40+ years of UMKC's Clinical Medical Librarian Program

Poster presented at the Quint Essential Conference: Convergence and Collaboration in Denver, Colorado, October 14, 201

Dislodging Anchored Diagnoses: An Unusual Presentation Of Acute Appendicitis

Cognitive errors are the most common cause of diagnostic errors in the process of clinical decision making. Recently, there has been an immense focus on the new science of error prevention in health care. Anchored thinking or heuristics is a form of cognitive error that portrays shortcuts or abbreviated thinking in the light of diagnostic uncertainty. The risk is of comfort in a typical scenario and not being able to adapt to a new situation. Here we present an intriguing case of acute appendicitis in a patient who was initially admitted and treated for hypothermia and alcohol withdrawal. As the patient recovered from his withdrawal and neared the end of his hospital stay, he developed persistent leukocytosis, mild metabolic acidosis and vague abdominal discomfort, leading us to pursue further work up resulting in a new diagnosis. If unrecognized, delayed diagnosis and significant harm with potential for rupture of the appendix, peritonitis, significant morbidity and even mortality could have occurred. This case serves as an example of how to avoid errors resulting from heuristic thinking for the reason that incongruity of data was specifically looked for and consequently recognized

Spinal Cord Injury and Autonomic Dysreflexia- A Case Report

Autonomic dysreflexia (AD) is a life threatening condition affecting patients with spinal cord lesions T6 level and above. A 51 year old male with a history of paraplegia due to a C6 spinal cord injury (30 years prior) presented with recurrent debilitating episodic diaphoresis, hypertension, low body temperature, and bradycardia. Previous hospitalizations presumed sepsis from UTI to be the etiology, however on further evaluation his symptoms were consistent with undiagnosed AD. This article describes a unique case presentation and reviews AD in depth, including the etiology, pathophysiology and management

Dislodging Anchored Diagnoses: An Unusual Presentation Of Acute Appendicitis

Cognitive errors are the most common cause of diagnostic errors in the process of clinical decision making. Recently, there has been an immense focus on the new science of error prevention in health care. Anchored thinking or heuristics is a form of cognitive error that portrays shortcuts or abbreviated thinking in the light of diagnostic uncertainty. The risk is of comfort in a typical scenario and not being able to adapt to a new situation. Here we present an intriguing case of acute appendicitis in a patient who was initially admitted and treated for hypothermia and alcohol withdrawal. As the patient recovered from his withdrawal and neared the end of his hospital stay, he developed persistent leukocytosis, mild metabolic acidosis and vague abdominal discomfort, leading us to pursue further work up resulting in a new diagnosis. If unrecognized, delayed diagnosis and significant harm with potential for rupture of the appendix, peritonitis, significant morbidity and even mortality could have occurred. This case serves as an example of how to avoid errors resulting from heuristic thinking for the reason that incongruity of data was specifically looked for and consequently recognized

Spinal Cord Injury and Autonomic Dysreflexia- A Case Report

Autonomic dysreflexia (AD) is a life threatening condition affecting patients with spinal cord lesions T6 level and above. A 51 year old male with a history of paraplegia due to a C6 spinal cord injury (30 years prior) presented with recurrent debilitating episodic diaphoresis, hypertension, low body temperature, and bradycardia. Previous hospitalizations presumed sepsis from UTI to be the etiology, however on further evaluation his symptoms were consistent with undiagnosed AD. This article describes a unique case presentation and reviews AD in depth, including the etiology, pathophysiology and management