in the pulmonary artery pressure that was ma...
Source: Life in the Fast Lane - July 21, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Anaesthetics Emergency Medicine Evidence Based Medicine Featured Gastroenterology Haematology Health Infectious Disease Intensive Care Neurology Pre-hospital / Retrieval Respiratory critical care literature R&R in the FASTLANE Source Type: blogs
Research and Reviews in the Fastlane 038
This study, however, has major flaws and biases that question the validity of their conclusions. Only 19% of centers that were contacted agreed to contribute data to the Consortium. Additionally, the researchers do not assess the quality of the studies included in their meta-analysis. Regardless, observational data should not be used to trump the RCT data included in the recent, Cochrane review. Finally, Roche pharmaceuticals was a major sponsor of this research team. The accompanying editorial is a must-read.
Recommended by: Anand Swaminathan
Infection Control, Hand hygiene
D’Egidio G et al. A study of the ...
Source: Life in the Fast Lane - July 10, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Cardiology Emergency Medicine Featured Infectious Disease Intensive Care Neurology Palliative care R&R in the FASTLANE Radiology Resuscitation Trauma critical care literature recommendations research and reviews Source Type: blogs
Twitter and the dissemination of research evidence
Trip aggregates some wonderful content. The main route for people finding this evidence is via search or by registering with Trip and indicating what topic areas they're interested (in which case we email the user with the latest research that matches their interests).Towards Christmas I started to experiment with using Twitter as a dissemination route. Basically, I created two topic areas (Primary care and Cancer) and starting tweeting simply the title of the article and the URL of relevant articles that were recently added to Trip. The Trip techie (Phil) suggested I use some tracking to see if people ar...
Source: Liberating the literature - January 17, 2014 Category: Technology Consultants Source Type: blogs
Medical Mispronunciations and Misspelled Words: The Definitive List.
Hearing medical mispronunciations and seeing misspelled words are an under appreciated joy of working in healthcare. Physicians often forget just how alien the language of medicine is to people who don't live it everyday. The best part about being a physician is not helping people recover from critical illness. The best part is not about listening and understanding with compassion and empathy. Nope, the best part about being a physician is hearing patients and other healthcare providers butcher the language of medicine and experiencing great entertainment in the process. Doctors c...
Source: The Happy Hospitalist - October 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Paul Krugman: China’s economy has hit its Great Wall
China has a drug problem. While most Western countries spend 10-12% of their healthcare budget on medicines, in China it is well over 40%, a disparity that goes to the heart of Beijing’s crackdown on the industry.All economic data are best viewed as a peculiarly boring genre of science fiction, but Chinese data are even more fictional than most. Add a secretive government, a controlled press and the sheer size of the country, and it’s harder to figure out what’s really happening in China than it is in any other major economy.Yet the signs are now unmistakable: China is in big trouble. Read more.A promise this we...
Source: PharmaGossip - July 27, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
Healthcare Update Satellite — 07-09-2013
More updates available tomorrow on my other blog at DrWhitecoat.com
Why does an $11,596 emergency department visit cost $1,100? A spokesperson for the California Hospital Association says that it is because of government regulation. I want to know what doctor ever gets paid $4,242 for a Level 4 emergency department visit.
California attorneys are trying to raise the cap on damages under California’s Medical Injury Compensation Reform Act. Caps are currently $250,000 and haven’t been raised in more than 35 years.
The article says that many attorneys won’t take medical malpractice cases in California because they are t...
Source: WhiteCoat's Call Room - July 9, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
DOJ Probing International Pharmaceutical Manufacturing
Earlier this year, we noted that a new enforcement focus for the U.S. Department of Justice (DOJ) will be increased oversight to ensure compliance with the Food and Drug Administration's (FDA) current good manufacturing practices (cGMPs) regulations. Specifically, Maame Ewusi-Mensah Frimpong, Deputy Assistant Attorney General (DAAG) for DOJ's Consumer Protection Branch (CPB), noted her division has long worked closely with FDA to promote the safety of pharmaceutical products.
Several months later, it appears that DOJ is acting on this promise in two recent cases. As reported by the Washington Post, Reuters, and ...
Source: Policy and Medicine - July 5, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs
The Last Doctor is Always the Smartest
Twice recently, I’ve been privy to patient complaints about emergency department “misdiagnoses” when patients have gone to follow up appointments with their physicians.
One case involved a young girl who had a rash. The rash was preceded by a low grade fever in the days prior, began on the chest and spread outward, and had the classic appearance of a viral exanthem. The girl’s parents weren’t happy with that diagnosis. They believed that the girl was suffering from an allergic reaction and that she needed antihistamines and steroids. The doctor explained that the rash was not an allergic-type ...
Source: WhiteCoat's Call Room - June 17, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs
Please Poke My Paronychium!
THE BASICSWhat is more satisfying than draining a pus-filled paronychium? Seeing the look of relief on the face of your patient when his painful, pulsating digit is relieved of all that tension! This rather elementary procedure could be perceived as stale and uneventful for some of you. The more thorough and astute clinicians, however, realize these tiny infections around the nail root may open the door to a mixed bag of insidious and harmful bacterial infections including MRSA, chronic reoccurrences, cellulitis, subungual abscesses, osteomyelitis, herpetic whitlow, or even the dreaded felon.
Whatever your pleasure, thi...
Source: The Procedural Pause - May 1, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Lyme Disease
Pathophysiology of Lyme Disease
Lyme disease is an
1) infection with Borrelia burgdorferi via tick bite
2) previous thinking held tick vector was Ixodes but transmission is now thought by some experts to be possible with additional tick species
3) occurs in stage I and stage II days to weeks after infection and in stage III months to years after infection (usually with preceding latency period
Signs and Symptoms
Stage I
1) characteristic expanding annular rash with central clearing (“bull’s eye or “target” rash) that occurs in only 40% of infections
Stage II
2) multiple secondary annular skin lesio...
Source: Inside Surgery - March 19, 2013 Category: Surgeons Authors: Editor Tags: Infectious Disease babesia bulls eye rash coinfections deer tick erythema migrans hyperbaric ixodes target rash Source Type: blogs
In Which We Finally Get All the Medications
Nolan was prescribed Augmentin (a really common antibiotic) and Flonase compounded with Bactroban. Our ENT sent the prescriptions to Rite Aid, the pharmacy we've been using. They've been notoriously horrible at filling Nolan's prescriptions, and I keep... (Source: Deaf Village)
Source: Deaf Village - February 28, 2013 Category: Other Conditions Authors: Say What? Tags: AVT Hard-of-Hearing vm Source Type: blogs
