When the topic of agitated patients in the ED is brought up, most people conjure up an image of a psychotic manic patient or tell the story of a patient brought in after ingesting a combination of methamphetamine and bath salts. Acutely agitated patients like this are a danger to themselves and anyone near them. Assessing and treating these undifferentiated patients in the ED can be a formidable task even if it is possible …
FOAM + Curriculum = FOAM-U?
With the first SMACC conference a wild success, I think it is becoming obvious, at least to the early adopters, that FOAM is here to stay. Some of the recent discussion on the future of FOAM has centered upon building a structure for the FOAM “tree of knowledge.” The tree of knowledge reference and a very eloquent summary of this topic is available from a new member of the FOAM-o-sphere, the Mid Med …
Requesting Consultations using Kessler’s 5-Cs
Bad consults are bad for patients. Consulting colleagues is a critical skill in Emergency Medicine. The success of a good consultation is more than simply getting the consultant to come see the patient. Rather, it’s about getting the best out of your consultant so that ultimately the patient benefits. Poor consultations not only make you look like a dork, they will also have downstream effects on how well your consultations are received for the …
Would you rather misdiagnose or misdispose?
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
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
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 …