Posts about Emergency Medicine
I grew up on a military base near a small border town in New Mexico. As a child of the 90s, the ideas of what were considered reasonable and safe childhood activities differed greatly from today's standards. A shining example of this was at Moore's Trading Post, a local pawn shop and military surplus store just a few miles from the city limits. They were most famous for their rattlesnake pit near the entrance to the shop.
Picture this: your next patient is a 35-year-old female presenting to the ED with pelvic pain. You biopsy the chart—this is the fifth visit this month. Over the past six months, she’s been coming in two to three times per month with the same chief complaint. She’s had all the tests you’ve ever heard of, some you haven’t heard of, and enough CT scans that you expect she might glow in the dark a little. Yet nothing definite has been found....
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.
Outdoor recreation has exploded in popularity over the last five years. Today, more than 55% of the U.S. population ages six and up participate in activities like hiking, biking, camping, and climbing. While that’s great news for our collective well-being, more people in the wild also means more people getting injured or sick in the wild. So, who helps when things go sideways far away from civilization? Enter the specialty of Wilderness...
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As a young nursing student, I can remember delivering my elderly patient his dinner tray, complete with his evening beer. He was recovering from surgery, and due to his history of heavy drinking, his doctor had ordered an ice-cold beer with each meal to prevent him from developing withdrawals.
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.