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Emergency Medicine

This page shows you the most recent publications within this specialty of the MedWorm directory.

Pulse oximetry
is the measurement of oxygen saturation in arterial blood by using a non-invasive device, usually connected to one of the fingers. A wave form and percentage saturation display are usually given. Pulse oximeters are routinely used in operating rooms, emergency rooms and intensive  care units. Outside of the medical setting, they can be used by mountain climbers and pilots of un-pressurized aircrafts to decide whether supplemental oxygen is needed at high altitudes. Usual normal range for pulse oximetry readings would be 95 to 99 percent. But in patients with chronic obstructive pulmonary disease, slightly lower levels ma...
Source: Cardiophile MD - September 1, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

This surprising request brought an emergency doctor to tears
Most of the time I feel as though I am running in quicksand attempting to bring patients to a place of grace and dignity in dying. On occasion, there is someone who jerks me out of my quicksand and plants me squarely on stable shore and then proceeds to show me what grace and dignity in the face of death really look and feel like. Please meet Mr. Jefferson. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 31, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Palliative care Source Type: blogs

The Last Thing On Our Mind
She was having excruciating pain in her pelvic area.  I pulled the sheets down cautiously and noted the bruising encircling the waist and inching towards the thighs.  I finished my exam and retreated to the nursing station of the skilled nursing facility to comb through the chart.  ER records, floor notes, consultations, but no X-ray of the pelvis. There was no mention of pelvic pain.The emergency room physician had dutifully ordered a cat scan of the head and neck to rule out injury.  The hospitalist had noted a fourteen point review of symptoms.  The social worker had informed the patient that sh...
Source: In My Humble Opinion - August 31, 2014 Category: Primary Care Authors: Jordan Grumet Source Type: blogs

An American doctor’s experience with the NHS
You know it’s going to be one of those days when one of the first tweets on vacation inquires about the closest hospital. Victor, one of my 11-year-olds, had something in his eye courtesy of a big gust of wind outside of Westminster Abbey. He was complaining enough to let me flip his eyelid and irrigate his eye on the square in front of Big Ben. (I’m sure several people thought I was torturing him.)  Despite an extensive search and rinse mission no object or relief was to be found. I fretted about going to the hospital. It wasn’t the prospect of navigating a slightly foreign ER, but simply the prospect of the wait. ...
Source: Kevin, M.D. - Medical Weblog - August 30, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Health reform Source Type: blogs

MKSAP: 55-year-old man with a wrist fracture and anemia
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is reevaluated during a follow-up examination for a wrist fracture and anemia. The patient is otherwise asymptomatic. He was treated in the emergency department 2 weeks ago after he slipped in his driveway and sustained a right wrist fracture; mild iron deficiency anemia was detected at that time. He had normal results of a routine screening colonoscopy 5 years ago. Since his emergency department evaluation, 3 stool samples have been negative for occult blood. He takes no medication. On physica...
Source: Kevin, M.D. - Medical Weblog - August 30, 2014 Category: Journals (General) Authors: Tags: Conditions Endocrinology GI Source Type: blogs

Developing EM, Brazil 2014
aka Postcards from the Edge 010 This candid interview with Lee Fineberg and Mark Newcombe, conference organisers for DevelopingEM Brazil 2014, looks at what the upcoming conference has in store. Developing EM is a conference with a reputation for ethics, innovation and action in the arena of emergency medicine in the developing world. //www.youtube.com/watch?v=pn62NH_jz3s The video interview touched on the highlights of last year’s conference in Cuba and discusses the sustainable aspects that came out of the educational congregation. These themes are part of the core philosophy of this conference and is one of the ...
Source: Life in the Fast Lane - August 30, 2014 Category: Emergency Medicine Authors: Bishan Rajapakse Tags: Conference Education International Emergency Medicine bishan rajapakse brazil 2014 Developing EM Lee Fineberg Mark Newcombe Source Type: blogs

