Blog

Clinical Decision Support…your daily helper.

Continuing with the theme of clinical informatics, today we will touch on the topic of Clinical Decision Support Systems (CDSS), or sometimes just called Clinical Decision Support (CDS). The basic premise of clinical decision support is that it delivers timely and useful patient/disease/ or treatment-related information in an organized manner, with the goal of improvingRead more

What Is Clinical Informatics?

If you loved the super sexy topic of cerumen impaction yesterday…Well, hold on to your socks, because today we will continue our rousing educational foray by tackling the riveting question: What is Clinical Informatics? Shall we begin? According to the Oxford dictionary: Informatics is the science of processing data for storage and retrieval. In theRead more

Cerumen Impaction: an Update.

The last time www.sinaiem.org addressed the topic of cerumen (ear wax) impaction was in 2013. See this post: http://sinaiem.org/50yo-man-with-chest-pain-and-also-with-r-ear-pain/  If you’re like me, you likely believe that the world of cerumen impaction is a rather static one. Given that, another post on cerumen impaction would seem to be duplicative…Well you (and I) are wrong, and here’sRead more

Cervical Artery Dissection

Cervical artery dissection (CAD) accounts for 1-2% of all ischemic strokes but 10-25% of strokes in younger individuals.  CAD includes extracranial carotid and vertebral artery dissections.  A review of the literature suggests that there may be a significant risk of recurrence in subsequent years.  At this time, it is unclear whether an anti-platelet or anticoagulationRead more

Opioid Substitution Therapy

ED physicians need to be comfortable with the various modalities of opioid substitution therapy (OST) and their associated complications.  We are all familiar with the patient who has missed a daily dose of methadone on the way to booking and is subsequently brought to the ED by corrections officers to address this issue.  A recentRead more

Use the HEART Score

There are approximately 8 million ED visits annually in the United States for chest pain. 10%-20% go on to receive an acute coronary syndrome diagnosis. The goal of the ED physician is to differentiate between ischemic chest pain and other, more benign causes of chest pain. Historical features and laboratory values are helpful, but 2%-5%Read more