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

A Check-Up On Dental Coverage And The ACA
Oral health is an important but often overlooked part of health and insurance coverage. State Medicaid and the Children’s Health Insurance Program (CHIP) are required to cover children’s dental services (and children’s access to care has been improving over the last ten years), but coverage for adults is optional. As noted in a recent Health Affairs GrantWatch Blog post, only about 15 states offer extensive coverage for adult dental services in Medicaid. Medicare does not cover most dental services. And most private dental coverage is offered through stand-alone dental products that are separate from medical plan...
Source: Health Affairs Blog - March 24, 2015 Category: Health Management Authors: Andrew Snyder and Keerti Kanchinadam Tags: All Categories Children Coverage Dental Care Health Care Costs Health Care Delivery Health Law Health Reform Policy States Source Type: blogs

LITFL Review 174
Welcome to the 174th LITFL Review. 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.The Most Fair Dinkum Ripper Beauts of the WeekThe 15th International Symposium on Intensive Care and Emergency Medicine (ISICEM-15) took place from the 17th to the 20th of March. Lots of FOAMy goodness bubbled up from the event, including:A neat summary from Adrian Wong in the OXICM blog: day 1 ...
Source: Life in the Fast Lane - March 22, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

How do you shoot a troubled pacemaker ?
We have been taught right from first year cardiology residency  how to trouble shoot a pacemaker .It has been a real complex thing for us. Now looking  back ,all the troubles we took to understand seems to be redundant.Here is a summary of my thought process on the issue. It can be approached  with reference  to time, symptoms and ECG features.  With due respects to all those brainy hardworking   EP experts  , I have taken few academic liberties! Timing Within 24 hours -100% technical or procedural Issues , like lead dislodgement/Screws and nuts. Within 1-2 week – Again technical , Pocket issues , Infectio...
Source: Dr.S.Venkatesan MD - March 22, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology - Electrophysiology -Pacemaker Pace maker Tips and tricks atrial lead issues in ddd pacing best pacemaker tips and tricks capture failure pacemaker dc shock in pacing rhythm ddd vs vvi pacing intermittent pacemaker spikes pacema Source Type: blogs

A thank you to a mother and son in the ER
I walked into room 30 to find two eager sets of eyes awaiting me. One set belonged to a young man, late-twenties, muscular and imposing, sitting in a chair in the corner of the room. His eyes were hazel brown, big and inviting, relieved at seeing my entry into their sheltered world. The other set of eyes, darker brown and magnified by her gold-stemmed glasses, belonged to my patient, a woman in her early sixties. She sat  upright in her treatment cot, knees drawn up to her chest and covered by the thin hospital-issued bed sheet. Continue reading ... Your patients are rating you online: How to respond. Manage your online ...
Source: Kevin, M.D. - Medical Weblog - March 22, 2015 Category: Journals (General) Authors: Tags: Physician Cancer Emergency GI Source Type: blogs

This is why physicians are burning out
American physicians have had it.  We are retiring early, cutting back, changing careers, and moping in to work in astounding numbers.  The typical pep talks, whether given aloud by medical directors and administrators or consisting of internal dialog occurring in the physician’s mind, are not working anymore.  “You have it better than most people.”  “You are still making good money.”  “Your patients still need you.”  “It will get better.” “You invested a lot of time, money, blood, sweat, and tears into this.”   “This is the path you chose, and it isn’t as bad as you think.” Continue read...
Source: Kevin, M.D. - Medical Weblog - March 21, 2015 Category: Journals (General) Authors: Tags: Physician Emergency Hospital Primary care Source Type: blogs

Heart-wrenching photo of a doctor crying goes viral. Here’s why.
Outside of a Southern California hospital, an ER doctor is crouched down against a concrete wall grieving the loss of his 19-year-old patient. A paramedic snaps a photo of the tender scene. His coworker, a close friend of the doctor, posts the photo (with permission) online. Minutes after the photograph, the doctor returns to work “holding his head high.” 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 - March 21, 2015 Category: Journals (General) Authors: Tags: Physician Emergency Source Type: blogs

