A unique aspect of emergency medicine is being on the front lines of clinical care. We are fortunate to be among the first to be exposed to all things, from novel respiratory pathogens to newly approved pharmaceuticals. Here are a few of the new approvals potentially relevant to emergency medicine practice. First off the rack…
ACEP is strongly opposed to the drastic changes to Medicaid, including stricter eligibility rules, work requirements, and a $1 trillion reduction in spending over the next decade, that are part of the One Big Beautiful Bill Act (OBBBA), which was passed by Congress in late June and signed into law last month. The College is…
A 60-year-old woman with multivessel coronary artery disease status-post percutaneous coronary intervention with a drug-eluting stent to the left anterior descending and circumflex arteries 1-year prior presented to the emergency department with unrelenting chest pain intermittently relieved with sublingual nitroglycerin that started abruptly 3 days prior. She also had a history of ischemic heart failure…
At CAMC, we offer a truly unique training experience that prepares residents to excel in emergency medicine. Our patient population is one of the most medically complex in the country, with many individuals delaying care until they’re critically ill. This provides an unparalleled opportunity to manage severe and challenging cases on a regular basis. With…
It is a busy Saturday evening in your emergency department (ED). Every bed is filled, including those in the hallways. The waiting room is packed, with some of the wait times exceeding six to eight hours. A stricken nurse hands over the phone, and a pressured voice comes through saying, “There was a bombing at…
Today, let’s talk paracentesis! This is really not resuscitation, but there is so much silliness attached to this procedure that I just wanted to put some thoughts out there. Diagnostic Taps Indication In a patient presenting with illness, the indication is the presence of ascites. SBP is a silent killer! Fluid Analysis from HEPATOLOGY 2004;39:841–856…
#2: Liberal vs. Conservative Fluid in Sepsis + CHF Spoon Feed —This systematic review and meta-analysis found no significant difference in outcomes between conservative and liberal IV fluid resuscitation strategies in septic patients with CHF, CKD, or cirrhosis, highlighting the need for high-quality randomized trials in these high-risk populations. SourceConservative versus liberal fluid resuscitation for…
Background One of my many jobs, and one that i really enjoy is woking in a large tertiary Paeds ED here in Virchester. We are one of the busiest in the country and have a huge catchment area for trauma. Thankfully major trauma in kids is not that common, but when it all gets concentrated…
When you’re tasked with implementing a workplace automated external defibrillator (AED) program, it’s easy to focus on the upfront price of the device. But the sticker price is just the beginning. To create a sustainable and effective safety program, you need to understand the Total Cost of Ownership (TCO), a comprehensive budget that accounts for…
By Raj Parikh, MD Regarding your recent interview with ABEM President Dr. Diane Gorgas in ACEP Now, I’d like to share a few thoughts as I think it’s critical to show a different viewpoint. In 1992, I graduated from the University of Texas Southwestern Medical School at Dallas, known for Parkland Hospital. At that time,…