Author Archives: Sam Ashoo, MD

The ED Dashboard

Picture this: You are driving along a 4 lane highway and your passenger asks “Why are you driving so fast?” You glance at your dashboard and see that you are moving at the speed limit and reply “What do you mean? I’m driving the speed limit.” Your passenger says “Oh, it feels faster. Maybe it’s all the cars we are

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Passion, The Fire of Injustice, and Healthcare

There is so much suffering and pain in this world. It seems present wherever we look, especially in healthcare. We are exposed to trauma, unexpected death, cancer, infections, life altering illnesses, and tragedy daily. Even within the microcosm of the hospital, we can see and feel injustices. The insurance crisis and poverty, the opioid epidemic and addiction, human trafficking, child

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In 2017, the American College of Cardiology (ACC) / American Heart Association (AHA) Task Force on Clinical Practice Guidelines and the Heart Rhythm Society released their practice guideline on the evaluation and management of patient with syncope (pdf). It is a massive document. Of the 278 pages, the references, appendix, and data supplement combined take up 210 pages. The Admin EM

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Pulmonary Embolism Algorithm

The American College of Emergency Physicians recently revised its clinical policy on the evaluation of adults presenting to the emergency department with suspected acute venous thromboembolic disease. It was published in the May issue of Annals of Emergency Medicine and is available to read here. The revision answers 5 key questions regarding the evaluation and treatment of patients with thromboembolic

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ED Boarding in 2018

It is 2018 and the we have been discussing ED boarding for well over 20 years. There are numerous resources that have suggested methods to combat the problem. What once was a problem easily fixed by moving people out of the ED and parking them on nursing units, has become an increasingly complex beast. If your hospital is struggling, like

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Decision Fatigue … Do You Feel It?

If you haven’t heard the term decision fatigue, you need to familiarize yourself with it. In the psychology literature, decision fatigue refers to the reduction in quality of decisions made by a person after long periods of decision making. It is an interesting phenomenon. There are descriptions of it occurring in shoppers after long periods of intense decision making, ending in

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