Kids and Cutting to Air
This is a guest post written by Dr Mike Cameron FACEM, a Queensland-based emergency physician. It was the mid-1980s and I was almost at the end of my third year as a doctor. I was working in England, about an hour’s motorcycle ride North of London, in a district hospital of a few hundred beds. I remember it was cold. That night I was the Anaesthetic Senior House Officer (SHO) on call. I had done a few cases in Theatre but I had got out before midnight and things were looking pretty good sleep-wise. Labour Ward had a couple in early labour but no epidurals required. I was on a 1:2 roster, but my Registrar and I alternated...
Source: Life in the Fast Lane - August 30, 2014 Category: Emergency Medicine Authors: Chris Nickson Tags: Anaesthetics Emergency Medicine child cricothyroidotomy mike cameron paediatric surgical airway trick of the trade Source Type: blogs

Healthcare Update Satellite — 08-28-2014
Good news is that the number of medical malpractice cases in Pennsylvania is decreasing. Bad news is that if you practice medicine in the Philadelphia area, you’ve got a big target painted on your back. Philadelphia accounts for only 12 percent of the state’s population yet in 2013, 40 percent of medical malpractice trials resulting in verdicts took place in the city. Philadelphia medical malpractice plaintiffs won 45% of trials, more than any other jurisdiction and significantly higher rate than the national average. Looks like we’ve found another place to avoid when looking for your next place to practi...
Source: WhiteCoat's Call Room - August 28, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

The RUC. "an Independent Group of Physicians?" - But It Includes Executives and Board Members of For-Profit Health Care Corporations and Large Hospital Systems
Introduction We just discussed how a major story in Politico has once again drawn attention to the opaque RUC (Resource Based Relative Value System Update Committee) and its important role in determining what physicians are paid for different kinds of services, and hence the incentives that have helped make the US health care system so procedurally oriented.  (See the end of our last post for a summary of the complex issues that swirl around the RUC.)The Politico article covered most of the bases, but notably omitted how the RUC may be tied to various large health care organizations, especially for-profit, and how the...
Source: Health Care Renewal - August 28, 2014 Category: Health Management Tags: AMA boards of directors conflicts of interest health care prices healthcare executive hospital systems perverse incentives regulatory capture RUC Source Type: blogs

Collaboration, Consistency, and Community Spirit: How Durham Advances Health
TweetEditor’s note: This post is part of an ongoing series written for Health Affairs Blog by local leaders from communities honored with the annual Robert Wood Johnson Foundation Culture of Health Prize. In 2014, six winning communities were selected by RWJF from more than 250 applicants and celebrated for placing a priority on health and creating powerful partnerships to drive change. Interested communities are encouraged to apply for the 2015 RWJF Culture of Health Prize. Applications are due September 17, 2014. Durham, North Carolina is so richly endowed with health care resources that it is known as “the City of M...
Source: Health Affairs Blog - August 28, 2014 Category: Health Management Authors: Erika Samoff Tags: All Categories Nonmedical Determinants Public Health States Source Type: blogs

Hospitals are taking a page from the big pharma playbook
I recently wrote about a hospital system in Colorado that had discovered a way to cross market its more profitable emergency room services if a patient first came to its urgent care center. Pretty clever! Then recently I came across another health care marketing trick close to home and just as sly. As I sat on a New York subway one sizzler of a day, an ad for an ice cream cone grabbed my attention. Ice cream! Hot day! After a closer read, I realized the ad was not touting ice cream but the Center for Advanced Digestive Care, a part of New York Presbyterian, one of the city’s most prestigious hospitals and well kn...
Source: Kevin, M.D. - Medical Weblog - August 28, 2014 Category: Journals (General) Authors: Tags: Policy Hospital Medications Source Type: blogs

TechTool Thursday 057 iNIV
TechTool review iNIV by Gecod s.r.l Apps on iOS iNIV was developed by a team of Emergency Doctors in an Italian hospital. It aims to guide acute care staff in managing non-invasive ventilation effectively, and to provide practical education around NIV use in general Website: – iTunes Design The app icon and overall graphics work well. The font style and colour make the text very easy to read. However there is something very un-Apple about the design. There are buttons and navigation in unusual places, so it’s not immediately intuitive to use on the iPhone. It’s hard to pinpoint the issue here, but when using ...
Source: Life in the Fast Lane - August 28, 2014 Category: Emergency Medicine Authors: Tessa Davis Tags: Review Tech Tool Gecod iNIV tech review Source Type: blogs

