MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'emergency medicine'. Sat, 03 Sep 2011 01:48:01 +0100 http://www.medworm.com/index.php?rid=5181810&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FsuwvoByosDQ%2F Do you work in an emergency department? Or maybe in an ICU? Or perhaps the prehospital environment? Regardless, of where you look after critically ill patients you MUST click on this LINK now! What will you find there? Two things: The first part of a talk by ‘Early Goal Directed Therapy’ legend Dr Manny Rivers on [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5181810 Thu, 01 Sep 2011 17:38:31 +0100 5181810 http://www.medworm.com/index.php?rid=5181811&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FTmWWsO6C2Iw%2F A modified mnemonic for recalling the key issues in the supportive care of critically ill patients. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5181811 Thu, 01 Sep 2011 16:07:16 +0100 5181811 http://www.medworm.com/index.php?rid=5181815&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1841 : ‘Not now.’ (This column first appeared in the Greenville News, but I re-wrote and expanded  it for my EMN readers in the September edition.  So here it is with a few special thoughts for the medical community.) Here’s the link to the EMN online edition as well: http://journals.lww.com/em-news/Fulltext/2011/09000/Second_Opinion__Two_of_the_Worst_Words_of_All__Not.8.aspx If you were watching me, secretly, you would see that I sometimes do things that are decidedly non-adult. I can be seen dancing across the hardwood floor with my daughter, with no music audible (except inside her lovely head). She apparently aspires to be a choreographer, and though I am no dancer, I am the only male in the house who will dance with her. When she asks, what can I say? I know many l... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5181815 Thu, 01 Sep 2011 13:02:36 +0100 5181815 http://www.medworm.com/index.php?rid=5181816&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1837 I think a lot about the slow, certain dissolution of medicine as we know it.  Mental health issues crowd emergency departments, as few mental health clinics are available.  Psychiatrists are in short supply.  Drug abuse overwhelms the medical system, with either patients seeking pills or patients families hoping to get them off of pills. Persons with little interest in their own health continue to smoke and drink, use Meth and eat poorly.  Disability claims are skyrocketing as younger and younger individuals confabulate their misery in hopes of attaining a check, paid for by someone else. The poor, with genuine medical problems, have increasing difficulty finding care as jobs, and insurance, fade away.  Politicians, eager to be re-elected, eager to be loved, promise more and supply le... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5181816 Wed, 31 Aug 2011 14:14:08 +0100 5181816 http://www.medworm.com/index.php?rid=5174622&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FX8KSTUUJEno%2F A chest trauma patient lies before you. When would you perform an emergency thoracotomy? A case-based Q&A approach to the indications and contraindications. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5174622 Tue, 30 Aug 2011 00:00:10 +0100 5174622 http://www.medworm.com/index.php?rid=5174623&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Ft2VfNF7BdPo%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5174623 Mon, 29 Aug 2011 02:06:00 +0100 5174623 http://www.medworm.com/index.php?rid=5159265&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Fi5_13bnxbZQ%2Fheart-test-laboratories-myovista-system-to-present-results-of-clinical-trials-at-the-american-heart-association-scientific-sessions.html Heart Test Laboratories will be presenting clinical trial results of their Myovista cardiac screening system at the American Heart Association (AHA) Scientific Sessions in November 2011.  The proprietary patent-pending device is a portable diagnostic screening device that uses ECG technology to potentially detect coronary artery disease within minutes. The technology uses three-dimensional mapping and proprietary algorithms that continuously multiplex surface electrodes to provide information in regards to potential obstruction in the coronary arteries.  Heart Test Laboratories claim to have an impressive average 90% or greater correlation to an invasive angiogram with the MyoVista technology.  The device was awarded CE Marking in September 2010.  Look here on Medgadget for follow up f... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5159265 Wed, 24 Aug 2011 18:09:52 +0100 5159265 http://www.medworm.com/index.php?rid=5159267&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FzmVPncSmu00%2Fphysio-control-releases-readylink-12-lead-ecg-for-emergency-responders.html Physio-Control, a division of Medtronic for not much longer, has unveiled the ReadyLink 12-Lead ECG. The device allows paramedics to transmit ECG data to hospital physicians via the LIFENET network and get immediate cardiac specialist opinion on the readings. In particular, the firm hopes that first responders will be able to quickly identify patients with ST-segment elevation myocardial infarctions (STEMI), hopefully leading to earlier treatment and more lives saved. From the announcement: As simple as it is portable, ReadyLink only requires a three-step process to capture and transmit a 12-lead ECG: 1) prepare patient’s skin and place electrodes; 2) one-button push to acquire 12-lead ECG; and 3) one-button push to transmit ECG to selected hospital facility via the LIFENET System. Addi... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5159267 Wed, 24 Aug 2011 18:00:36 +0100 5159267 http://www.medworm.com/index.php?rid=5159008&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FA_Uef_POJIA%2F "VT or not VT? That is the question..." you muse. Then your patient Bill says "A shock, a shock, my kingdom for a shock"... (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5159008 Wed, 24 Aug 2011 00:00:08 +0100 5159008 http://www.medworm.com/index.php?rid=5159009&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fs7S_ZPgTeFY%2F A case-based Q&A on the assessment and management of patients presenting with suspected rectal foreign bodies. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5159009 Tue, 23 Aug 2011 00:00:50 +0100 5159009 http://www.medworm.com/index.php?rid=5159010&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FYnCNffSklNA%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5159010 Mon, 22 Aug 2011 15:32:21 +0100 5159010 http://www.medworm.com/index.php?rid=5139757&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1811 On a scale of one to ten, What is your loneliness? Think of one as a day when your Family was out shopping, Laughing, going to movies, but You were sick in bed. Ten is Like everyone you knew Perished, or decided you were Worthless and abandoned you. What about your fear? Ten is the worst, one is the least. Be candid; maybe we can help. One is when you reach Into your desk drawer and Find a rubber spider, a ridiculous Fuzzy black joke that Makes you fall out of Your swivel chair while across The divider coworkers laugh. Five is the idea that everyone In the world knows your thoughts, Knows your hopes and how to Shatter them. Eight that everyone Knows what you think of them, Including her. Ten is that nothing about you Is a secret to anyone. Tell me about your sadness. Ten is the memory ... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5139757 Thu, 18 Aug 2011 15:28:20 +0100 5139757 http://www.medworm.com/index.php?rid=5139747&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fa1y67ymUsQ4%2F A review of the literature on the assessment and management of the patient suffering from cannabinoid hyperemesis syndrome. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5139747 Wed, 17 Aug 2011 00:00:35 +0100 5139747 http://www.medworm.com/index.php?rid=5130757&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fkeul9R00j44%2F The LITFL weekly review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5130757 Mon, 15 Aug 2011 02:56:21 +0100 5130757 http://www.medworm.com/index.php?rid=5125760&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1796 Moped vs. Groundhog:  a play based on a true story. Groundhog Union Local 17 approved this post Driver on moped, busy rural road:  ngngngngngngngnggn, putter, putter, ngngng… Groundhog:  Munch, much, waddle, waddle. Moped:  ngngngngngngngngng, putter, spas, skip, ngngngng Groundhog:  Looks up, curious, munch, munch, waddle, waddle. Moped driver sees furry beast, doesn’t worry.  Riding manly moped:  ngngngngngngng, whine, ngngng, choke, ngngngng Groundhog:  Munch, munch, more curious, waddle, waddle, sit up, munch.  Head turned toward sound. Moped driver:  Puts the hammer down.  ngngngngngngngngng, cough, cough, skip, ngngng.  Ramming speed of some 15 nautical miles per hour. Groundhog:  relatively low IQ.  Munch, munch.  ‘Maybe I should move!  Aw, $%#@ no,... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5125760 Fri, 12 Aug 2011 02:10:08 +0100 5125760 http://www.medworm.com/index.php?rid=5118734&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2F7ZoFm-D13ro%2Fdigitial-dog-tags-for-your-personal-health-records.html Asahi Kasei, a Japanese technology company, has just developed a small RFID tag (pictured) for storing personal health records. The device allows clinicians and emergency response personnel to instantly access a patient’s health records using a phone or laptop.The tag incorporates Sony’s FeliCa smart card technology as it is currently compatible with a  large number of Japanese devices which incorporate FeliCa card readers. In an emergency or clinical setting, paramedics or clinicians can tap the tag against compatible equipment to view the medical data of its owner in just a few seconds. Asahi Kasei says that a patient’s entire medical history can be viewed. If the clinician needs to view larger data files, the tag can provide links to the data which is stored on extern... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5118734 Thu, 11 Aug 2011 18:16:37 +0100 5118734 http://www.medworm.com/index.php?rid=5118641&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbeing-a-doctor-is-a-lot-like-being-a-parent-you-cant-tap-out%2F2011.08.11 The American College of Graduate Medical Education has enacted further restrictions on resident work hours.  No more than 80 hours per week of work for resident physicians, averaged over one month.  And no more than 16 hours of continuous work for first year residents (24 after that), which includes patient care, academic lectures, etc. Whenever they do this sort of thing, everyone seems excited that it will make everyone safer.  After all, residents won’t be working as much, so they’ll be more rested and make much better decisions.  It’s all ‘win-win,’ as physicians in training and patients alike are safer. I guess.  The problem of course is that after training, work hours aren’t restricted.  There is no set limit on the amount of work a physician can be expected to do, ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5118641 Thu, 11 Aug 2011 18:05:30 +0100 5118641 http://www.medworm.com/index.php?rid=5118658&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1789 In following the stories out of the UK, I am saddened by the violence and senseless destruction in the nation that so many of us look to as kindred.  Many of us have a deep, almost genetic, reverence for the land of so many of our ancestors.  I certainly wish we could once again unite and rise up, standing for freedom and the greatness of the West.  