Tactical Medicine News Blog

Background: Syncope, the sudden, brief loss of consciousness followed by spontaneous, complete recovery is a common presentation to the Emergency Department (ED). It represents a significant portion of overall admissions to the hospital because while many cases are benign (i.e. vasovagal syncope), some may result from a life-threatening cause (ventricular tachydysrhythmia, myocardial ischemia, gastrointestinal bleeding etc). Admission or 24 hour observation is often sought for continuous dysrhythmia monitoring but they are infrequently found. A decision instrument directed at stratifying patients to high or low risk for a dysrhythmia causing syncope (and thus subsequent risk for a recurrent dysrhythmia) would be useful in managing patients with syncope.

A young man is brought into an emergency department after an electric lawn edger cut through his work boot and into the dorsum of his right foot. He has a clearly contaminated 5 cm x 1 cm laceration on the lateral side, and an underlying tendon is exposed. Sensation is diminished around the wound and he is unable to actively extend his 5th toe past a neutral position. How would you diagnose and repair his extensor tendon injury?

Dr. Linda Regan is an emergency physician from Baltimore, Maryland. When she’s not on shift, she can be found taking care of her residents and colleagues, always placing others before herself. Dr. Regan’s holistic approach to her career and everyday life is something for all of us to emulate! When she’s not occupied with one of her many jobs, she can be found enjoying time with family and friends. Here’s how she stays healthy in EM!

If you have spent any time working in an emergency department in the last 10 years, you have undoubtedly come across a conversation about wellness and burnout in medicine. Despite increasing awareness, the data is bleak: Emergency Medicine (EM) physicians experience burnout more than any other specialty.1 As we consider that EM was the second most popular Match in 2017, it’s important to focus on collaborative efforts and ensure that the increasing number of EM trainees does not lead to a generation of burned out EM providers.2

Background: Alcoholism is a chronic disease with a staggering impact on society, costing the nation approximately 100 billion dollars per year, an expenditure greater than the costs associated with all cancers and respiratory diseases combined (Whiteman 2000). Large public hospital emergency department studies have demonstrated the enormous strain of alcohol use on resources, and the disproportionate burden that the care of the alcohol abusing patient places on the emergency medical system and the ED (Zook 1980). In one observational cohort, 24% of adult patients brought to the ED by ambulance were determined to likely suffer from alcoholism, further underscoring the tremendous frequency of this disease (Whiteman 2000).