Top stories in health and medicine, August 28, 2014
From MedPage Today: I, Intern: Common Problems, Elusive Answers. Rebecca Karb, MD, crosses paths with patients in the Rhode Island Hospital emergency department who have ailments that she rarely saw as a medical student. Results Mixed With Home BP Monitoring. A hypertension self-management program reduced systolic blood pressure in high-risk patients, including those with cardiovascular disease, diabetes, or chronic kidney disease. Surgery No Help for Mild Knee OA. Arthroscopic surgery for degenerative meniscal tears in patients with mild knee osteoarthritis had no benefit for function or pain. Study Flags ECG Change as ...
Source: Kevin, M.D. - Medical Weblog - August 28, 2014 Category: Journals (General) Authors: Tags: News Heart Orthopedics Source Type: blogs

Electronic Health Records Update: As Adoption of EHRs Increases, So Do Privacy and Data Security Concerns
  Physicians in all specialties have steadily adopted electronic health records (EHRs). However, as doctors have embraced technology for streamlining patient records, we have seen a marked uptick in data breaches by hackers who want access to the reams of information stored in these systems.  Current State of Electronic Health Records: High EHR Adoption, Low Interoperability A soon to be published article in Health Affairs outlines the current state of EHR adoption: “Using data from the 2009–13 Electronic Health Records Survey, we found that EHR adoption continues to grow: In 2013, 78 percent of offic...
Source: Policy and Medicine - August 28, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs

9 Hours of Chest Pain and Deep Q-waves: Is it too late for Thrombolytics? (Time Window for Reperfusion; Acuteness on the ECG)
Conclusion: An invasive strategy based on coronary stenting with adjunctive use ofabciximab reduces infarct size in patients with acute STEMI without persistent symptomspresenting 12 to 48 hours after symptom onset.This is a section on "Acuteness" that I wrote in a Chapter on Reperfusion therapy that I wrote with Bill Brady in Critical Decisions in Emergency and Acute Care Electrocardiography.  I have updated it here.Here are a couple posts that demonstrate the issue of acuteness.Acuteness—when is it too late for reperfusion?  In deciding on reperfusion, particularly on fibrinolytic therapy, it is imp...
Source: Dr. Smith's ECG Blog - August 28, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs

September is National Preparedness Month
“Be Disaster Aware, Take Action to Prepare”. Get The 2014 National Preparedness Month Toolkit Now!  http://bit.ly/disastertoolkit For more information and  ideas for National Preparedness Month  go to: http://1.usa.gov/1p8z5Lh   (Source: BHIC)
Source: BHIC - August 27, 2014 Category: Databases & Libraries Authors: Michelle Burda Tags: Emergency Preparedness Public Health Source Type: blogs

Rescue Me: The Challenge Of Compassionate Use In The Social Media Era
TweetThe Development of Brincidofovir And Its Possible Use To Treat Josh Hardy Last March 4, seven-year old Josh Hardy lay critically ill in the intensive care unit at St Jude Children’s Hospital in Memphis, Tennessee with a life-threatening adenovirus infection. His weakened immune system was unable to control the infection, a complication of a bone marrow stem cell transplant he needed as a result of treatments for several different cancers since he was 9 months old. His physicians tried to treat the adenovirus with an anti-viral agent, Vistide (IV cidofovir), but had to stop due to dialysis-dependent renal failure. Th...
Source: Health Affairs Blog - August 27, 2014 Category: Health Management Authors: Arthur Caplan and Kenneth Moch Tags: Access All Categories Bioethics Biotech Consumers Pharma Policy Research Technology Source Type: blogs

