EM Bound

As medical students it can be hard at times to find ways to contribute to the care of our patients and teams. Sure, we see and evaluate patients on our own, but that doesn't preclude a more senior member from also doing their own evaluation, work-up, and note. Most everything we do needs to be approved or observed: our orders must be signed, procedures must often be carried out under watchful eyes, and patients are sometimes (understandably so!) unwilling to let the junior members of the team practice basic skills on them. When you know that asserting yourself in the care of your patient requires everyone else to chip in, it is easy to feel like a burden rather than a team player, especially in the fast-paced and busy environment of the emergency room. The flip side, of course, is that if you can find a way to carve out a niche for yourself by owning certain areas of your patients' care, you can work within the team to ease the workload of everyone around you and drive patie

AVS is characterized by rapid onset of vertigo, nausea/vomiting, and gait unsteadiness with head motion intolerance and nystagmus.   The most common cause tends to be viral in nature, affecting the inner ear.   While this may be the domain of our esteemed neurology colleagues, there are 2.6 million ED visits for dizziness or vertigo annually in the United States, where the differential between a benign viral cause of vertigo or dizziness must be delineated from potentially lethal causes such as brainstem or cerebellar strokes. Vertigo and dizziness, especially in cases of labyrinthitis, is caused by inflammation along the semicircular canals, affecting the flow of fluid throughout the system and causing the brain to interpret tilt or head spinning when there is none.   However, these same systems can be disrupted by central nervous pathologies that affect the vestibulocochlear nerve or the pons, which CN VIII enters.   Acute stroke in the vertebrobasilar circulation along the brai

Whether it is in the Emergency Department or on the floor, the patient hand-off is one of the most dangerous times in a patient's hospital stay. A review of the causes for medical error finds that problems with communication during transitions in care is a common source of mistakes: vital information gets lost, forgotten, or communicated incorrectly leading to potential safety issues.  eD-PASS is a standardized tool to help you give clear and consistent sign-outs during your rotation in the ED. You can download it onto your mobile device here .