Posts about Emergency Medicine
It’s the middle of a busy shift when you walk into the room and find your patient cradling their shoulder, equal parts uncomfortable and frustrated. There’s no trauma, no clear inciting event, just a story that starts with mild pain a few weeks ago and has quietly progressed to the point where they can’t reach overhead, can’t get dressed without help, and can’t quite understand what went wrong. You run through the usual differential —...
It’s 2 a.m. in the ED. The waiting room is full, and the next patient sounds straightforward: fever. Then they add, “I just got back from an international trip.”
I was working in one of our satellite EDs talking with an elderly patient and her daughter about some recent headaches and increased confusion. She was in her early 70s, with a history of Alzheimer’s Dementia (AD). After my initial evaluation and exam, I went back to my computer to place some orders. Looking over her chart, I noticed something odd; the patient had been getting MRIs of her brain every month.
Last month, we started a two-part series on the evaluation and treatment of acute lower back pain (LBP) in the ED. This month, we are going to get into treatment options and how to help arrange follow-up care.
Emergency medicine is a team sport. From physicians to nurses and respiratory therapists, every person on the shift has a role to play. When we work together, we get to help people navigate through their toughest moments (and occasionally, their worst decisions).
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Whether you are working in primary care, urgent care, or the emergency department, chances are you see a patient complaining of lower back pain during every shift. It’s one of the most common reasons patients seek care, but also a chief complaint that leads to over-testing, over-treating, and is one of the driving factors behind the opioid epidemic.
Early in my career, I encountered a patient with severe renal colic who also had a history of opioid use disorder, now with several years of sobriety. Our initial treatment options with the usual non-narcotic medications and IV fluids had offered some initial relief, but his pain had returned with a vengeance. His battle with opioids had been hard fought, and he was adamant that he would only resort to opioids if we had exhausted every...
At Hippo, we make choices big and small based on our mission: to empower the people of medicine to learn, grow, and thrive through education and community. As emergency medicine and EM education continue to evolve, we’ve been asking ourselves some important questions:
Managing a cardiac arrest is the paramount skill of an emergency medicine physician. The process is a furious loop of assessments, actions, and decisions. Choices are often made with minimal information to fall back on, and delays of mere seconds can define the outcome. When running the rapid mental checklist of Hs and Ts, the decision to give or withhold thrombolytics is one that is often made amidst a fog of uncertainty. And while the...
Bedside ultrasound has become a common tool in many EDs. Potentially one of the most important uses of ultrasound is during resuscitation. When a patient is crashing and every moment counts, having the ability to quickly assess the clinical situation and make critical decisions is paramount.
It’s 2 a.m., and you’ve got a 28‑year‑old with signs of meningitis: fever, neck stiffness, altered mentation. You prep for the usual midline lumbar puncture, but the patient is obese, and you can’t clearly palpate the landmarks. The first stick goes bone‑deep, and there’s no CSF. Your frustration builds. The patient shifts; you adjust, but there is still no flow! What are you going to do next?
“My dermatologist sent me to the ER for my blood pressure, and they told me I’m going to have a stroke.”