An Interview with Amanda Sager
Amanda Sager graduated from Bridgewater College in 2009 where she received a Bachelor of Science degree in Family and Consumer Sciences with an emphasis on Early Childhood Development. After college, she became the Site Director for the After School program at Cub Run Elementary in Rockingham County, Virginia. After a year at Cub Run, Amanda then moved to Mountain View Elementary in Rockingham County to open the Before and After School program as the Site Director there.  She was at Mountain View for three years before accepting the position as Behavioral Specialist at Spotswood Elementary School in Harrisonburg City. Aft...
Source: Disruptive Women in Health Care - August 27, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Access Advocacy Children Source Type: blogs

The LITFL Review 150
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. Welcome to the 150th edition, brought to you by: Anand Swaminathan [AS] (EM Lyceum, iTeachEM) Brent Thoma [BT] (BoringEM and Academic Life in EM) Chris Connolly [CC] Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC) Joe-Anthony Rotella [JAR] Kane Guthrie [KG] Mat Goebel [MG] Segun Olusany...
Source: Life in the Fast Lane - August 27, 2014 Category: Emergency Medicine Authors: Kane Guthrie Tags: LITFL review LITFL R/V Source Type: blogs

Out of hospital cardiac arrest
is an important mechanism of death through out the world and the survival rates are poor even in those who are resuscitated [Berdowski J et al. Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation,2010: 81:1479–1487]. Survival to discharge range from two percent in Asia to eleven percent in Australia, with Europe and North America coming in between. It is well known that the critical links in the chain of survival for out of hospital cardiac arrest (or for any cardiac arrest for that matter) are early activation of emergency response, early c...
Source: Cardiophile MD - August 26, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Research and Reviews in the Fastlane 045
Welcome to the 45th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 10 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out the f...
Source: Life in the Fast Lane - August 25, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Clinical Research Emergency Medicine Intensive Care R&R in the FASTLANE critical care Education literature recommendations Research and Review Source Type: blogs

DNR/DNI: More code than status
“If a tree falls in a forest and no one is around to hear it, does it make a sound?” Chances are that many of you have duked this out with your college roommates back in the day, but how about this one? “If a doctor and a patient make an advance care plan, but when an emergency happens, nobody can find a copy of it, the proxy doesn’t know what’s in it, or nobody can figure out what it means, was there even a plan to begin with?” Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 25, 2014 Category: Journals (General) Authors: Tags: Physician Geriatrics Hospital Source Type: blogs

When medications devalue the opportunity to listen
When I hear debate over the association between SSRIs (selective serotonin re-uptake inhibitors, a class of antidepressant medication) and suicidal behavior in children and adolescents, I am immediately brought back to a night in the early 2000s.  As the covering pediatrician I was called to the emergency room to see a young man, a patient of a pediatrician in a neighboring town, who had attempted suicide by taking a nearly lethal overdose. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 25, 2014 Category: Journals (General) Authors: Tags: Conditions Pediatrics Psychiatry Source Type: blogs

Partnership And Progress On The Path To Achieving Millennium Development Goal 6
TweetEditor’s note: For more on global health, stay tuned for the upcoming September issue of Health Affairs. In 2000, nearly 200 world leaders came together and agreed on a set of objectives intended to tackle some of the most pressing development challenges of our time, such as poverty, AIDS, and child mortality. With a target date of December 31, 2015, the Millennium Development Goals (MDGs) provided a clear path for progress and a platform for immediate action. Last week, on August 18, we reached a milestone on that path – as of that date, 500 days remained to achieve these eight goals. So where do we stand, a...
Source: Health Affairs Blog - August 25, 2014 Category: Health Management Authors: Deb Derrick and Peter Yeo Tags: AIDS All Categories Global Health Policy Public Health Source Type: blogs

Recognize the potential victims of human trafficking
If you’ve ever worked in an emergency room, you’ve likely treated a victim of human trafficking. We all have, often without knowing it. With nearly thirty million people in modern-day slavery around the world, there are more slaves today than at any point in history. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 24, 2014 Category: Journals (General) Authors: Tags: Conditions Emergency Source Type: blogs

