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Emergency Medicine

CDC: Not everybody with the flu needs antivirals

September 23, 2009

While asserting that clinical judgment is always an important part of treatment decisions, the CDC has updated its advice on the use of antiviral agents for the prevention and treatment of flu, including 2009 H1N1 influenza infection.

MICRA survives yet another challenge

August 19, 2009

The California Supreme Court upheld the landmark law's constitutionality, but that doesn't mean the battle has ended.

Back pain diagnosis and management tools

July 15, 2009

An effective and relatively quick method for zeroing in on the root of back pain coupled with new findings about acupuncture treatment could help clinicians better manage this common complaint from patients.

Colorectal cancer rising among younger patients

By Myra Dembrow July 13, 2009

New data support current screening recommendations, but family and other history will help you identify which patients need colonoscopy regardless of age.

Reforms cited for dramatic caseload decline

June 09, 2009

Since 2003, Pennsylvania courts have required malpractice plaintiffs to file certificates of merit in which a medical expert attests that the applicable standard of care was violated. The number of medical malpractice cases has plunged since then.

Medication errors can come from weight-y mistakes

June 09, 2009

Mistakes or omissions in obtaining patient weights caused almost 500 medication errors in Pennsylvania hospitals.

Peculiar violaceous, atraumatic rash

By Esan O. Simon, MD, MBA June 02, 2009

A 79-year-old Caucasian man with a history of chest pain, light-headedness, and diaphoresis was admitted to rule out acute coronary syndrome. He incidentally noted a bruise that had appeared spontaneously on his chest without trauma four days prior to admission.

Discrete yellow lesions on the eyelid

By Craig G. Burkhart, MD, MPH June 02, 2009

A 57-year-old Caucasian woman has had discrete yellow areas on her eyelids for several years. According to the patient, the precipitating factor was an episode of poison ivy that involved her eyelids four summers ago.

Primary care on front line for atrial fibrillation

May 22, 2009

Diagnosing atrial fibrillation could sharply reduce strokes in the United States, and primary-care physicians have a key role to play, according to experts at the American College of Cardiology.

Stat Consult: Influenza A (H1N1) (Swine Flu)

By Brian S. Alper, MD, MSPH May 21, 2009

The latest information on swine flu diagnosis and treatment.

Safety experts urge focus on diagnostic mistakes

May 20, 2009

Diagnostic errors should be the next major target of patient-safety efforts and research, a pair of Johns Hopkins experts urge.

Utah demands more malpractice proof for emergency errors

May 11, 2009

The state legislature raises the standard of proof from the traditional "preponderance of the evidence" to the higher "clear and convincing evidence" for patients treated in an emergency department.

What procedures should med students learn?

By Delicia Yard April 30, 2009

Teaching physicians and new doctors have different ideas about which procedures medical students need to learn before graduating—particularly when it comes to minimally invasive activities.

Arizona top court OKs qualifications for expert witnesses

By Myra Dembrow April 29, 2009

The Arizona Supreme Court has upheld a law that requires experts with defined minimum qualifications to certify that the malpractice allegations raise legitimate issues before a case can proceed.

Elena's ear: Would the buzzing stop?

By Joshua B. Grossman, MD March 31, 2009

A student physician assistant sustained blunt trauma to her right ear, hit hard in the head in the emergency department while treating a college football player who had gotten quite drunk after his school's homecoming game. The resultant drone gave the author an opportunity for an improbable diagnosis.

Subcutaneous vs. IV insulin

Question from Dennis A. Fito, MD, Oklahoma City; response by Lyle Mitzner, MD February 17, 2009

Can administering subcutaneous insulin every one to two hours substitute of IV insulin therapy?

Early recognition of diabetes complications

Lyle Mitzner, MD February 06, 2009

Too often patients focus on daily goals of diabetes management, but don't let them lose sight of the ultimate goal: preventing end-organ damage.

FDA approves new extended release painkiller

January 05, 2009

The agency gives the nod to Ryzolt (tramadol HCl extended-release tablets), a once-daily formulation of the analgesic tramadol. Ryzolt is indicated for the management of moderate-to-moderately severe chronic pain in adults who require long-term, around-the-clock pain treatment.

MRSA boosts CAP numbers

October 02, 2008

A new CDC report published online in Annals of Emergency Medicine (www.annemergmed .com, accessed July 7, 2008) found an unusually high number of community-acquired pneumonia cases caused by staph infection during the 2006-2007 flu season.

Kidney stones: Helping patients avoid the pain

By Edgar V. Lerma, MD August 01, 2008

Some risk factors are unavoidable, but adjusting your patient's diet and addressing comorbidities can prevent excruciating episodes.

Appendicitis: Toward better diagnosis

By Christina M. Surawicz, MD March 14, 2008

It's a delicate balance: A missed diagnosis can lead to rupture and peritonitis, but 12%-18% of appendectomies are unnecessary.

Bypassing nasotracheal intubation

Question raised by Mapara Qureshi, MD, Frederick, Md. and answered by Christopher Ruser, MD October 17, 2007

Is it possible to give food or oral medications to nasotracheally intubated patients?

Unusual allergy presentation

Question raised by S.A. Claassen, MD, Bristow, Neb. and answered by Jeffrey M. Weinberg, MD May 22, 2007

In 1985, a 22-year-old woman presented with a six-year history of itching, cracking, and vesiculation on the sole that frequently progressed to raw oozing. She had tried many topical agents, antihistamines, and corticosteroids. Because the symptoms were worse in the spring when the mold count was high and she had greater contact with grass, I did allergy testing and gave her a hyposensitivity shot for molds.