The Hot Stove League of EM/Tox

I am joined by Tony Mazzeo MD, Chairman of Emergency Medicine at Mercy Catholic Medical Center and Vice Chairman of Mercy Operations for me here at Drexel Emergency Medicine. Tony and I tackle the ever important concept of efficiency and try to distill it down to some basic tips. Here’s the Hot Stove Tips:

1) empty the beds
2) Start with the dispo in mind (leave the room with a plan) and identify blockers
3) measure and track your throughput
4) anticipate problems
5)process in parallel and not in serial

Hope you enjoy it and let me know if you agree or have other great ideas!!!

 

Changes ahead in pregnancy labeling that will eliminate the ABCDX categories and supplant them with evidence specific information. Get ready/comfortable with understanding the risks of drugs for your patients and communicating that risk appropriately. Many of your former category B drugs may have risks (acetaminophen, ondansetron) and you may not be prescribing the safest drugs available – e.g. pyridoxine/doxylamine combination is the safest out there for morning sickness. But wait – isn’t that Bendectin, listen on to find out more…

 

This was my first podcast, wanted to do something quick and educational.

Here’s the article I like:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1343297/

The key is to hold the detector close/against the body and to go slowly.

Enjoy:

I tried to create a heuristic approach to reversal of oral anticoagulant induced bleeding.

Four basic principles guide your approach:

1. Identify the drug and it’s mechanism of action as either anti-platelet or anti-clotting cascade.
2. Predict the time to hemostasis (or loss of anticoagulation effect) with  no intervention (mechanism of action, metabolism, elimination, hepatic function, renal function, etc)
3. Establish the time frame for the NEED for hemostasis
4. Decide to intervene or not and pick an intervention typically combining a) antidotes, b) factor replacement, c) platelet transfusion, or d) procoagulants… depending.

Here it is:

Reversing Anticoagulant Induced Bleeding

http://

 

In baseball, the hot stove league is a term used to describe a bunch of guys sitting around a hot stove in the winter time talking about all the moves their favorite baseball teams should make in the offseason. Well, I think #FOAMed is the hot stove league of medicine. When I reflect on the great learning moments of my medical career, I realize they often occurred when I was sitting around, chewing the fat with my favorite educators. When we were in the midst of patient care we generally focused on executing the game plan. Sitting around the ED and talking about what to do if… was the best way to get ready for a real emergency. This blog/cast is the hot stove where I sit down and teach Emergency Medicine and Medical Toxicology. Hope you like it!