Like it or not, urgent care centers are here to stay
The New York Times had a front-page story about the growth of urgent care clinics nationwide. These are the places that are often referred to as “minor emergency rooms,” or “doc-in-a-box” outfits. Their value proposition is simple: You don’t need an appointment. The costs are “reasonable,” and much more transparent than usual medical care at a doctor’s office, emergency room, or hospital. Best of all: They can treat a majority of acute conditions and have you in and out in under an hour. No ER can make that claim. Heck, not many doctors’ offices can make that claim. Continue reading ... Your patien...
Source: Kevin, M.D. - Medical Weblog - August 22, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Primary care Source Type: blogs

Cryopreservation at Alcor
Cryonics is the process of vitrifying the body and brain at death, preserving as much of the fine tissue structure as possible to enable the possibility of future restoration to life. There's no fundamental barrier to achieving that revival other than the fact that the necessary technology doesn't yet exist, and subject to the continuation of storage facilities the vitrified cryopreservees can wait for that time to arrive. A small cryonics industry has existed for some four decades now, with the most established non-profit groups being Alcor and the Cryonics Institute in the US. Several hundred people are presently preserv...
Source: Fight Aging! - August 22, 2014 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Kids.gov September Calendar
Start your school year off right by checking the Kids.gov September calendar for upcoming special events. The calendar features websites, lesson plans, and activities for Hispanic Heritage Month, National Cholesterol Education Month, National Preparedness Month, World Suicide Prevention Day and a lot more! Don’t forget to bookmark the main calendar page, so you can plan for the rest of the school year! September calendar: http://1.usa.gov/YFlC8z Main calendar page: http://1.usa.gov/1pW3LUH   (Source: BHIC)
Source: BHIC - August 21, 2014 Category: Databases & Libraries Authors: Monica Rogers Tags: Children and Teens Emergency Preparedness Health Information Literacy Mental Health Websites Source Type: blogs

Key Success Factors For the Medicare Shared Savings Program
TweetIn January 2012 the Centers for Medicare & Medicaid Services (CMS) officially launched the Medicare Shared Savings Program (MSSP) for the formation of national Accountable Care Organizations (ACOs). Early participants were charged with bringing the theory of accountable care into practice. Premier, a national health care improvement alliance of hospitals and health systems, created a population health collaborative in 2010 designed to assist providers with developing and implementing successful ACOs in both the public and private sectors. Thus far, the Premier collaborative has advised nearly 30 MSSP applicants, a...
Source: Health Affairs Blog - August 21, 2014 Category: Health Management Authors: Joe Damore and Wes Champion Tags: All Categories Health Reform Medicaid Medicare Payment Physicians Policy Quality Source Type: blogs

Transforming urgent and emergency care services in England: urgent and emergency care review - end of phase 1 report
NHS England - This interim report outlines the progress with NHS England’s work with local commissioners and the development of their five year strategic and two year operational plans as well as updates on planning to develop demonstrator sites to trial new models, including the new NHS 111 service specification. Report Press release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - August 20, 2014 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Changing configuration of health services Commissioning NHS finances and productivity Source Type: blogs

Transforming urgent and emergency care services in England: update on the urgent and emergency care review
NHS England - This interim report outlines the progress with NHS England’s work with local commissioners and the development of their five year strategic and two year operational plans as well as updates on planning to develop demonstrator sites to trial new models, including the new NHS 111 service specification. Report Press release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - August 20, 2014 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Changing configuration of health services Commissioning NHS finances and productivity Source Type: blogs

Clever Hospitals Find Another Way to Snag New Patients
Last month, I wrote about a hospital system in Colorado that had discovered a way to cross market its more profitable emergency room services if a patient first came to its urgent care center. Pretty clever! Then recently I came across another health care marketing trick close to home and just as sly. As I sat on a New York subway one sizzler of a day, an ad for an ice cream cone grabbed my attention. Ice cream! Hot day! After a closer read, I realized the ad was not touting ice cream but the Center for Advanced Digestive Care, a part of New York Presbyterian, one of the city’s most prestigious hospitals and well kno...
Source: Disruptive Women in Health Care - August 19, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Uncategorized Source Type: blogs

