Root Cause Analysis in the Time of COVID-19:

In Education & Quality Improvement, Featured Education Innovations (FEI), HiQuiPs by Tayler YoungLeave a Comment

You are midway through a busy rapid response shift where you have noticed an increased response time of the hospital’s intubating teams to decompensating patients. Over the last few months, the COVID-19 pandemic has prompted restructuring of the use of many spaces to accommodate the influx of patients. You understand that the system is overwhelmed but you are optimistic that you can optimize the interprofessional team’s response times. This sets off a new …

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What is the role of POCUS to differentiate between cellulitis and abscess?

In Clinical Questions, Medical Concepts by Justin HsuLeave a Comment

A 30-year-old male presents to the ER with right forearm redness, swelling and pain. On exam, you are unsure whether this infection represents cellulitis or abscess. You wonder if point-of-care ultrasound (POCUS) can be helpful. Superficial soft tissue infections are a common ED presentation. Cellulitis appears as an area of erythema, edema and tenderness. An abscess is suspected when a discrete fluctuant mass is palpated within the infected tissue. However, relying on these …

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Tiny Tip: HOUSE as a discharge guide for marginalized patients that incorporates the social determinants of health

In Tiny Tips by Nicole MathiesLeave a Comment

Emergency Departments are often the primary source of healthcare for marginalized patients with substance use disorders and precarious housing​1​. As such, we have unique opportunities to intervene and initiate change. While many screening tools exist to identify substance use disorders, the novel H.O.U.S.E. mnemonic is the first to cover high yield items to be discussed with patients prior to discharge​2​. It can be used as an easy to remember tool to ensure that …

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Hosting More Effective Morbidity & Mortality Rounds

In Education & Quality Improvement, HiQuiPs by Dominick SheltonLeave a Comment

LeBron was in the last few months of his emergency medicine (EM) residency and was tasked with presenting morbidity and mortality (M&M) rounds during an EM rotation.  Between clinical shifts and incessant studying for his exam, he carved out time to prepare the rounds.  Although he had been a participant in many M&M rounds, he realized that he had never presented at one.  He didn’t have a good case to present and wondered …

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Vicious Cycles: Management of the Tricyclic Antidepressant Overdose

In Medical Concepts by Sophie RamsdenLeave a Comment

You’re on a night shift in the ED and receive a patch about a 75-year-old female with altered LOC. EMS reports an empty bottle of doxepin was found in her home. The patient is tachycardic and hypotensive, and on arrival has a GCS of around 12. You quickly look up the class of medication that doxepin belongs to, and realize it’s a TCA. What do you need to worry about in this patient, …