July 01, 2017

Journal Club May 2017 - Suicide Risk Assessment

July 01, 2017/ Kevin Kelleher, MD

Emergency physicians regularly see psychiatric patients who are having suicidal thoughts or engage in non-suicidal self-injurious (NSSI) behavior. In addition to working these patients up medically, it is part of our job to determine who needs emergent evaluation by a psychiatric provider and who is safe for discharge. This is a very important decision, as we do not want to send high risk patients home and keep low risk patients for extended periods of time while they await their evaluation. Balancing this can be difficult - oftentimes it is not obvious where a patient falls on this spectrum. We are taught various decision aids in medical school to help us risk stratify these patients - but how do they perform on emergency department patients? For this month's journal club, we looked at three papers that examine three different decision aids to help elucidate this issue.

May 26, 2017

Bud's Common and Simples - Fingernail Avulsion Repair

May 26, 2017/ Jeffrey A. Holmes, MD

Fingernail avulsions constitute a unique fingertip injury as they have the potential to result in long term nail deformity and impaired function if not repaired properly. In order to treat these injuries effectively, the treating provider must understand the anatomy of the nail bed, nail root, and the intricacies of nail growth. In this brief video, Dr. George "Bud" Higgins shares with us how to assess and treat this injury to optimize our patient's chances for successful nail regrowth, function and cosmesis.

April 03, 2017

Perron's Airway Pearls from AAEM 2017

April 03, 2017/ Andrew Perron, MD, FACEP

The following airway pearls were gleaned from Dr. Mike Winters' lecture "Critical Care Quickies - Pearls for the Moribund Patient." This was presented at the pre-conference workshop "Resuscitation for Emergency Physicians" (23rd Annual Scientific Assembly of the American Academy of Emergency Medicine in Orlando, Fl).

March 18, 2017

Vision Loss in the Emergency Department Patient

March 18, 2017/ Jeff Holmes

Hi guys! Sorry it has been so long since our last post. We were busy preparing for our Winter Symposium Conference last week in Sugarloaf, Maine. We had a fantastic line up of speakers and hope to share them with you over the coming months. Here is a sample from one of our guest speakers, Jacob Avila, MD. He spoke to us about vision loss in the emergency department patient.

February 21, 2017

Fluoroquinolones, Your Lawyer and You

February 21, 2017/ Matthew Delaney, MD, FACEP

Fluoroquinolones are a widely used class of antibiotics that are effective in treating a wide variety of infections. Despite their popularity there is increasing concern regarding the potential complications associated with these agents. Here we discusses the current evidence regarding the risks associated with fluoroquinolone use.

February 09, 2017

Liver Failure Patients - Ten Simple Tips for Complicated Patients

February 09, 2017/ Samantha Wood, MD

Whether it is from alcoholic cirrhosis, acetaminophen overdose, or chronic hepatitis, liver failure patients are complicated. Their exams are difficult, multiple organ systems are affected and they have complex pathophysiology. Here are ten simple tips for these complicated patients.

January 31, 2017

"It starts with a K . . . " - Low Dose Ketamine for Pain Control

January 31, 2017/ Joleen Bierlein. Pharm.D.

Pain control in the emergency department is an important part of patient care and a key reason patients seek our help. Current pharmacologic methods include opiates, non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and regional anesthesia. Opiates often produce inadequate pain control in both opiate tolerant and opiate naïve patients and have adverse effects such as over-sedation, respiratory depression, nausea, hypotension, tolerance, and dependence [1]. NSAID use can be complicated by nephrotoxicity, gastropathy, and cardiac toxicity and have been implicated in 11% of adverse drug reaction related hospital admissions [2].