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A 25-year-old female with no pertinent past medical history presented to an emergencydepartment in Massachusetts with four days of generalized malaise, myalgias, congestion, low-grade fever, and a rash behind her left knee. link] www.cdc.gov/lyme/ Steere AC. Clin Infect Dis. 2010 Feb 15;50(4):512-20. doi: 10.1086/649920.
Bupe Allergy Buprenorphine induction has been the mainstay of emergencydepartment treatment of opioid use disorder for more than a decade [11, 12]. DOI: Papudesi BN, Malayala SV, Regina AC. Emergencydepartment–initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial.
Owen Hibberd The use and utility of the paediatric oral fluid challenge in a single tertiary paediatric emergencydepartment Why? The paediatric oral fluid challenge (OFC) has been a staple in emergencydepartments for years, helping to determine which children struggling with oral intake truly need IV fluids.
Acute toxic ingestions are a common reason for presentation to the emergencydepartment (ED) and clinical scenarios range from benign accidental ingestions to large overdoses resulting in hemodynamic instability. Papudesi BN, Malayala SV, Regina AC. Wagner ML, Pergolizzi J Jr, LeQuang JAK, et al. 2023;15(6):e40688. 2023 Jul 17.
Paper: Alwang AK, Law AC, Klings ES, Cohen RT, Bosch NA. PMID: 28106307 Alwang AK, Law AC, Klings ES, Cohen RT, Bosch NA. To assess the clinical impact and relevance of these concerns, Alwang et al. performed the retrospective cohort study below ( Alwang 2024 ). JAMA Intern Med. 2024;184(11):1365-1372. Microcirculation.
link] Hummell AC, Cummings M. HIV Prevention and Treatment: The Evolving Role of the EmergencyDepartment. Ann Emerg Med. Undernourished children presenting to an urban emergencydepartment of a tertiary hospital in Tanzania: a prospective descriptive study. Accessed October 5, 2024. 2022;37(1):41-49.
Blood sampled from existing peripheral IV cannulae yields results equivalent to venepuncture: a systematic review [ 10.1177/2054270419894817 ] Second Line 18 G Should we be placing in the AC? Questions Before Joining (FAQ) Join Now! Future Show: Upping your IV Game Fluids Get dinged for 4, rectal temps on elderly, etc.
Emergent EEG in the emergencydepartment in patients with altered mental states. The new wave: time to bring EEG to the emergencydepartment. Int J Emerg Med. Can patients with non-convulsive seizure be identified in the emergency department? Zehtabchi S, Abdel Baki SG, Malhotra S, Grant AC.
Communicate with EmergencyDepartment teams: Let them know if you suspect medetomidine exposure, especially in cases of incomplete naloxone response or bradycardia. ACS Chemical Neuroscience, 15(21), 3874–3883. Use naloxone wisely: Titrate to restore respiration, not to wake the patient. References 1. de Andrade Horn, P.,
Vision loss carries a high degree of morbidity and is associated with higher all-cause mortality, 4 and it is our role as emergency providers to recognize potentially reversible causes of such adverse outcomes. 5 Epidemiology Onchocerciasis is endemic in 31 African countries but is also problematic in Brazil, Venezuela, and Yemen.
Reviews and opinion articles Disparities in Pediatric Mental Health Care in EmergencyDepartments: A Scoping Review. Katheria AC, et al. Both cystatin C and creatinine show promise as helpful biomarkers for detecting early kidney function decline in at-risk groups. You will find the list is broken down into four sections: 1.Reviews
10 g/dL in patients with acute coronary syndrome (ACS). A 55-year-old man with a history of left lung squamous cell carcinoma who is currently undergoing chemotherapy presents to the emergencydepartment with hemoptysis. Foreign bodies in the nose and ear: a review of techniques for removal in the emergencydepartment.
HIV Prevention and Treatment: The Evolving Role of the EmergencyDepartment. Ann Emerg Med. link] Jung AC, Paauw DS. He has been having unprotected receptive anal intercourse with two male sexual partners over the past 6 months. Sultan Qaboos Univ Med J. 2012;12(4):442-448. 2017;70(4):562-572.e3. J Clin Invest.
Diagnosing PE in the emergencydepartment is tricky. Cardiovascular Read More REBEL Cast Ep114: High Flow O2, Suspected ACS, and Mortality? Cardiovascular Read More REBEL Core Cast – Basics of EM – Chest Pain Take Home Points Take chest pain seriously – ACS and PE. Where do you start?
In fifteen years of practice in trauma and emergency medicine (Mother of God, fifteen years) Ive seen patient dignity shredded down to near nothingness, to more or less an afterthought, to an empty signifier, a catchphrase for foundation advertising. Questions Before Joining (FAQ) Join Now!
Presented to the emergencydepartment with hyperglycemia, hypertension, general body aches, and concern that skin is dry and peeling. Differential diagnoses include hyperglycemia, DKA, and ACS. The patient denies chest pain or SOB First EKG Old EKG 1 year prior EKG 2 at 1.5
Trauma season is at hand and like all other pediatric emergencydepartments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. Pediatr Emerg Care. We see all different flavors of upper extremity injuries. J Bone Joint Surg Br. 2001;83:1173-5. Oakley EA, Ooi KS, Barnett PLJ.
