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In an attempt to clarify criteria for diagnosing adrenal insufficiency in patients with severe sepsis and septic shock, this group of French investigators serially performed both the cosyntropin stimulation test and the metyrapone stimulation test in 2 cohorts of such patients, and compared the findings with those from concurrent ICU patients without sepsis as well as a group of healthy volunteers.
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A few weeks ago a technical representative of one of the leading ICU ventilator manufacturers gave an "in-service" presentation to the leaders of the respiratory care department at my institution.
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The foot is divided into three anatomic regions: the forefoot, made up of the fourteen phalanges and the five metatarsals; the midfoot, made up of the navicular, the cuboid, and the three cuneiforms (the medial, the middle, and the lateral); and the hindfoot, made up the talus and calcaneus.
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Dermatologic complaints are common presentations in the emergency department and the emergency physician should have a working knowledge of the most common of these complaints.
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Gastrointestinal (GI) bleed. Cancer. Myocardial infarction (MI). Constipation. These are just some of the conditions that could present as abdominal pain in ED patients.
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It's a common source of frustration in many EDs: leaving patients in the waiting room until a "specialty" room is available, or placing the patient in a room that doesn't have the right equipment, which delays care. That's why many EDs are investing in mobile workstations on laptops or wheeled carts.
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The minute you learn that accreditation surveyors are on site, you probably have a "wish list" of tasks that should be done immediately. At Providence St. Vincent Medical Center in Portland, OR, ED nurses created checklists for technicians, nurses, physicians, and health unit coordinators to use.
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Long waits are the most common cause of patient complaints in many EDs, so why not give patients a special "thank you" when wait times are long?