Alas, not yet. http://www.foxnews.com/world/2011/08/11/london-police-raiding-houses-over-uk-riots/?test=latestnews It is, of course, like all such violence in places where a perfect storm of ideology brews. Closing the trough First, young poor people, told for decades it was the duty of the government and taxpayers to care for them, become animal-like when their feed-trough is threatened.  And, animal-like, brutal in nature, ‘red in t... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5118658 Thu, 11 Aug 2011 13:54:36 +0100 5118658 http://www.medworm.com/index.php?rid=5118653&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FW-aNiA8dkQc%2F The trailer for the documentary '24 hours in the ER' - this looks like one thats not to be missed. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5118653 Thu, 11 Aug 2011 06:33:20 +0100 5118653 http://www.medworm.com/index.php?rid=5118659&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1786 Our county recently had a large drug-bust.  Some 37 people were arrested, for a variety of charges, from distribution to manufacturing and all the rest. Since it was in the paper, and public knowledge, I felt it important to find out how many of them were regular ‘customers’ of the emergency department. Of the 37 arrested, there were some 167 ED visits over the past few years since we have had EMR. Now, what do we do with that number?  What does the customer service model say?  What do we feel about the need for insurance, or other social supports, provided by government? Complicated question, I suppose.  But looking through the chief complaints, it seems that an inordinate number were for painful conditions. As prescription drug abuse skyrockets, as deaths from those drugs... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5118659 Wed, 10 Aug 2011 03:26:22 +0100 5118659 http://www.medworm.com/index.php?rid=5107526&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F15W16oOgdJ8%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5107526 Mon, 08 Aug 2011 00:35:15 +0100 5107526 http://www.medworm.com/index.php?rid=5103350&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1773 The American College of Graduate Medical Education has enacted further restrictions on resident work hours.  No more than 80 hours per week of work for resident physicians, averaged over one month.  And no more than 16 hours of continuous work for first year residents (24 after that), which includes patient care, academic lectures, etc. Whenever they do this sort of thing, everyone seems excited that it will make everyone safer.  After all, residents won’t be working as much, so they’ll be more rested and make much better decisions.  It’s all ‘win-win,’ as physicians in training and patients alike are safer. I guess.  The problem of course is that after training, work hours aren’t restricted.  There is no set limit on the amount of work physician c... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5103350 Sat, 06 Aug 2011 03:31:30 +0100 5103350 http://www.medworm.com/index.php?rid=5103394&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FQ9mRCjXmKms%2Fnovel-watch-based-device-detects-pulselessness-in-humans.html This study was designed to simulate cardiac arrest and assess the device’s ability to correctly identify pulse status.  24 hospitalized patients and 10 patients planned for implantable cardioverter defibrillator (ICD) testing were enrolled in the trial.  Pulselessness was simulated in the hospitalized patients via inflation of a blood pressure cuff on the same arm as the watch while they held still.  Ventricular fibrillation was induced in the 10 ICD patients as part of normal protocol to test the ICDs – essentially creating a pulseless, motionless state.  Of the 34 subjects, 5 had unusable signals, device ejection, or too much motion artifact.  Of the 29 remaining, the device correctly identified a pulse state in 3 of 4 patients and the time of pulselessness in 23 of 25 patie... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5103394 Fri, 05 Aug 2011 17:06:56 +0100 5103394 http://www.medworm.com/index.php?rid=5096217&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fz_hroKVr_D8%2F Sick of your patients waiting in the ED for life saving treatment as a result of interminable ICU / CCU bed-block? Worry no more...move to Indonesia (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5096217 Wed, 03 Aug 2011 06:10:43 +0100 5096217 http://www.medworm.com/index.php?rid=5096221&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1769 We are called by Christ, among other things, to mourn with those who mourn, to weep with those who weep. This sometimes happens, suddenly and briefly, in the emergency room.  I was sitting at my desk one quiet morning recently.  EMS traffic caught my ear and I learned that there had been a terrible accident not far from the hospital.  However, far enough that the regional helicopter had been called to the scene. One patient would fly out.  One patient, one poor girl, one daughter, would not fly out.  And she would not come to me for care.  She died on the road at about 7:15 am.  She died on the road I sometimes drive to work, about 20 minutes after I would have passed the exact place she passed from this life. I was stricken, I was saddened.  Father of four, I was nauseated and hea... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5096221 Wed, 03 Aug 2011 02:42:20 +0100 5096221 http://www.medworm.com/index.php?rid=5096218&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FUSTuFGYGhvM%2F LITFL puts you to the test, with 10 of the best Questions and Answer from this months EM Critical Care Article on Noninvasive Ventilation. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5096218 Tue, 02 Aug 2011 01:52:36 +0100 5096218 http://www.medworm.com/index.php?rid=5086181&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F6lpnY5uHtW0%2F LITFL puts you to the test, with 10 of the best Questions and Answer from this months EM Critical Care Article on Noninvasive Ventilation. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5086181 Tue, 02 Aug 2011 01:52:36 +0100 5086181 http://www.medworm.com/index.php?rid=5086307&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FMvx06NzFUfM%2Fcool-it-no-really%25e2%2580%25a6it-may-make-a-difference-between-life-and-death.html Remember the Arctic Sun, a non-invasive system designed to rapidly manage the core temperature of critically ill patients? Further studies continue to demonstrate its positive role in treating out-of-hospital cardiac arrest (OHCA) patients via therapeutic hypothermia. In the July 12, 2011 issue of Circulation, Michael Mooney, et al. from  Minneapolis Heart Institute and Northwestern University in Chicago published data on 140 consecutive OHCA patients who were treated and transferred to a central therapeutic hypothermia-capable hospital. Patients were initially cooled in the ambulances or referring hospitals with ice packs and then transferred to the central hospital where they were further cooled and maintained at 33°C (92°F) for 24 hours with the Arctic Sun device (Medivance, Louisvil... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5086307 Mon, 01 Aug 2011 16:47:21 +0100 5086307 http://www.medworm.com/index.php?rid=5086172&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Foverwhelmed-ers-continue-to-rise-to-the-challenge%2F2011.07.31 Last night I was contacted by a physician in the local urgent-care.   I like him, and we made polite, but brief, conversation.  ‘So, are you guys busy?’ I gave him the status report.  ‘Well, yeah.  We have about 25 people waiting to be seen the waiting room is full and every patient room is full.  Also, we just received a gun-shot wound to the head by EMS.’ ‘Wow, sounds terrible!  So, here’s what I need to send you…’ What he sent was, in fact, reasonable.  A young woman with signs and symptoms of meningitis (who was treated earlier in the day for and upper respiratory virus…with Amoxicillin, of course.) She needed a lumbar puncture, which I performed and which was  negative. But I had this thought.  I could probably have said, (more…) *This blog ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5086172 Sun, 31 Jul 2011 21:00:39 +0100 5086172 http://www.medworm.com/index.php?rid=5077697&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FcAKgzU3LuFY%2F In the critical care specialties we have to make things happen, sometimes this involves life-saving actions that may have never before performed. We must be ready, after all, in the words of Peter Safar, "it's up to us to save the world!" Cliff Reid tells us how. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5077697 Thu, 28 Jul 2011 00:00:43 +0100 5077697 http://www.medworm.com/index.php?rid=5069485&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1750 Last night I was contacted by a physician in the local urgent-care.   I like him, and we made polite, but brief, conversation.  ‘So, are you guys busy?’ I gave him the status report.  ‘Well, yeah.  We have about 25 people waiting to be seen the waiting room is full and every patient room is full.  Also, we just received a gun-shot wound to the head by EMS.’ ‘Wow, sounds terrible!  So, here’s what I need to send you…’ What he sent was, in fact, reasonable.  A young woman with signs and symptoms of meningitis (who was treated earlier in the day for and upper respiratory virus…with Amoxicillin, of course.) She needed a lumbar puncture, which I performed and which was  negative. But I had this thought.  I could probably have said,... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5069485 Tue, 26 Jul 2011 14:35:39 +0100 5069485 http://www.medworm.com/index.php?rid=5069483&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FQjFJJAGGWqo%2F Sim Wars is coming to Australia... Find out what its all about and enter your team to chase the glory at www.acem2011.com (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5069483 Tue, 26 Jul 2011 09:34:12 +0100 5069483 http://www.medworm.com/index.php?rid=5062255&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1745 Good news on disability:  or should I say ‘disability.’ Anyone working in social services or medicine (well, anyone with half a cerebrum and some rational thinking capacity mixed in with their compassion) knows that the disability system in the US is completely out of control.  We routinely see patients who say, when queried about their disability, ‘well doc, honestly, I don’t know why I’m on disability!’  Which is fine if you’ve had a serious head injury or stroke, but if your complaint is ‘injured back while using chain-saw,’ maybe disability is a little generous. So, here’s some light in the darkness: http://lsolum.typepad.com/legaltheory/2011/07/pierce-on-administrative-law-judge-disability-decisionmaking.html Hallelujah! ... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5062255 Mon, 25 Jul 2011 17:03:37 +0100 5062255 http://www.medworm.com/index.php?rid=5062241&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthrombolytics-to-give-or-not-to-give%2F2011.07.25 For years now, we’ve all heard the drum-beat.  Bill-boards in cities have proclaimed it.  Various medical associations have touted it’s importance.  Stroke symptoms have to be treated immediately!  Give clot-busting drugs, also known as ‘thrombolytics!’ Until, of course, those in favor of giving the drugs (namely neurologists)  realized that a)  Not everyone with a stroke, aka ‘brain attack’ has insurance and b) people have a very inconsiderate habit of having said strokes at the most inconvenient of hours.  For instance, after 5PM, on the weekend, on holidays.  