Tactical Medicine News Blog

A patient may present to the ED after foley catheter placement for acute urinary retention (AUR) a few days ago and now requests catheter removal. Ideally this should be performed in the urologist’s office. However, occasionally patients cannot or do not follow up with the urologist in a timely manner and return to the ED expecting urethral catheter removal. A careful history and physical should be performed along with a consulting urologist. If the eventual decision is to remove the urethral catheter in the ED, what is important to know about a Trial of Void (TOV)?

Dr. Rahul Patwari reviews the basics of respiratory physiology, the pathophysiology behind respiratory failure, and ventilator management. What do all the ventilator settings mean?

Have you seen how some speakers can seemingly just give AMAZING talks? It actually takes a lot of hard work to make impactful talks look easy and effortless. The CORD Academy for Scholarship in Education in Emergency Medicine recently has started the “Distinguished Educator’s Coaching Program” to help established educators improve their presentation skills. The concept of coaching for mastery is a hot topic, often discussed by Dr. Atul Gawande (surgeon at Brigham and Women’s and professor at Harvard Medical School and the Harvard School of Public Health).

Is the physical exam a relic of the past, because our tools are relics of a prior era? It is important to do and teach a thorough physical exam. I cautioned against the overreliance on diagnostic testing in lieu of a physical exam, which can be initially burdensome and prolonged. But perhaps our difficulty with the physical exam is not the exam itself, but the tools that we have at our disposal to perform an exam, rather than the exam itself.

Suppose you have a patient in whom you highly suspect a pulmonary embolism (PE) that devolves into PEA arrest while awaiting a CT angiogram. Or, what about a patient with an ECG showing clear STEMI that loses pulses?