The Deteriorating Patient
If you want to know all there is to know about ‘The Deteriorating Patient‘, the Gold Coast is the place to be on July 6th and 7th 2015:Approximately 10% of hospitalised patients will experience a serious adverse event.   To improve the detection, recognition and response to deteriorating ward patients Australian and New Zealand clinicians pioneered Rapid Response Teams (RRTs) and Medical Emergency Teams.   Two thirds of ICUs in Australia and New Zealand are involved in Rapid Response Systems. Rapid Response Systems are an essential part of our hospital patient safety system.In 2015, ANZICS will again host a...
Source: Life in the Fast Lane - March 20, 2015 Category: Emergency Medicine Authors: Chris Nickson Tags: Conference Intensive Care ANZICS Safety and Quality Conference The Deteriorating Patient Source Type: blogs

Research and Reviews in the Fastlane 075
This study further defends the pathway of early discharge from the ED without evocative testing in subsets of patients with low risk chest pain.Recommended by Anand SwaminathanNeurology Edwards C, et al. Residency Training: A failed lumbar puncture is more about obesity than lack of ability. Neurology 2015; 84(10):e69-72. PMID: 25754807This is an interesting article exploring the reasons for LP failure. The authors reviewed all elective LPs done by Neurology residents in a LP clinic. They recorded all the demographic of the patient and the characteristics of the proceduralist. The overall LP failure rate was 19% and it w...
Source: Life in the Fast Lane - March 19, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Emergency Medicine Infectious Disease Neurology R&R in the FASTLANE Respiratory Toxicology and Toxinology literature recommendations research and reviews Source Type: blogs

For You Shooters…
… some blowhard you know has a new article in Shooting Illustrated. And while I may be writing about and teaching this stuff, credit should be given to the guy who developed the original curriculum. If your club or range would like a Emergency Medical Response for Range Safety Officers class, hit DiverMedic up on ... (Source: A Day In the Life of An Ambulance Driver)
Source: A Day In the Life of An Ambulance Driver - March 18, 2015 Category: Emergency Medicine Authors: ambulancedriverfiles Tags: Shooter Self Care Shooting Illustrated Source Type: blogs

Assessing accessory muscle use – what Dr. Orhan Muren taught me
Orhan Muren stood approximately 5 feet tall, spoke with a Turkish accent (he trained at “University Istanbul”), and won the “Golden Apple” Award for many consecutive years. As a medical student at the Medical College of Virginia (I refuse to call it VCU), he was one of our first heroes. He understand and could teach respiratory physiology and acid-base physiology, and help us understand. He was a kind man who encouraged us to become smarter and better physicians. During my internship, I had the good fortune to have Dr. Muren as my RCU (respiratory intensive care) attending. I still remember a young ...
Source: DB's Medical Rants - March 18, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Interested in Toxicology? APAMT and TAPNA
You took WHAT???The more you know, the less you know about a poison…. just look at paracetamol! And if your patient took something you knew a little bit about…. it is always combined with a new chemical name that you have never heard about! Not to mention the forever changing and amazing routes to administer it!If you would like to know more about Toxicology, there will be two amazing Toxicology conferences in Australia this year.On 1st and 2nd of May 2015 there is the TAPNA (Toxicology and Poisons Network Australasia) scientific meeting in Sydney. Since it is closely linked with Emergency Medicine and the pois...
Source: Life in the Fast Lane - March 18, 2015 Category: Emergency Medicine Authors: Ioana Vlad Tags: Australia Conference Education Emergency Medicine Toxicology and Toxinology Source Type: blogs

LITFL Review 173
Welcome to the 173rd LITFL Review. 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.The Most Fair Dinkum Ripper Beauts of the WeekRemember Scott Weingart and Michael Lauria’s podcast on mental toughness? A beautifully nuanced comment was made following it, and it’s worth reading for all present and budding resuscitationists. [SO]The Best of #FOAMed Emergency MedicineExcell...
Source: Life in the Fast Lane - March 17, 2015 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Education LITFL review LITFL R/V Source Type: blogs

An Electronic Survey Methodology
Emergency Medicine News spoke with Jeff Strickler, RN, the associate vice president of University of North Carolina (UNC) hospitals about Bivarus, an electronic survey methodology. He discussed why UNC’s ED made the switch, how it works, and the differences between Bivarus and paper-based survey tools. Why did you decide to try this analytics company? Did it have anything to do with Press Ganey dissatisfaction? The satisfaction with Press Ganey is maybe a strong word but I think it had a lot to do with the limitations related to what was our current customer service survey methodology, which happened to be Press Ganey. ...
Source: Technology & Inventions - March 17, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Want your ER physician to leave happy? Do these things.
I have been doing emergency medicine for almost ten years — thirteen if residency counts, and I sure think it does.  I face the same issues that cause my work colleagues, physicians and nurses alike, to burnout. I struggle with burnout myself, but I keep coming back.  Many days (and nights), I ask myself why I continue to do what I do.  I work strange hours, weekends, and holidays caring for an onslaught of humanity which is sick, poor, addicted, injured, neglected, and despondent.  It pays well (for now), but that isn’t enough to sustain me. Continue reading ... Your patients are rating you online: How to res...
Source: Kevin, M.D. - Medical Weblog - March 17, 2015 Category: Journals (General) Authors: Tags: Physician Emergency Patients Source Type: blogs

