The most commonly used induction agent for rapid sequence intubation in the acutely injured patient is etomidate, largely due to its rapid onset of action and hemodynamically "neutral" effects. The dose-dependent effect of etomidate in suppressing adrenal synthesis of cortisol leading to adrenal insufficiency has left the door open for ketamine to be also considered as the rapid induction agent of choice in these critically injured patients.
Ketorolac (toradol) remains one of the giant pillars of pain management in the Emergency Department as the climate of non-opiate analgesia strengthens. This post aims to summarize recently published evidence revealing a lower analgesic ceiling for this medication.
During Week 12 of this NFL season, Washington Redskins tight end Jordan Reed injured his shoulder while attempting to catch a pass in the endzone against the Dallas Cowboys. While Reed continued to finish the first half, he was diagnosed with an AC joint separation at halftime. This posts will give an review of the evaluation and management of AC joint separations in the ED.
In the era of Press Ganey, patient-oriented outcomes, hospital reimbursement, and physician compensation are all tied to patient satisfaction. Improving patient satisfaction is now a multi-billion dollar industry and encroaches on every aspect of healthcare, including residency training. How do doctors at the beginning of their careers affect patient satisfaction and impact Press Ganey Scores? This post reviews two studies shedding light on this issue.
During a preseason exhibition game of this NFL season, Dallas Cowboys quarterback Tony Romo suffered a compression fracture of his lumbar spine against the Seattle Seahawks. While this was not a season-ending injury for Romo, the veteran quarterback lost his starting position to the exceptional play of rookie quarterback Dak Prescott during his absence. Also included in this post is key pearls about a Chance fracture, another important fracture of the thoracic/lumbar spine!
There are an estimated 25 million golfers in the United States. Every time they step onto the course they spend hours walking in the sun and placing stress on their backs and nearly every joint in their bodies. It should be no surprise if one of these patients make their way into one of your Emergency Departments or Urgent Cares. Below are two of the most common golf injuries as well as pearls on how to prevent/treat them:
Low Back Pain/Strain:
In Week 8 of this NFL season, Houston Texans offensive tackle Derek Newton suffered bilateral patella tendons rupture against the Denver Broncos. Newton's injury was particularly rare not only because of it's bilateral nature but also because it occured without direct trauma. This is a season-ending injury for Newton. On the field, Newton received immediate immobilization and eventually underwent surgery to repair the tendons.
Practicing in an Emergency Department gives any Emergency Physician a different perspective on many facets of life. We operate on the borders of life and death 24 hours a day, 7 days a week, 365 days a year. However this constant commitment to our patients does not come without a price. For many of us, our careers in Emergency Medicine have some negative effect on our personal wellness and a common area that suffers is our sleep.