No one can deny the severity of the opioid crisis in which we currently reside. But what is less clear is whether we are innocent bystanders, facing the consequences of someone else’s problem, or directly responsible for causing a portion of the addiction we are currently witnessing.In a recent publication in the NEJM, Barnett et al attempted to define the role of the … [Read more...]
EMNerd
The Nihilistic Ramblings of Rory Spiegel, MD
CC Nerd-The Case of the Elusive Mirage
Tales are often told of an exhausted travel who has lost their way in the desert, and are drawn astray by the the sight of a lush oasis. But as they draw close, their salvation vanishes only to reappear on the distant horizon. This optical tormentor continues to lead the hapless travelers further and further off course, until they collapse from sheer exhaustion. Such is the … [Read more...]
EM Nerd-The Case of the Cryptic Truth
On the morning of January 1st, 2017 a number of proud South Carolinians woke up to find themselves no longer living in their former state of residence. Without moving from the beds in which they slept, they were all magically transported into the neighboring the state of North Carolina. Due to a border dispute which has been underway for more than 20 years, the state line which … [Read more...]
EM Nerd-The Case of the Otalgic Squire
As the year draws to a close it is safe to say that it has not been a productive twelve months for antibiotic stewardship in the Emergency Department. A recent example is the latest NEJM publication by Hoberman et al examining the efficacy of antibiotics for children with acute otitis media (OM) (1).Using a non-inferiority trial design, the authors compared the use of the … [Read more...]
CC Nerd-The Case of the Uncertain Surrogate
I’ve often wondered if the devastating outcomes observed in patients presenting in status epilepticus (SE), are far more influenced by the underlying etiology inciting this seizure activity than the time it takes us to control this neurological outburst. And while the HYBERNATUS study does not directly address this question, it does allow for some interesting … [Read more...]
Hi, my name is Scott Weingart.