The LITFL Review 149
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. Welcome to the 149th edition, brought to you by: Anand Swaminathan [AS] (EM Lyceum, iTeachEM) Brent Thoma [BT] (BoringEM and Academic Life in EM) Chris Connolly [CC] Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC) Joe-Anthony Rotella [JAR] Kane Guthrie [KG] Mat Goebel [MG] Segun Olusany...
Source: Life in the Fast Lane - August 19, 2014 Category: Emergency Medicine Authors: Kane Guthrie Tags: Education LITFL R/V Source Type: blogs

Reimbursement of urgent and emergency care: discussion document on options for reform
Monitor - In this paper, Monitor and NHS England set out their current thinking on options for reforming the urgent and emergency care payment approach. It outlines preliminary options for implementing a new payment approach to support improved delivery of urgent and emergency care, as well as the way forward for NHS England and Monitor. Report Monitor news (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - August 19, 2014 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Commissioning NHS finances and productivity Source Type: blogs

Research and Reviews in the Fastlane 044
This study looks at the agreement between radiologists in reading CTPAs for pulmonary embolism. They found that more than 10% of studies initially read as positive were later read as either negative or indeterminate. Many of the change in read occurred in subsegmental embolisms. This study throws further doubt on starting patients on long term anticoagulation based on the presence of a subsegmental pulmonary embolism. Recommended by: Anand Swaminathan Education Raemer DB. Ignaz semmelweis redux? Simul Healthc. 2014 Jun;9(3):153-5. PMID: 24401925 As a rabid in situ simulationist it is good to be tempered now an then by a...
Source: Life in the Fast Lane - August 18, 2014 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Education Emergency Medicine Haematology Infectious Disease Intensive Care R&R in the FASTLANE Resuscitation critical care literature recommendations Research and Review Source Type: blogs

It’s Hard To Be Neutral About Network Neutrality For Health
TweetNote: In addition to Mark Gaynor, this post is also coauthored by Leslie Lenert, Kristin Wilson, and Scott Bradner.  Network Neutrality (NN) has been in the news because the FCC is considering two options related to a neutral Internet: either regulation forcing NN, or an approach that creates a “fast lane” on the Internet for those content providers that are willing to pay extra for it. Network Neutrality reflects a vision of a network in which users are able to exchange and consume data, as they choose, without the interference of the organization providing the network basic data transport services. The second ...
Source: Health Affairs Blog - August 18, 2014 Category: Health Management Authors: Mark Gaynor, Leslie Lenert, Kristin Wilson, and Scott Bradner Tags: Access All Categories Connected Health Health IT Technology Source Type: blogs

Tension Pneumothorax – an alternative view
Ever since I was a junior medical officer and I was faced with a spontaneous tension pneumothorax at sea on a dived submarine…I have had an interest in managing pneumothorax. A tension pneumothorax is the presence of intrapleural air that is under positive pressure throughout the entire respiratory cycle. It occurs when air enters the thorax through a pleural defect but can not leave (a one way cat flap). We have all been taught that we should never see a chest x-ray of a tension pneumothorax, with good reason. It is a diagnosis that should be made on clinical grounds only and certainly never have a chest x-ray perfo...
Source: Life in the Fast Lane - August 18, 2014 Category: Emergency Medicine Authors: Fraser Brims Tags: Clinical Case Emergency Medicine Intensive Care Respiratory CT scan ICC Pthx tension tension pneumothorax Source Type: blogs

ACEP Now still silent on EM President interviews.
Which is terrible, yet predictable. ACEP Now | The Official Voice of Emergency Medicine. Yeah, it’s completely devoid of interviews or conversations with the purported future leaders of Emergency Medicine. What a surprise. Again, if you’re running for President of ACEP but abide by the Gag Order, you aren’t worthy, and we (as a specialty) shouldn’t support them. Related posts: My professional college beclowns itself A fisking of a paranoid, ill-considered and frankly stupid idea... 33 Charts — medicine. health. social media. Well put! After a recent presentation on social physicians, someone... ...
Source: GruntDoc - August 18, 2014 Category: Emergency Medicine Authors: GruntDoc Tags: Policy Rants Source Type: blogs

