Emergency Medicine

Nepenthe

May 21, 2012

A patient with chronic pain and opiate dependence reveals to the author how much pain there is in every salvation.
 

Acute and chronic adrenal insufficiency

May 08, 2012

This month, the authors review acute adrenal insufficiency and chronic adrenocortical insufficiency (Addison disease).
 

Fast food medicine

March 20, 2012

Hospitals are not fast food restaurants. You cannot always get what you want. But most times, if you chose to wait, you do get what you need.
 

Is trauma care really free of bias?

January 26, 2012

Many health care providers believe trauma care is free of health disparities. But is subconscious bias actually influencing care based on race?
 

Expiration date

January 24, 2012

My patient died 45 minutes after he left the ER. His death was beautiful and awful, and I remember snapshot moments that will last to eternity.
 

An unusual presentation in an elderly man

November 23, 2011

Nocturnal abdominal and right-sided shoulder pain signal a life-threatening condition in a patient whose history revealed tell-tale clues.
 

The surgeon's 
epic break

November 15, 2011

I am learning to roll with the punches. I am becoming more resilient, developing a degree of toughness. I hope in the process I do not forget my manners, or the tears on the face of the mother.
 

What caused the medical emergency in this patient with type 1 diabetes?

, November 04, 2011

Even though patients in diabetic ketoacidosis commonly present with hyperglycemia, 
normal blood glucose levels don't allow you to rule out this diabetic emergency.
 

What's new in emergency medicine
: The utility of bedside ultrasonography

October 20, 2011

Bedside ultrasonography has advanced the practice of emergency medicine, allowing physicians to establish prompt diagnoses and even improve patient outcomes.
 

The butterfly effect: Beyond Dilaudid

September 08, 2011

We do not work alone: your work affects my work, and my work affects yours. A kind word, a harsh word, a procedure done well, cancer pain untreated; our practice has a ripple effect that spreads far beyond my workplace and yours.
 

Laceration repair: Avoid infection, optimize healing, minimize scarring

, September 01, 2011

A thorough history and examination, use of proper materials, and familiarity with the 
different wound closure techniques make it easier to achieve these objectives.
 

Saving lives with popsicles and pillows

July 14, 2011

Haircuts, ice chips, popsicles, and pillows; sometimes I wonder—did I go to school for this? Yes, I think I did.
 

Mesenteric ischemia: Rapid diagnosis and prompt treatment are essential

, Frank A. Acevedo, PA-C, MS, DFAAPA July 07, 2011

Immediate attention is required if the patient is to have a chance of survival. Critical care, surgical, and vascular consultations should be obtained early in the disease process.
 

"Love the 
way you lie"*

May 17, 2011

Is it acceptable to sacrifice the best interests of one patient to the confidentiality rights of another? Is it ethical for a clinician not to tell the truth?
 

A Day in the Life: Robert G. Baeten II, MCMS, PA-C

April 12, 2011

A PA who practices in cardiac critical care recounts his responsibilities during a particularly busy night shift at Piedmont Hospital.
 

Should etomidate be used for emergency 
intubation in patients with sepsis?

April 08, 2011

The ED community has preferred etomidate for intubation because of its reduced hemodynamic effects, but it is associated with a definite increase in adrenal suppression.
 

Imaging the appendix

March 16, 2011

The laying on of hands is essential to learning the art of medicine. If clinicians do not practice this art, how can they hope to become skilled diagnosticians?
 

Short cuts

January 19, 2011

A patient's dramatic amputation injury causes the author to reflect on the dangers of taking shortcuts, for clinicians as well as patients.
 

A Day in the Life: Leslie Brooks, MS, PA-C

December 14, 2010

The author describes her last day as a medical volunteer caring for orphaned and homeless children in Haiti after the earthquake.
 

Is it ethical to substitute restraints for 
adequate treatment resources?

, Reamer Bushardt, PharmD, PA-C December 08, 2010

Given that the potential for abuse is considerable, the authors suggest that a policy of minimally restraining patients, increased training, and optimizing restraint alternatives is vital to prevent unethical practice.
 

Concussion: 
Assessment of traumatic brain injuries

From CSAC, the Clinical and Scientific Affairs Committee of the AAPA November 16, 2010

Mild traumatic brain injury, or concussion, is a common injury seen in the urgent care setting. PAs should be able to evaluate the patient and determine the appropriate management.
 

Metoclopramide for migraines; how to stock a first aid kit

November 12, 2010

This month's topics are using metoclopromide to treat migraine in the emergency department and stocking a first aid kit appropriately.
 

Left flank pain following cardiac catheterization

R. Steve Andrews, RRT; Andres C. Marte-Grau, MD; Rathnakar Sherigar, MD; Jennifer Pitts Hanopole; Urvi R. Shah, MD August 24, 2010

This patient's condition highlights the importance of paying close attention to history and not ruling out a rare complication of a procedure.
 

Rapid sequence intubation: Stay up to date on this important procedure

August 13, 2010

The ability to perform intubation is increasingly required by emergency room physicians, internists, PAs, and paramedics.
 
 

Acute evaluation and management of the anterior shoulder dislocation

, August 02, 2010

PAs, especially those in emergency or urgent care settings, should be familiar with several techniques.
 

Nonhealing wound following trauma

June 22, 2010

Continuing symptoms raise suspicions of a serious complication after a young man catches his finger in a car door.
 

Vomiting and apparent discomfort in an 11-month-old girl

April 26, 2010

The baby's physical reaction to her symptoms led to the diagnostic imaging that identified the problem.
 

A Day in the Life of Scott Blow, MPAS, PA-C

Scott Blow, MPAS, PA-C December 28, 2009

Follow this PA as he treats a wide range of burn wounds in the operating room and clinic at a regional burn center in Florida.
 

An immigrant with fever, chills, and pleural effusion

, December 15, 2009

This disease is uncommon in persons born in United States, but those caring for immigrants should consider its different manifestations.
 

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