Author: Jonathan McMahon, DO, MA Edited by: Robert Allen, MD Case A 46-year-old female with a past medical history of hyperlipidemia presents to the ED with a chief complaint of syncope that happened about an hour ago. She states that she was walking to the kitchen when she suddenly lost Read more…
Thought Experiment: Applying an EBM Disease Model to Defensive Medicine But, if a lawyer were to review your chart, how would you defend that decision? We have all had attendings say this to us when we present a plan for a patient, perpetuating the next generation of defensive medical practitioners. Read more…
Last month Academic Emergency Medicine published the article “Can emergency physician gestalt ‘rule in’ or ‘rule out’ acute coronary syndrome: validation in a multi-center prospective diagnostic cohort study”. The following is a critique by Dr. deSouza and Dr. Sinert: In this large multi-center, prospective diagnostic accuracy study, the investigators conclude Read more…
Chest pain: Cause for more than 8k…no, 80k…no, 8 MILLION visits!! What this is about? -Not the 60 year-old sweaty guy with crushing chest pain, ST-Elevations, and trop of 4000 (How many of those do you see?) -Not the 18 year-old girl elbowed in the chest, now with a bruise, Read more…
It seems like only yesterday, I was writing about the silliness of some order set (link) with a one-click stop for amylase, lipase, and ketones. Now, for another. In some hospitals, a single, “cardiac markers” click orders troponin I and a CK with a reflex to CK-MB. Two tests in Read more…