Emergency medicine

2,327 articles · Since 2004

Emergency physicians, nurses, and residents writing on KevinMD from the emergency department: acute care, the realities of the ER, boarding and overcrowding, violence against staff, and medicine practiced under pressure. Most contributors work in emergency departments. For what emergency physicians and nurses have said about being assaulted at work and told it was part of the job, see Violence against health care workers: what physicians and nurses say, in their own words. For what emergency physicians wrote in the first weeks and months of the pandemic, see COVID-19: what physicians wrote as it happened. For what emergency physicians and pain patients have said about opioid prescribing, see Opioids: what physicians and pain patients say, in their own words. For what physicians in the highest-burnout specialty have said about burnout since 2009, see Physician burnout: what physicians say, in their own words.

Latest articles

Conditions and diseases

Sedation after intubation cannot be an afterthought

Dr. Girishkumar Modi

November 6, 2026Nov 6, 2026

An emergency intubation can create a moment of relief. The breathing tube is in place, its position is confirmed, and the ventilator is supporting a patient who may have been deteriorating only minutes earlier. But the procedure has not answered another urgent question: What happens when the drug that made the patient unconscious wears off, especially if the drug preventing movement is still working?

In anesthesiology, paralysis, sedation, and pain relief …

Conditions and diseases

What the 2026 MI definition means for myocardial injury

Dr. Tarik Alsalih

November 5, 2026Nov 5, 2026

An elevated cardiac troponin level often changes the trajectory of a clinical encounter. A patient presents with pneumonia, severe anemia, tachycardia, hypoxemia, or another acute illness, and the troponin comes back above the laboratory's upper reference limit. The immediate question…

An elevated cardiac troponin level often changes the trajectory of a clinical encounter. A patient presents with pneumonia, severe anemia, tachycardia, hypoxemia, or another acute illness, and the troponin comes back above the laboratory’s upper reference limit. The immediate question is often: “Is this a myocardial infarction?” The answer is not necessarily.

The Fifth Universal Definition of Myocardial Infarction (UDMI), released in 2026 by the European Society of Cardiology, American …

Health technology

Shadow AI: why clinicians paste patient data into chatbots

Harvey Castro, MD, MBA

November 5, 2026Nov 5, 2026

It's 3 a.m. There's a septic patient in room 6 and someone intoxicated yelling in the hallway. A 78-year-old on eleven medications is going home, and her daughter needs discharge instructions she can actually follow. The hospital's approved AI tool…

It’s 3 a.m. There’s a septic patient in room 6 and someone intoxicated yelling in the hallway. A 78-year-old on eleven medications is going home, and her daughter needs discharge instructions she can actually follow. The hospital’s approved AI tool sits behind two logins and only runs on a desktop. The chatbot on your phone opens with one tap.

Most clinicians I know have felt that pull. Some have given in.

Late …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Physician voices

Are civilian hospitals ready for 1,000 war casualties a day?

Matthew Turner, MD & Kaitlin Rainwater-Lovett, PhD, MD

November 3, 2026Nov 3, 20262

The looming threat of LSCO It has been decades since the United States has experienced sustained, high-casualty large-scale combat operations (LSCO) at the level of the Second World War, the Korean War, and Vietnam. However, in the changing geopolitical landscape,…

The looming threat of LSCO

It has been decades since the United States has experienced sustained, high-casualty large-scale combat operations (LSCO) at the level of the Second World War, the Korean War, and Vietnam. However, in the changing geopolitical landscape, the possibility of the U.S. entering LSCO is high. Within the next decade, these conflicts are most likely to be with near-peer adversaries in complex, austere, and ambiguous environments.

In …

Health technology

AI in radiology: A missing flag is not a negative read

Harvey Castro, MD, MBA

October 29, 2026Oct 29, 2026

Picture a busy ED at 1 a.m. A CT pulmonary angiogram comes back from the scanner. The worklist shows no AI flag for pulmonary embolism. The radiologist has 30 studies in the queue. The patient's heart rate is still 112.…

What does the missing flag mean? A new study says: less than most of us assume.

On Oct. 21, researchers at Emory published a look at two FDA-cleared PE detection algorithms …

Health technology

Read clinical AI the way you read an incomplete chart

J. Wayne Saul, MD

October 27, 2026Oct 27, 2026

Every shift, I read charts that are missing something. The patient can't tell me when the pain started. The outside records haven't come through. The family remembers a different medication list than the pharmacy does. I am not going to…

Every shift, I read charts that are missing something.

