Antimicrobial Stewardship in the ED: The Buck Stops Here
Caitlin Carter July 13, 2017 Antimicrobial overuse is the most significant preventable cause of drug resistance in both hospital and community settings[i]. Antibiotic overuse occurs among practitioners in nearly 2/3 of cases. Overuse contributes to the growth of...
Behavioral Health Emergencies in the Emergency Department
Sonya Chistov July 6, 2017 A young patient presents to the emergency department (ED) with altered mental status. According to EMS providers, she had ingested an unknown substance, and now was combative, screaming and flailing uncontrollably. Her point-of-care glucose...
Asking about Sexual Orientation in the Emergency Department: An Invasion of Privacy or a Step Toward More Patient-Centered Care
Rose Kleiman June 26, 2017 Is the emergency department (ED) the right place to inquire about a patient’s sexual orientation? A recent study published in JAMA Internal Medicine points toward yes[i]. While lesbian, gay, bisexual, transgender, and queer (LGBTQ)...
Is IV Contrast for CT Imaging associated with acute kidney injury?
Evan Kuhl, MD June 15, 2017 Radiographic contrast media is considered a common cause of hospital-acquired renal insufficiency, yet the latest research on contrast-induced nephropathy (CIN) suggests there may be no relationship between contrast use and renal injury1,2....
Efficacy of Prescription Guidelines on Opioid Prescriptions in the ED
Austin Wu June 7, 2017 As described in a previous Urgent Matters blog post, opioid prescriptions in the emergency department (ED) have the potential to cause long-term opioid use (defined as 180 days or more of opioids within 12 months of the index ED visit). Further,...
Prevalence of Pulmonary Embolism among Patients Hospitalized for Syncope
Will Denq, MD & Evan Kuhl, MD May 31, 2017 In 2016, an interesting and potentially practice-changing articles was published: the PESIT trial by Prandoni et al.. The prospective study utilized 11 Italian hospitals and evaluated all patients for pulmonary embolism...
Low-risk chest pain in the ED: treat the patient, not the complaint
Ameer Khalek March 21, 2017 Patients presenting with chest pain associated with normal EKGs, negative cardiac enzymes, and few cardiac risk factors are designated “low-risk,” and can often be safely to discharge from the emergency department (ED) for early patient...
Marik’s “Sepsis Cocktail” Exciting & Hypothesis Generating
Mohammed Alabdrab Alnabi, MD May 18, 2017 Emergency care for sepsis has evolved considerably over the past two decades. Prior to the Rivers trial in 2001, antibiotics were the mainstay of treatment, which then evolved into early resuscitation with intravenous fluids,...
New Data: Linking prescribing practices of emergency physicians with long-term opioid use
Evan Kuhl, MD April 4, 2017 I thought I had caught him. Logging onto our prescription monitoring system, I found recently filled prescriptions for hundreds of doses of Oxycodone, Morphine, and Hydromorphone from multiple emergency departments and pain management...
New on Health Affairs Blog: the role of freestanding emergency centers in rural communities
Ameer Khalek April 3, 2017 There is a rural healthcare crisis due to alarming closure rates of Critical Access Hospitals (CAHs) in sparsely populated communities. These communities are experiencing a gap in healthcare access and consequent economic loss in healthcare...
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