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
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
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 …
Lean: Fad or Healthcare Revolution?
In August of 2012 the provincial government of Saskatchewan signed an agreement with a consulting company to assist in the implementation of the Lean quality improvement system throughout healthcare system. This deal, which will cost up to 38 million dollars, will see Lean quality improvement consultants working to imbed the Lean system in the culture of Saskatchewan healthcare over the next 4 years. Is this initiative going to revolutionize healthcare in the province? …
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 …
Coffee Fund for a Road Trip – Lessons for Healthcare
Guest post by Shawn Mondoux. Suppose that you had worked your entire life and put away savings, small amounts from each paycheck that had gone into a fund that you were accumulating over 20 or more years of work. The goal of this money was to cover the cost of a dream trip with four of your closest, most intimate friends. The four of you had been pooling your money, together and in …