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Suppose a patient is being seen in your ED for an extremity injury resulting from a motorcycle accident, and chooses to leave right after his arm is put in a splint, although the emergency physician (EP) hasn't yet done a full examination.
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Busy EDs are increasingly relying on temporary staff to cope with nursing shortages, unanticipated spikes in volume, and other personnel challenges, but the practice is coming at a steep price, according to research from Johns Hopkins University (JHU) School of Medicine in Baltimore, MD.
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Some electronic medical record (EMR) systems make it difficult for emergency physicians (EPs) to view the nursing notes, says Jonathan D. Lawrence, MD, JD, FACEP, an ED physician at St. Mary Medical Center in Long Beach, CA, and assistant professor of medicine at Harbor/University of California Los Angeles Medical Center, which increases the chance of conflicting information getting into the patient's chart.
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Penetrating and blunt cardiac trauma are serious causes of morbidity and mortality. Presentation for blunt cardiac trauma may be subtle and nonspecific, challenging the clinician to make a timely diagnosis.
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Treating pain in the ED is relatively straightforward if the cause is obvious like a broken leg or acute myocardial infarction for which there is clear evidence for the diagnosis. Treating pain is somewhat more problematic when there is no diagnostic test. So it is with headaches, especially the severe migraine types.
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Lyon and colleagues performed a retrospective cohort study of the relationship between insurance status and 30-day mortality, as well as the use of five common ICU procedures, among 138,720 adult patients admitted to ICUs in Pennsylvania in fiscal years 2005 and 2006.
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Prasad and associates conducted a retrospective cohort study of associations between internal medicine trainee exposure to mechanical ventilation protocols and their performance on questions related to this topic on the critical care board-certifying examination.
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In this issue: New indication for rivaroxaban; new study on warfarin testing; medications causing adverse drug events; niacin as an add-on therapy; and FDA actions.
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Hemodynamic monitoring is an essential part of caring for critically ill patients. Critical care providers are regularly faced with the challenge of determining whether a patient is adequately volume resuscitated, and hemodynamic assessments are often the first step in making a proper diagnosis so that other life-saving therapies can be promptly implemented.
