Infective Endocarditis

IE is an infection of native or prosthetic heart valves, endocardial surface or an indwelling cardiac device (such as a pacer or defibrillator). In recent years, we’re seeing it happen in older and more chronically ill patients. And more MRSA. The diagnosis is tricky because the presentation can be fairly subtle. You need a high … Continue reading Infective Endocarditis →

Non-Traumatic Lower Back Pain

Most of us will have lower back pain in our lives (80–90% lifetime prevalence) and it accounts for 2–3% of ED visits (so quite a bit). As with everything in EM, there are benign and serious causes and we need to differentiate between the two. The serious causes include diagnoses in the back and those … Continue reading Non-Traumatic Lower Back Pain →

Brief Resolved Unexplained Events (BRUE)

ALTE has been deprecated and replaced with BRUE. Apparent Life-Threatening Events scared parents and led physicians to unnecessary testing. The American Academy of Pediatrics has issued the following guideline. BRUE ==== STEP 1: Meets DEFINITION of BRUE - BRIEF: less than 1 minute episode - RESOLVED: back to baseline/normal - UNEXPLAINED: no other etiology (no URI, … Continue reading Brief Resolved Unexplained Events (BRUE) →

Active Shooter

Today, September 16, 2013, marks yet another day when a gunman opened fire upon civilians, killing unnecessarily. It seems that this is happening more frequently, and it would be foolish to think it is limited to schools, movie theaters and military compounds. As grim as it sounds, we should open the conversation as to what … Continue reading Active Shooter →

How Ed gets great Patient Satisfaction scores

We're all expected to get great patient satisfaction scores in addition to providing excellent care. No one does this more consistently than Ed Ward (click for his scores). So, we talked and he let me know what he does to get great scores. Not only are his scores good, but he also gets more surveys … Continue reading How Ed gets great Patient Satisfaction scores →

What Makes Yanina So Fast

We have a lot of people with great skills in our department with whom we can share our best practices. One thing Yanina excels at is efficiency. No one can deny she's a machine when it comes to seeing patients. Here she describes how she's able to keep her patients and the entire department moving. … Continue reading What Makes Yanina So Fast →