Background: Uncertainty of viral transmission and PPE availability early in the SARS-CoV-2 pandemic created unique infection control challenges for hospitals. Prior to masking recommendations and widespread testing availability, the hospital medicine service at an academic hospital system published “medical distancing” guidelines to reduce the frequency and proximity of physician-patient interactions to minimize transmission. While previous [...]

Background: The SARS-CoV-2 outbreak presents an infection control challenge to deliver care in a safe environment for patients and healthcare workers (HCW), further complicated by uncertainty regarding the nature of contagion of SARS-CoV-2 and PPE supply chain. On March 15, 2020, we introduced “medical distancing” rounding guidelines, with the aim of reducing transmission of COVID-19 when [...]

Background: During the COVID19 pandemic, the Centers for Medicare and Medicaid Services and US Department of Health and Human Services liberalized guidelines to allow for broader access to telehealth services. Previously the use of telehealth platforms in hospital and by the hospitalists has been limited. Purpose: Describe rapid implementation of an interprofessional, inpatient, secure telehealth [...]

Case Presentation: A 56-year-old man with a past medical history of hypertension, hyperlipidemia, polysubstance abuse, and perforated appendicitis presented to the emergency department for one-week right lower quadrant abdominal pain. Of note, two-years prior, the patient had one-day of similar pain associated with nausea and emesis. A computed tomography (CT) scan of the abdomen and [...]

Case Presentation: A 57-year-old incarcerated male with end stage renal disease (ESRD) on hemodialysis, coronary artery disease (CAD), and Gastroesophageal reflux disease (GERD) presented to the emergency department with several episodes of hematemesis, shortness of breath and fatigue for the past 2 days without any associated abdominal pain, dysphagia, or odynophagia. On exam, he was [...]

Case Presentation: A 76-year-old Caucasian male with a past medical history of essential hypertension and type II diabetes mellitus presented with groin pain, nausea, vomiting, and right lower quadrant (RLQ) abdominal pain. The patient’s labs showed a high neutrophil count (82.3) and leukocytopenia (7). CT scan of the abdomen showed an abnormality of the mid [...]

Case Presentation: An 80-year-old female smoker with no known medical history presented to the emergency department after being accidentally pepper-sprayed in her face by her grandson. She reported discomfort in her eyes and throat but denied visual changes, chest pain or dyspnea. Physical exam revealed hypertension, tachycardia, and conjunctival injection. She was discharged home after [...]