Top 10 reasons NOT to order a CT scan for suspected renal colic

CT_Scanner_01.jpg2d5efea2-a1b7-4c15-848e-4d6c5567eecfLargerExpertPeerReviewStamp2x200It appears that the excitement and utilization of computed tomography (CT) imaging in the emergency department (ED) has far outpaced our concern for the short- and long-term consequences of increased reliance on this technology. CT has greatly supplemented, or even replaced, our clinical decision making for many chief complaints.  Many articles document the dramatic increased CT use in contemporary practice, including a 330% increase in the rate of CT imaging from 1996 to 2007. The likelihood of a CT order being part of any ED encounter now approaches 15%, with no signs of decline.1

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Uncomplicated Urinary Tract Infections in Older Adults: Diagnosis and Treatment (Part 2)

abxIt seems like a simple enough question: How do you diagnose and treat uncomplicated urinary tract infections (UTIs) in older adults? The answer is: It depends. In Part 1 of this post we discussed the diagnosis of UTIs in cognitively intact older adults and those with underlying cognitive impairment. This post will discuss treatment options.

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By |2018-01-30T02:47:20-08:00Apr 2, 2014|Genitourinary, Geriatrics|

First ALiEM journal article: Trial of void for acute urinary retention

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)?

By |2018-01-30T01:58:58-08:00Mar 19, 2013|Genitourinary|