It was Midnight in the ER

"It was midnight in the Emergency Room. I was the senior resident on call with an intern and we were working on our seventh admission of the shift. As the intern finished the paperwork from the previous admission, I grabbed the next chart and began to scan the work up already performed by the ER staff. We were admitting a 45 year old gentleman previously seen by his primary care physician the previous day. He was sent to the hospital for fever and headache with the possible diagnosis of West Nile Virus infection. I remembered a medical school lecture on this topic many years ago, and I knew what to do for both viral and bacterial meningitis, but had no idea as to what to do for West Nile Viral infections. I pulled out my palm and accessed Skyscape's version of Griffith's 5 minute Medical Consult and to my surprise, I found a helpful monograph on West Nile Virus infection. There were also several other monographs on additional causes of encephalopathy which helped me to construct the differential diagnoses, determine other necessary lab tests, discuss the case intelligently with the both the intern and the attending physician on call, and quickly finish the admission before moving on to the next waiting patient. What a timesaver as well as an educational tool! "

Dana Perrin, PGY-2 Family Practice Resident, The University of South Florida