Tactical Medicine News Blog

The Case of Cognitive Overload outlined a scenario of a junior resident dealing with the harsh realities of working in emergency medicine when she experiences the negative impacts of cognitive overload while caring for a sick patient. This month, the MEdIC team (Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, and Brent Thoma), hosted a discussion around this case with insights from the ALiEM community. We are proud to present to you the Curated Community Commentary and our 2 expert opinions. Thank-you to all participants for contributing to the very rich discussions surrounding this case!

Wellness is not the sole responsibility of each individual physician, rather it is something we have to foster as a community. Many if not most of the things that contribute to burnout or detract from wellness are systems-level problems. Therefore the solutions also need to be systems-based, which inspired us to launch this series on how to promote wellness in EM. The goal is to share ideas, practices, and programs that have worked at different institutions to promote wellness. Our hope is that in reading these posts, you will be inspired to take some of the ideas and implement them in your own program. In this way we can slowly change the system that has produced a 70% burnout rate among Emergency Physicians and start to build programs and systems that promote wellness, resiliency, and career longevity. In this post, Dr. Pilarski discusses how she founded the Medical College of Wisconsin Wellness Committee, the challenges she overcame, and what the committee has accomplished.

In anticipation of EM Cases Episode 87 on Alcohol Withdrawal Dr. Sara Gray describes her Best Case Ever of severe alcohol withdrawal and Delirium Tremens from Janus General. Also on this podcast Dr. Anand Swaminathan reacts to Episode 86 Emergency Management of Hyperkalemia and discusses the use of calcium in the setting of digoxin toxicity. Early recognition and treatment of Delirium Tremens - a rapid onset of severe alcohol withdrawal accompanied by delirium and autonomic instability about 3-10 days after the appearance of withdrawal symptoms - is key to preventing long term morbidity and mortality... The post Best Case Ever 50 – Delirium Tremens appeared first on Emergency Medicine Cases.

In anticipation of EM Cases Episode 87 on Alcohol Withdrawal Dr. Sara Gray describes her Best Case Ever of severe alcohol withdrawal and Delirium Tremens from Janus General. Also on this podcast Dr. Anand Swaminathan reacts to Episode 86 Emergency Management of Hyperkalemia and discusses the use of calcium in the setting of digoxin toxicity. Early recognition and treatment of Delirium Tremens - a rapid onset of severe alcohol withdrawal accompanied by delirium and autonomic instability about 3-10 days after the appearance of withdrawal symptoms - is key to preventing long term morbidity and mortality... The post Best Case Ever 50 – Delirium Tremens appeared first on Emergency Medicine Cases.

Every few years we get updates in the guidelines based on new evidence. Guidelines give us a framework to work with in the treatment of disease processes, such as pneumonia. The last Infectious Disease Society of America (IDSA) guidelines update on the treatment of pneumonia came from 2005, but recently, the new 2016 guidelines were just published. This was a massive 51 page summary that starts off by saying: “It is important to realize that guidelines cannot always account for individual variation among patients.  They are not intended to supplant physician judgment with respect to particular patients or special clinical situations.  IDSA considers adherence to these guidelines to be VOLUNTARY, with the ultimate determination regarding their application to be made by the physician in the light of each patient’s individual circumstances.”