Exceptional communication is essential when providing care to patients in the ED. This is especially true given that we don’t have a preexisting relationship with our patients. They have never seen us before, have little or no information about us, and didn’t choose us. They are typically anxious, uncomfortable, and would probably rather be somewhere else. Exceptional communication allows patients to gain trust in us, in our skills, and in our recommendations. Strong communication skills not only allow physician and non-physician staff to gather relevant information and share important findings, but also help improve healthcare outcomes, reduce misunderstandings, and minimize litigation. Below are 10 pearls, divided into 4 habits [Permanente Journal PDF], to help you get the most out of the clinical encounter and improve your patient’s care experience.
Child abuse is a common cause of pediatric morbidity and mortality. In 2015, over 650,000 children were found to be victims of maltreatment and over 1,500 child deaths occurred due to child abuse or neglect in the United States.1 Children under 1 year of age are at the highest risk of abuse with potential for lifelong sequelae. Emergency department providers are in a unique position to recognize child abuse and take appropriate steps to reduce further injury to children. An understanding of the motor development of young children can aid physicians in the identification of clinical red flags in the history.
Preeclampsia is on a spectrum of pregnancy related illness that includes eclampsia and HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets – debate exists about if this is a separate entity altogether). It carries a high mortality for both mom and baby, and can lead to a number of complications including pulmonary edema, hepatic rupture, placental abruption, and seizures (eclampsia). Created by Dr. Sam Ashoo, ALiEM Cards: Preeclampsia gives you a rapid review of its presentation, criteria, and management.
A middle-aged man with a history of diabetes and hypertension presents with nausea, vomiting, and shortness of breath. His laboratory testing is remarkable for a leukocytosis, ketonemia, and an anion gap acidosis (pH of 7.13). The EM resident caring for this patient is surprised to find that the blood glucose is 121 mg/dL.
Which home medication is likely responsible for this presentation?
We are set to wrap-up the 3rd Annual Emergency Medicine Wellness Week. The ALiEM Wellness Think Tank (WTT) collaborated with CanadiEM, ACEP, and the Canadian Association of Emergency Physicians (CAEP) to encourage participation from EDs across North America and around the world. Many of you shared your individual and group successes, which have helped to build collective wellness across the specialty. We are proud to present some of the Wellness Week highlights, and remain hugely motivated to participate in this important movement! When you’re done reading, be sure to welcome today’s newly matched EM interns with the hashtag #WelcometoEM!
You have just signed out from one of the best shifts in your career. You feel like you were born to do this! You’re a great EM doctor! Then, you spot him, a man in a dark suit making eye contact as you walk through the lobby towards the exit. He stops and asks, “Are you Dr. About-to-get Sued?” Being named in a malpractice lawsuit is a potentially devastating, frequently unmentioned, and yet rather common event in EM. Providers may find themselves feeling isolated and ashamed, questioning their career choice regardless of the trial outcome. Members of the ALiEM Wellness Think Tank recently spoke with Dr. Gita Pensa about how to find resilience in EM despite involvement in a lawsuit. We provide the full podcast and a summary below.
Nuts and Bolts of Competency-Based Medical Education: Interviews with Drs. Sherbino, Cooney, Chan, and Hamstra
Are you confused about competency-based medical education (CBME)? Look no further! The Faculty Incubator conducted 2 Google Hangouts with 4 experts on the subject: Dr. Stanley Hamstra, the ACGME Vice-President of Milestones Research and Evaluation, and Drs. Teresa Chan, Robert Cooney, and Jonathan Sherbino. We summarized some of the key points from this robust discussion, which is available to you both in podcast and video formats. Enjoy!