Emergency departments (EDs) bill more frequently at the highest levels of service than they did in prior years. This trend has generated questions as to whether the apparent rise in case severity is due to real changes in patient care needs or “upcoding” – the practice of coding cases at Read more…
Background 2017 AHA/ACC guidelines for the treatment of hemodynamically stable patients with ventricular tachycardia (VT) include the following recommendations:1 Intravenous procainamide can be useful to terminate VT. (Class IIa) Intravenous amiodarone or sotalol may be considered to terminate VT. (Class IIb) In 2013, deSouza et al conducted a systematic literature Read more…
The use of whole body CT (WBCT) – or “pan scan” – in trauma is an often debated topic in the emergency department (ED). The poly-consult setting of trauma involves multiple services that rapidly evaluate and treat a patient. With improved protocols, higher resolution imaging, and closer proximity of CT Read more…
For those who were not in conference yesterday: Dr. Rushabh Shah discussed AV nodal blocks: For all AV blocks consider: beta blocker or calcium channel blocker overdose, hyperkalemia, inferior MI, cardiomyopathy, and myocarditis 1st degree and 2nd degree Mobitz type 1 AV block: typically benign 2nd degree Mobitz type 2: Read more…
You just spent the last three months on off-service rotations and you’re so relieved to be back home in your ED. You arrive 30 minutes early to your first shift and high five all the ED nurses, technicians, patient care assistants, the clerk, your attending, and the maintenance staff with Read more…
This article is brief overview of the management of femur fractures in the emergency department. In general, femur fractures can be identified with x-ray. AP pelvis, hip and femur x-rays will be sufficient in most cases. Femur fractures can be categorized as proximal fractures and femoral shaft fractures. There are Read more…
We are excited to announce the reinstatement of the Administration Mini-Fellowship with our meeting last month. The Administration Mini-Fellowship will be a learning and networking group advised by Dr. Ninfa Mehta, SUNY Downstate’s ED Medical Director. At our first meeting we discussed physician leadership & hospital performance from 2 articles: Read more…
Working with kids can sometimes be great. They’re funny, adorable, have a lot of energy, and are always running around. Sometimes though, it’s not their legs that are running. Often, it’s their nose, and that’s okay. Other times, it’s their stomach and intestines, and that’s when things get a Read more…
It is a quiet morning in the ED. I know it’s difficult to believe. The triage nurse rolls in a young patient who is screaming in pain. “Doc, doc, my n@&* are killing me!” You can’t help but start thinking about a differential diagnosis on your way to interview your Read more…
Case: It’s your 5th straight night and your pediatric ED shift ends in one hour. A few stable patients came in during your shift, and you’re happy about that. No one wants kids to be sick. Your mind begins to wander. To be honest, the inner fat kid you’ve always Read more…