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 …
Pearls of Evaluating Psych Patients in the ER
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 …