Browsing: Clinical

Infectious Disease , Sepsis

Sepsis Alert: Care Pathways in the ED

1/30/2023 Amelia R. Barber, MD , Keasha N. Kuhnen, DO

Sepsis identification tools have many criticisms and vulnerabilities. The value of different sepsis care pathways has been a major area of research and discussion among clinicians. This has caused lar

Simulation

The Portable Sim Gym: An Eye-Opening Tool in Medical Education

1/30/2023 Kandria Ledesma, MD , Matthew Kiefer, MD , Yasamin Soltanianzadeh, MD

The art of on-shift teaching is a skill that many attendings struggle with and aim to master, especially during a busy shift. A few residents hope to help via the “Sim Gym,” their version of a portabl

Toxicology

Top Gun Toxicity: Military-Grade Hydrocarbon Exposure Management in the ED

1/30/2023 E. Mason Jackson, MD , Michael Troise, MD

The ramifications of military fuel leaks extend beyond environmental disasters to acute exposures/ingestions and chronic toxicity. With more than 450 military bases in the United States, many of which

ECG Challenge , Cardiology

ECG Challenge: January-February-March 2023

1/30/2023 Graham Clifford, DO , Pooja Mysore, MD , Raema Mimrod Jean, MD , Jeremy Berberian, MD

A 62-year-old male presents with chest pain that has been gradually worsening over the past 2 weeks. What is your interpretation of his ECG?

Op-Ed , Patient Interactions

Words Matter: The Importance of Communication in Medicine

1/30/2023 Robert Allen, MD

The next time you or I see a patient, let’s take a second to confirm the patient can adequately understand us. That may mean speaking slower, speaking louder, or making sure the patient has hearing ai

Toxicology , Nephrology

A Case of Intentional Salt Ingestion Leading to Life-Threatening Hypernatremia

1/30/2023 Christopher M Mashiak, MD , Johndavid M Storn, MD , Jennifer V Pope, MD

Acute salt ingestion should be rapidly corrected to reduce serum osmolality. This can be done with an infusion of hypotonic solutions, such as 5% dextrose in water (D5W), with a goal reduction of 1 mm

Patient Interactions

Emergency Physicians’ Perspective: Caring for Persons with Disabilities

1/30/2023 Cori Poffenberger, MD , Anika Backster, MD , Jason Rotoli, MD

As health care professionals, we interact with and see patients with disabilities in one tiny microcosm of their world, in the hospital or the clinic, where they are the patient who may be ill or suff

Airway , Orthopedics

Oh Snap! Ketamine-Induced Laryngospasm in an Adult Patient

1/30/2023 Ashleigh MacLean, MD , Neha Sehgal, DO

Overall, laryngospasm is rare. When it does occur, it almost always resolves with simple interventions such as pressure to Larson’s notch and assisted positive pressure ventilation. Supplemental oxyge

Infectious Disease , Neurology

Remember to Inspect the Skin: A Clue to Diagnosing VSV Encephalitis

1/30/2023 Jay Patel, MD , Jordan Miller, DO

Meningitis is a cause for concern when it comes to a patient in the ED. It is one of those cannot-miss diagnoses, as there are devastating neurological complications that can occur if bacterial, funga

Palliative Care , Op-Ed

Palliative Care in the ED: Past, Present, and Future

1/30/2023 Alice Chang, DO

Palliative-care training and education, quality improvement, and research within EM has surged in the past decade. As a result, the practice paradigm for seriously ill patients in the ED has begun to