All posts by Lindsay Peters

A Model for Every Occasion

Michael Greenwald, MD  FACEP

Associate Professor of Pediatrics and Emergency Medicine

Emory University/Children’s Healthcare of Atlanta

A new academic year is upon us and that means brand new students and interns who rotate through the emergency department with a variety of backgrounds, skills, comfort and interests.  To some this may cause a flare-up of acid reflux; but I love this time of year.  The new learners are eager and optimistic and each new face represents a puzzle.  What kind of learner do I have? Moreover – what approach should I take when trying to make the most out of each patient encounter. read more

Electronic health records (EHRs): Are they good for emergency department providers and for throughput?

Mohsen Saidinejad, MD, MBA, FAAP

Children’s National Health System

With the passage of meaningful use act of 2009, requiring a phased implementation of electronic health record (EHR) system, more and more healthcare organizations have rushed to beat the technology compliance clock and to be eligible for incentives and reimbursements.  As a result of this electronic transformation, all patient-encounter data is now potentially more transparent, accurate and up to date.1   More importantly, data is more accessible, shareable, and coordinated.2 On the flipside, reliance of digital data can paralyze the entire system during system downtimes, data breaches, or data loss.  In addition to this, back-up systems and servers that are sometimes thousands of miles away can potentially put sensitive personal patient information at risk. EHRs are also expensive and are challenging to successfully implement without growing pains.  Electronic documentation also can be more tedious and time-consuming. In this article, we examine the impact of EHRs specifically on ED providers. read more

First Place EMages Winner 2015: Neck Pain

Megan Marino, MD

Baylor College of Medicine and Texas Children’s Hospital, H uston, Texas

Department of Pediatrics, Section of Emergency Medicine

CASE  PRESENTATION

9 year old female with history of acute lymphocytic leukemia (ALL), status post heart transplant 9 months ago for chemotherapy related cardiomyopathy, presented to the emergency department with 4 weeks of worsening neck pain and 2 days of dysphagia and voice changes. She stopped moving her neck, refuses solids, but is able to drink liquids. She has been afebrile.  She has been seen twice by other providers over the last month, was diagnosed with torticollis, and given diazepam and acetaminophen with codeine without improvement. Home medications included tacrolimus, mycophenolate and prednisone. read more

Second Place EMages Winner 2015: It’s All in the Eyes

Camilo E. Gutiérrez, MD, FAAEM

Boston Medical Center / Boston University School of Medicine

CASE PRESENTATION

A 17 year old teenager presents as a new immigrant from Haiti for evaluation of “heart murmur” diagnosed there. Has no immediate family with him so past medical or family history is unclear. He is on no medications and denies drug abuse.

Complaints of occasional chest pain, palpitations and shortness of breath.

His vital signs are within normal limits.

On examination patient is noted to be tall and thin, pectus excavatum and high arched feet. Has evidence of scoliosis, fingers are long and thumbs are very lax. Lung exam is normal. Cardiovascular exam is remarkable for a holosystolic murmur with mid-systolic click, heard best at the apex and accentuated by valsalva. Mental status is normal. Neurologic examination is also within normal limits. read more

Third Place EMages Winner 2015: Pediatric Rash with Fever, When History and Physical are Paramount

Andres Bayona, MD, Robert M Lapus, MD

Department of Emergency Medicine, University of Texas Medical School at Houston, Houston, Texas

Children’s Memorial Hermann Hospital, Houston, Texas

CASE PRESENTATION

A one month old girl with a history of congenital complete Atrioventricular (AV) block with an implanted pacemaker placement on day of life 6, presented to the Emergency Department (ED) with rash and fever. One week prior to presentation she developed a rash on her face, which slowly spread to her chest, abdomen and extremities. On the day of presentation she developed a fever at home. Mom brought her to the pediatrician, who then referred them to the ED. read more