Necessary or Nonsense: Screening for the Suicidal Patient Pt. 2

By Matthew DeLaney, MD
on November 29, 2024

Across a wide variety of practice environments, the concept of medically screening a patient who presents with suicidal ideation is often a source of friction between the emergency department and psychiatry. In theory, a medical screening exam would help the ED team identify acute medical conditions in patients with co-existing psychiatric pathology, but in reality, local guidelines and protocols can lead to extensive and often unnecessary medical workups in patients who present with strictly psychiatric chief complaints.

Necessary or Nonsense: Screening for the Suicidal Patient

By Amber Sheeley, PA-C, and Matthew DeLaney, MD
on October 29, 2024

Suicide ranks as the 11th leading cause of death in the United States, claiming 48,183 lives in 2021 alone—equivalent to one life lost every 11 minutes. For us, as clinicians, suicide prevention starts in our emergency department, where at-risk individuals often seek help in the days or weeks leading up to a suicide attempt. Unfortunately, in the ED, the opportunity to screen for suicide risk can be overlooked due to high patient values, the assumption that mental health is for psychiatry, or because we see the same patient multiple times.  Still, screening for suicidal ideation (SI) in the ED, while challenging, can significantly improve patient outcomes and save lives.

Acute Mountain Sickness

By Geoff Comp, DO
on October 08, 2024

The headache felt like my skull was splitting in half.

Time Management Pearls for Clinicians: Optimizing Efficiency

By Ashley Greer PA-C
on September 20, 2024

As healthcare professionals, our days are filled with many tasks, such as patient encounters, documentation, and administrative work, not to mention keeping track of a household or family. Time management becomes crucial in ensuring that we provide quality care while maintaining our well-being. In this blog, we'll explore some valuable pearls for efficient clinical time management, and I’ll note some tips that have worked well for me.

Dive In: Deciding on Suture Material for Deep Layer Closures

By Jen Swisher, PA-C
on September 18, 2024

Selecting the ideal suture material for deeper layers involves careful consideration since specific materials offer varying absorption rates, making them suitable for different wound depths. When speaking with Dr. Christina Shenvi on an episode of ERcast, Dr. Cohen recommended the following suture material options for closing the deeper layers of the skin (buried):

Introducing Practical Pharmacology: An Outpatient Audio Course

Nowhere is the gap between book learning and clinical practice quite so apparent as in the world of pharmacology. The best medication for Diagnosis X is Drug Y on the boards, but what about when your real-life patient is allergic to that medication? What if they can’t afford it? What if there’s a drug shortage?

How to Repair a Facial Laceration Like a Plastic Surgeon

By Jen Swisher, PA-C
on August 14, 2024

Emergency medicine often puts us face-to-face with lacerations requiring precision and care. Dr. Justin Cohen's visit to ERcast, alongside Dr. Christina Shenvi, illuminated the path to handling facial lacerations with the finesse of a plastic surgeon. Here are key takeaways to elevate your emergency room responses.

Beyond Delta-9: The Surge of Synthetic THC

By Melissa Orman, MD
on August 05, 2024

In recent years, the landscape of cannabis accessibility has dramatically shifted, not just in conventional dispensaries but in everyday storefronts across the United States. This new wave of products, stemming from the 2018 Farm Bill's legal distinction between hemp and marijuana, has ushered in an era of synthetic cannabinoids like Delta-8 THC, Delta-10 THC, and THCA, which are finding their way into the hands of consumers and, inevitably, into emergency departments. As emergency clinicians, it's crucial to understand the implications of these substances, their legal ambiguities, and their effects on public health.

The Hidden Widowmaker

By Amber Sheeley, PA-C
on July 15, 2024

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.