You turn to the attending and ask, “do you really think this could be acute coronary syndrome (ACS)?” Background: Patients 65 years and older account for about 15% of emergencydepartment visits in the United States. The proportion of patients with ACS at the index visit or within 30 days. *
A 5-year-old female presented to the emergencydepartment (ED) with a one-year history of gradually increasing anterior neck swelling. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper DS, Kim BW, Peeters RP, Rosenthal MS, Sawka AM; American Thyroid Association Task Force on Thyroid Hormone Replacement.
Rapid Administration of Methoxyflurane to Patients in the EmergencyDepartment (RAMPED): A Randomised controlled trial of Methoxyflurane vs Standard care. […] The post SGEM#320: The RAMPED Trial – It’s a Gas, Gas, Gas first appeared on The Skeptics Guide to Emergency Medicine. Reference: Brichko et al. Reference: Brichko et al.
He presented to the EmergencyDepartment with a blood pressure of 111/66 and a pulse of 117. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. Then ACS (STEMI) might be primary; this might be cardiogenic shock. One must clearly rule out these processes before jumping on the ACS diagnosis.
Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. If we thought about ACS, we brought them in. AEM June 2022.
He arrived in the emergencydepartment hemodynamically stable. ACS would be highly unusual in a young athlete, and given the information on his race bib, one must first suspect that the abnormal ST elevation is due to demand ischemia, not ACS. On his bib it stated that he had a congenital heart disorder.
Guidelines for Reasonable and Appropriate Care in the EmergencyDepartment (GRACE) 2: Low-Risk, Recurrent Abdominal Pain in the EmergencyDepartment. Guidelines for Reasonable and Appropriate Care in the EmergencyDepartment (GRACE) 2: Low-Risk, Recurrent Abdominal Pain in the EmergencyDepartment.
It is commonly used in EmergencyDepartments, especially in febrile and possibly infectious patients. ACS and Aortic Dissection - For ACS and Dissection, the higher CRP levels, the worse prognosis. It is not used to diagnose ACS/Dissection. Utility of CRP 1.
Case 1: Case 2: Case 3: Triage ECGs labeled ‘normal’ There have been a number of small studies suggesting that triage ECGs labeled ‘normal’ are unlikely to have clinical significance, and therefore that emergency physicians should not be interrupted to interpret them, and that such patients can safely wait to be seen.
It should be emphasized here that this is a presentation of high-pretest probability for Acute Coronary Syndrome (ACS). ACS and hyperkalemia both have lethal downstream consequences, so it is imperative for the clinician to acclimate to the presentation, or developing, features of each. ECG's are difficult. link] [1] Zachary et al.
Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the EmergencyDepartment (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergencydepartment. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.
She arrives in the emergencydepartment (ED) with decreased level of consciousness and shock. Acute coronary syndrome (ACS) is responsible for the majority (60%) of all OHCAs in patients. She has a history of hypertension and non-insulin dependent diabetes mellitus.
The parents of 18-month-old Susie brought her to the EmergencyDepartment after she had a seizure at home. The role of brain computed tomography in evaluating children with new onset of seizures in the emergencydepartment. Emergency management of the paediatric patient with convulsive status epilepticus.
The fire department, who operate at an EMT level in this municipality, arrived before us and administered 324 mg of baby aspirin to the patient due to concern for ACS. Upon arrival to the emergencydepartment, a senior emergency physician looked at the ECG and said "Nothing too exciting." References: 1.
A 41-year-old male who presents to the emergencydepartment with chest pain. The faculty physician thought this is highly likely to be ACS. Patient reports approximately 2 hours prior to arrival he developed a sharp chest pain that radiates into his left arm and left lower leg. Describes the radiating pain as numbness/tingling.
Smith comment : Is the ACS (rupture plaque) with occlusion that is now reperfusing? Diagnosis of Type I vs. Type II Myocardial Infarction in EmergencyDepartment patients with Ischemic Symptoms (abstract 102). Annals of Emergency Medicine 2011; Suppl 58(4): S211. Assuming that was indeed a culprit, then this was ACS.
Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergencydepartment at around 3 AM complaining of chest pain onset around 9 PM the evening prior.
1 It is a quickly deployable and easily interpreted study that can be done in real time to guide decisions in the EmergencyDepartment. Point of care biliary ultrasound in the emergencydepartment (BUSED) predicts final surgical management decisions. and specificity of 88.0% Trauma Surg Acute Care Open.
, tells us that we physicians do not need to even look at this ECG until the patient is placed in a room because the computer says it is normal: Validity of Computer-interpreted “Normal” and “Otherwise Normal” ECG in EmergencyDepartment Triage Patients I reviewed this article for a different journal and recommended rejection and it was rejected.
A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergencydepartment after being found unresponsive at home. Vital signs were within normal limits on arrival to the EmergencyDepartment. Written by Bobby Nicholson What do you think of this “STEMI”? Blood glucose was not low at 162 mg/dL.
The measure, developed in collaboration with the American College of Surgeons (ACS), the Institute for Healthcare Improvement (IHI) and the American College of Emergency Physicians (ACEP), aims to improve older adult patient care and outcomes. Read the CMS fact sheet here. “It Hartford Foundation and ACEP.
University of Maryland Department of Emergency Med
APRIL 30, 2023
In this study the researchers looked at patients presenting to the emergencydepartment with high suspicion for ACS and explored if. Click to view the rest
There are greater than 2 million annual emergencydepartment visits for suspected renal colic in the US, and Ct scanning is performed for more than 90% of patients who receive a diagnosis of kidney stone. PMID: 25229916 DOI: 10.1056/NEJMoa1404446 Westphalen AC, Hsia RY, Maselli JH, Wang R, Gonzales R. N Engl J Med.
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