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Reasoning during the COVID-19 pandemic

The Clinical Problem Solvers

We walked down to the emergency room and reviewed his chart. Then things started to get a little bit different… His chest x-ray had some peripheral infiltrates, and the emergency department providers ordered a CT scan. But, this requires an adequate understanding of the syndrome and having well-defined illness scripts.

Illness 52
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PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen

GeriPal

Well, as a kick off to this year’s first in-person State of the Science plenary, held in conjunction with the closing Saturday session of the AAHPM/HPNA Annual Assembly, 3 randomized clinical trials were presented. Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Also the same hospital system?

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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients.

Families 112
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RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest

GeriPal

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? This is not why I went into emergency medicine. I went into emergency medicine to act. Tammie 03:04 Depends on how long they were pre-hospital.

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Assisted Living Communities: Podcast with Sheryl Zimmerman, Kenny Lam, and Ken Covinsky

GeriPal

AlexSmithMD (still on Twitter at present). I mean, people who used to be in hospitals are now with quicker DRGs. So, the top two were that assisted living communities, in those communities the resident should be present during assessment and care planning. Or do you want to go to the hospital if something happens?

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Aging and the ICU: Podcast with Lauren Ferrante and Julien Cobert

GeriPal

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. To this day, Ken’s post is still one of the most searched and viewed posts on GeriPal. Eric: What was that paper?

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Palliative Care in Liver Disease: A Podcast with Kirsten Engel, Sarah Gillespie-Heyman, Brittany Waterman, & Amy Johnson

GeriPal

We get a bit of, in the veteran population, kind of a mix of a lot of mental health issues thrown into these comorbid illnesses, including cirrhosis, but it’s usually the decompensated cirrhotics or the folks with liver cancer and cirrhosis, or one of both. I’m embedded in the ICU in one of our smaller hospitals.