Incorporating urgent care into the medical home
During her annual physical exam, one of my patients recently asked me, “Are urgent care centers any good, Dr. P?” She recounted an incident a few months earlier where she awoke with an acute illness and was sick enough that she felt she needed to receive care — at least some medical attention — more imminently than she could get from waiting to speak to my office in the morning. She said she thought about calling the answering service, but thought they would have told her to go to the emergency department. Continue reading ... Your patients are rating you online: How to respond. Manage your online ...
Source: Kevin, M.D. - Medical Weblog - August 16, 2014 Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs

August 2014 Man of the Month: Michael G. Dermer
An innovator, author, entrepreneur and health leader,  our August Man of the Month, Michael  G. Dermer, is a true disruptor in the health care industry. Michael G. Dermer is the Senior Vice President and Chief Incentive Officer of Welltok. Prior to his current role, Michael was the founder and CEO of IncentOne, the first company that in 2003 identified incentives in health care as a critical solution to driving cost savings and engagement.  Since then, he has been guiding health plans, partners and employers in how to use incentives to deliver cost reductions. Today, he shares with us his perspective on what consumers t...
Source: Disruptive Women in Health Care - August 15, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Consumer Health Care Insurance Man of the Month Uncategorized Source Type: blogs

EMA Journal August 2014
Issue 4 (Vol. 26) of EMA Journal for 2014 was published online on 4th August. Editorial overview by Andrew Gosbell & Geoff Hughes Lifers – the loneliest doctors   (#FOAMed) In the latest dispatch from the FOAM Frontier, Spiegel (@EMNerd_), Johnston (@Eleytherius), Ercleve (@Ercleve) and Nickson (@precordialthump) takes us on board the deep space transporter Odysseus where the deep space medics, jovially known as ‘Lifers’, deal with the perils of the induced mental and physiological stasis of passengers who make the centuries long voyages through deep space. The goal of appropriate sedation and ‘quenc...
Source: Life in the Fast Lane - August 15, 2014 Category: Emergency Medicine Authors: Mike Cadogan Tags: Education EMA Journal Emergency Medicine dental emergencies esop tool kit Lifers pediatric fractures Source Type: blogs

Interdependent physician practice is here to stay
We hear a lot about the death of the independent physician practice. But perhaps the more important discussion is about the death of practicing medicine independently. That is, the days when individual physician groups could operate their businesses and treat patients independently and without regard to the surrounding network of other physicians, nursing facilities, health networks, social workers, case managers, and other support is over. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - August 14, 2014 Category: Journals (General) Authors: Tags: Policy Emergency Primary care Source Type: blogs

Help patients by addressing the health of the community
When I was a medical student, I worked with an non-government organization (NGO) in Rwanda to provide medical care to women with HIV. Nearly all had witnessed their family members murdered during the genocide, and many became afflicted with HIV as a result of rape. Our initial focus was on getting antiretroviral therapy to these women, but we quickly realized that while it was important for them to have access to medications, they couldn’t be healthy unless they also had enough food to eat. They couldn’t stay safe unless they had shelter. They couldn’t be well unless we addressed their psychological trauma. Continue ...
Source: Kevin, M.D. - Medical Weblog - August 14, 2014 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

Responding to Ebola
<p class="MsoNormal">I was struck by the NY Times article that described tracing the path of the recent Ebola outbreak back to a two year old boy living in Guinea, Africa (<a href="http://www.nytimes.com/2014/08/10/world/africa/tracing-ebolas-breakout-to-an-african-2-year-old.html?_r=0">NY Times</a>) on the border of Sierra Leone. Not only does it forever impress me how epidemiologists and health officials are able to map the transmission of a rapidly spreading disease back to a likely origin, but the mystery surrounding how it all began is not, nor likely to ever be, known. Was it a...
Source: blog.bioethics.net - August 14, 2014 Category: Medical Ethics Authors: Hayley Dittus-Doria Tags: Health Care epidemic syndicated World Health Source Type: blogs

