Background: ED visits increased to 145.59 million in 2016 (CDC 2019), resulting in an increase in hospital admissions. Chen et al. showed a correlation between the overall ED census and likelihood of admission; while, Velasquez et al. found up to 28% of hospitalists reported having admitted patients when no admission criteria were met. They described […]

Background: ED visits increased to 145.59 million in 2016 (CDC 2019), resulting in an increase in hospital admissions. Chen et al. showed a correlation between the overall ED census and likelihood of admission; while, Velasquez et al. found up to 28% of hospitalists reported having admitted patients when no admission criteria were met. They described […]

Background: Despite system-level focus on avoidance of potentially preventable hospitalizations, the decision to admit a patient with low medical acuity has been understudied. Our study sought to identify factors associated with admission versus discharge from the Emergency Department (ED) for patients considered unlikely to be medically appropriate for admission. Methods: We conducted a retrospective cross-sectional […]

Case Presentation: A 57‐year‐old woman with a history of herpes encephalitis and residual right temporal lobe encephalomalacia (diagnosed 9 years prior to our encounter) presented to the emergency department on 2 separate occasions 1 month apart, with altered mental status and subjective fevers. The patient was taking valacyclovir prophylactically due to similar presentations in the […]

Case Presentation: A 73‐year‐old African American man presented with productive cough and shortness of breath for 2½ weeks. He was ex‐smoker with about a 30‐pack‐per‐year history and family history of lung cancer. On presentation, vital signs were stable. Chest examination was unremarkable and other systemic exam was within normal limit. Initial chest x‐ray showed a […]

Background: Hospitalists have increasingly engaged in admission decision-making for acute care medical patients. The role, duties, and impact of a Hospital Medicine Triage Attending (“triagist”) are emerging yet ill-defined. To our knowledge, no study thus far has catalogued the activities of these physicians in a comprehensive way. Our objectives were to 1) characterize the demands […]

Case Presentation: A 33 year‐old otherwise healthy man presented with severe muscle pain and inability to ambulate, associated with dark urine for four days. He reported social alcohol use in the days prior, along with his usual exercise routine of 45 minutes on a stationary bike. Physical exam was significant for severe lower extremity muscle […]

Case Presentation: A 65 year old male with no significant medical history presented to an outside facility complaining of fatigue, weakness, nausea and vomiting. He had moderate alcohol history and significant weight loss over the past 6 months. Initial lab workup was notable for elevated liver transaminases with a hepatocellular pattern, Maddrey score of 53.6 […]