A Case of Salty Voluminous Urine

Case Presentation: A 51‐year‐old woman with a history of glioblastoma multiforme resection and meningitis presented with mental status changes. Ventriculostomy was performed for hydrocephalus, and CSF revealed recurrent staph meningitis. Antibiotics were started. The RNs [...]

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A Penetrating Odor from a Comatose Patient: A Case of Severe Organophosphate Poisoning

Case Presentation: An 82‐year‐old woman with a history of depression presented to the ER unconscious with a report of seizurelike activity and urinary incontinence. On exam she had copious oral secretions, pinpoint pupils, tachycardia, diffuse [...]

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Acute Stroke Mimicking as Postpartum Depression

Case Presentation: A 31‐year‐old woman with history of depression was 7 days postpartum with no peripartum complications and presented with depressed mood and aphasia. Her family reported depressed mood, decreased verbal communication, and fatigue. She [...]

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“Please Come Back to the Hospital: Your Test Results Show You May Have…“

Case Presentation: A 61‐year‐old nonsmoker presented with right‐sided weakness and an unstable gait for 2 days. Exam showed an obvious right‐sided weakness and dysarthria. He was admitted for inpatient care. PE revealed an edentulous, frail [...]

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Standardization and Simulation Training for Central Venous Catheter Placement to Improve Patient Safety

Background: Improved methods for training medical residents on common procedures offer the possibility of minimizing complications. Currently residents are often trained to perform procedures such as central venous catheter (CVC) placement on real patients in [...]

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A Pilot Study Using the Confusion Assessment Method (CAM) Instrument to Assess for Delirium among Hospitalized Patients

Background: Delirium is an underdiagnosed and often untreated health care burden associated with poor outcomes including increased length of stay, increased inpatient mortality, and higher rates of institutionalization. One technique for identifying patients with delirium [...]

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Bringing Root Cause Analysis up to Speed: The Impact of Increasing the Volume and Rapidity of RCAs

Background: In 1999, the Institute of Medicine's To Err is Human reported that nearly 100,000 people die from medical errors each year in the United States. One proposed solution was detailed root cause analyses of [...]

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Improving Patient Identification of Their Inpatient Physicians: Use of FACE™ Cards

Background: Although stating both the names and roles of physicians is considered an important part of physicians' introductions, patients frequently complain that doctors do not introduce themselves and that they are not sure who they [...]

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Effects of Computerized Alerts on the Use of Unapproved Medication Abbreviations by Medical Interns

Background: Medication abbreviation errors account for a substantial proportion of total medication errors. National regulatory organizations have prohibited the use of certain commonly misinterpreted medication abbreviations in an effort to improve patient safety, yet physician [...]

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Simple Ultrasound Measurement of the Internal Jugular Vein Accurately Estimates Central Venous Pressure Target in Critically III Patients

Background: Early goal‐directed therapy (EGDT) for severe sepsis or septic shock requires placement of a central venous catheter (CVC) to measure central venous pressure (CVP), with the aim of maintaining CVP ≥ 8‐12 mm Hg. This requirement [...]

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Communication and Information Deficits in Patients Discharged to Rehabilitation Facilities: An Evaluation of 5 Acute Care Hospitals

Background: Effective communication among physicians during the hospital discharge process is critical to patient care. The quality of discharge documentation of patients discharged to rehabilitation centers and other subacute facilities has been less well studied [...]

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Staff‐Only Pediatric Hospitalist Care of Medically Complex Subspecialty Patients in a Major Teaching Hospital

Background: General pediatric hospitalists are increasingly relied on to manage patients with subspecialty and/or complex medical conditions. Resident duty‐hour restrictions have limited resident coverage of these patients, prompting the proliferation of staff‐only pediatric hospitalist models. [...]

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Tylenol 'Round the Clock

Case Presentation: A 3‐week‐old was admitted to the pediatrics service for evaluation of fever and administration of parenteral antibiotics. Acetaminophen 15 mg/kg/dose every 4 hours was ordered. The infant received 6 daily doses of acetaminophen [...]

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Not Always Is Preeclampsia: Viral Encephalitis in Pregnancy

Case Presentation: A 23‐year‐old woman with a 24‐week pregnancy presented to the ED with complaints of a progressively worsening headache of 2 weeks' duration. The headache was frontal, pounding in nature, rated 10/10 in severity, [...]

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Persistent Obstructive Jaundice in a 56‐Year‐Old Man

Case Presentation: A 56‐year‐old white man with history of gallstone cholecystitis status post‐ERCP 11 years ago with sphincterotomy presented with bilateral upper quadrant pain after meals for 2 days. He had dark urine but no [...]

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