Amber Sheeley, PA-C
It’s 10:42 a.m. and the emergency department already looks like an overbooked flight. Every waiting room chair is full, people are standing along the walls, and the triage nurse just flagged you about a patient whose O2 sat is hovering in the mid-80s. Welcome to the new normal in emergency medicine.
Few things complicate an already challenging resuscitation effort more than a concomitant poisoning or toxic exposure—and unfortunately, this scenario is becoming more common.
Starting the conversation about code status and goals of care in the ED matters. Not infrequently, we’re caring for patients with life-threatening injuries, advanced age, or serious medical comorbidities. Our training prepares us to stabilize these acute conditions, but in doing so, we often establish a trajectory for the rest of the hospital stay—one that profoundly impacts both the patient and their family. Having these conversations...
When I joined a Family Medicine practice in July 2004, fresh out of PA school, I was fortunate enough to share an office space with Dr. Robert Wettach, a 76-year-old GP who had spent decades caring for patients in a small town in southeast Iowa. Semi-retired, he still saw patients a few days a week, but his real passion was storytelling.
Acute low back pain is one of the most common reasons patients present to the emergency department. Yet, when it comes to evidence-based management, our approaches often feel like “dealer’s choice.” We know NSAIDs are better than muscle relaxers and opioids, but what about topical options?
You've seen it countless times: a patient walks into the ED with chest pain, and the EKG isn't screaming STEMI. But in follow-up, they end up having a massive myocardial infarction. What is the hidden culprit lurking behind those non-alarming EKGs? Welcome to the Occlusive Myocardial Infarction (OMI) world, where traditional STEMI criteria fall short, and a new paradigm shifts our approach to acute cardiac ischemia.