The Safety Nets Have Gaping Holes – Our Sewing Kit!
Anne Klee & Laurie Harkness In our country, two words that should never be spoken or written in the same sentence are Veteran and homelessness.  Yet all too frequently we hear this is the case.   Ten years ago there were estimated to be 250,000 homeless Veterans on the streets of America each night.  Today through the multi-pronged efforts of the U.S. Department of Veterans Affairs (VA), the Department of Housing and Urban Development (HUD), many state Governor’s, state agencies, and community agencies and partners, there are now less than 50,000 homeless Veterans each night.  Veterans are about 50 percent more ...
Source: Disruptive Women in Health Care - March 17, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Women Veterans Source Type: blogs

Increasing Bad Press for Today's Healthcare Information Technology - Deserved and Overdue
Here are three candid, quite revealing articles about the distaste for today's health IT that appeared recently.  I will address each,The first seems like pure deja vu (see my June 4, 2009 post "If The Military Can't Get Electronic Health Records Right, Why Would We Think Conflicted EHR Companies And IT-Backwater Hospitals Can?" at http://hcrenewal.blogspot.com/2009/06/if-military-cant-get-electronic-health.html):1.  Forbes:  Pentagon's $11 Billion Healthcare Record System Will Be Obsolete Before It's Even Built -  March 3, 2015http://www.forbes.com/sites/lorenthompson/2015/03/03/military-healthcare-11-...
Source: Health Care Renewal - March 16, 2015 Category: Health Management Tags: forbes health affairs healthcare IT difficulties healthcare IT risks HealthcareDive.com Source Type: blogs

The Intimacy Gap
I used to think that there was a communication gulf between doctors and patients.  Somewhere in the hub-bub of of the harried office visit some secret sauce was missing.  A divide that was so fundamental that both parties often left the room feeling disjointed and uneasy.  Patients wondered if doctors truly heard them.  Physicians wondered if any one was listening to what they were saying.  The tension ebbed and flowed but never disappeared.  This has been the state of health care over the last decade.  This has been the environment in which I have built my clinical career.I now believe t...
Source: In My Humble Opinion - March 16, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs

Top stories in health and medicine, March 13, 2015
From MedPage Today: Opioid Abuse Drops, Then Levels Off. Making an abuse-deterrent formulation of OxyContin (oxycodone ) diminished abuse in the short term, but the reductions eventually hit a plateau. After Ebola, Measles Death Toll Could Be High. The death toll from post-Ebola measles outbreaks in three West African countries could rival that of Ebola itself. Time Is Right for E-Cig Regulation. Reducing the risks of e-cigarettes to smokers, encouraging the smoking-cessation potential, and restricting access by nonsmokers offer a regulatory trifecta that can be implemented immediately. Risky Business: Working Where Viol...
Source: Kevin, M.D. - Medical Weblog - March 13, 2015 Category: Journals (General) Authors: Tags: News Emergency Infectious disease Pain management Source Type: blogs

News from the FastLane
Thank you for the condolences, but contrary to popular belief…I am not dead…I am neither resting, stunned nor pining for the fjordsAn unfortunate series of events have made the last 6 months a poor medium for cerebral engagement.Rather than trawl the 4000+ stagnating emails choking my inbox, I thought it easier to answer the most common questions online.1) I am not dead, I am not suffering a terminal illness…I have merely been unconsciously uncoupled. This has resulted in my reverting to an administrative rather than an innovative role in #FOAMed deployment.2) GMEP on the other hand…is dead, it is...
Source: Life in the Fast Lane - March 13, 2015 Category: Emergency Medicine Authors: Mike Cadogan Tags: Blog News Education inFOAMatica LITFL TFG unconsciously uncoupled update Source Type: blogs

