Effect of Emergency Department and ICU Occupancy on Admission Decisions and Outcomes for Critically Ill Patients Kusum S. Mathews et al. Critical Care Medicine. May 2018. [paper] Why I Chose This Study “We have no beds, the MICU is now down to our crash bed” It seems all too frequent that we hear those dreaded
Midnight Musings Why I’m a Nocturnist Hi. I’m Tim Meehan. I’m one of the nocturnists at UIHealth. I’m hoping this semi-regular column will help shed some light (hehe) on the practice of EM in the wee hours of the day. Things that we will (hopefully) talk about over the course of this experiment: How to
Balanced Crystalloids versus Saline in Noncritically Ill Adults WH Self et al. New England Journal of Medicine, March 2018. [paper] Why I chose this article This article is another flashpoint in the long debate – typically between internists and surgeons – regarding the use of normal saline versus balanced crystalloids for resuscitation. I remember being
Key High-Efficiency Practices of Emergency Department Providers: a Mixed-Methods Study. Morgan R. Bobb et al. Society for Academic Emergency Medicine, Dec 2017. [paper] Why I chose this study Efficiency matters, and not just for the physician. Efficiency has a profound impact on patient care and patient outcomes. We all have heard of (or perhaps have
We continue the series with Knowledge Bomb #17. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background As EM docs we see a lot of opiate overdose cases, usually heroin. As a resident learning from attendings, who have different practice patterns, I have noticed varying
Feeling Argumentative In this series we are going to pick apart the arguments and evidence surrounding a common but controversial topic in Emergency Medicine. The goal is to take a hard look at the practices we are handing down to future generations of ED docs and see what is based on opinion and what is
Simplified Diagnostic Management of Suspected Pulmonary Embolism (the YEARS study): a Prospective, Multicentre, Cohort Study. van der Hulle, Tom, et al. The Lancet 2017 . [paper] Why I chose this study Determining if a patient has a pulmonary embolism (PE) is a routine occurrence in the emergency department (ED) and on the medicine inpatient service. I
We continue the series with Knowledge Bomb #16. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background Simple febrile seizures are common in the pediatric population, ages 6 months to 5 years. However, complex febrile seizures are more rare, affecting less than 1% of children.
We continue on with the series with Knowledge Bomb #15. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background: Annually, 250,000 patients are mechanically ventilated in US Emergency Departments (ED). Of these patients, 20% will develop complications such as Acute Respiratory Distress Syndrome (ARDS) or
Dr. Janae Hohbein (PGY2) brings us part 2/2 of our cardiology pearls this week, presenting the rare phenomenon of Electrical Storm! Dr. Janae Hohbein
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