The patient can’t tell me when the pain started. The outside records haven’t come through. The family remembers a different medication list than the pharmacy does. I am not going to get a complete account, and waiting for one is how people die in hallways. So I do what emergency physicians do: I work from what is actually in front of me, …

Physician voices

What The Hunger Games reveals about moral injury in medicine

Dr. Rida Jawed

October 23, 2026Oct 23, 20263

Shortly after graduating from my emergency medicine training, I reread The Hunger Games by Suzanne Collins. I didn't expect a dystopian novel to follow me into the emergency department, but it did. Somewhere between ambulance radios, a full waiting room,…

Shortly after graduating from my emergency medicine training, I reread The Hunger Games by Suzanne Collins. I didn’t expect a dystopian novel to follow me into the emergency department, but it did. Somewhere between ambulance radios, a full waiting room, and those pages, I realized how familiar the logic felt. Not the violence. The structure.

Both worlds revolve around the same question: What happens when there isn’t enough, and someone has …

Medical education

Trauma-informed consent does not end when the exam begins

Michael Duell

October 21, 2026Oct 21, 2026

She wanted treatment. She understood why she needed it. But when it came to the intimate part of her care, she struggled to continue. The patient had survived sexual assault. Now, years later, medically necessary treatment required her to expose…

She wanted treatment. She understood why she needed it. But when it came to the intimate part of her care, she struggled to continue.

The patient had survived sexual assault. Now, years later, medically necessary treatment required her to expose her body, tolerate intimate examination, and surrender some degree of physical control to people she rarely knew.

By the conventional markers of informed consent, nothing appeared to have gone wrong. The treatment …

Conditions and diseases

What a reassuring sepsis screening score can hide

Dr. Gautam Kumar Panjiyar

October 20, 2026Oct 20, 2026

Sepsis remains one of the most time-critical diagnoses an emergency physician can miss. Every hour that antibiotic administration is delayed after the onset of septic shock has been linked to rising mortality, yet the very tools designed to flag sepsis early, the quick Sequential Organ Failure Assessment (qSOFA) foremost among them, have come under growing scrutiny for missing patients until they are already critically unwell. Since the Sepsis-3 consensus introduced …

Patient voices

Emergency medicine: a tribute and call to action from an old friend

John Holstein

October 17, 2026Oct 17, 20262

I write to you as a person with four decades of experience on the business side of health care, specifically in the revenue cycle industry. Importantly in those forty years, the overwhelming majority of my time was spent serving all of you in emergency medicine. At the outset of this article, I wish to express my appreciation and gratitude to each, and every one of you, for the opportunity to …

Physician voices

6 lessons from William Osler for emergency medicine

Dr. Rida Jawed

October 17, 2026Oct 17, 2026

Emergency medicine has changed dramatically since Sir William Osler practiced medicine. Our departments now run on rapid triage, bedside ultrasound, advanced imaging, resuscitation protocols, electronic records, and increasingly sophisticated decision tools. Yet some of the hardest parts of the job…

Yet some of the hardest parts of the job have changed very little. We still make decisions with incomplete information. We still care for frightened patients and families on some of the worst days of their lives. We still make …

Health technology

How to catch AI scribe errors before you sign the note

Harvey Castro, MD, MBA

October 15, 2026Oct 15, 2026

Ambient AI scribes have earned a place in a lot of emergency departments, and I understand why. Documentation in emergency medicine is relentless, and anything that gives time back at the end of a shift gets attention. Some of the…

Some of the hype holds up. A single-center study in JMIR AI this year followed more than 10,000 emergency encounters over 13 months and tied scribe use to about 73 seconds less documentation …

Physician voices

AI diagnosis can list 100 causes but can’t examine you

Duane Penshorn, MD

October 13, 2026Oct 13, 2026

The triage note read, "The patient wants her thyroid checked." On the stretcher, fully dressed, sat a 65-year-old woman with her family members at the bedside. She said she had been feeling weak and tired lately, so bad that even…

The triage note read, “The patient wants her thyroid checked.”