Waiting for problems to become emergencies is terribly expensive 
“I’ve been getting winded lately.” He’s a middle-aged man with diabetes.  This kind of thing is a “red flag” on certain patients.  He’s one of those patients. “When does it happen?” I ask. “Just when I do things.  If I rest for a few minutes, I feel better.” 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 - March 12, 2015 Category: Journals (General) Authors: Tags: Physician Heart Primary care Source Type: blogs

Bioethics Commission Makes Recommendations on Research Ethics in Public Health Emergencies
In its recently published brief, Ethics and Ebola: Public Health Planning and Response, the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) considered what lessons might be drawn from U.S. engagement in the global response to the Ebola epidemic. The brief examined two areas of human subjects research ethics that have been particularly […] (Source: blog.bioethics.net)
Source: blog.bioethics.net - March 12, 2015 Category: Medical Ethics Authors: Tenny Zhang Tags: Health Care ebola syndicated Source Type: blogs

Transforming Health Care: Tapping into the Innovative Capacity of Academic Medical Centers
By: Peter Slavin, MD, president, Massachusetts General Hospital, and professor of health care policy, Harvard Medical School In his commentary “Academic Medicine in a Transformational Time,” Senator Thomas Daschle addresses five of the most important, game-changing forces that will affect health care in the coming years. He suggests – and I agree – that the innovative capacity of academic medical centers put these institutions in an advantageous position to address these forces. Indeed, given the heritage of academic medical centers addressing our society’s most important health care challenges, we have an obli...
Source: Academic Medicine Blog - March 12, 2015 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective academic medical center care coordination clinical outcomes health care reform medicare New Conversations Source Type: blogs

Research and Reviews in the Fastlane 074
This study is further evidence that the HEART pathway is a safe approach to the management of low risk chest pain and decreases unnecessary health care utilization.Recommended by Anand SwaminathanThe Best of the Rest Resuscitation Sanghavi BS et al. Outcomes After Out-of-Hospital Cardiac Arrest Treated by Basic vs Advanced Life Support. JAMA Intern Med. 2015;175(2):196-204. PMID: 25419698The OPALS trial, published in 2004, demonstrated the lack of added benefit of ACLS over BLS in out-of-hospital cardiac arrest (OHCA). ACLS continues to be standard care despite repeatedly demonstrating improved ROSC without improved R...
Source: Life in the Fast Lane - March 11, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Clinical Research Emergency Medicine LITFL R&R in the FASTLANE critical care literature recommendations research and reviews Trauma Source Type: blogs

Price Transparency: Removing The Blindfold
Shopping for health care is like shopping blindfolded in Macy’s, says noted health care economist Uwe Reinhardt — consumers don’t know what they are buying or how much it will cost until they have paid and gone home. Moreover, consumers are not the only ones affected by the lack of information; employers as purchasers of insurance, government policy makers, and insurers are all frustrated by the lack of price and quality information that would allow consumers to shop for value in their care. We hope that 2015 will be the year of transparency and the first year in an era of higher value health care. This blog po...
Source: Health Affairs Blog - March 11, 2015 Category: Health Management Authors: Eric Barrette and David Newman Tags: All Categories Big Data Business of Health Care Competition Consumers Health Care Costs Payment Source Type: blogs

The JavaScript Event loop for Emergency Physicians
If you’re a reader of my blog past or present you’ll know that I’ve long been interested in programming and am also an Emergency Medicine physician.  While studying javacript callback functions I was referred to this talk which explains them well, but it didn’t really “click” until I saw the visual “event loop” waiting for it’s opportunity to let the main stack know there were results to dealt with from prior callback functions. What’s a callback function? This is one I’m still wrapping my head around, but it allows for a task to be worked on while the main...
Source: Mr. Hassle's Long Underpants - March 10, 2015 Category: Emergency Medicine Authors: Doc Shazam Tags: Computing callback functions event loop JavaScript Source Type: blogs

