aka American ER Doc Gone Walkabout 026 Wise use of EBM makes us much more reasonable Doctors. I meet a young woman, previously healthy... She’s had a little fever, some congestion, has been coughing and sneezing for a few days, and now her chest hurts. She’s been a little wheezy and minimally dyspneic with exertion. Her exam is normal except for some costochondral … [Read more...] about EBM and the rule of thumb
aka American ER Doc Gone Walkabout 025 I recently listened to ERCast's Rob Orman interviewing Dr Jean Abbott on EM:RAP. They carried on a conversation about end-of-life discussions in the ER. It’s nice to know some of the options, but some of us need a bit of a script to help us – we may not want to re-invent the wheel every time we carry on one of these … [Read more...] about If you die, do you want to stay dead?
aka American ER Doc Gone Walkabout 024 We've been treated to a number of papers pointing out that a very small proportion of acute strokes present within the "treatment window" (I'll avoid the controversies as to whether thrombolytic treatment is a good idea, or a bad idea) compared with STEMI's which often present within a time period where thrombolytics or PCI is clearly … [Read more...] about Why do we get to treat so few strokes?
aka American ER Doc Gone Walkabout 023 Let's take a single complaint - "sore throat" - and look at a few of the ways that it can be handled. Let's say that we're satisfied with having a good outcome with no further intervention, say 90% of the time. And, another 9% of the time we get a second chance on a "bounceback" to get it right. To do this we might develop a very … [Read more...] about Sore throats and the learned professional
aka American ER Doc Gone Walkabout 022 An older gentleman with quite severe Parkinson's hadn't opened his bowels for about a week. He came to the ER - solver of all problems. He had a nice normal pulse when taken the old fashioned way - by placing the nurse's trained fingers upon the radial pulse. And, he - appropriate to the modern world of high tech - was placed on an … [Read more...] about Lies, Damned Lies and Monitors