Tactical Medicine News Blog
Peeing into the wind? Urine drug screens, part 1 (benzodiazepines)
Posted by Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP on
Let’s be honest. When was the last time results from urine drug screens (UDS) changed your management plan? Many times it takes hours for the patient to give the urine sample anyway. And, with all of the false positives out there, how do we know what the heck the result is actually telling us?
Paucis Verbis: Does this adult patient need blood cultures?
Posted by Michelle Lin, MD on
Do you order blood cultures for all your ED patients with a fever? Obviously no. What’s your decision making process on ordering this test? There are really no findings or tests with high specificity (rules-IN bacteremia), except interestingly “shaking chills”. Notice almost all the criteria listed below approach a likelihood ratio (LR) of 1.0. Two prediction rules do exist, however, to help you virtually rule-OUT bacteremia: SIRS Shapiro prediction rule The list of LRs also will be helpful to show learners in the ED that an isolated serum WBC number is useless risk-stratifier.
Trick of the Trade: Incision and loop drainage of abscesses
Posted by Michelle Lin, MD on
Why are we still teaching the traditional incision and drainage approach to simple abscess drainage? They require frequent, painful packing changes to ensure persistent drainage of retained pus. Trick of the Trade Incision and loop drainage (I&LD) technique As per usual, Dr. Rob Orman (ercast) beat me to this. He already reviewed the technique on [+] The post Trick of the Trade: Incision and loop drainage of abscesses appeared first on ALiEM.
RIP: Ode to my textbooks
Posted by Javier Benitez, MD on
If you were to take a look at my bookcases, you would classify me as a book hoarder. Yes, it’s true I have been collecting book. Some have been with me since college. Books have so much information, and I have always felt a bit paranoid about throwing them away and then not having them for a critical piece of information that I need.
Paucis Verbis: Overanticoagulation and supratherapeutic INR
Posted by Michelle Lin, MD on
I find it amazing that I know more non-emergency physicians virtually in the social media world rather than in person. Primarily through Twitter, I follow and am followed by medical educators from various specialties. If you haven’t joined Twitter yet, I think it might be time. There is a whole world of collaboration and conversation going on in this virtual community, which crosses specialties and geography.