Would you rather misdiagnose or misdispose?

In Medical Concepts by Brent Thoma1 Comment

Over the past two weeks I have been completing a rotation focusing on the administrative aspects of the emergency department. Halfway through a shift with one of my admin mentors, the quality improvement ninja and philosopher king known to most as Dr. Mark Wahba, we played a brief game of “Would you rather?” If you have yet to be initiated, you probably need to get out more. “Would you rather?” is a party …

Injecting into the Carpal Tunnel

In Medical Concepts by Brent Thoma5 Comments

It’s been awesome working in the ED with the benefit of the knowledge gained on off-service rotations in specialties like Plastic and Orthopedic Surgery. Great learning experiences on these rotations have led to a run of success with injections into all sorts of places and have given me a desire to inject into… well… most things that there is evidence for treating with needles. Recently I’ve treated a carpal tunnel syndrome (median nerve …

A Review of Systematic Reviews

In Knowledge Translation by Brent Thoma9 Comments

Dr. Wikipedia said that:“An understanding of systematic reviews and how to implement them in practice is becoming mandatory for all professionals involved in the delivery of health care.” And to me, the word of Wikipedia is the next best thing to the word of Weingart. As usual, I think Dr. Wikipedia is correct. Systematic reviews are where a lot of the evidence-based medicine that we aspire to practice is consolidated, and we require …

Pearls of Evaluating Psych Patients in the ER

In Medical Concepts by Nadim LalaniLeave a Comment

Psychiatry presentations comprise about 5-6% of total presentations,1,2 but account for way more work. It’s a common mis-perception that psych patients require a one-hour intensive interview in order to ascertain what they need. Not true. We got an inservice from one of our psychiatry faculty today. He allowed me to share his pearls on evaluating psych patients with the most important parts of a history that can be done in 15 minutes: The …

Arguments for a Journal of FOAM

In Knowledge Translation by Brent Thoma19 Comments

Over the past couple of weeks myself and others (Michelle Lin, Todd Raine, Lauren Westafer, Minh Le Cong, Javier Benítez , Simon Carley, Nadim Lalani, etc!) have tweeted, mused and, in the case of Michelle Lin, even experimented with the idea of peer-review for FOAM. My thoughts are summarized in blog posts here and here. Those posts, along with Todd Raine’s Storified version of the twitter conversation and Michelle Lin’s post on her experiment …

Flipside: A Dissenting Opinion on Crystalloid Fluids

In Medical Concepts by Brent Thoma1 Comment

As mentioned in my previous posts on Peer-review in FOAM (here and here), following my post on Ringer’s Lactate and Normal Saline I received feedback via e-mail in an e-mail from Dr. Rory Spiegel, an EM resident from Newark, NJ. He offered a well thought out dissenting opinion on Crystalloid Fluids that I felt deserved a post of its own to counterbalance my previous one (Greetings/goodbyes removed for length). On the topic of …