Posts about Emergency Medicine
First-trimester vaginal bleeding is one of the most common—and nerve-wracking—reasons patients come to the Emergency Department (ED). As emergency clinicians, we’re often the first stop. That means assessing and managing everything from the routine to the truly serious.
You’re in the middle of suturing a pediatric facial laceration, and your tiny patient has just entered full wiggle mode. Arms are flailing, legs are kicking, and you’re starting to wonder if you’ve accidentally been cast in a live-action wrestling match.
Prescribing antibiotics in the outpatient setting is more complex than it gets credit for. We’re balancing evolving guidelines, limited face-to-face time, patient expectations, and a growing public health threat: antimicrobial resistance.
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...
Working in the ER often feels like trying to perform surgery while riding on a rollercoaster. Between the chaos of nonstop patients and the art of keeping everyone (mostly) comfortable, every little hack counts.
It is tragic that in 2025, measles—a fully preventable disease—has caused two deaths (at the time of writing) and sickened hundreds across the United States. With outbreaks making headlines, patients are flooding our inboxes and exam rooms with urgent questions:
When Brit Long brought us another segment, "High Risk, Low Prevalence: Spontaneous Cervical Artery Dissection" in his High Risk/Low Prevalence series on ERcast, he dove deep into the world of spontaneous arterial dissections, particularly cervical artery dissections (SCAD). While the term “spontaneous” suggests these cases occur without a clear cause, studies show that up to 40% of SCAD cases follow minor trauma—and among the suspected...
Every hospital has one. Maybe it’s the cardiologist who's never “impressed” by the EKG. The urologist who insists that every stone should go home with a follow-up. Or that one hospitalist who never quite understands why social admissions exist.
January’s critical care topics go hand in hand, thinking about sepsis management and specifically septic shock with early initiation of vasopressors in the form of microdose pressors. In the segment “Upstairs Rumblings: What I Wish ER Docs Knew About Septic Shock,” Dr. David Page lays out a great argument for early treatment of possible septic shock with antibiotics, fluid, and pressors when needed. Before we go there, however, let’s take...
If you’ve ever worked an ED at 3 AM during a holiday weekend, you know what’s coming: a patient visiting from out of town presents with a radiology report that is positive for a DVT. With no hematology or cardiology consults available, no access to the patient’s records, and the clock ticking, you’re left to manage the situation.
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?