Archive for 'ER' Category
Top 10 Rules of Emergency Medicine
Dr. Keith Wrenn of the University of Rochester underscores the following 10 tenents of Emergency Medicine in a timeless paper: Secure the ABCs. Consider or give naloxone, glucose and thiamine. Get a pregnancy test. Assume the worst: rule out serious disease. Do not send unstable patients to radiology. Look for the common red flags. Trust [...]
Revisiting Resuscitation – 2010 AHA CPR Guidelines
2010 marks the 50th anniversary of modern cardiopulmonary resuscitation (CPR). The American Heart Association has revisited CPR technique with contemporary evidence. Excerpts from their executive summary of CPR guidelines: The Change From “A-B-C” to “C-A-B” The newest development in the 2010 AHA Guidelines for CPR and ECC is a change in the basic life support [...]
General Treatment Strategies of the ICU
Although care for each patient in the ICU is customized, there are general treatment strategies that are used by all trauma and critical care physicians in treating severely injured patients On the transfer to the trauma bay, the patient would receive packed red blood cells. Upon arrival in the trauma bay, a series of diagnostic [...]
Cervical Spine Injuries in the ER
Not everyone with a neck injury calls 911… and some of them walk in themselves. Such was the case of a high school football player whose coaches thought had suffered a “stinger” during a game. After a tackle, he developed neck pain and numbness to the left arm. When someone walks into the ER on [...]
How to Ease Anxiety in the ER (Randy Pausch)
As Jai was being rushed into surgery for an emergency C-section, she said to the doctor, “This is bad, isn’t it?” I admired the doctor’s response. It was the perfect answer for our times: “If we were really in a panic, we wouldn’t have had you sign all the insurance forms, would we?” she said [...]
How to Select the Best Residency
The American Medical Association offers FREIDA, which provides the numbers on each program’s duration, residents, benefits and other factual information. there are abundant resources available at most university bookstores that can be very helpful with thinking about various important criteria that go into selecting a residency…. At the very least, these books are worth checking [...]
Removal of Foreign Body
I recently treated a young patient with a cylindrical metallic foreign body in the ear canal …it was a tiny fuse. The smoothness and rounded edges of the object made grasping with alligator forceps impossible. The width of the object prohibited the use of a cerumen spoon since the object fit the canal almost perfectly. [...]
Common Chief Complaints in the ER
list of most common diagnosis codes used in our ER, in order: 786.50 UNSPEC CHEST PAIN 789.09 ABDOMINAL PAIN OTHER SITE 465.9 ACUTE UPPER RESP INFECTIONS UNS 847.2 SPRAIN/STRAIN LUMBAR REGION 558.9 OTH NONINFECTIOUS GASTROENTERITIS 486 PNEUMONIA ORGANISM UNS 466.0 ACUTE BRONCHITIS 780.99 OTHER GENERAL SYMPTOMS 784.0 HEADACHE 346.90 UNS MIGRAINE NOT INTRACT 847.0 SPRAIN/STRAIN [...]
Intro to Emergency Medicine
Panda Bear MD gives an excellent overview of his work in the emergency room. I generally work 14 twelve-hour shifts in every 28-day block. I either work the 9 AM to 9 PM shift or the 9 PM to 9 AM shift, with seven consecutive days on one or the other. Next year I will [...]
The Value of CPR
Mr. and Mrs. John Q. Public are sitting on the couch relaxing after a busy Christmas. All of a sudden Mr. Public clutches his chest and falls over onto the floor. Mrs. Public calls 911 and starts CPR. 10 minutes later, EMS arrives with their portable electricity and shocks Mr. Public’s VFib into asystole. [...]