You are on a flight, halfway across the Atlantic Ocean at the start of a much needed vacation, binge watching that new show everyone has been talking about but you’ve never had time to see. Suddenly, the screen freezes and an overhead announcement interrupts your zen-like, screen-induced partial stupor. “Is there a doctor on board?”Read more
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Your patient with a newly diagnosed PE hates hospitals. He or she agrees to defer to your judgement about admission versus discharge home, but makes it clear they would prefer to go home if it is safe. Which tool should you use to help you decide? Up until recently, there were no prospective studiesRead more
We give out canes like they’re candy. But are we doing a good job adjusting the cane and teaching patients how to use them? Canes that are not the right height for your patient or are being used incorrectly can put patients at an even greater risk of falls. The proper height can beRead more
A patient comes to the emergency department reporting a few days of excruciating pain in a band around his right chest. Today, he developed vesicles over the same area which prompted him to come in. Classic shingles. Like most patients diagnosed with this disease, he is sent home with wound care, return precautions, contact precautions,Read more
You are the leader of the code team. Your patient is in refractory VF after multiple rounds of shocks and drugs. You’ve tried repositioning the pads into an anterior-posterior position. Looking around, you ask for suggestions. Someone suggests double sequence defibrillation. After all, what’s the harm? Sorry to take away one of yourRead more
It’s 1 am and things are winding down. The trickle of patients has slowed and it actually looks like you and your team are catching up. Suddenly, you hear yelling, swearing and crashes coming from triage. Other patients are looking around to see what is going on. The sound of the triage nurse comesRead more
Ah, cold and flu season. It’s that joyous time of year when our department is flooded with miserable people complaining of sinus headaches, rhinorrhea and feeling terrible. We all know that for most viruses, symptomatic care is the way to go. A nose spray would be helpful, but what about all of those warning labelsRead more
Penicillin allergy is a common finding in many patient charts. Sometimes it can be difficult to figure out who, when and why this label was added to a medical record. Sometimes patients themselves perpetuate the label, unwittingly reporting something a parent told them about a possible reaction as a child, or mistaking side effectsRead more
We all prescribe antibiotics frequently. While the debate about who is contributing more to the terrifying antibiotic resistance patterns and the emergence of superbugs rages on, we can sometimes forget or minimize the fact that antibiotics have immediate side effects for our patients. Serious and seriously unpleasant side effects. A publication in JAMA fromRead more
For many of our patients, frequent UTIs can be a big source of discomfort and frequent ED or PMD visits. Women, in particular, are impacted by this issue as they have >50% lifetime risk of acute cystitis. Many are treated with antibiotics which may or may not be appropriate (don’t worry, that is aRead more