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Emergency medicine resident: What it's like to lose a patient
The Blaze (opinion contribution)
Author Amy Ho writes: The sad thing is, I hardly remember the patient. Everything about her is just an overhead Pediatric Trauma alert followed by the flurry of cutting clothes off, throwing IV lines, and calling out our primary and secondary survey — “blown right pupil;” “unequal breath sounds;” “gross deformity to left ankle;” and then “no pulse” — followed by the age-old barbaric resuscitation efforts that are now muscle memory to us, as we compressed her sternum still with bits of her Forever21 bra on it and shoved an MAC blade past her pink braces.
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AAEM Oral Board Review Course — Register today!
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March Madness at EMresource.org!
For all of March you and your students or residents can get 50% off two great EM pocketbooks written by the author of the Tarascon Emergency Department Quick Reference Guide. Log in to the AAEM Member Center to get started!
Help create “How-To” videos of >100 common procedures. These will be made available for free around the world in multiple languages on Merck Manuals websites and apps.
CLICK HERE to learn more.
Online Learning Library
Superb, AAEM-quality educational content with AMA PRA Category 1 Credits™ available. Online learning optimized for your convenience. Get started today with the 2014 Scientific Assembly or 2014 Written Board Review Course. Look for information about the 2015 Scientific Assembly coming soon!
Do emergency medicine physicians and EMS providers understand Physicians Orders for Life-Sustaining Treatment (POLST) documents?
On March 1, the Journal of Patient Safety released the results of the TRIAD VI & VII studies revealing concerns for understanding among providers and potential risk for patient safety. Learn more.
New Special Enrollment Period (SEP) for the AAEM Health Insurance Exchange!
The Federal Government has announced there will be a special enrollment period this year for those who didn't realize they had to buy health insurance when they did their taxes. Learn more.
Affordable Care Act faces more hurdles in coming months
By Rosemary Sparacio
The Affordable Care Act has survived one repeal attempt in the Supreme Court, as well as more than 50 repeal attempts by the House of Representatives and the Senate. However, President Barack Obama's signature legislation faces yet another significant challenge to its existence.
In the current case before the Supreme Court (King v. Burwell), a ruling in favor of the plaintiffs this June would essentially cut off the healthcare law's tax credits/subsidies in roughly two-thirds of the states.
Malpractice fears spurring most ER docs to order unnecessary tests
HealthDay News via U.S. News & World Report
Nearly all emergency room doctors surveyed order pricey MRIs or CT scans their patients may not need, mainly because they fear malpractice lawsuits, according to a new report.
Of 435 ER physicians who completed the survey, 97 percent admitted to ordering some advanced imaging scans that weren't medically necessary, the findings showed.
Such scans contribute to the estimated $210 billion wasted annually on unnecessary tests, procedures and treatments, the researchers contended.
Bedside rounds versus board rounds in an emergency department
The Clinical Teacher
Bedside rounding in the emergency department, as compared with board rounding, appears to increase the frequency of learner education measures. Emergency medicine residents reported the quality of education was better with bedside rounding. Bedside rounds took on average 4 minutes longer, without achieving statistical significance.
Diagnostic influence of routine point-of-care pocket-size ultrasound examinations performed by medical residents
Journal of Ultrasound in Medicine
By implementing pocket-size ultrasound examinations that took less than 11 minutes to the usual care, we corrected, verified, or added important diagnoses in more than 1 of 3 emergency medical admissions. Point-of-care examinations with a pocket-size imaging device increased medical residents' diagnostic accuracy and capability.
The effectiveness of endodontic solvents to remove endodontic sealers
Dental emergencies negatively affect troop readiness, especially during combat. Endodontic retreatment, when required, is especially challenging when the removal of endodontic sealer is required. In this study, we investigated the effectiveness of synthetic endodontic solvents to remove endodontic sealers.
For med students who didn't match, it's a SOAP opera
It was recently a great day for most of the nation's about-to-be-doctors: It was Match Day, when they'll learn what is to become of their futures, at least several years' worth. But for some, it was a painful week of uncertainly, anxiety and doubt.
During this particular week, medical students and graduates learned whether they would match into one of their ranked intern and/or residency programs. Those who didn't match, began a maddening scramble in the Supplemental Offer and Acceptance Program (SOAP) to find a spot.
More than 8,600 unmatched PGY-1s competed for fewer than 1,200 spots, most of which were in family medicine, internal medicine, radiology, and general surgery programs.
How teamwork, trust and improved communication reduce mistakes in the ER
It's so easy to think you've communicated a message clearly. After all, you understand the instructions, so it only stands to reason that the person receiving them must also understand what you meant.
And though most misunderstandings can be cleared up quickly in everyday situations, studies show that they pose a significant danger for patients when signals get crossed. In fact, an estimated 80 percent of the most serious medical errors in hospitals are linked to miscommunications.
1 in 9 needs emergency revisit for kidney stones
HealthDay News via Doctors Lounge
The need for repeat high-acuity care affects one in nine patients discharged from initial emergency department visits for kidney stones, according to a study published online March 16 in Academic Emergency Medicine.
Charles D. Scales Jr., M.D., from the Duke University School of Medicine in Durham, N.C., and colleagues analyzed data from all patients in California initially treated and released from emergency departments for kidney stones from February 2008 through November 2009.
Rural hospitals, one of the cornerstones of small town life, face increasing pressure
Kaiser Health News via U.S. News & World Report
Despite residents’ concerns and a continuing need for services, the 25-bed hospital that served this small East Texas town for more than 25 years closed its doors at the end of 2014, joining the ranks of dozens of other small rural hospitals that have been unable to weather the punishment of a changing national health care environment.
For the high percentages of elderly and uninsured patients who live in rural areas, closures mean longer trips for treatment and uncertainty during times of crisis. “I came to the emergency room when I had panic attacks,” said George Taylor, 60, a retired federal government employee. “It was very soothing and the staff was great. I can’t imagine Mount Vernon without a hospital.”
Lean business approach helps hospitals run more efficiently
Implementing a well-established business approach allowed physicians to shave hours off pediatric patient discharges without affecting readmission rates, according to researchers at Penn State Hershey Children's Hospital.
This approach could help hospitals around the country open up existing beds to more patients, and reduce emergency department crowding and lost referrals without investing significant capital.
Patients don't always pick ER closest to home
HealthDay News via MPR
Less than half of all emergency department visits occur at the emergency department closest to a patient's home, according to a March data brief published by the U.S. Center for Disease Control and Prevention's National Center for Health Statistics (NCHS).
Amy M. Brown, MPH, from the NCHS in Hyattsville, M.D., and colleagues examined which emergency department patients visit, how often patients visit the emergency department closest to their home, and the factors associated with emergency department selection patterns.
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