Life in the ER
Dying With Dignity: Instituting a Moment of Silence in the ER
A little over a year ago, my father died in his sleep. He ate dinner in his assistant living facility one night, told his fellow residents he was tired and went to sleep. The next morning, he was found lifeless in his bed. He must have passed away in his sleep, most likely peacefully and […]
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Working Shifts on Nantucket: “What Medicine Is All About”
Speaking with the providers who staff the emergency department at Cottage Hospital on Nantucket Island, one word keeps coming up in their descriptions: magical. Even then, Nantucket seems to evoke a special kind of magic, a kind of nostalgic wistfulness for the most perfect, wonderful, calming place in the world. They talk about the island’s […]
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Journalist, Tattoo Shop Owner, and Sheriff: Three Physicians Who Came to Emergency Medicine As a Second Career
There is a certain stereotype of the fresh-faced, brand new attending: young, ambitious, their heads filled to the brim with medical education. These attendings first come to their post-residency clinical practice with plenty of intense educational experience – and often little life experience. These are not those. Dr. T.J. Milling, currently an attending at Dell Seton Medical Center in […]
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The Work, Life, Schedules, and Challenges of Husband-Wife ER Docs
There is no doubt that working in emergency medicine can make for unique scheduling challenges, especially when you have young children at home. It’s not uncommon to rely on one’s spouse to maintain a more normal 9-5 schedule and take on primary responsibility for kids. But what if you and your partner are both emergency medicine […]
Read ArticleIn the Emergency Department: Recognizing and Responding to Signs of Human Trafficking
It is estimated that more than 20 million people worldwide are victims of exploitation and of sex trafficking or labor trafficking. Human trafficking is not the same as human smuggling. Smuggling is a violation of immigration laws. Trafficking is a violation of human rights. Victims are females and males, children and adults, foreign nationals and […]
Read ArticleHave You Observed Your Clinical Decision Unit Lately?
Better collaboration between the ED and hospitalists. A more satisfying patient experience. The majority of admissions discharged home. Shorter lengths of stay. These are the results being achieved at hospitals nationwide thanks to the advantages provided by our Clinical Decision Unit (CDU). A well-run CDU speeds patient turnaround and improves throughput. Patients move out of the […]
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As Go Your Relationships, So Goes Your Resiliency
We hear a lot about how your work can affect your personal relationships, usually for the worse. In fact, I wrote about how cynicism at work can negatively affect your relationships at home in a recent column. This is a well-worn topic in emergency medicine, and there are a lot of strategies to deal with it. Go […]
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The Exact Moment When I Realized I Needed To Change
A fellow resident and I were working a busy Monday shift, and I was walking by the room where he was seeing a patient when I heard him say, “Let me step out for a moment.” He came out, quickly closed the curtain, flexed his fists, sucked in some air, held it, and finally blew […]
Read ArticleIntubation Tips, Part 2
Hopefully, you have already read about NO DESAT and the importance of pre-oxygenation before intubation in Intubation Tips, Part 1. We want to share some more tips that optimize the safety and success of this high-risk procedure. In a great intubation lecture by Dr. Levitan, he covers a wide variety of airway topics. It will […]
Read ArticleYoung Adult With Blurred Vision, Weakness
Dr. Jordan Kramer, former VEP Healthcare Chief Medical Officer, saw an interesting patient in the ED recently and prepared the following case summary. A 21-year-old college student with no past medical history came to the ED recently with a chief complaint of blurred vision for two days and weakness for one day. The patient complained […]
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