Background: Peripherally inserted central catheters (PICCs) are commonly inserted/ordered by hospitalists for venous access, long‐term therapies, and infusion of total parenteral nutrition, Despite these salient roles, little is known about PICC use in hospitalized patients. To understand hospitalist practice related to PICC, a Web‐based survey of a convenience sample of hospitalists in 4 health care […]

Background: The Choosing Wisely campaign discourages CT imaging in low-risk patients with suspected pulmonary embolism (PE) (e.g., low clinical probability and negative d-dimer). Few studies have investigated patient, provider, or operational characteristics associated with overuse of CT imaging. One possible approach to this research question is to examine variability in diagnostic yield (i.e., the percentage […]

Background: Physical and occupational therapy (PT/OT) services are a limited resource in the inpatient setting. PT/OT consults ordered by resident physicians on patients who do not need them take time and resources away from patients more deserving of skilled rehab services. Purpose: Our objective was to understand utilization of PT/OT services on our medical floors, […]

Background: Pulmonary embolism (PE), refers to obstruction of the pulmonary artery or one of its branches by material (thrombus, tumor, air or fat) that originated elsewhere in the body.Wells criteria must be part of the clinical assessment for PE. With these criteria, we can classify patients as high probability (>6 pts), moderate (2 to 6 […]

Case Presentation: A 57‐year‐old woman who had undergone an elective total knee replacement 9 days earlier presented to the ED with 1 day of progressive, diffuse abdominal pain, nausea, and fevers. Her postoperative course had been notable only for a supratherapeutic INR of 6.2 in the setting of routine DVT prophylaxis with warfarin, for which […]

Background: Until the advent of novel oral anticoagulants (NOACs), Warfarin was the only oral agent available for the treatment of deep venous thrombosis (DVT) and Pulmonary embolism (PE). Bridging with parenteral anticoagulation until warfarin reaches a full therapeutic level often results in prolonged hospitalization. Rivaroxaban, Dabigatran, Apixaban, Edoxaban were approved by the FDA for DVT […]

Case Presentation: A 64‐year‐old Japanese man was admitted because of the low‐grade fever and progressive shortness of breath on exertion for two months. He also developed visual disturbance one month prior to admission and ocular steroid therapy has been instituted based on the diagnosis of uveitis. About a year ago, he had right lower leg […]

Case Presentation: A 62-year-old male with past medical history of type 2 diabetes mellitus, coronary and peripheral arterial disease, heart failure with reduced ejection fraction, history of peripheral arterial embolism, history of stroke, vascular dementia and hypertension who presented with sudden onset of shortness of breath associated with cough and chest pain for one day. […]

Case Presentation: AR is a 3-week-old full term, previously healthy girl, who presented to the Emergency Department (ED) with a rash involving the perianal skin and gluteal crease. The rash began at 1 week of life. The primary care provider (PCP) presumed it was a typical diaper dermatitis, and prescribed oral amoxicillin and mupirocin ointment. […]

Case Presentation: The patient was a 38 year old male with a 5 year history of ulcerative colitis (UC) who presented with a flare of symptoms during the past year, resulting in a 60 lb weight loss. He had been having up to 42 bloody bowel movements per day. The patient was found to have […]