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Emergency Relief: Pea Shoots in Lung Parenchyma and Other Tales from the ED

Scheck, Anne

doi: 10.1097/01.EEM.0000398965.24527.8e
Emergency Relief
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The Pajama Game

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A few years ago, a study suggested that male physicians who wear a tie have instantaneous credibility with some patients. The investigation failed to delve into why some physicians would spurn such neckwear. Now comes an informal survey from — you guessed it! — emergency physicians. It suggests that male EPs not only don't want to wear ties, they seem to prefer scrubs, apparently because they resemble pajamas. This isn't news to anyone who reads postings or blogs in emergency medicine. Eric Silman, MD, calls it a “perk” of working in the ED; emergency medicine resident Justin Devlin, MD, identifies his dream job by explaining it would be a place where he could wear “Hawaiian-style scrubs and sandals.” But an online discussion also includes some criticism of people who don't share enthusiasm for PJ-like attire. “I am really wary of someone who wears nice clothes,” posits one respondent, explaining it's a possible sign of “focus in the wrong direction.”

“ER Doctor Clothes,”http://erstories.net/archives/2412.

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Attack of the Lone Bed Bug

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As if the lowly bed bug hadn't got-ten enough publicity, a single sighting of the insect in a New York ambulance caused a Brooklyn medical center to shut part of its emergency room, giving the creature — and Kings County Hospital — blaring news coverage. “The ambulance crew was able to capture the critter,” NBC reassuringly reported. However, because the arriving patient was treated in the triage room, it was quarantined and exterminators were called in. (After the area was declared pest-controlled, full use resumed.) However, news accounts noted these tiny bugs can escape even cautious eradication measures — by lurking in furniture. Is this yet another good reason for those easy-to-wipe chairs found in waiting areas? Can such hard plastic provide protection? Updates are expected, as experts in the big apple continue to battle this pesky parasite.

“Bed Bug Scare at Brooklyn Hospital,”http://bit.ly/BrooklynBedbug.

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Pop Goes the Specialty!

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Emergency departments apparently have become a source of musical inspiration over the past few rock-n-roll, hip-hoppy, rap-singing decades. It is not that surprising. After all, some musicians tend to make visits to the ED from time to time, and what activity would they be likely to do during those wait periods but compose a tune to the event? If you are unfamiliar with such ballads, a list of them can be found at www.studentdoctor.net, in which one participant has helpfully provided a Top 10 list. It includes “Broken Head” by Manfred Mann and “Gimme Stitches” by the Foo Fighters. But for a totally chart-topping experience, give a listen to sensational superstar Rihanna, whose vocals will melt your heart in a song about extinguishing the blood supply to that very same organ. It's simply titled “Emergency Room.” It ends, predictably, with a loss of heartbeat, as the songstress croons: “Flat line on the EKG, flat line on the EKG.”

Music Plaza,http://bit.ly/rihannaER

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Lights, Noise, Action!

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The burden of harsh lights and need for instant action have been shown to affect the health of emergency physicians, really throwing circadian rhythms out of whack. But is there an up side? That eye-opening, overhead light in winter may do more than prevent reading errors on charts and medications. Just look at what happens to financial analysts in their office warrens every December. Evidence from two enterprising researchers at the University of British Columbia suggests that analysts and equity investors are affected by seasonal affective disorder. So, is this the reason for so many gloomy forecasts? That's inconclusive, but this much is for sure: “bright lights” and “big city” don't always work together to ward off wintry woes on Wall Street.

“The Impact of SAD on Financial Analysts,” http://bit.ly/AnalystsSAD.

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Bucking Status Quo for Rodeo Medicine

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What will 2011 hold in terms of preventive medicine? Better protection against injury for bucking bull and bronco riders, if Mark Brandenburg, MD, prevails in his quest to lasso more attention for “rodeo medicine.” The Tulsa, OK, emergency physician, along with athletic trainer Dale Butterwick, trotted out a brief white paper to raise awareness of this “extreme” sport. “Cowboys are extreme athletes, participating in rodeo events with extreme risks,” the pair point out, noting that these events now span the globe. Will their efforts wrangle needed medical support? “The future of rodeo medicine is optimistic,” they observe. “Research initiatives grow monthly.” Sounds like some doctors are saddling up and hitting the trail, scientifically speaking, to investigate the field.

“Rodeo Medicine,”http://bit.ly/RodeoMedicine.

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Good News: No Cancer! Bad News: Internal Vegetable Growth

Just when you thought you had seen it all in the emergency department, a retired educator from Massachusetts proves you wrong. (Or rather, the surprising findings from his diagnostic image do.) A spot on the radiograph that looked like it could be a tumor turned out to be a pea, which was sprouting in lung parenchyma. “Whether this would have grown full term and I would be working for the Jolly Green Giant, I don't know,” the patient told a Boston television station, following confirmation that it was plant vegetation and not life-threatening carcinoma that caused the suspicious growth.

WHDH TV, Boston,http://bit.ly/PeaInLung

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Penny-Pinching Guide for EP Hobbyists

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Who could doubt that hobbies help de-stress emergency physicians? After all, EPs tout them on just about every medical center's ED web page, describing everything from the calm provided by pumpkin-patch tending to the fun that can be had in paintball fighting. But there seems to be a professional favorite: making beer. Lars Beatty, MD, an associate residency program director, is one aficionado of this hands-on undertaking, according to his department bio; ditto for Jeremy Olsen, MD, who also lists downhill skiing as another, and they are but two of many to cite this same pastime pleasure. But wait, could all this beer-brewing lead to stewing over money? Put aside the relaxing nature of imbibing the result and ask yourselves, all beer-brewers in emergency medicine, what have you really got? A very expensive manufacturing process, says Mainstreet.com, which this past April put home brewing as No. 9 in a countdown of costly hobbies, right behind tornado-chasing and just before helicopter-flying. You can save lots of money by buying and assembling the equipment yourself, the online publication advises. It cites a step-by-step guide for brewski-makers not averse to building their own chemistry sets.

MainStreet,http://bit.ly/EPsBeer.

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Dentists Worry About Teeth

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Dental clinics face increasing likelihood of a medical emergency during routine office visits, says a recent study. One reason is unexpected cardiovascular events. This could be because of the aging population, suggest the researchers. But whatever the cause, it is causing a lot of worry on the side of the dental chair usually not known to incite such fear: the dentists and dental students themselves. There should be training to “increase dentists' confidence and ability to manage emergencies,” the investigators propose. Not only will this mean better patient outcomes, but it “will result in decreased anxiety for dentists.” J Dent Educ 2010;74(4):392.

© 2011 Lippincott Williams & Wilkins, Inc.