The Agitated Patient in the ED: Moderate & Severe Agitation

In Medical Concepts by Brent Thoma10 Comments

In my first post of a trilogy on the agitated patient in the ED I outlined BARS sedation score for defining levels of agitation, discussed how to risk stratify a potentially agitated patient and offered some tips on how to deal with the mildly agitated patient. This post will discuss what to do with moderately and severely agitated patients while the final chapter will delve into the work-up of these challenging patients. If you’ve been …

A Commitment to Pre-publication Peer Review

In Knowledge Translation by Brent Thoma5 Comments

Many keys have been tapped relating the merits and problems with various mechanisms of peer review for FOAM (Free Open-Access Meducation). It has been discussed on this site in multiple forms (Crowdsourced Instantaneous Review, FOAM: A Market of Ideas, Arguments for a Journal of FOAM, FOAM + Curriculum = FOAM-U?) by Aaron Sparshott at IVLine (Capturing the Great FOAM), by Damian Rolond at The Rolobot Rambles (Peer Review: Pointless, Perfunctionary or Practical) as well as on twitter (thanks …

The Agitated Patient in the ED: Assessment & Mild Agitation

In Medical Concepts by Brent Thoma9 Comments

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?

In Knowledge Translation by Brent Thoma6 Comments

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

In Medical Concepts, Tiny Tips by Nadim Lalani1 Comment

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?

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 …