Medical Training Blog | Provider Practice Essentials

Asymptomatic Hypertension (2013)

April 4, 2020October 16, 2018 by PPE Medical

Inclusion: Age ≥ 18 Symptomatic elevated BP Lack signs of symptoms of acute target organ injury. Exclusion: Acute hypertensive emergencies (acute stroke, cardiac ischemia, pulmonary edema, encephalopathy, CHF) Pregnant ESRD Emergent conditions that are likely to cause elevated BP not directly related to acute target organ injury Acute presentation of serious medical conditions associated with …

Procedural Sedation (2013)

October 16, 2018 by PPE Medical

Inclusion: Patients of all age with emergent/urgent condition that require pain +/or anxiety management to accomplish interventional or diagnostic procedure High-risk patients (cardiopulmonary d/o, multiple/head trauma, CNS depressant) w understanding that these patients are at increased risk of complications from procedural sedation and analgesia. Exclusion: Inhalational anesthetics Analgesia for pain control without sedatives Sedation solely …

Seizures (2014)

October 16, 2018 by PPE Medical

Inclusion: Adult ≥ 18 with generalized convulsive seizures Exclusion: Pediatrics Complex partial seizures Acute head trauma Multi-system trauma Brain mass or tumor Immunocompromised patients Eclampsia. Level A: Administer additional antiepileptic medication in refractory status epilepticus who have failed treatment with BZDs Level B: Administer IV phenytoin, fosphenytoin, or valproate in refractory status epilepticus who have failed BZD …

Nontraumatic Thoracic Aortic Dissection (2014)

October 16, 2018 by PPE Medical

Inclusion: Adult ≥ 18 with suspected acute nontraumatic thoracic aortic dissection Exclusion: Traumatic aortic dissection, pediatric, pregnant Level A: None Level B: CTA to exclude thoracic aortic dissection (accuracy similar to that of TEE and MRA). Do not rely on abnormal bedside TTE result to definitively establish diagnosis Level C: Do not use clinical decision rules alone to …

Antibiotics for Abscesses

October 16, 2018 by PPE Medical

TMP-SMX vs Placebo for Uncomplicated Skin Abscess Talan DA et al.. “Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess”. NEJM. 2016. 374(9):823-832. PubMed Full text PDF Clinical Question In settings with MRSA, does Trimethoprim-sulfamethoxazole treatment after Incision and drainage of an abscess result in a greater cure rate? Conclusion Trimethoprim–sulfamethoxazole treatment resulted in a higher cure rate among patients with a drained cutaneous abscess than placebo for abscess that …

Are there too many ‘Doctors’?

September 28, 2025October 1, 2018 by Scott Biggs, PA-C

Higher Education

In our society significant emphasis is placed on higher education, specifically the number of levels of higher education. At one point in time, having a high school diploma was sufficient for most professions, and a college degree made you stand out and put you in line for management of some sort. Doctorate level education was reserved for professionals such as Physicians and Dentists, or career academics like college level professors. As more and more people went on to college and obtained degrees, the Bachelor’s degree replaced the High School diploma as the entry level of higher education and the Master’s degree was conferred upon those who sought more advanced training in specific fields and wished to further their careers.