The nerve! So across the country, physicians in emergency departments like mine are finding themselves expected by the court of public opinion to give a potentially dangerous drug (albeit a sometimes useful drug... Better Health blogs http://www.medworm.com/rss/comments.php?id=5062241 Mon, 25 Jul 2011 16:00:57 +0100 5062241 http://www.medworm.com/index.php?rid=5062251&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F7B6Augv049A%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5062251 Mon, 25 Jul 2011 07:36:13 +0100 5062251 http://www.medworm.com/index.php?rid=5057790&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FMqLbb4cDhNU%2Fdiagnostic-imaging-pathways-app-for-ipad.html University of Western Australia’s Centre for Software Practice has released an iPhone app to help doctors decide what imaging modality is most appropriate for a particular patient. The tool was developed along with Department of Imaging Services at the Royal Perth Hospital and is now available at the iTunes App Store for $26. Diagnostic Imaging Pathways includes more than 130 pathways covering all the major organ systems and common clinical scenarios. The pathways have been developed based on broad clinical consensus, and best-available evidence, and are under continuous review and development. The principle clinical lead behind the Diagnostic Imaging Pathways, Professor Richard Mendelson, said the application will help doctors make the right decisions delivering the right treatment ... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5057790 Fri, 22 Jul 2011 18:36:52 +0100 5057790 http://www.medworm.com/index.php?rid=5057794&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FBDvwYc3vTEA%2Fspacelabs-healthcare-xprezzon-patient-monitor-from-the-future-also-viewable-on-ipad.html Spacelabs Healthcare (named so because it originally developed telemetry devices to monitor the vital signs of orbiting astronauts) has recently launched XPREZZON, a patient monitor that pretty much fullfills all the wishes we ever had for a monitor and that also makes some clever use of existing remote desktop technology. It has a sleek, frameless, iPad-like high resolution touchscreen display. It can display custom trends which can be accessed with a single touch, or they can be displayed continuously and arranged to the user’s liking. It has bright LED alarm lights both on the front and the back. For those accustomed to dual-screen desktop set-ups, a second display can be attached to the monitor, acting as a secondary screen for charting and other clinical applications. Under the ... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5057794 Fri, 22 Jul 2011 15:08:50 +0100 5057794 http://www.medworm.com/index.php?rid=5050603&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1737 Leap’s quotient   The number of F-bombs used is inversely proportional to the chance of receiving narcotic analgesics in the emergency department.   That is,  # F-bomb=1/narcotic Rx (Source: edwinleap.com) edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5050603 Thu, 21 Jul 2011 14:50:28 +0100 5050603 http://www.medworm.com/index.php?rid=5050604&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1735 Look, I have no delusions that I’m a psychiatrist. (Get it?  Delusions?)  My specialty encompasses many things, but my general involvement with psychiatry is trying to assess depression, anxiety, psychosis and suicidal ideations; or the risk for future suicidal or homocidal events.  I do practice medicine well. As an emergency physician, I know sick.  It’s what I was trained to do, and what I have practice for nearly two decades. So I find it very unsettling to have this conversation, prior to a psychiatric hospital accepting a patient: ‘We can’t accept him, he has an elevated white blood count.  It’s 13,000.’ ‘He fell down, it means nothing.  He has no focus of infection.’ ‘He might be medically unstable, or have an infection. Yo... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5050604 Thu, 21 Jul 2011 13:37:14 +0100 5050604 http://www.medworm.com/index.php?rid=5050580&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Frecognizing-different-arrhythmias-theres-an-app-for-that%2F2011.07.21 The recognition and management of cardiac arrhythmias is a must-have clinical skill for residents and physicians, and one that is often not well-taught at some institutions. For example, deciding whether a patient is in a shockable rhythm, realizing what medications should or should not be given in a particular situation, or assessing the degree of atrioventricular block, can all be important considerations in patient care. The Arrhythmias app, designed by Abe Balsamo, recently cracked the Top 10 list of most-downloaded medical apps in the app store.  This app represents Mr. Balsamo’s first foray into the app world, though he has several other apps in development, according to his website AppsByAbe.com.  The app’s growing popularity has been driven by its point-of-care abilities that... Better Health blogs http://www.medworm.com/rss/comments.php?id=5050580 Thu, 21 Jul 2011 12:00:55 +0100 5050580 http://www.medworm.com/index.php?rid=5050597&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FUa00kaWpclI%2F Welcome to the impressive 27th edition! The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team will cast the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5050597 Tue, 19 Jul 2011 13:55:15 +0100 5050597 http://www.medworm.com/index.php?rid=5050607&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1728 For years now, we’ve all heard the drum-beat.  Bill-boards in cities have proclaimed it.  Various medical associations have touted it’s importance.  Stroke symptoms have to be treated immediately!  Give clot-busting drugs, also known as ‘thrombolytics!’ Until, of course, those in favor of giving the drugs (namely neurologists)  realized that a)  Not everyone with a stroke, aka ‘brain attack’ has insurance and b) people have a very inconsiderate habit of having said strokes at the most inconvenient of hours.  For instance, after 5PM, on the weekend, on holidays.  The nerve! So across the country, physicians in emergency departments like mine are finding themselves expected by the court of public opinion to give a potentially dangerous drug (albeit... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5050607 Tue, 19 Jul 2011 01:27:57 +0100 5050607 http://www.medworm.com/index.php?rid=5036240&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1726 Church Camp Helps Kids Learn How to Choose This is my column in today’s Greenville News. My wife and I just returned from helping to chaperone 20 middle and high-school students at a church camp populated by a total of 600 youth. We were at SummerSalt, the flagship camp of the South Carolina Baptist Convention, located near Winnsboro, SC at White Oak Conference Center. (Actually, I’ve always referred to it as ‘Hotternhades, South Carolina,’ but that’s just me.) Since it is a Southern Baptist Camp, let me immediately set fire to the standard ’straw-man’ stereotypes leveled at our denomination; and indeed, at evangelicals in general. We did not spend our time making lists of all the people we believed were going to hell. We did not meet secretly to d... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5036240 Sun, 17 Jul 2011 18:59:47 +0100 5036240 http://www.medworm.com/index.php?rid=5036238&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F1LTHl_vklng%2F Great news LITFLers, Keeping Up with Emergency Medicine is back! Once again, you can stay up to date with the literature in 10 minutes a week, for free! (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5036238 Sun, 17 Jul 2011 03:37:52 +0100 5036238 http://www.medworm.com/index.php?rid=5036311&cid=t_94412_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FiOwGujYEzao%2F Remember back in February when I cut my face open at the HIMSS conference and needed medical assistance while 1,000 miles from home? I blogged then about how I used Google Maps to find an urgent care clinic close to the convention center instead of riding to a hospital emergency room in an ambulance? I’m guessing that course of action saved me at least $1,500, money that would have come out of my pocket because, as a self-employed individual, I was only able to qualify for an afford an insurance policy with a high deductible. Though most Americans still aren’t engaged as consumers when they seek healthcare services, there are tens of millions of uninsured people and a smaller number of people like me with high-deductible plans that would face the same conundrum when they have a... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=5036311 Fri, 15 Jul 2011 16:05:14 +0100 5036311 http://www.medworm.com/index.php?rid=5028235&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Flifeinthefastlane.com%2Fwp-content%2Fuploads%2F2009%2F12%2FCircle_Of_Care_5.mov In response to a recent conversation with @Prof_Elemental regarding an engagement to perform at the upcoming Utopian Conference of Waiting Room Medicine, the Council executive have urged us to re-post the UCEM concept of Waiting Room design (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5028235 Fri, 15 Jul 2011 07:02:49 +0100 5028235 http://www.medworm.com/index.php?rid=5028530&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Fs-4xj09jBs4%2Fnew-technology-paves-way-for-low-energy-cardiac-defibrillation.html One of the most dramatic scenes in medicine is reviving a patient in ventricular fibrillation using a defibrillator.  An international team of scientists however has developed a new low-energy method that may take a lot of the drama out of the procedure. Their technique, called LEAP (Low-Energy Anti-fibrillation Pacing), reduces the energy required for defibrillation by 84%. LEAP, tested in dogs, works by applying a series of five small shocks, instead of one large one. It takes advantage of the shape of the heart’s vasculature, which affects spatial patterns of electric currents, creating ‘virtual electrodes’ that essentially amplify the voltage applied to the tissue. The technique was first developed and tested in isolated pieces of dog atria and ventricles, and then l... Medgadget blogs http://www.medworm.com/rss/comments.php?id=5028530 Thu, 14 Jul 2011 15:04:43 +0100 5028530 http://www.medworm.com/index.php?rid=5028243&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1724 Does it seem ironic that ARG stands for Antibiotic Resistant Gonorrhea?  Maybe a little? In an era of movies like ‘Friends with Benefits,’ in a time when entertainers like Russell Brand and David Duchovny are treated for sexual addiction, in a time when we simply shrug off the words ‘promiscuous’ or ‘fornication; as antiquated bits of fundamentalism, we have yet another reason to pause and think. Gonorrhea that resists current antibiotic therapy. http://www.cdc.gov/std/gonorrhea/arg/default.htm It isn’t just burning, unfortunately.  It’s also infertility and in some cases infections of the blood-stream, heart valves or brain that can result from untreated (or now, untreatable) gonorrhea. But we’ll probably ignore this too.  Moderns are sim... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=5028243 Thu, 14 Jul 2011 14:00:07 +0100 5028243 http://www.medworm.com/index.php?rid=5028236&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FdZxZApVvIzQ%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5028236 Mon, 11 Jul 2011 13:43:55 +0100 5028236 http://www.medworm.com/index.php?rid=5028237&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FWyjziQ_V90I%2F We review another misdirected and underdone 'research' article from the most recent issue of Emergency Medicine Australasia... (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5028237 Sun, 10 Jul 2011 16:21:53 +0100 5028237 http://www.medworm.com/index.php?rid=5028239&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FJzcJ0iXgn6M%2F A real case highlighting the challenges of managing the critically ill obstetric patient in remote regions of Australia. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5028239 Thu, 07 Jul 2011 07:00:23 +0100 5028239 http://www.medworm.com/index.php?rid=5008205&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F3S8wYPz7964%2F Insights from the podcast PE/ PERC wars that are raging on the web as a result of the clash of two New York titans on EMCrit... (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5008205 Wed, 06 Jul 2011 18:12:58 +0100 5008205 http://www.medworm.com/index.php?rid=5008206&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FXn9mMMR1B58%2F aka Hematology Hoodwinker 003 Emergency department management of the critically bleeding patient requiring massive transfusion  is an area thats constantly changing and developing, making it difficult to keep up with what we should and what we shouldn’t be doing. The National Blood Authority has just released it’s first module  Critical Bleeding/Massive Transfusion the first in a six [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5008206 Wed, 06 Jul 2011 00:00:35 +0100 5008206 http://www.medworm.com/index.php?rid=5008207&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fj69mxbcbNbM%2F Getting very excited about this November…as conference fever sets in If all goes to plan various members of the LITFL team will be traveling and speaking around the globe - spreading the word about the use of social media in education So far on the agenda we have…San Fransisco, Cape Town, Sydney and Molvania. Hopefully [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=5008207 Tue, 05 Jul 2011 06:55:02 +0100 5008207 http://www.medworm.com/index.php?rid=4997531&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FK8QR1AOJNx8%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4997531 Mon, 04 Jul 2011 14:08:22 +0100 4997531 http://www.medworm.com/index.php?rid=4997532&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FeGWyjEbJ2TY%2F We have just started the long process of cataloguing the LITFL image collection - currently standing at 120,000 prospectively consented images from the last 15 years. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4997532 Sun, 03 Jul 2011 07:28:58 +0100 4997532 http://www.medworm.com/index.php?rid=4992699&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1711 This is my column in July’s EM News.  Have a restful day! http://journals.lww.com/em-news/Fulltext/2011/07000/Second_Opinion__A_Rest_for_the_Heart.10.aspx We travel to Hilton Head, SC, every spring for an ‘end of school-year’ vacation. It is a tradition that started several years ago; one which our family treasures. We plan months ahead, when we arrange lodging. Then, as the date draws closer we have to restrain ourselves from jumping up and down at odd, inappropriate times. The beach calls to us in an inexplicable way. We live in a beautiful county, surrounded by mountains and lakes. It is, in itself, a worthy destination, perfect for biking, hiking, fishing and/or kayaking. But when May rolls around, our eyes turn to the east, and we long for the sand and sea. It is on... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4992699 Fri, 01 Jul 2011 22:24:09 +0100 4992699 http://www.medworm.com/index.php?rid=4992690&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffourth-of-july-top-tips-for-fireworks-safety%2F2011.07.01 As the 4th of July approaches, I’ve begun to hear fireworks exploding in my neighborhood.  It’s been dry here, so in addition to the risk of injuring a person, there is a risk of setting the fields on fire.  I sure hope my neighbors are being responsible. I hope you will all have a safe and happy July 4th.  Be safe and stay out of the ER. Please use the following tips: Never allow children to play with or ignite fireworks.  A responsible adult should be in charge. Read and follow all warnings and instructions. Be sure other people are out-of-range before lighting fireworks. Small children should be kept a safe distance from the fireworks; older children that use fireworks need to be carefully supervised. Do not smoke when handling any type of “live” firecracker, rocke... Better Health blogs http://www.medworm.com/rss/comments.php?id=4992690 Fri, 01 Jul 2011 16:00:00 +0100 4992690 http://www.medworm.com/index.php?rid=4984450&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fred-neck-physician-antics%2F2011.06.29 A physician friend of mine recently bragged that, while driving along a rural South Carolina road, he had stopped, chased a timber-rattler into the bushes, located said rattler, then urinated on it. ‘I wanted to say I had peed on a rattlesnake!’  He beat a hasty retreat (and I imagine a hasty zip-up) when the snake rattled and struck at the air.  Who can blame Mr. Snake? You can take the redneck to medical school, but you’ll just get a redneck with a medical degree. Which brings me to me.  I have to work on our tool-shed/work-shop in the morning.  The tool-shed/work-shop is, however, over-run with red-wasps.  I counted no less than ten nests inside.  These are irritable, contentious creatures with no love of humanity.  If they were humans, they would be (more…) ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4984450 Wed, 29 Jun 2011 20:00:45 +0100 4984450 http://www.medworm.com/index.php?rid=4975876&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1706 Trained as an emergency physician, my entire career has been spent pondering, searching for, often finding and managing the worst possible eventualities in my patients.  Chest pain is, first and foremost, a heart attack or pulmonary embolus.  Abdominal pain is appendicitis, a ruptured tubal pregnancy.  Fever with headache is meningitis.  And neck pain from a car wreck is an unstable cervical spine fracture. So it has taken enormous effort to ‘dial-down’ my response to my wife’s recent cancer, treatment and recovery.  I drive her to distraction with ‘how are you feeling?’  I pester her endlessly to eat.  I have imagined every bump or cough a metastasis.  I have envisioned all the worst outcomes imaginable.  I endlessly ‘catastrophize,’ as o... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4975876 Tue, 28 Jun 2011 21:01:30 +0100 4975876 http://www.medworm.com/index.php?rid=4997533&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FkIUxHYA-kTM%2F LITFL gives a shout-out to new emergency blog - EM Literature of Note. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4997533 Tue, 28 Jun 2011 07:49:58 +0100 4997533 http://www.medworm.com/index.php?rid=4975872&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Fwww.emergencyweb.net%2Flibrary%2Fmp3.php%3Ff%3Deits_ep042_ett.mp3 The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4975872 Mon, 27 Jun 2011 08:04:45 +0100 4975872 http://www.medworm.com/index.php?rid=4968505&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1704 Last night, working in the emergency department, I realized yet again that EMR is a problem.  While governmental bodies and consulting firms endlessly praise the utility and wonders of electronic medical records, the hard reality ‘on the ground’ is that entering electronic data, for every patient encounter, is a productivity killer. In fact, I realized that I spend far more time looking at the screen, clicking the mouse and typing the history for the patient counter than I ever spend actually talking to, and touching, the patient. I believe that EMR, while having some utility, has simply caused us to obtain and store more data than ever, most of which is unnecessary at best, and at worst, damning and confusing.  (Damning because if my vast chart conflicts with the nurse&#8217... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4968505 Thu, 23 Jun 2011 20:26:51 +0100 4968505 http://www.medworm.com/index.php?rid=4997535&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FFAw3qq0vzrY%2F The AHA combine the acting skills of Ken Jeong, MD (trained physician and crazy-ass actor from the Hangover II) with the metronomic beat of Stayin' Alive to teach CPR rhythm. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4997535 Thu, 23 Jun 2011 13:04:39 +0100 4997535 http://www.medworm.com/index.php?rid=4997536&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fi5up-SjFC0Q%2F This one's for our medical student friends... and anyone else fighting the axis of evil! Understanding axis is one of the keys to understanding ECGs. Super Axis Man (SAM) is here to help! (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4997536 Thu, 23 Jun 2011 09:29:03 +0100 4997536 http://www.medworm.com/index.php?rid=4960075&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1693 I haven’t worked a night shift in many months.  For a time, years ago, I worked full-time nights.  I did it for about seven years, at which time my wife told me I was acting depressed and should move to a daytime schedule.  Still, the vagaries of the ER require that we sometimes be here all night.  Blech.  So, I thought I’d take this opportunity to chronicle my thoughts through the night.  Please be patient if my thought processes seem to ramble. 1)  I had, in my lunch container, a cheeseburger, two packs of Swiss Cake Rolls, and a turkey, pepper-jack and honey-wheat bread sandwich.  I arrived at 2250.  It is 2330.  I have consumed one turkey sandwich and one pack of Swiss Cake Rolls.  It may be a long night. 2)  I came to work without sleeping much.  I simply coul... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4960075 Thu, 23 Jun 2011 04:26:16 +0100 4960075 http://www.medworm.com/index.php?rid=4997537&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FFLVaN6eQC5w%2F At LITFL we are constantly trying to find interesting and enigmatic individuals with a passion for emergency medicine to share their experiences. We have a particular passion of International Emergency Medicine and are proud to introduce Dr Bishan Rajapakse. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4997537 Wed, 22 Jun 2011 09:03:33 +0100 4997537 http://www.medworm.com/index.php?rid=4953030&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2F4hfZyRZqbXY%2Fnew-allied-healthcare-mass-casualty-ventilators.html St. Louis-based Allied Healthcare has released a line of ventilators designed for mass casualty situations. During natural or man-made disasters, hospitals may be overwhelmed by the sheer number of patients needing life support, and clinical staff typically not qualified to provide life support may be required to assist. Additionally, electric power may become unavailable for stand-alone mobile ventilators that can operate for extended periods of time and demand continuous electricity. The Allied Mass Casualty Ventilators were designed for such situations, and they feature simple operation, long battery life, and are able to operate without external gas connections. “If you can’t breathe nothing else matters,” said Jack Dabrowski, Allied’s National Product Manager. “Early respon... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4953030 Tue, 21 Jun 2011 18:23:40 +0100 4953030 http://www.medworm.com/index.php?rid=4952852&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FLbq2SFrYZZ0%2F The first of EB Medicine's EM Critical Care review articles is out - here is a Q&A on respiratory monitoring inspired by this exciting new publication. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4952852 Mon, 20 Jun 2011 00:00:31 +0100 4952852 http://www.medworm.com/index.php?rid=4952853&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FOl21m5-oQ7s%2F Introducing The African Journal of Emergency Medicine (AfJEM), the official journal of the African Federation for Emergency Medicine. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4952853 Sun, 19 Jun 2011 00:00:28 +0100 4952853 http://www.medworm.com/index.php?rid=4952864&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1681 For all of you fans of electronic books (which have finally out-sold print books), my latest book, The Practice Test, is available as an e-book.  