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You don’t need X-Rays in a child with bronchiolitis, croup, asthma, or first time wheezing

PEMBlog

System level innovations such as the electronic health platform, including order entry, were intended to improve efficiency but may result in the unintended consequence of making it easier to order a chest radiograph without substantiating the need or in conflict with best clinical practice guidelines.

Asthma 52
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GeriPal 300th Episode: Ask Me Anything Hot Ones Style

GeriPal

The hot sauces progressed from mild to extreme (and I mean extreme) heat. Can I just say…it works? Being asked a question with your mouth on fire, sweat streaming down your face, feeling the most awake and terrified you have ever been in your life, forces you to give an unadorned answer, straight from the heart. Lynn: Okay. Anne: GeriPal edition.

IT 126
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POLST Evidence and Update: Kelly Vranas, Abby Dotson, Karl Steinberg, and Scott Halpern

GeriPal

And we have Scott Halpern, who is Professor of Medical Ethics and Health Policy and Director of the Palliative and Advanced Illness Research Center or Payer Center at the University of Pennsylvania. The answers to these questions will vary. Reasonable people will disagree. And today, on our podcast, our guests disagree. Welcome, Karl.

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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

In case you miss the introductions at the start of the podcast, Bernie and Laurie are married, and offer wonderful reminiscence of their clinical practice over the last several decades. The hospital refused without a court order, and the case eventually made its way to the Supreme Court. What words to use? Is the POLST useful?

Families 112
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PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen

GeriPal

Kate: So it was an embedded alert in the electronic health record and they just clicked those two answers very quickly. I’m just stunned even writing that! We’ve come so far as a field. This is Eric Widera. Alex: This is Alex Smith. Eric: Alex, who do we have with us today? Were you at the GeriPal pub crawl? laughter] Eric: 2:30 AM.

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Jumpstarting Goals of Care Convos: Erin Kross, Bob Lee, and Ruth Engelberg

GeriPal

Today we discuss a new paper in JAMA that tests a stripped down version of the clinician only facing intervention in a pragmatic randomized trial for older adults with serious illness and those 80+. Eric and I also reflect on the podcast Randy generously did with us on his experience living with and studying serious illness.

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Pragmatic Trial of ACP: Jennifer Wolff, Sydney Dy, Danny Scerpella, and Jasmine Santoyo-Olsson

GeriPal

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. But before we dive into the study and the implications it has for the practice that we do, I believe someone has a song request. Outcomes are typically assessed from available records.