Tactical Medicine News Blog

In this EM cases Waiting to Be Seen blog we discuss how to make Emergency Departments safe places for transgender patients to access care that is informed and non-judgmental. A big part of our job is to advocate for our patients. Dr. Nadia Primiani helps us understand where some of our most vulnerable populations are coming from and aims to improve our familiarity and comfort with issues around gender to improve care... The post WTBS 13 Transgender Patients: How to Foster a Safer Emergency Department Environment appeared first on Emergency Medicine Cases.

In this EM cases Waiting to Be Seen blog we discuss how to make Emergency Departments safe places for transgender patients to access care that is informed and non-judgmental. A big part of our job is to advocate for our patients. Dr. Nadia Primiani helps us understand where some of our most vulnerable populations are coming from and aims to improve our familiarity and comfort with issues around gender to improve care... The post WTBS 13 Transgender Patients: How to Foster a Safer Emergency Department Environment appeared first on Emergency Medicine Cases.

Background: Apneic oxygenation (ApOx) is the passive flow of oxygen into the alveoli during apnea.  This passive movement occurs due to the differential rate between alveolar oxygen absorption and carbon dioxide excretion producing a mass flow of gas from the upper respiratory tract into the lungs.  Another important component of this maneuver is maintaining a patent airway so that supplemental oxygen administered through the nares is able to be delivered to the alveoli.  This practice has been a game changer in emergency airway management for many providers.  However, there are still some naysayers that believe in the sickest patients ApOx may not be so beneficial. This post is a review of two recent systematic reviews/meta-analyses published in the critical care and ED/retrieval settings on the use of ApOx.

After a STEMI activation from the field on Monday morning, the cardiac catheterization team scoops the patient away shortly after the paramedics arrive in the Emergency Department (ED). “Well that was a smooth and seamless resuscitation. The patient was barely in the ED for more than 15 minutes,” you think to yourself. You diligently complete your critical care documentation, noting 20 minutes of critical care time, before seeing your next patient. A few weeks later the chart is bounced back and noted as an erroneous documentation of critical care time. The coding department notifies you that the case will be billed as a Level 3 visit (E/M code #99283). Why is that the case?

Our final case of this season, The Case of the Competency Conundrum, outlined a scenario of residency competency committee members who are divided in their approach to a superstar R4 resident, Josh, who has already completed the requirements of his training program. They struggle with competing opinions surrounding competency based medical education (CBME) early advancement principles and the importance of continued exposure/service. This month, the MEdIC team (Drs. Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, Alkarim Velji, and Brent Thoma), hosted an online discussion around this case with insights from the ALiEM community. We are proud to present to you the curated community commentary and our expert opinions. Thank-you to all participants for contributing to the very rich discussions surrounding this case!