A Solution to the SGR: Value-Based Medicare Payments
You have probably heard of the SGR, or Sustainable Growth Rate. It is a formula that was put in place in 1997 as part of the Balanced Budget Act t
Developing the Physician Advocate
While most of you will have graduated and moved into practice by the time all these changes take place, it is important to remain informed about the current challeng
Adult-Sized Problems
It was one of my first shifts of residency after spending a few years with the U.S. Marines. Until recently, I had not treated a patient under the age of 17 since my internship t
Understanding Alcoholic Ketoacidosis
A 49-year-old male with a history of alcohol abuse presents to the ED with complaints of generalized abdominal pain and vomiting for the last 36 hours. The patien
A Different Perspective
Ian and I found out we were pregnant on the Sunday after Thanksgiving – one month along; everything seemed to be going right in life, and this just felt like it was meant to b
A Reflection on Mental Health and Emergency Medicine
After a knock on the door, I entered the hospital room to find Lisa, a 12-year-old patient who was seated on the exam table, eyes fixed on her sho
A Temporal Problem: Diagnosing and Treating Viral Encephalitis in the ED
Case Report A 49-year-old male presents to the emergency department with two days of confusion, agitation, and speech abnormal
12 Ways to Prosper in Emergency Medicine
After 35 years in emergency medicine, you gain a little more than just medical knowledge. The day in and day out, grueling aspects of our chosen field can som
Backboards: Do They Really Have Your Back?
Spinal immobilization has long been considered standard practice for pre-hospital trauma patients. Placing patients on long spinal boards is one of the most
Practical Tips: When and How to Use a Femoral Nerve Block
An 82-year-old female shows up  in your ED with severe hip pain    after a fall at home. You already know what the x-ray is before you see it