The Recruiter: Hot Spots

The Recruiter: Hot Spots.

The supply and demand scale for emergency physicians is obviously going to be tipped in favor of physicians for many years to come. If you’re an ABEM/AOBEM certified physician with a solid track record, typically the job hunt can be akin to achieving celebrity status – “Everybody wants you – everybody needs you”.  In most parts of the country, a well-qualified EP is highly likely to secure a position at the hospital of his or her choice.

If you’re an underwriter reading this, sorry this link is not for you.

If you’re related to me and starting your emergency medicine residency in June then, Bud this link’s for you.

Notes from the Field: Acetyl Fentanyl Overdose Fatalities — Rhode Island, March–May 2013

The GC/MS toxicology results for 10 of the 12 decedents showed, in addition to acetyl fentanyl, various mixtures of other drugs, including cocaine (58%), other opioids (33%), ethanol (25%), and benzodiazepines (17%).

via Notes from the Field: Acetyl Fentanyl Overdose Fatalities — Rhode Island, March–May 2013.

So what do you do when you see a script for Naloxone prescribed by an EM specialist?

 

Injuries from Ingestion of Wire Bristles from Grill-Cleaning Brushes — Providence, Rhode Island, March 2011–June 2012

Case Reports

A man aged 50 years arrived at the ED with abdominal pain that had begun after eating steak at a backyard barbeque. Computed tomography (CT) scan of the abdomen and pelvis revealed a linear object extending through the wall of a loop of small intestine into the omentum (Figure). Laparotomy was performed to remove the foreign body, which appeared to be a wire bristle from a grill-cleaning brush. The patient fully recovered and was discharged the next day.

Five more patients visited the ED during August 2011–June 2012 after inadvertent ingestion of a wire bristle that had become dislodged from a grill-cleaning brush and embedded in food. In all of the cases, the bristles were initially identified by radiographs of the neck or CT scans of the abdomen and pelvis, and their origin was confirmed after removal (Table). Patient interviews revealed a common history of recent ingestion of grilled meat. After definitive treatment, all six patients recovered fully.

Severe pain on swallowing was the chief symptom in three of the six patients. In all three of these patients, a wire bristle from a grill-cleaning brush was found in the neck. The three included a woman aged 46 years and two men aged 50 and 64 years (Table). The three initially were evaluated with plain radiography, which identified the foreign object in each patient. One who was initially evaluated with plain radiography then underwent CT for precise localization. All three were treated successfully with laryngoscopic removal of the wire bristle.

Severe abdominal pain was the chief symptom of the other patients, who were three men aged 31, 35, and 50 years (Table). These patients were evaluated primarily with intravenous contrast-enhanced CT of the abdomen and pelvis. In two patients, the wire bristle was noted lodged within the omentum adjacent to a loop of small intestine. In one patient, the wire bristle was located within the sigmoid colon, indenting the bladder. Two patients underwent emergency abdominal surgery to retrieve the foreign object and repair the intestine. In one patient, the wire had not perforated the intestine and was removed via colonoscopy.

via Injuries from Ingestion of Wire Bristles from Grill-Cleaning Brushes — Providence, Rhode Island, March 2011–June 2012.

Tomorrow is July 4 and many grills will be fired up for the holiday.  I thought this article was particularly well timed.

FME’s – 2011

CDC Features – Prescription Painkiller Overdoses in the U.S.

Overdose deaths from prescription painkillers have skyrocketed in the past decade. Every year, nearly 15,000 people die from overdoses involving these drugs—more than those who die from heroin and cocaine combined.

Thinking About Heath..Just Another FME | Underwriting Solutions LLC

It’s been over three years since I posted about Heath Ledger and his unfortunate FME (Fatal Medication Error).  Fresh research from the CDC indicates the problem is getting worse.  The current state of the US economy virtually guarantees the staggering increase in prescription painkiller abuse and overdose will get worse before it gets better.