Here’s the link! http://booklocker.com/books/5196.html Thanks for your support! Edwin (Source: edwinleap.com) edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4952864 Sat, 18 Jun 2011 17:18:09 +0100 4952864 http://www.medworm.com/index.php?rid=4952855&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FlsVr9tmLC6U%2F LITFL's first 'Postcard from the Edge', a series highlighting the emerging field of International Emergency Medicine, features Australian IEM trailblazer Associate Professor Chris Curry. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4952855 Fri, 17 Jun 2011 08:26:44 +0100 4952855 http://www.medworm.com/index.php?rid=4934409&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FCbqi-F3AL34%2Fchristie-medical-announces-veinviewer-vision-omnimount.html Christie Medical Innovations has announced its new VeinViewer Vision OmniMount, which provides a smaller physical footprint and reduced cost for the company’s VeinViewer platform. The VeinViewer technology uses near-infrared light to produce an image of a patient’s veins, and then projects the image directly onto the skin to aid in IV placement. From the press release: The form factor of OmniMount is further reduced compared to the high-mobility cart model of VeinViewer Vision, but it features the same clinically proven vein-viewing capabilities. With OmniMount, customers have the key option of using the semi-permanent mount to position the device on a wall or table. The reduced size and mounting feature will prove to be especially useful in smaller treatment settings such as clinics, ... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4934409 Wed, 15 Jun 2011 16:20:36 +0100 4934409 http://www.medworm.com/index.php?rid=4934171&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FVKOk8s-E5yQ%2F Having a look on the web to review some fundamental chemistry I saw a couple of demonstrations of audiovisual knowledge sharing, though not sure how many of these ideas we can realistically incorporate into emergency medicine and critical care learning! (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4934171 Wed, 15 Jun 2011 07:52:04 +0100 4934171 http://www.medworm.com/index.php?rid=4934173&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FCwetCV_vWps%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4934173 Mon, 13 Jun 2011 01:25:31 +0100 4934173 http://www.medworm.com/index.php?rid=4934174&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FwtkDNQWHJKA%2F I’ve always thought ‘GP proceduralist’ is a very understated term for people who should really be considered the ‘MacGyvers of medicine’. GP proceduralists in remote Australia are what most doctors were maybe eighty years ago — and what most of us dreamed of being when we went into medical school: having a baby? They’ll deliver [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4934174 Sun, 12 Jun 2011 00:00:45 +0100 4934174 http://www.medworm.com/index.php?rid=4921433&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FQRQSaDbuHok%2F Wow! This week's FFFF features some funtabulous findings that may at first feel frivolous, but --- fear not --- will help you figure out the furtive factors that are enfeebling your less-than-forthcoming ED frequenters... (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4921433 Fri, 10 Jun 2011 10:34:19 +0100 4921433 http://www.medworm.com/index.php?rid=4921434&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FQQBNAcIPgo8%2F ACEM Fellowship examination questions for the SAQ, VAQ and SCE now updated (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4921434 Thu, 09 Jun 2011 13:20:57 +0100 4921434 http://www.medworm.com/index.php?rid=4921435&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FjkJtnC7xuoA%2F LITFL reviews the June edition of Emergency Medicine Practice on Traumatic Hand Injuries. Are you ready for the Top 10 Review Questions? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4921435 Thu, 09 Jun 2011 09:29:16 +0100 4921435 http://www.medworm.com/index.php?rid=4911606&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2F-RCfr_LN-c8%2Fmedegrip-given-go-ahead-in-europe.html MedeGrip, a simple foam device for working with small or breakable things in the clinic or on the floor, has received the European CE Mark of approval.  It was less than a month ago that MedeGrip was successfully registered with the FDA as a Class 1 device and Access Scientific included it as part of the POWERWAND Maximum Barrier Kit. Developed by a PICC line nurse, the device helps take away the pain of handling things like Luer Loks and pin knots, and makes it a bit safer to work with glass ampules. Here’s a short video demonstrating the MedeGrip: Product page: MedeGrip… Flashbacks: MedeGrip to Make Work With Central Lines, Ampules, Other Devices Easier and Safer; MedeGrip for Pain Free Fingers Gets FDA Registered (Source: Medgadget) Medgadget blogs http://www.medworm.com/rss/comments.php?id=4911606 Tue, 07 Jun 2011 21:54:35 +0100 4911606 http://www.medworm.com/index.php?rid=4911607&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FyaO1kZqzbqE%2Fphilips-new-budget-conscious-petct-with-time-of-flight-technology.html Philips has introduced its Astonish TF Time-of-Flight (TOF) technology into its new budget PET/CT scanner, the TruFlight Select, and will be making TOF a standard on the company’s entire PET line.  By using intelligent timing, Astonish TF pinpoints the location of events with greater precision, leading to what the company claims is an up to 30% greater contrast resolution compared with non-TOF equipped systems. From the announcement: TOF technology for positron emission tomography (PET) scanners is designed to enhance image quality by reducing image artifacts and providing higher sensitivity. The resulting images help clinicians better detect and locate lesions to increase diagnostic confidence and preserve healthy tissue during treatment. According to a recent study, TOF scans can ... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4911607 Tue, 07 Jun 2011 19:55:06 +0100 4911607 http://www.medworm.com/index.php?rid=4911608&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FG7r1FUknrNc%2Faustralian-researchers-develop-color-changing-bandage.html Louise van der Werff, a Ph.D. student from Monash University in Melbourne, Australia, has created a bandage that changes color in response to changes in heat. Looking somewhat like a giant mood ring, the psychedelic bandage is made up of special thermochromatic fibers that can detect changes in temperature as small as half a degree Celsius. Since inflammation or problems with blood supply at the wound site can cause an increase in temperature that can lead to an infection, a quick and accurate diagnosis is necessary. The color-changing bandage holds many advantages over the most common method of using electronic instruments in that it requires no electricity, gives a near-instant measurements, and costs less. Moreover, as the thermochromatic fibers can change to a wide range of colors, ph... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4911608 Tue, 07 Jun 2011 18:18:23 +0100 4911608 http://www.medworm.com/index.php?rid=4911493&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FIJ5pagkDJTU%2F We recently featured a video on what could turn out to be the emergency medicine/ critical care 'Trial of the Year'... That's right, the FEAST Trial: (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4911493 Tue, 07 Jun 2011 00:00:18 +0100 4911493 http://www.medworm.com/index.php?rid=4902509&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2Fpw7mTXLHXzE%2Fmasimo-e1-pulse-oximetry-ear-sensor-receives-fda-and-ce-approval.html Masimo has received both US FDA and European CE clearance for its E1 single-patient-use pulse oximetry ear sensor. The ear is often used as an alternative site to measure oxygenation in situations where measurement at the fingertip is impractical, such as when there is excessive patient movement or when perfusion is too low to obtain reliable results. While traditional fingerclip sensors are often applied to the earlobe, the E1 is attached more securely in the cavum conchae. It promises to give faster detection of oxygen saturation changes during low perfusion, and to avoid cross-contamination risks associated with reusable sensors. Masimo has started a limited market release of the device. Press release: Masimo Initiates Limited Market Release of E1, Single-Patient-Use Ear Sensor for Puls... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4902509 Mon, 06 Jun 2011 13:00:43 +0100 4902509 http://www.medworm.com/index.php?rid=4911494&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FfAUV6GRDJcU%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4911494 Mon, 06 Jun 2011 01:48:35 +0100 4911494 http://www.medworm.com/index.php?rid=4902422&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-young-person-refuses-life-saving-treatment-is-that-ok%2F2011.06.05 Discussion: (more…) *This blog post was originally published at Movin' Meat* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4902422 Sun, 05 Jun 2011 19:00:00 +0100 4902422 http://www.medworm.com/index.php?rid=4893457&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FSen8YuWqphg%2F Some fun figures well worth engraving on the surface of your encephalon if you're an emergency or critical care doc in this week's FFFF. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4893457 Fri, 03 Jun 2011 00:00:23 +0100 4893457 http://www.medworm.com/index.php?rid=4893459&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F4KSMp8AaGAU%2F A surprising FEAST: "Fluid boluses significantly increased 48-hour mortality in critically ill children with impaired perfusion in... resource-limited settings in Africa." (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4893459 Thu, 02 Jun 2011 09:23:02 +0100 4893459 http://www.medworm.com/index.php?rid=4893385&cid=t_94412_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F2p7f2HNbkQM%2F It would seem logical that giving people access to primary health-care services would help cut down on visits to the emergency room. But a new study suggests that when it comes to mental-health services for kids, that may not be the case. Researchers at Johns Hopkins Children’s Center looked at patient records for kids aged 3 to 17 who made visits to the hospital’s ER for mental-health issues. The majority of these visits were for relatively minor problems such as disruptive behavior at school, fighting with siblings or running away, Emily Frosch, lead author of the study and a pediatric psychiatrist at Hopkins Children’s, tells the Health Blog. Of 2,903 patients who initially visited the ER for mental-health reasons, 338 returned within six months. That, despite the fact... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4893385 Wed, 01 Jun 2011 20:49:23 +0100 4893385 http://www.medworm.com/index.php?rid=4883580&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FNmMlUs04hTY%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4883580 Mon, 30 May 2011 07:56:03 +0100 4883580 http://www.medworm.com/index.php?rid=4872193&cid=t_94412_113_f&fid=22291&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedgadget%2F%7E3%2FU5wYhJSV5d8%2Fthe-oxylator-emergency-ventilation-with-no-wires.html The Oxylator from Primedic is a combination between a bag-valve mask and a portable ventilator.  Designed to be operated by either lay rescuers or EMS personnel, it is powered only by an oxygen cylinder, with no electricity required.  This device basically acts as a pressure-controlled ventilator, leaving EMS personnel with free hands to take care of other life-savings tasks. The Oxylator is affixed either to a facemask or a more invasive airway device such as an LMA or endotracheal tube, and with the touch of a button, it begins delivering a preset pressure in the range of 20-45 cm H2O.  