On the stretcher, fully dressed, sat a 65-year-old woman with her family members at the bedside. She said she had been feeling weak and tired lately, so bad that even her voice had turned hoarse. She’d never had any problems with her thyroid in her life, but she had looked it up; maybe it was her thyroid or anemia. That was …

The Podcast by KevinMD

Trusting the lab over the patient is the new medical error [PODCAST]

The Podcast by KevinMD

October 9, 2026Oct 9, 2026

The lab says the potassium is critically low. You walk in, and the patient looks completely fine. Duane Penshorn is an emergency physician and author. This episode is based on his article "Automation bias is the new medical error," published…

Listen on Apple Podcasts · Spotify

Listen and followApple Podcasts Spotify YouTubeMore apps · Browse all episodes

The lab says the potassium is critically low. You walk in, and the patient looks completely fine. Duane Penshorn is an emergency physician and author. This episode is based on his article “Automation bias is the new medical error,” published on KevinMD. He explains that automation bias got its …

Physician voices

Physician leaders at the bedside see what dashboards miss

Manoj Sreedharan, MD

October 8, 2026Oct 8, 2026

Some of the most useful information I get as a medical director does not come from a dashboard or a meeting. It comes from working a clinical shift. When you are seeing patients alongside the people affected by the processes…

Some of the most useful information I get as a medical director does not come from a dashboard or a meeting. It comes from working a clinical shift.

When you are seeing patients alongside the people affected by the processes you help oversee, problems become difficult to ignore. You see where the workflow slows down, where responsibilities are unclear, and where a seemingly simple administrative change creates extra work. That is …

Health policy

First Nations mental health care must not end at discharge

Olumuyiwa Bamgbade, MD

October 1, 2026Oct 1, 2026

An emergency department can stabilize a mental health crisis. It cannot, by itself, provide the relationships, housing, and continuing support that sustain recovery. For First Nations patients in Canada, we should promote mental health and substance use services that communities help govern, and patients can reach before, during, and after a crisis. For example, a patient receives instructions to arrange counseling, attend substance misuse therapy, and return if symptoms worsen. …

Physician voices

Why I wrote an emergency medicine novel about 1 night

Matt Barmmer, MD

September 25, 2026Sep 25, 2026

Every patient who has spent time in an emergency department knows it's overcrowded. They've sat in the waiting room for hours. They've watched physicians move fast and nurses move faster. They've heard the department through the curtain: the monitor alarms,…

Every patient who has spent time in an emergency department knows it’s overcrowded. They’ve sat in the waiting room for hours. They’ve watched physicians move fast and nurses move faster. They’ve heard the department through the curtain: the monitor alarms, the overhead pages, the sound of a place where everyone is doing too many things at once.

What they haven’t seen is the board.

The board is how an emergency physician experiences …

Health technology

ChatGPT for triage: 5 rules I teach ER residents

Harvey Castro, MD, MBA

September 22, 2026Sep 22, 2026

I work in Dallas-Fort Worth (DFW) emergency departments where Spanish and English share the same hallway. Residents ask me the same question every block: Can we use ChatGPT for triage? My answer is short. You can use it to practice…

I work in Dallas-Fort Worth (DFW) emergency departments where Spanish and English share the same hallway. Residents ask me the same question every block: Can we use ChatGPT for triage?

My answer is short. You can use it to practice thinking. You cannot use it to decide who waits. Here is what I actually teach on shift and in conference.

1. Fluency is not acuity

A clean English summary can hide a Spanish …

Physician voices

How emergency medicine decision making works under pressure

Geoffrey Mount Varner, MD, MPH

September 20, 2026Sep 20, 2026

Ask most physicians outside emergency medicine how they'd handle a patient presenting with three possible diagnoses, incomplete labs, and a deteriorating vital sign trend, and you'll usually get a version of "I'd want more information first." Ask an ER physician…

Ask most physicians outside emergency medicine how they’d handle a patient presenting with three possible diagnoses, incomplete labs, and a deteriorating vital sign trend, and you’ll usually get a version of “I’d want more information first.” Ask an ER physician the same question, and you’ll get an action plan within seconds. That gap isn’t intelligence. It’s training. And I think it’s worth naming exactly what that training builds, because most …

Physician voices

Why I stay in emergency medicine: a dancer at nearly 100

Howie Mell, MD, MPH

September 19, 2026Sep 19, 2026

People ask what being an emergency physician is like, and they expect the blood, the saves, the codes, the worst nights. Those happen, and they matter, but I try not to carry those home. What I try to keep is…

Emergency medicine

Latest articles

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular