Case Presentation: Patient is a 4-year old male with history of developmental disorder who presented for primary concern of weight loss. Two months prior, patient developed left femoral metaphysis fracture following a collision with another child. He underwent casting. Following removal, he refused to bare weight on his lower extremities. Thereafter, patient developed bilateral leg [...]

Case Presentation: A 17-year-old female presented to the ED with progressive encephalopathy. Three weeks prior, patient began experiencing pre-syncope, anorexia, increased sleep, and frequent urination. Her family described pressured, child-like speech. Patient endorsed smoking marijuana prior to symptom onset. History ascertainment was limited by her family’s inconsistent presence at bedside and her poor engagement during [...]

Case Presentation: An otherwise healthy 17-year-old female presented with arm pain and dark urine after riding a roller coaster. She was found to have a creatine kinase >32,000 with elevated liver enzymes and was admitted for treatment of rhabdomyolysis. She had been admitted a year and a half prior with rhabdomyolysis and compartment syndrome requiring [...]

Case Presentation: A 15 month old female with a history of poor weight gain but normal development was transferred for evaluation of atypical seizure-like episodes in the setting of diarrhea and vomiting. Over five days, she had multiple ED visits for abnormal movements—shaking, unusual eye movements, hypotonia and lethargy—some occurring without fever. Initial workup, including [...]

Case Presentation: A 13-year-old previously healthy female with recent psychosocial stressors was admitted with progressive expressive aphasia and right upper extremity sensorimotor changes. Symptoms began six weeks prior to admission with recurrent right arm tingling sensations that progressed to right-sided upper and lower extremity twitching. During the period between onset of symptoms and admission, she [...]

Case Presentation: An 11 year old male with chronic migraines presented with two weeks of worsening headaches, vomiting, poor intake, fever, fatigue, and fluctuating mental status. What initially resembled his usual migraines evolved into unrelenting daily headaches that no longer responded to home therapy. He developed new concerning features, including weakness in his legs, urinary [...]

Case Presentation: 13-month-old male was found unresponsive and cyanotic in his crib at home by family members. Bystander CPR was initiated by family. Pulses palpated upon EMS arrival; rescue breathing initiated. Per history, his older brother had emptied a “drawer full of clothes” on him. No recent illness noted. On arrival to the ER, he [...]

Background: The drive for high-quality, efficient, and patient-centered care is paramount in contemporary hospital settings. At a large community hospital, a recognized need to reduce variability in clinical practice and optimize patient throughput led to a significant strategic undertaking. Led by the hospitalist team with substantial nursing input, new structured scripted Interdisciplinary rounds were developed. [...]

Background: Hospitalists are experts in inpatient medicine, managing patients with high acuity, severe illnesses, and coordinating care between multiple providers. Given these challenges, it is imperative that they are equipped with the skills to be able to successfully navigate serious illness conversations (SICs). SICs are wide-ranging and include discussions of goals of care, chronic illnesses [...]

Background: Structured interdisciplinary bedside rounding (SIBR) has been shown to improve patient communication, patient satisfaction, and reduce clinical errors. However, there continue to be challenges in sustainable and consistent implementation due to many logistical challenges. In 2022, we implemented geographic localization for our general internal medicine inpatient services at our academic medical center. This increased [...]