In addition, there is an audio-visual alarm that alerts to increased pressures that can occur if more head-tilt/chin-lift is needed in the case of mask ventilation or if the tube slips into the right m... Medgadget blogs http://www.medworm.com/rss/comments.php?id=4872193 Fri, 27 May 2011 19:16:35 +0100 4872193 http://www.medworm.com/index.php?rid=4872107&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1631 How many times have you heard this on the radio: Base, this is Medic 3, and we’re 15 minutes from your facility with a 38-year-old white male with, uh, some chest pain, numbness all over, headache, and anxiety, as well as some bruises from a fall. He says his pain radiates from his earlobes to his nipples, and well, we’ll just give you more details on arrival, base. This is Medic 3 clear. God love those paramedics. The truth is, if we doctors were on the truck ourselves, we still wouldn’t know what the diagnosis was. Frequently, when I discharge people from the emergency department, I still don’t know the diagnosis. Thank heavens for medical screening exams because that’s about the best I can do some nights. But I have come to realize that if the medics can&#8... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4872107 Fri, 27 May 2011 16:37:55 +0100 4872107 http://www.medworm.com/index.php?rid=4872091&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-avoid-dog-bites%2F2011.05.27 Last year I didn’t write about dog bite prevention until the first week of June even though I know National Dog Bite Prevention Week is always the third full of week of May. The numbers shared by the American Veterinary Medical Association (AVMA) haven’t changed:   4.7 million people are bitten by dogs each year in the US with 800,000 of them requiring medical attention. If you have read this blog for very long, you know I dearly love my dogs — deceased ones (Columbo, Ladybug (photo), and Girlfriend) and the living one, Rusty.  Still, I have no illusions that dogs bite and given the right provocation, I think mine would though most of the time they are totally harmless and would just invite you in to rob me. Sadly, children are by far the most common victims of dog bites, occu... Better Health blogs http://www.medworm.com/rss/comments.php?id=4872091 Fri, 27 May 2011 16:00:00 +0100 4872091 http://www.medworm.com/index.php?rid=4872092&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fstrange-requests-in-the-emergency-department-virginity-testing-and-more%2F2011.05.27 As the country wrestles with the cost of health-care, and as various media outlets address the role of emergency departments, I thought this little guide-might be helpful!  I pulled it out of my archives from several years ago.  Enjoy! All too often, I discharge a patient and think to myself, What instructions can I give for this? Sometimes there are problems and questions that don’t have obvious solutions or answers. And in these situations, coming up with something useful for the patient to read at home is, to say the least, difficult. I’ve come up with a few based on some of the enigmas I see at Oconee Memorial Hospital. Virginity evaluation: The emergency physician has not determined the status of your daughter’s virginity. In fact, the emergency physician does not wish to know... Better Health blogs http://www.medworm.com/rss/comments.php?id=4872092 Fri, 27 May 2011 14:00:34 +0100 4872092 http://www.medworm.com/index.php?rid=4872095&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fkudos-to-the-cdc-for-creative-health-messaging-the-zombie-project%2F2011.05.26 This is good.  I knew the CDC was socially tuned-in but this came as a surprise:  Preparedness 101: Zombie Apocalypse .  It’s every American’s guide to dealing with a zombie attack.  You come thinking zombies but take away principles for emergency preparedness.  Well done, CDC. The real take away for those of us looking under the hood: effective health messaging should be creative and fun.  While we’ll never be able to measure the true effectiveness of this approach in an emergency, expect the post’s massive traffic to convert important links on emergency preparedness.  Hopefully the CDC will release stats on the effectiveness of this campaign. I’d like to write more, but I’m goin’ to make my kit. *This blog post was originally published at 33 Charts* (Source... Better Health blogs http://www.medworm.com/rss/comments.php?id=4872095 Thu, 26 May 2011 19:00:36 +0100 4872095 http://www.medworm.com/index.php?rid=4862562&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1626 The video lives!  Our nursing staff helped me to film this years ago, and now I present it to you.  Invincibility Syndrome concerns our patients who just can’t die, no matter how hard they try. And whose motto is:  ‘I gotta get outta here!’ No actual drunks or patients were harmed in the making of this film.  Kudos to Frank Mason, RN, the star of the production. http://www.youtube.com/watch?v=1cepDYbKNkA&feature=related (Source: edwinleap.com) edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4862562 Wed, 25 May 2011 16:21:56 +0100 4862562 http://www.medworm.com/index.php?rid=4862556&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FL2NSxYI8gSY%2F Feature post giving a shout-out to the newly created blog Emergency Medicine Ireland. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4862556 Wed, 25 May 2011 11:52:56 +0100 4862556 http://www.medworm.com/index.php?rid=4862557&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FzMal2K2f9cg%2F You can't get through emergency medicine training these days without the TLA 'NAI' ringing in your ears every time a sick child pops up on the triage screen. Can you remember all the things to look for if you suspect non-accidental injury? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4862557 Wed, 25 May 2011 06:16:45 +0100 4862557 http://www.medworm.com/index.php?rid=4862558&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Fwww.emergencyweb.net%2Flibrary%2Fmp3.php%3Ff%3Deits_ep040_toxicologypart1.mp3 The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4862558 Tue, 24 May 2011 11:42:18 +0100 4862558 http://www.medworm.com/index.php?rid=4852882&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1623 As the country wrestles with the cost of health-care, and as various media outlets address the role of emergency departments, I thought this little guide-might be helpful!  I pulled it out of my archives from several years ago.  Enjoy! All too often, I discharge a patient and think to myself, What instructions can I give for this? Sometimes there are problems and questions that don’t have obvious solutions or answers. And in these situations, coming up with something useful for the patient to read at home is, to say the least, difficult. I’ve come up with a few based on some of the enigmas I see at Oconee Memorial Hospital. Virginity evaluation: The emergency physician has not determined the status of your daughter’s virginity. In fact, the emergency physician does not ... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4852882 Mon, 23 May 2011 19:14:34 +0100 4852882 http://www.medworm.com/index.php?rid=4852856&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-to-stop-bleeding-the-combat-application-tourniquet-and-quikclot%2F2011.05.23 The Combat Application Tourniquet Dr. Brad Bennett provided an excellent workshop at the 2010 Wilderness Medical Society annual meeting in Snowmass, Colorado on how to manage severe bleeding, based on his work with the Committee on Tactical Combat Casualty Care. From time to time, wilderness medicine practitioners encounter situations of severe bleeding, so this information is essential for anyone responsible for the health and safety of outdoor explorers and adventurers. In a simple algorithm, we learned that the first attempt to control bleeding is almost always direct hand pressure. This is followed by application of a pressure bandage. If that is successful, the victim then is evacuated. If the pressure bandage does not adequately control bleeding on the torso of the victim, t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4852856 Mon, 23 May 2011 16:00:00 +0100 4852856 http://www.medworm.com/index.php?rid=4847965&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1617 The Suffering Prevention Act Dr. Sam Fisher walked into the small exam room with chart in hand. He looked up, and extended a tired hand to the well dressed gentleman on the exam table before him. Mr. Mason, I’m Dr. Fisher. What can I do for you? he said for the 35th time that evening. Without a pause, Roger Mason looked at him, and said the words that had become so common. I claim the right to free care and to your voluntary effort as guaranteed by the Federal Health Care Rights Charter. Sam Fisher knew that he was required to reply in one manner and one manner only. I am here to serve you. What is your need? Roger Mason looked at him with a disdain that seemed to ask if there were any other doctors available. I’m in pain, as if you shouldn’t know by now. He looked down a... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4847965 Sat, 21 May 2011 03:50:23 +0100 4847965 http://www.medworm.com/index.php?rid=4847966&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1614 This is my article in today’s edition of Taki’s Magazine. http://takimag.com/article/aggressive_care_for_the_elderly_too_much_too_late Edwin (Source: edwinleap.com) edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4847966 Fri, 20 May 2011 04:35:08 +0100 4847966 http://www.medworm.com/index.php?rid=4847967&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1610 Kindness as Medical Treatment (This originally appeared as one of my columns in Emergency Medicine News, in 2001.) Before me on the exam table was a young woman in her mid- to late 30s. She was a little anxious. Her chart indicated that she had back pain, neck pain, headache, chest pain, and insomnia. I took a deep breath, rolled my eyes, and began to take a history. I tried my best to tease out what things might be serious and what was not. No injuries, no weakness, no shortness of breath, no history of heart disease, no thunderclap headaches, no, no, no. Her exam was almost as unremarkable. Until we went a little further. As her history continued and she opened up, I learned that she was working third shift at a local factory, raising three small children and caring for a husband on dia... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4847967 Fri, 20 May 2011 03:09:05 +0100 4847967 http://www.medworm.com/index.php?rid=4841490&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1599 Heck, if we have to see patients for free, at least we could bill for a dating service.  Couldn’t we? http://www.xtranormal.com/watch/11938527/emergidate-the-er-matchmaking-service (Source: edwinleap.com) edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4841490 Thu, 19 May 2011 03:11:49 +0100 4841490 http://www.medworm.com/index.php?rid=4841422&cid=t_94412_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F4S3N0HJCLFw%2F Hepatitis Tie-Up: Roche will promote Merck’s newly approved hepatitis C drug Victrelis alongside two of its own therapies used against the virus as part of a non-exclusive U.S. marketing agreement that could expand to other countries, Dow Jones Newswires reports. The market for hepatitis C drugs is expected to heat up further if the FDA approves a competitor to Victrelis made by Vertex Pharmaceuticals and Johnson & Johnson, which those companies plan to market as Incivek. New ACO Options: The Obama administration proposed some new sweeteners for accountable care organizations, hoping to convince wary hospitals and physicians who fear setting up the groups will will be expensive and burdensome, Kaiser Health News reports. There will be a fast-track “Pioneer” model inte... