How Often Do We Miss Serious Causes of Headache and Back Pain?

How Often Do We Miss Serious Causes of Headache and Back Pain?

In patients presenting to the ED with headache or back pain, very few return with serious, missed diagnoses after the initial evaluation. Patient who are elderly, immunocompromised, or have preexisting neurologic disease were at greater risk of missing serious conditions.

Sign-Out Bombs and Resident Productivity

Sign-Out Bombs and Resident Productivity

With ED boarding, the burden of sign-out patients is greater than ever. This study shows just what I expected.  All of these sign-out patients negatively affects how many new cases each resident is able to see on each shift.

Antibiotic Resistance - The Problem and Solution

Antibiotic Resistance - The Problem and Solution

Most doctors and clinicians think someone else is the problem when it comes to antibiotic resistance and stewardship.  We are the problem.  And we are the solution.

Start Strong, Finish Weak - Attending Shift Productivity

Start Strong, Finish Weak - Attending Shift Productivity

Attending physician productivity peaks at the beginning of the shift, starting with about 3 new patients in the first hour and decreases as the shift progresses.  This has important implications for staffing models.  Assuming a simple, uniform average over the shift won't work.

Just Drunk or Critically Ill?

Just Drunk or Critically Ill?

One percent of patients presenting with acute alcohol intoxication eventually needed critical care admission.  Be wary of abnormal vital signs, hypoglycemia, or the need for additional chemical sedation, as these were associated with an increased odds of needing the ICU in such people.

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