Posts about Emergency Medicine
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.”
Opioid overdoses have become an unavoidable part of our daily shifts in the ED. It is a tragic commonality that transcends social and economic lines. It would be a safe bet that if you are reading this, you likely have a friend, family member, or colleague whose life has been disrupted by opioid abuse.
The population is aging fast, and clinicians are feeling the impact. By 2030, 1 in 5 Americans will be over 65, and older adults already represent the highest healthcare utilization of any age group. Yet fewer than 45% of medical schools have a required geriatrics rotation, leaving most of us to piece together our knowledge on the fly.
Aesthetic surgery is booming. Data from the last year show a 14% increase in total procedures, driven largely by a 23% rise in nonsurgical interventions and dramatic gains in body contouring. Liposuction procedures increased by 63%, abdominoplasty by 55%, and overall U.S. spending on aesthetics exceeded $11.8 billion, up 2% from the previous year.
“It all started a few days after I got back from my trip.”
In the emergency department, we’re trained to act quickly on clear, testable diagnoses—STEMI, stroke, sepsis. But every day, we also see patients whose stories don’t fit neatly into a protocol. Their test results may look "normal," but their lived experience is anything but.
Read moreFew chief complaints in pediatrics are as common—or deceptively simple—as fever in children. Especially when that fever shows up in toddlers without a clear source.
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.