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4841422 Wed, 18 May 2011 12:33:52 +0100 4841422 http://www.medworm.com/index.php?rid=4841486&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F-a0s0sef6dE%2F So, what are you gonna use for this rapid sequence intubation --- roc or sux? Can you answer the hard questions to determine once and for all, whether roc rocks and sux sucks or if it should be the other way around? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4841486 Wed, 18 May 2011 00:00:19 +0100 4841486 http://www.medworm.com/index.php?rid=4828882&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-psychiatrists-approach-wrist-cutting-cries-for-help%2F2011.05.16 When Roy and I were on Talk of the Nation this past week, a called phoned in to ask about her sister. The question was about care in the Emergency Room/Department, so it was a perfect Roy question and he fielded it. I’ve been playing with it since, and wanted to talk more about this particular scenario, because the scenario was very common, and the question was more complicated than it seems. From the transcript of the show: ANN (Caller): Hi, thank you very much. I would like to ask Dr. Roy (oh, I gave him his blog name here) a question: My sister was admitted to emergency when she cut her wrists, and the doctor on call pulled me aside and said, do you think she was trying to kill herself? And I said – because my sister is very intelligent – I said, if my sister really wa... Better Health blogs http://www.medworm.com/rss/comments.php?id=4828882 Mon, 16 May 2011 21:00:00 +0100 4828882 http://www.medworm.com/index.php?rid=4828891&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FtCB0TGVPk04%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4828891 Mon, 16 May 2011 04:30:32 +0100 4828891 http://www.medworm.com/index.php?rid=4828893&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F2iveVBdGXJo%2F It was tea time at Enlightenment Boulevard, and the members of the UCEM Council Executive were taking a well earned break. For a bit of light-hearted fun Professor Oliver Orvil Jeremiah Octavia Bristol suggested they all gather around his iPad to see what the latest creation from ZDoggMD and team had to offer. “What is [...] (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4828893 Sun, 15 May 2011 09:21:46 +0100 4828893 http://www.medworm.com/index.php?rid=4820852&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fkudos-to-a-pain-free-dental-practice%2F2011.05.13 Ordinarily, I’m wary of all things dental.  I had too many cavities as a child.  As a young man, I had a root canal done on the wrong tooth, followed immediately by the correct one.  My dental memories are a bit tainted.  Not an indictment of the entire profession so much as a kind of PPSD…post procedure stress disorder. But when I moved to South Carolina, my wife and I found a wonderful general dentist in Dr. Ronald Moore, in Seneca, SC.  Rarely would I ascribe the words ‘painless dentistry’ to one of the practitioners of that esteemed profession.  But I have to give credit where credit is due.  His hygenists, and Dr. Moore, have all been the pinnacle of gentility.  Even my children aren’t afraid to go for cleanings.  And when I need anesthesia, well Dr. Moore is an art... Better Health blogs http://www.medworm.com/rss/comments.php?id=4820852 Fri, 13 May 2011 14:00:24 +0100 4820852 http://www.medworm.com/index.php?rid=4820855&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fan-er-physicians-checklist%2F2011.05.12 Laugh if you want, this helps my life, at least at work. For months after starting my current gig, I would sometimes get to work with everything in all my pockets, and sometimes not. I’d forget my ID, or my pen, or my phone, or my…well, there you go. Then my OCD started to kick in, and, a Mental Checklist was born. I now have to get 6 things, and set them on the table or I screw it up every time. ID stethoscope my phone work phone pen sharp stick (I’ve written about this before, but cannot find it. You should search an ER blog for the word ‘knife’ and then wonder why you bothered). Last week I apparently went against the checklist, and halfway through the shift realized I’d lost my ID. Of course, after about a combined half-hour of fruitless search I gave up, and found it in ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4820855 Thu, 12 May 2011 19:00:37 +0100 4820855 http://www.medworm.com/index.php?rid=4813297&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FwwfhM2wbtq0%2F A review on the emergency department assessment and management of high-pressure injection injuries. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4813297 Thu, 12 May 2011 01:42:09 +0100 4813297 http://www.medworm.com/index.php?rid=4813303&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1586   Ordinarily, I’m wary of all things dental.  I had too many cavities as a child.  As a young man, I had a root canal done on the wrong tooth, followed immediately be the correct one.  My dental memories are a bit tainted.  Not an indictment of the entire profession so much as a kind of PPSD…post procedure stress disorder. But when I moved to South Carolina, my wife and I found a wonderful general dentist in Dr. Ronald Moore, in Seneca, SC.  Rarely would I ascribe the words ‘painless dentistry’ to one of the practitioners of that esteemed profession.  But I have to give credit where credit is due.  His hygenists, and Dr. Moore, have all been the pinnacle of gentility.  Even my children aren’t afraid to go for cleanings.  And when I need anesthesia, w... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4813303 Wed, 11 May 2011 17:57:24 +0100 4813303 http://www.medworm.com/index.php?rid=4803027&cid=t_94412_87_f&fid=36224&url=http%3A%2F%2Ffeeds.wsjonline.com%2F%7Er%2Fwsj%2Fhealth%2Ffeed%2F%7E3%2F9CWiYYUTua4%2F Given the growing cost of malpractice suits from missed or delayed diagnoses in the emergency department, hospitals and their liability insurers are mining resolved claims for lessons on how to reduce such errors, today’s Informed Patient column reports. In one of the more ambitious efforts, Crico/RMF, which insures Harvard-affiliated hospitals, last year convened an emergency medicine leadership summit with insured hospitals and clients of its risk-management strategies business to identify the key factors contributing to missed or delayed diagnoses in the ER. Their main finding: physician-nurse communication breakdowns often happen at a critical juncture in care. The participating hospitals field-tested strategies to improve communication, and compiled a list of best practices that hosp... WSJ.com: Health Blog blogs http://www.medworm.com/rss/comments.php?id=4803027 Tue, 10 May 2011 13:50:01 +0100 4803027 http://www.medworm.com/index.php?rid=4803139&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-eats-toxic-chemical-emits-hazardous-gas-in-hospital%2F2011.05.09 Absent other information, the referred to ‘rodent poison’ is probably a superwarfarin. It’s like regular people-coumadin, but superconcentrated. It kills rodentia by causing them to bleed to death. Which makes the ‘gas effect’ seem really odd, but possibly explainable. A patient who apparently ingested rodent poison and is emitting potentially harmful gasses has created a hazardous material situation at St. Joseph Mercy Hospital in Ann Arbor. The man is isolated in his room in the medical intensive care unit on the hospital’s sixth floor, 5301 McAuley at East Huron River Drive, hospital spokeswoman Lauren Jones said this afternoon. via Patient emits potentially harmful gas; hazmat called to Ann Arbor hospital | Detroit Free Press | freep.com. Two thoughts: 1) I sincerely hope t... Better Health blogs http://www.medworm.com/rss/comments.php?id=4803139 Mon, 09 May 2011 18:00:15 +0100 4803139 http://www.medworm.com/index.php?rid=4801883&cid=t_94412_139_f&fid=38879&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FVirologyBlog%2F%7E3%2FAjU2KX-f-9Q%2F Hosts: Vincent Racaniello, Rich Condit, Dickson Despommier, Alan Dove, and Alfred Sacchetti Vincent, Rich, Alan, and Dickson speak with Alfred Sacchetti, MD, Chief of Emergency Services at Our Lady of Lourdes Medical Center, about viral infections encountered in the emergency room. Click the arrow above to play, or right-click to download TWiV #132 (48 MB .mp3, 100 minutes). Subscribe to TWiV (free) in iTunes , at the Zune Marketplace, by the RSS feed, by email, or listen on your mobile device with the Microbeworld app. Links for this episode: Dr. Sacchetti’s posts at EM-blog Molluscum contagiousum TWiV on Facebook Letters read on TWiV 132 Weekly Science Picks Al – The Physics of Superheroes and NKT Watch Dickson - Fibonacci Fun by Trudi Hammel Garland and Rachel Gage... virology blog blogs http://www.medworm.com/rss/comments.php?id=4801883 Mon, 09 May 2011 00:21:43 +0100 4801883 http://www.medworm.com/index.php?rid=4789263&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1576 Years ago I had a conversation with a surgeon at our facility.  He was unhappy that a seriously injured trauma patient came to our facility after an MVC.  ‘These patients shouldn’t come here Ed, they should go to a trauma center!’ Fair enough; we aren’t a trauma center.  Not a Level I, not a Level II or III; not even a level 0.5!  But we are the only hospital in a large rural county, and the closest, largest facility for portions of a few other counties nearby.  The nearest hospital with neurosurgery and thoracic surgery is at least 30 minutes further away. The problem is, torn blood vessels, crushed spleens,  collapsed lungs, swollen brains don’t look at the clock, and cars aren’t designed to wreck only near trauma centers, any  more than assaila... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4789263 Wed, 04 May 2011 14:43:20 +0100 4789263 http://www.medworm.com/index.php?rid=4803146&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FRL51oCgViVc%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4803146 Mon, 02 May 2011 05:51:07 +0100 4803146 http://www.medworm.com/index.php?rid=4775395&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fend-of-life-care-costs-does-your-doctor-know-when-youre-going-to-die%2F2011.05.01 One interesting comment I have seen come up over and over is the idea that end-of-life costs are the thing that is spiralling out of control and that if we could somehow find a way to curb the costs of futile care, then that would somehow solve the health care inflation crisis. Andrew Sullivan endorsed such an idea the other day, a “Modest Proposal,” which is not nearly as radical or amusing as Swift’s. And indeed, there is a modicum of sense in the idea. Estimates are that spending in the last six months of a person’s life account for 30-50% of their overall health care costs, and that the spending in the last year of a person’s life accounts for 25% of overall medicare spending. So — simple solution, right? cut down on the futile care, and we’re ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775395 Sun, 01 May 2011 18:00:00 +0100 4775395 http://www.medworm.com/index.php?rid=4775396&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fjudging-illness-severity-and-the-financial-implications-of-dialing-911%2F2011.05.01 Nora misjudged the height of the stair outside the restaurant, stepped down too hard, jammed her knee and tore her meniscus.  Not that we knew this at the time.  All we knew then was that she was howling from the pain. There we were on a dark, empty, wet street in lower Manhattan, not a cab in sight, with a wailing, immobile woman.  What to do?  Call 911? Find a cab to take her home and contact her primary care doctor for advice?  Take her home, put ice on her knee, feed her Advil and call her doctor in the morning? Sometimes it is clear that the only response to a health crisis is to call 911 and head for the emergency department (ED).  