How do you tell a parent their child is faking it?

Before we all go crazy from Ebola-palooza, let's go crazy with an often unspoken phenomenon in the pediatric ED.  Children with intentional or unintentional psychosomatization. There is so little written in the emergency medicine literature for children who present with conversion disorder, secondary gain, and even less about guidelines, best practices, or descriptive data on what often occurs in Emergency Departments across the world with these types of patients.  ED Psychosomatization in children is completely different than the adult version, as you now have a potential ally or a potential Read more [...]

The Reasons Why It Is Difficult to Match: A Closer Look at America’s Medical Training Status

Recently I came across an article in the New York Times describing the life of a foreign intern at Woodhull Hospital Center in Brooklyn, New York. The article highlighted many interesting aspects of interns' daily life and revealed the expensive price that individuals pay to become doctors in the United States. Yet far more disturbing were the readers' comments. Some went too far describing foreign doctors like Dr. Sanchez as the reason why some US medical graduates could not match into training. The taboo of US versus International Medical Graduates (IMGs) training in the US is an uncharted Read more [...]

Ebola– how prepared is your PED?

With all of the news about Ebola our ED staff was fearful and concerned that our ED was not ready.  After hearing about nurses in Texas acquiring the disease the staff started to discuss if they would care for a patient with Ebola or call out sick.  Our senior staff remembered the days of similar fear related to caring for patient with HIV. What would we do if we had a parent or patient screen positive at triage?  Where we prepared?  Are we safe?  Do we have PPE?  Can we don? Can we doff?  Do we have each others backs?? We conducted an in-situ simulations to walk through our EDs Read more [...]
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Answer: “Just Roll With It.”

  This post is in response to the post “Just Roll With It.” To summarize, this was a 17-yo male who presented to the ED with worsening visual acuity over the course of a month. There was no history of trauma, environmental exposures, prior vision problems, photophobia, eye discharge or eye redness. While awaiting the ophthalmology consult, a point-of-care ocular ultrasound was performed and the following video clip was obtained which was consistent with a retinal detachment.   Thank you to all of you who took the quiz! Here are your results below: 83% of you Read more [...]
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Just Roll With It.

  This was a 17-yo male with no PMH who presented to the ED complaining of decreasing visual acuity in his left eye that had been worsening over the past month. It had progressed to the point where he could only differentiate between light and dark. He felt like a 'curtain was falling' when he tried to see through his left eye. He denied trauma, environmental exposures, prior vision problems, photophobia, eye discharge or eye redness.   While awaiting the ophthalmology consult, a point-of-care ocular ultrasound was performed and the following video clip was obtained. Image Read more [...]

The Section on Emergency Medicine at the American Academy of Pediatrics National Conference Exhibit

The American Academy of Pediatrics (AAP) Section on Emergency Medicine (SOEM), founded in 1981, is the leading advocate for the care of acutely ill and injured children and a professional home for pediatric emergency physicians and affiliated health professionals. Its mission is to optimize the emergency care of all children and provide a forum for section members to meet, discuss cases and treatment issues, and stimulate research and teaching in the subspecialty.  Membership is open to all AAP and ACEP members.   Benefits of SOEM Membership: € Advocacy (Federal & State) € Scientific Read more [...]

What does California Prop 46 say about physicians?

For those outside of California (and frankly, for those within California), there is a new ballot called Proposition 46 for the November 4, 2014 elections.  According to Ballotopedia , Prop 46 was begun as 'Troy and Alana Pack Patient Safety Act of 2014.'  This measure sprung from 2 children in a Auto-vs-Pedestrian incident involving a driver who had been on prescription medications and was asleep at the wheel.  The intent of Prop 46 is to improve patient safety indirectly by curbing unnecessary prescription medication overprescribing & doctor-shopping.  This is a topic well-known to Read more [...]

Getting a Job in PEM: A practical guide

Fall means fellowship interview season for many institutions. Fall also kicks off an unofficial job hunting season for newly minted senior PEM fellows. Dr. Mark Roback, the Director of the Division of Emergency Medicine at the University of Minnesota Children's Hospital, first created this handout after interviewing for his first "real job" over 20 years ago. He shares his tips from the prospective of the applicant and as someone who now hires. Dr. Roback has recently updated it for PEMNetwork readers. The handout covers recognizing the large range of jobs available, how to evaluate jobs Read more [...]