HEART Score for ED Chest Pain

This is the HEART score, which be used to decide which patients require admission to the hospital for chest pain, and which ones can be safely discharged. It is recommended that the score (and criteria) be documented in your chart! Favorite

ACEP Clinical Policies

Nontraumatic Thoracic Aortic Dissection (2014) Seizures (2014) Procedural Sedation (2013) Asymptomatic Hypertension (2013) tPA for Acute Ischemic Stroke (2015) Prescribing Opioids (2012) Neuroimaging and decision making in TBI (2008) Syncope (2007) Favorite

Measuring Compartment Syndrome

OVERVIEW Compartment Syndrome is a known complaint of orthopedic injuries, fractures, and crush injuries, and is an often overlooked side effect of tight splint or cast application. Compartment syndrome can also be the result of space occupying lesions, infections, or fasciitis. SYMPTOMS Classically, compartment syndrome presents with severe pain, out of proportion to examination, pallor … Read more

COPD Exacerbation – Do they also need antibiotic coverage?

COPD exacerbations are commonly seen in the emergency room, urgent care, and primary care setting. Treatment can usually be managed outpatient with the combination of beta adrenergic agonists ( albuterol ) and or with anticholinergic agents ( ipratropium) with MDI or nebulizer, In addition patients are usually prescribed systemic glucocorticoid therapy. Current guidelines suggest a … Read more

Part 3: How do PA’s and RN’s fit into healthcare reform

And so the rest of this blog post comes to you – the biggest investment in healthcare.


Physicians, Physician Assistants, Nurse Practitioners – anyone who is considered a provider in healthcare, is now having their own quality measures applied to their care delivery.  As part of the permanent “Doc Fix” the Medicare Access and CHIP Reauthorization Act (MACRA) was passed in 2015. CHIP is the Children’s Health Insurance Plan that provides matching federal payments to state-funded children’s insurance programs.  MACRA is designed to shift the healthcare fee-for-service model of payments to the value-based payment (quality) payment model through Merit-based Incentive Programs (MIPs), which are designed to focus on quality measures at the provider level. Each specialty will have different requirements.  The intent of these quality measures is aimed at reducing cost, but their application to current medical standards is debatable.

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