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The drowned patient represents a unique and difficult challenge. A wide range of physiologic insults may occur, making each management decision critical. This review describes the epidemiology, pathophysiology, critical actions, and prognostic factors the emergency physician must know to provide the best care for the drowned patient.
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With trauma as the leading cause of death in children nationwide, pediatric abdominal trauma is a commonly encountered clinical situation in the emergency department (ED).
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To address patient flow EDs across the country are employing different variations around boarding inpatients in upstairs hallways.
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How would you like to be told that the hospital that houses your ED the large, "mother" facility that receives your patients for admission and provides a host of ancillary services that makes the running of your department go more smoothly was going to shut down, and that you were going to have to transform into a satellite ED (SED)?
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What are the leading ED best practices in large health systems? According to one national survey, they include taking a business-like approach to the management of the department.
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A growing number of EDs are using physician scribes to help with histories and physical exams, but Joe Danna, MD, FACEP, has been using scribes for much, much more, and he says it's made a world of difference when it comes to staff morale.
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An intervention that provided housing and case management to homeless adults with chronic medical illnesses reduced hospitalizations and ED visits in two Chicago-area hospitals, according to a study recently published in The Journal of the American Medical Association.
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The leaders at San Francisco General Hospital were more than happy to participate in a nationwide Centers for Disease Control and Prevention (CDC) program that offers routine rapid HIV testing to all ED patients, but they believed strongly that universal testing was not practical.
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In a recently released advisory opinion, the Health and Human Services' Office of Inspector General (OIG) has told the facility that requested the opinion, which they didn't disclose, that its plan to compensate physicians for taking call represented "a low risk of fraud and abuse."
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I remember when the Goldman myocardial infarction (MI) algorithm came out, quickly followed by a seven-button hand-held "calculator." It promised to reduce all decision-making regarding ED chest pain patients to seven yes or no questions. But when you looked into the mathematics, if you answered no or negative to all of the questions, it indicated a 4% chance of acute cardiac ischemia. So, what would you do with this information? Could you tell the patient that there was only a 4% chance of a heart attack, so it was OK to go home?