But in this case – and in so many others we encounter with our kids, our parents, our co-workers and on the street – the course of action is les... Better Health blogs http://www.medworm.com/rss/comments.php?id=4775396 Sun, 01 May 2011 16:00:04 +0100 4775396 http://www.medworm.com/index.php?rid=4771028&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1567 Paying hospitals for quality…and good patient satisfaction scores.  Are you kidding me? http://www.acep.org/Content.aspx?id=78862 So now, in addition to the many other bits of medical meddling we have from CMS, there’s this. Reimbursements to hospitals, from Medicare, will be partly tied to patient satisfaction scores. We’ve seen payments already being tied to ‘quality indicators,’ as dictated by the federal government; rewards for doing a better job on care for heart attacks, pneumonia, etc.. At least that’s quantifiable, whether scientifically correct or not. But patient satisfaction scores? These scores, part of the constant ‘customer satisfaction’ trend in medicine, are fraught with peril. And despite the validation and complex statistic... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4771028 Sat, 30 Apr 2011 20:58:08 +0100 4771028 http://www.medworm.com/index.php?rid=4803148&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F9EW9Mif-9Q0%2F In this materialistic day and age you can never own too many things... It's time to Own the Chest Tube! (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4803148 Thu, 28 Apr 2011 00:00:56 +0100 4803148 http://www.medworm.com/index.php?rid=4758761&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1531 A young woman saw me on my shift today.  In the process of being evaluated for a work related injury, her physician ordered some x-rays.  One of them showed an incidental finding of a lung nodule.  She was told she would need a CT scan to rule out a malignancy.  But, her workman’s compensation doctor wouldn’t order it, since it was not work related.  And she did not have a personal physician.  Anxious, she came to the ER. Long and short; the chest CT showed a benign, calcified granuloma.  No cancer!  She stood up, breathed a deep sigh of relief…then hugged me! Now, I do lots of things at work.  Close lacerations, evaluate sick children, treat heart attacks, negotiate with drug seekers, encourage alcoholics, and on and on.  But when I get a hug just for saying, &... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4758761 Wed, 27 Apr 2011 14:49:52 +0100 4758761 http://www.medworm.com/index.php?rid=4758756&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatients-expect-the-er-to-be-unpleasant-so-why-make-it-better%2F2011.04.27 Our emergency department was very busy recently. The hospital was full and we were holding patients. Three had been in the ER many hours; one waiting for a bed for six hours, another eight hours, and still one more for eleven hours. Of course, ambulance traffic hadn’t stopped and the waiting room was full, with patients waiting too long to be seen. (And we all know that the media loves to highlight bad outcomes from the ER waiting room!) Administration set up a ‘command post’ to try to arrange beds, discharges and moves. At one point I asked one of our administrators to move those waiting the longest to hallway beds up on the patient floors. He told me that he couldn’t because each of the two floors in question already had one patient in the hall. And besides, it would violate the ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4758756 Wed, 27 Apr 2011 11:00:03 +0100 4758756 http://www.medworm.com/index.php?rid=4803149&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fk_4ImiQmwmA%2F The plumbing problem is this: a man has a urinary catheter in situ, it won't come out. What are you going to do about it? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4803149 Wed, 27 Apr 2011 04:26:57 +0100 4803149 http://www.medworm.com/index.php?rid=4753694&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdeep-thoughts-wisdom-from-the-er%2F2011.04.26 If you’re alleging assault, don’t get loud with the Officer there to take a report. Especially if you have Felony warrants. *This blog post was originally published at GruntDoc* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=4753694 Tue, 26 Apr 2011 11:00:38 +0100 4753694 http://www.medworm.com/index.php?rid=4803151&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FxrbrsqDPjmU%2F Feeling unprepared for your upcoming FACEM Part 2 emergency medicine examination? Suffering from brain failure? Don't worry, UCEM have the solution thanks to pioneering work by neurosurgeon Robert J. White. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4803151 Tue, 26 Apr 2011 04:40:33 +0100 4803151 http://www.medworm.com/index.php?rid=4753702&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FJNBrgOGeUfs%2F Back from the Dead highlights the fascinating documentary by Dr Kevin Fong investigating a pioneering technique of extreme cooling that is being used to bring people back from the dead. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4753702 Tue, 26 Apr 2011 01:12:47 +0100 4753702 http://www.medworm.com/index.php?rid=4747619&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FOHY-ZNVzpjs%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4747619 Mon, 25 Apr 2011 12:47:48 +0100 4747619 http://www.medworm.com/index.php?rid=4742385&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fshould-you-self-insure-against-medical-malpractice%2F2011.04.22 I wrote at some length yesterday about the prerequisites for a medical group to self-insure. What I didn’t go into in detail was the why — the benefits and the risks. I’m going to tackle that a bit today. Potential Benefits to self-insurance Those who have been around a few years can testify that the medical malpractice insurance market is highly cyclic. It seems that about once a decade a crisis hits. Whether this is a rational market is another question entirely. Some have attributed these crises to macroeconomic factors, like the market crash of 2002, after which insurers had to recoup investment losses, or hurricanes and natural disasters in which insurers cost shifted onto other product lines. Other obervers cite skyrocketing medical malpractice losses as the driver... Better Health blogs http://www.medworm.com/rss/comments.php?id=4742385 Fri, 22 Apr 2011 19:00:00 +0100 4742385 http://www.medworm.com/index.php?rid=4742394&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F97wdnbqPnVw%2F We have added the data-table search function and sorting fields to assist readers finding the best emergency medicine resources, their twitter handles, FB pages and RSS feeds. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4742394 Fri, 22 Apr 2011 10:51:50 +0100 4742394 http://www.medworm.com/index.php?rid=4734108&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FGw3SydNx1Wc%2F Own the wound is a collection of videos on wound care created by Michelle Lin the guru behind Academic Life in Emergency Medicine. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4734108 Thu, 21 Apr 2011 00:00:34 +0100 4734108 http://www.medworm.com/index.php?rid=4734110&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F0k8uLaFZqTw%2F We turn to Osler to find out why examinations are necessary stumbling blocks in the path of the true student of medicine. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4734110 Wed, 20 Apr 2011 00:00:33 +0100 4734110 http://www.medworm.com/index.php?rid=4734112&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fu5FgaDGP8SQ%2F Introducing ED.EXAM: a free online forum and collection of resources for emergency medicine trainees studying for the ACEM Part 2 exams. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4734112 Tue, 19 Apr 2011 00:00:02 +0100 4734112 http://www.medworm.com/index.php?rid=4734114&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Fwww.emergencyweb.net%2Flibrary%2Fmp3.php%3Ff%3Deits_ep039_als_review_2010.mp3 The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4734114 Mon, 18 Apr 2011 03:55:11 +0100 4734114 http://www.medworm.com/index.php?rid=4723853&cid=t_94412_88_f&fid=39185&url=http%3A%2F%2Fedwinleap.com%2Fblog%2F%3Fp%3D1512 Our emergency department was very busy recently. The hospital was full and we were holding patients. Three had been in the ER many hours; one waiting for a bed for six hours, another eight hours, and still one more for eleven hours. Of course, ambulance traffic hadn’t stopped and the waiting room was full, with patients waiting too long to be seen. (And we all know that the media loves to highlight bad outcomes from the ER waiting room!) Administration set up a ‘command post’ to try to arrange beds, discharges and moves. At one point I asked one of our administrators to move those waiting the longest to hallway beds up on the patient floors. He told me that he couldn’t because each of the two floors in question already had one patient in the hall. And besides, it wo... edwinleap.com blogs http://www.medworm.com/rss/comments.php?id=4723853 Sun, 17 Apr 2011 22:56:03 +0100 4723853 http://www.medworm.com/index.php?rid=4723809&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fct-scans-for-kids-is-the-radiation-exposure-dangerous%2F2011.04.16 There was an interesting study published this week in the journal Radiology: Rising Use of CT in Child Visits to the Emergency Department in the United States, 1995–2008 (Abstract) The results are not surprising to anyone who has been working in medicine in the US over the last fifteen years. Basically, in 1995, a kid visiting the ER had a 1.2% likelihood of getting a CT scan, and by 2008, that number was 5.9%. I had written about this general phenomon not too long ago, in defense of the general increase of CT utilization in the ER, largely on the basis that CT is a better tool: it provides diagnoses in a rapid and timely manner, and excludes many potential life threats, saving lives and mitigating malpractice risk. That was largely relevant to the adult population, though, and kids are ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4723809 Sat, 16 Apr 2011 17:00:00 +0100 4723809 http://www.medworm.com/index.php?rid=4719899&cid=t_94412_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fer-physicians-are-the-number-one-user-of-mobile-apps%2F2011.04.15 At iMedicalApps, we’re always wary of physician surveys that claim to predict mobile use. We even did a feature article highlighting how sampling bias could be inflating the numbers of many of these surveys. With that said, Bulletin Healthcare just released a survey based on a large sample size of physicians, using the following methods: The analysis, based on the reading habits of more than 550,000 healthcare providers, including more than 400,000 physicians who subscribe to Bulletin Healthcare’s daily email briefings, focused on mobile device usage between June 1, 2010 and February 28, 2011. While the report went on to talk about the increased usage of mobile devices by physicians, with Apple continuing to dominate the market — the iPhone and iPad had a more than 90% share of phy... Better Health blogs http://www.medworm.com/rss/comments.php?id=4719899 Fri, 15 Apr 2011 18:00:48 +0100 4719899 http://www.medworm.com/index.php?rid=4714750&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FQiqApWaeJFc%2F It's April 2011 and time for @EBMedicineʼs Emergency Medicine Practice. This month the focus on the hottest of hot topics, therapeutic hypothermia. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4714750 Thu, 14 Apr 2011 15:07:15 +0100 4714750 http://www.medworm.com/index.php?rid=4709209&cid=t_94412_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FfxqSH9JDGF4%2F Is it safe to give a patient frusemide if he has an allergy to sulfa drugs? Are you feeling slightly immunologically discombobulated? The answer's here. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4709209 Wed, 13 Apr 2011 07:38:13 +0100 4709209