Tag Archives: patient care
woman holding a pill and glass of water

From Evidence Based Medicine to Medicine Based Evidence

Evidence based medicine, using randomized controlled trials and meta-analyses as the major tools and sources of evidence about average results for heterogeneous groups of patients, developed as a reaction against poorly designed observational treatment research and physician reliance on personal experience with other patients as a guide to decision-making about a patient at hand. However, […]

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Delayed Transient Cortical Blindness from Hypoxic Ischemic Encephalopathy

To the Editor: An 85-year-old woman with no significant past medical history presented after a mechanical fall complicated by multiple fractures. She received intravenous pain medications with resultant decreased level of consciousness and respiratory distress. Intubation was difficult because of bilateral mandibular fractures, and she consequently experienced 10 minutes of hypoxia before secure airway control […]

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Conquering ‘Neurophobia’

The evaluation of a patient with neurologic disease remains one of the most daunting and anxiety-provoking tasks in clinical medicine. From the perspective of physicians who are not trained in neurology, the performance and interpretation of the neurologic examination is shrouded in mystery. The angst associated with the study of neuroscience begins in medical school […]

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Mindfulness-Based Laboratory Reduction: Reducing Utilization Through Trainee-Led Daily ‘Time Outs’

Overuse of laboratory investigations is widely prevalent in hospitalized patients, leads to discomfort, and increases direct and indirect costs. Objective We implemented a simple, inexpensive, mindfulness strategy on our inpatient medical clinical teaching unit to reduce unnecessary laboratory orders through education, a forcing function, and daily structured laboratory “time outs.” Methods On a 26-bed unit […]

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woman holding knee

Black Pump Independence

“And just why do you need this blood test?” the elderly woman demanded in her fierce quiet voice. She glared up at me past elegant, hand-drawn eyebrows. This was her third day in the hospital; my third week as an intern. We had had this conversation before. Mildred refused to allow her blood to be […]

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