What is community acquired pneumonia?
Back in the 70s when I was training, we diagnosed pneumonia, and then tried to understand the likely bacteria causing the pneumonia. We knew the clinical presentations of various bacteria. We had a clear illness script for diagnosing pneumonia. Then, if I recollect correctly, we had a new diagnosis – CAP. Perhaps I am too old school, but CAP seems like a “cop out” diagnosis. Moreover, the label has become a crutch for hospital admission. Patients come to the emergency department with at least one symptom suggesting a chest X-ray. The CXR suggests an infiltrate and bingo we have an admission diagnosis. I l...
Source: DB's Medical Rants - March 10, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Top stories in health and medicine, March 10, 2015
From MedPage Today: Kid’s Asthma Not Linked to Maternal SSRIs in Pregnancy. Children whose depressed mothers took newer antidepressants while pregnant were not at increased risk of childhood asthma. Menopausal HT Not Tied to Greater Death Risk. Hormone therapy in postmenopausal women was not linked to a significant effect on all-cause mortality, cardiovascular death, or breast cancer death. In Cancer Wars, It’s Doctors vs. Hospitals. Colliding federal policies are fomenting a nasty money war that’s pitting community oncologists trying to treat patients in less expensive clinic settings against hospitals...
Source: Kevin, M.D. - Medical Weblog - March 10, 2015 Category: Journals (General) Authors: Tags: News Cancer OB/GYN Pulmonology Rheumatology Source Type: blogs

Go Slow On Reference Pricing: Why The Federal Agencies Have It Wrong On Regulations
Despite concerns outlined in our previous post on reference pricing, federal oversight agencies essentially have taken a hands-off approach. First, they announced that for large group and self-insured plans, the Affordable Care Act’s (ACA) annual maximum limits on out-of-pocket costs do not apply to charges above the reference price. These limits are already high: $6,600 for an individual and $13,200 for family coverage in 2015. Without any discussion the agencies asserted that non-designated providers are out-of-network, and therefore cost sharing falls within the ACA’s exclusion of out-of-network cost from the ma...
Source: Health Affairs Blog - March 9, 2015 Category: Health Management Authors: David Frankford and Sara Rosenbaum Tags: All Categories Business of Health Care Competition Consumers Cost Health Reform Insurance Payment Spending Source Type: blogs

Pay doctors and nurses for the time they spend charting
I have a unique perspective as a physician. Having traveled to many hospitals in the past two years, working as a locums emergency physician, I can comment on a variety of issues with a reasonable amount of experience. One of those issues is EMR, or electronic medical records. I have spent plenty of time writing about this in the past, and I will continue to do so. Because all across the country the same problems, the same frustrations are evident. And the institutional lack of concern is well-entrenched and well understood by everyone affected.Whether working in an academic teaching/trauma center or a small community depa...
Source: Kevin, M.D. - Medical Weblog - March 9, 2015 Category: Journals (General) Authors: Tags: Physician Health IT Hospital Source Type: blogs

Go Slow On Reference Pricing: Not Ready For Prime Time
Editor’s note: This post is part one of two on reference pricing.  The use of reference pricing by health insurers and employee health benefit plans stands high on the policy and regulatory agenda because it is gaining popularity, particularly now that federal agencies have blessed its use by large group insurers and self-insured plans, while imposing only relatively lax requirements. The purpose of reference pricing is to enable patients to “shop” for care and to spur provider competition by creating a group of “designated” in-network providers that agree to abide by the reference price while others do not...
Source: Health Affairs Blog - March 9, 2015 Category: Health Management Authors: David Frankford and Sara Rosenbaum Tags: All Categories Business of Health Care Competition Consumers Employer-Sponsored Insurance Health Care Costs Health Reform Hospitals Payment Pharma Spending Source Type: blogs

Hidden at home: the social care needs of people with cancer
Macmillan Cancer Support This research reveals that one in 10 (11 per cent) people with cancer in the UK, equivalent to at least 160,000 people, say they are constantly or often left housebound due to a lack of support. At least 100,000 people (seven per cent) are constantly or often unable to wash themselves, dress or go to the toilet. One in seven (15 per cent) of people with cancer have had to go to hospital for an unplanned or emergency visit because of a lack of support for their practical or personal needs. Report Press release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - March 9, 2015 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Quality of care and clinical outcomes Social care Source Type: blogs

LITFL Review 172
Welcome to the 172nd LITFL Review. 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.The Most Fair Dinkum Ripper Beauts of the WeekDi McMath writes a touching post reminding us all to build and maintain our resilience in “caring for the invisible wounds”. Thanks to Minh Le Cong for the tip! [SO]The Best of #FOAMed Emergency MedicineNice review of core content on skin and sof...
Source: Life in the Fast Lane - March 8, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