Desperate, Vulnerable Research Subjects, Cost-Cutting Contract Research Organizations and Threats to the Integrity of Clinical Research
Introduction - Clinical Research Done by Contract Research Organizations Dr Carl Elliott seems to be one of the few people willing to investigate how modern medical research may threaten vulnerable research subjects.  His book, White Coat, Black Hat, opened with a chapter on vulnerable "guinea pigs," people willing to be clinical research subjects for money.  Such people may be desperate for money, and further may be homeless, and have psychiatric problems, including psychosis or drug or alcohol problems.  Dr Elliott just wrote another important article on the plight of vulnerable research subjects. As Dr El...
Source: Health Care Renewal - August 13, 2014 Category: Health Management Tags: clinical research integrity clinical trials contract research organizations deception You heard it here first Source Type: blogs

ER Visits: Is Traumatic Brain Injury on the Rise?
Is it all in your head? Some new research suggests that more and more people are visiting the ER for traumatic brain injuries. A study, published in the Journal of the American Medical Association, analyzed the national trends in ER visits and noted a link in increased number of traumatic brain injuries. The researchers analyzed data from the Nationwide Emergency Department Sample (NEDS) database. This is a database that tracks emergency visits, and the reason for those visits. What Researchers Found Researchers were stunned to discover that the number of ER visits due to traumatic brain injury has increased 30 percent. Wh...
Source: Disruptive Women in Health Care - August 13, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Access Consumer Health Care Source Type: blogs

Top stories in health and medicine, August 13, 2014
From MedPage Today: CT Images Can Inform Clinical Decisions. The identification of high-risk plaque features using noninvasive CT imaging is a useful and independent predictor of acute coronary syndrome (ACS) in patients presenting to emergency departments with acute chest pain. Status of Spray Sunscreens Still Uncertain. The FDA has not reached a decision about the safety and efficacy of spray-on sunscreens, but continues to accumulate information to base an eventual verdict. Medicaid Expansion: Swapping Health Clinics for PCMH. When Medicaid expansion came to Louisville, Ky., it created an opportunity for a population ...
Source: Kevin, M.D. - Medical Weblog - August 13, 2014 Category: Journals (General) Authors: Tags: News Cancer Dermatology Source Type: blogs

Healthcare Update Satellite — 08-12-2014
** CLEAR! ** Not dead yet. Having withdrawal symptoms from lack of blogging and actually violating a cardinal rule of blogging by posting from work. Now that travel is done and life is getting back to normal, will hopefully have more time to write. Sabrina Kropp had damaged the cartilage in her nose from all of her cocaine use. She went to a plastic surgeon who repaired her nose and who then published anonymous before and after pictures of her nose on his web site. Ms. Kropp then sued the doctor for violating her privacy. The pictures pretty much isolate the patient’s nose, so it appears unlikely that anyone would be...
Source: WhiteCoat's Call Room - August 12, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

The LITFL Review 148
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. Welcome to the 148th edition, brought to you by: Anand Swaminathan [AS] (EM Lyceum, iTeachEM) Brent Thoma [BT] (BoringEM and Academic Life in EM) Chris Connolly [CC] Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC) Joe-Anthony Rotella [JAR] Kane Guthrie [KG] Mat Goebel [MG] Segun Olusany...
Source: Life in the Fast Lane - August 12, 2014 Category: Emergency Medicine Authors: Kane Guthrie Tags: LITFL review LITFL R/V Source Type: blogs

CCC Update 007
Hopefully you are well aware of LITFL’s Critical Care Compendium. It started out as a resource for the FCICM exam — which it is — but has grown into a 1500+ page mega-paedia of critical care. If something isn’t there and you think it should be, let me know and I’ll make it happen. If you are having trouble accessing some pages it is because LITFL has undergone a bit of spring cleaning. The “education/” part of the URL for CCC pages has been removed. For example: http://lifeinthefastlane.com/education/ccc/burnout/ is now http://lifeinthefastlane.com/ccc/burnout/ The links in the searchable...
Source: Life in the Fast Lane - August 12, 2014 Category: Emergency Medicine Authors: Chris Nickson Tags: Critical Care Compendium Emergency Medicine FCICM Fellowship Intensive Care CCC FCICM exam update Source Type: blogs