Articles related to Hospitalist

A poll conducted in 2021 shed light on the terrible state of many nurses’ mental health, and this story may be a reflection of those thoughts. When more than 9,500 critical care nurses were polled last October, more than half of them admitted to being “not emotionally well,” a trend that was most pronounced among younger nurses between the ages of 25 and 34 (Michael Odell was 27 years old at the time of his death).

Today’s understanding is that “pimping” on rounds and similar tactics tend to inhibit rather than promote learning. Yet residents and fellows, and to a lesser extent medical students, continue to complain of demeaning interactions in medical learning environments. Icahn School of Medicine instituted a system to take in reports of such behavior in an attempt to improve the educational environment there. In their model, the instructor is informed that an individual perceived a degrading interaction. The purpose is to allow the instructor to be aware and make changes as needed. But institutions who want to follow the example of the school need to be prepared to allocate the needed resources to do this follow up if the system is to have any benefit.

Commotio cordis — cardiac arrest after a blunt force trauma to the chest — is thought to occur because a hard object strikes the chest in a vulnerable moment in the cardiac cycle, setting off ventricular fibrillation. The rare condition has been described with a ball strike to the chest, but primarily in young men whose chests haven’t fully developed, making them more susceptible to the blunt force of a ball.

She has been treating her IBS with bismuth subsalicylate. Her symptoms include shortness of breath, nausea, and vomiting. On exam, the patient is confused. Laboratory testing showed primary anion-gap metabolic acidosis, primary respiratory alkalosis, and a salicylate level 25x greater than the normal upper limit.

Although the relationship between preceding viral illness and subsequent Guillain-Barre isn’t proven, it is a commonly observed pattern. The severity of GBS ranges from mild sensory disturbances to life-threatening loss of function requiring intubation.

A 63-year-old man is seen in the ER for new onset confusion. He has been taking codeine-guaifenesin as directed for a URI. Respirations are shallow and the rate is 10/min. Pupils are miotic and the patient is somnolent. Exam and vitals are otherwise normal. The confusion resolves with administration of naloxone. Why did this patient most likely have the drug reaction?