What's Happening To Health Care, A Damn Shame?
I understand that there is a difference between perception and reality.  I also get that the kind of people one meets on a tropical vacation in the middle of March are of a certain economic and sociopolitical status.Nonetheless, I am amazed at how history seems to repeat itself.  Year after year, while sitting in the shade and relaxing by the pool, I strike up a conversation with the vacationers sitting on either side of me.  The conversation starts innocently enough.  We talk of the details of our trips and about the kids.  More times than not, they are from Canada.  We bristle at the cold we...
Source: In My Humble Opinion - March 8, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs

Delirium and Physostigmine: ECG helps in Management
This patient took an unknown overdose and was delirious.  The axillae were dry.  Due to delirium and dry skin, there was suspicion of anticholinergic toxicity.Here is his ECG:There is sinus tachycardia.  There is also some QRS widening and a large R-wave in aVR, and an rSR' (RV conduction delay) in lead V1.  The QRS duration is 107 ms.  There is QT prolongation as well, with a computerized (Bazett) QTc of 480 ms (prolonged).The prolonged QRS and RV conduction delay make this very suspicious for Na channel blockade, and, most worrisome, for tricyclic antidepressant overdose (TCA).Do we treat the del...
Source: Dr. Smith's ECG Blog - March 7, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

Food insecurity is an undiagnosed medical problem
My last patient, Joyce, a 45-year-old single mother of four with high blood pressure and diabetes, is late. She was in the emergency department last week with dizziness and blurred vision, a blood sugar of 345 and a blood pressure of 190/110. 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 - March 6, 2015 Category: Journals (General) Authors: Tags: Conditions Obesity Source Type: blogs

An alcoholic patient, and his effect on a medical student
This article originally appeared in uvm medicine. 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 - March 6, 2015 Category: Journals (General) Authors: Tags: Education Emergency Hospital Medical school Source Type: blogs

A "PR Pawn" Confounds the Public Relations Burnishing of Texas Health Resources and its CEO
The Ebola virus epidemic in Africa is hopefully winding down.  The uproar, if not panic, over Ebola virus in the US has been eclipsed by the latest  internet craze.  However, we are still learning from the echoes of the brief, and thankfully very localized US experience with Ebola.In particular, the country's response to the virus should continue to inspire unease about how our supposedly market based, managerially focused health care non-system can handle real public health threats.Background - Ebola at Texas Health PresbyterianStarting on October 2, 2015, we discussed numerous concerns about whether proble...
Source: Health Care Renewal - March 5, 2015 Category: Health Management Tags: Ebola virus generic management generic managers public relations Texas Health Presbyterian Hospital Texas Health Resources Source Type: blogs

Using the Least Restrictive Limits in Public Health Emergencies
The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) recently released Ethics and Ebola: Public Health Planning and Response. In this brief, the Bioethics Commission examined U.S. engagement in the global response to the Ebola epidemic with the goals of 1) determining what lessons might be learned from the U.S. response and 2) […] (Source: blog.bioethics.net)
Source: blog.bioethics.net - March 5, 2015 Category: Medical Ethics Authors: Maneesha Sakhuja Tags: Health Care ebola syndicated Source Type: blogs

Stop trying to be God. Be human.
In medical school, I was taught to keep my distance. To remember that the patient is the one with the disease. I was told to protect my heart, to be a little cynical, a little deprecatory, to keep a separation between me and the patient. Because they can hurt you. For 18 years, I met people on what was arguably the worst day of their lives. You have cancer. You have a bowel obstruction and need emergency surgery. You need to have your entire colon removed and poop in a bag for the rest of your life. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guid...
Source: Kevin, M.D. - Medical Weblog - March 5, 2015 Category: Journals (General) Authors: Tags: Physician Surgery Source Type: blogs

Research and Reviews in the Fastlane 073
Welcome to the 73rd 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 7 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 ...
Source: Life in the Fast Lane - March 4, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: Education Emergency Medicine Neurosurgery Pre-hospital / Retrieval Resuscitation Trauma critical care examination Intensive Care R&R in the FASTLANE research and reviews Source Type: blogs

Healthcare Update Satellite — 03-04-2015
Homeless North Carolina VA patient comes into the ED to be evaluated for the sores on his feet. His shoes are falling apart. Nurse Chuck Maulden bandages up the patient’s feet and then gives the patient the brand new Nike sneakers off of his own feet. Chuck then works the rest of his shift in a pair of shoe covers and doesn’t say anything about it. Only way that people found out was because the patient’s family called to say thank you. We need more people like Chuck. I’m not aware of too many uses for virtual reality in medicine, but this seems to be a good one: seeing what it’s like to suffer...
Source: WhiteCoat's Call Room - March 4, 2015 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs

Group-Level Expanded Access to Unapproved Medicine: The realistic solution for patients
Guest Blog Author: Jess Rabourn*, Managing Director, ALS – Emergency Treatment FundSince 1962, Federal law prohibits open sales of any new pharmaceutical product until that product goes through years of clinical research and is granted approval by the FDA.   Yet unapproved new drugs are provided to thousands of patients daily.  They’re not openly sold, but instead made available by drug companies to study safety and effectiveness in humans.    FDA allows such managed uses of unapproved drugs through authorized Investigational New Drug (IND) exemptions, which are filed by drug compa...
Source: blog.bioethics.net - March 4, 2015 Category: Medical Ethics Authors: Practical Bioethics Tags: Health Care syndicated Source Type: blogs

The ACA’s Hospital Tax-Exemption Rules And The Practice Of Medicine
The Affordable Care Act (ACA) and related regulations include obligations for nonprofit (and some government) hospitals to provide benefits, such as free care, to their communities. On their face, these new obligations seem a valuable response to longstanding concerns of some legislators, litigators, and scholars that some nonprofit hospitals are really ‘for-profits in disguise’ and to the related calls to eliminate tax-deductions for gifts to nonprofit hospitals. Moreover, the requirements have been lauded for their potential to improve public health, particularly in leading to better consultation and collaboration wi...
Source: Health Affairs Blog - March 3, 2015 Category: Health Management Authors: Jill Horwitz and David Cutler Tags: All Categories Business of Health Care Health Law Health Reform Hospitals Policy Source Type: blogs

From Silos to Synergy: Creating Community Conversation
The Women Who Serve weekly blog is a visionary opportunity for civilians and service members and veterans to commune…to talk and listen together with profound intensity, rapport, intimacy and vulnerability.  We shall share an interchange of ideas and reflections, challenges and needs, those that are tangible and intangible as well as presenting action based solutions.  We are excited about the paradigm-shifting conversations we are entering into, where awareness is raised about military women’s experiences through eras and generations of peace and wartime. I am an insider/outsider- the mother of a GWOT three-time...
Source: Disruptive Women in Health Care - March 3, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Women Veterans Source Type: blogs

Your ER group was just bought.  What next?
Hospital leaders who are successful managers today are successful because they manage change. The great hospitals leaders by now have become masters at it. But there’s a difference between change you can see coming (bundled payments, EHR implementations, declining reimbursements) and change that shows up unannounced on the front door. 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 - March 3, 2015 Category: Journals (General) Authors: Tags: Policy Emergency Hospital Source Type: blogs

Using a Mobile App for Monitoring Post-Operative Quality of Recovery
By JAAN SIDOROV, MD While your correspondent is tantalized by the prospect of healthcare consumers using mHealth apps to lower costs, increase quality and improve care, he wanted to better understand their real-world value propositions. Are app-empowered patients less likely to use the emergency room? Do they have a higher survival rate? Do they have higher levels of satisfaction? In other […] (Source: The Health Care Blog)
Source: The Health Care Blog - March 2, 2015 Category: Consumer Health News Tags: THCB Apps Pain Patient Satisfaction Post operative patients Quality Recovery Source Type: blogs

Curious Consequences of the Lessor Metals
The vagaries of any list or group are that invariably some members are far more popular than others. Hyperkalemia gets all of the attention when we talk about the cardiac effects of electrolyte abnormalities. It is certainly important (read: life-threatening), and we have multiple life-saving treatments that lend themselves well to testing.   We are well versed in hyperkalemia, though one of its treatments has become controversial (I am looking at you, kayexalate). But other electrolyte abnormalities beyond hyperkalemia also deserve attention.   Hypokalemia: The potassium level in the body is closely regulated, but hypok...
Source: Spontaneous Circulation - March 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Owning Procedural Expertise
Emergency medicine, since its inception as a specialty, has continuously redefined itself by absorbing intellectual and procedural expertise traditionally owned by other specialties. Whether it is performing advanced airway procedures formerly unique to anesthesia, reducing and splinting various orthopedic dislocations and fractures, or managing urological emergencies such as priapism or otolaryngology procedures, emergency physicians have relentlessly expanded their procedural expertise. Some consultants have forced our hands by delaying or being reluctant to see these emergencies in the emergency department. Others willi...
Source: M2E Too! Mellick's Multimedia EduBlog - March 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs