Background: Hospitals are facing increasing pressure to optimize throughput in order to reduce excess length of stay and improve emergency department (ED) boarding times. Improving coordination and throughput in complex organizations with multiple care sites can be particularly challenging. Health systems have implemented numerous initiatives to improve hospital throughput, but these efforts have mainly been [...]

Background: Prior to the COVID Pandemic, the telemedicine market was expected to grow at a rate of 18.4 percent a year. With the Coronavirus Preparedness and Response Supplemental Appropriations Act signed into law in March 2020, Telehealth has experienced rapid expansion. Tele-hospital medicine is carving out several new niches. One is providing a virtual hospitalist [...]

Background: In the inpatient setting, serum potassium (K) and magnesium (Mg) are frequently replaced for patients with values within the reference range (generally K 3.5-5.0 mEq/L, Mg 1.3-2.2 mEq/L) to target an arbitrary goal of 4 mEq/L for K and 2 mEq/L for Mg.(1,2) For certain high-risk non-pregnant adults, K and Mg replacement to these [...]

Background: Like many other health systems, our large, academic, quaternary care center is experiencing a capacity crisis, with increasing number and duration of emergency department boarders. We hypothesized that there is a population of admitted patients who may be appropriately discharged home with timely follow-up and connection with community resources. Purpose: Our project sought to [...]

Background: While the Coronavirus Disease 2019 (COVID-19) pandemic has substantially affected health outcomes globally, care strategies have varied in different regions. For example, while US hospitals primarily admitted patients with severe COVID-19, hospitals in Egypt admitted most symptomatic COVID-19-positive individuals per the May 2020 Ministry of Health and Population management protocol. Additionally, the use of [...]

Case Presentation: Pharyngeal pain is typically associated with upper respiratory tract pathology; rarely is it considered the initial presentation of acute coronary syndrome (ACS). Delayed diagnosis and treatment of ACS in such cases can lead to poor patient outcomes and increased mortality (1). A 76-year-old male with a medical history of benign prostate hyperplasia and [...]

Case Presentation: A 76-year-old female with Diabetes Mellitus and COPD on 3L home oxygen and chronic prednisone, presented to the Emergency Department with diffuse abdominal pain and nausea. She denied alcohol or tobacco use. On arrival, vital signs were significant for tachycardia with new oxygen requirements. Physical exam was notable for epigastric, left lower quadrant, [...]

Case Presentation: A 57-year-old male with previous hemorrhagic stroke complicated by residual left sided deficits with vascular dementia, primary hypertension on a regimen of carvedilol 25mg twice daily, and recurrent urinary tract infections due to obstructive calculi presented with acute-onset lethargy and encephalopathy. Presenting vitals were notable for hypotension (64/53), bradycardia (43 beats per minute), [...]

Case Presentation: An 80-year-old man with a past medical history of hypertension, benign prostatic hyperplasia, and hypothyroidism, presented to the emergency department due to a sudden loss of consciousness. The episode lasted a few minutes and was not associated with trauma, prodrome, seizure, or postictal confusion. Patient had recently been prescribed phenazopyridine for a suspected [...]

Case Presentation: A 61-year male presents with complaints of a cough and progressive dyspnea for over a week. Pertinent history included a Tuberculosis (TB) infection over thirty years ago with an unclear treatment course. Social history was positive for a 40 pack-year smoking history. On presentation, he was tachycardic, hypoxic and tachypneic. Physical exam was [...]