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Emergency Medicine Clinics of North America

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https://read.qxmd.com/read/30940380/obstetric-and-gynecologic-emergencies
#1
EDITORIAL
Joelle Borhart, Rebecca A Bavolek
No abstract text is available yet for this article.
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940379/obstetric-and-gynecological-emergencies
#2
EDITORIAL
Amal Mattu
No abstract text is available yet for this article.
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940378/erratum
#3
(no author information available yet)
No abstract text is available yet for this article.
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940377/resuscitation-of-the-pregnant-patient
#4
REVIEW
Philippa N Soskin, Jennifer Yu
Many health care providers lack familiarity with maternal physiologic changes and the distinctive underlying etiology of cardiac arrest in pregnancy. Knowledge of what changes are expected in pregnancy and an understanding of how to adapt clinical practice is essential for the care of the pregnant woman in the emergency department. Amniotic fluid embolism should be recognized as a rare cause of cardiac arrest in pregnancy, characterized by the triad of cardiovascular collapse, hypoxic respiratory failure, and coagulopathy...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940376/cardiovascular-emergencies-in-pregnancy
#5
REVIEW
Joelle Borhart, Jessica Palmer
Cardiovascular disease has overtaken all other causes of maternal death in the United States. The physiologic changes of pregnancy place a significant amount of stress on the cardiovascular system and put pregnant women at risk for potentially catastrophic complications, such as pulmonary embolism, aortic or coronary artery dissection, myocardial infarction, and peripartum cardiomyopathy. The diagnosis of these conditions is challenging because the symptoms can mimic those experienced in normal pregnancies...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940375/trauma-in-pregnancy
#6
REVIEW
Jeffrey Sakamoto, Collin Michels, Bryn Eisfelder, Nikita Joshi
Although trauma in pregnancy is rare, it is one of the most common causes of morbidity and mortality to pregnant women and fetus. Pathophysiology of trauma is generally time sensitive, and this is still true in pregnant patients, with the additional challenge of rare presentation and balancing the management of two patients concurrently. Successful resuscitation requires understanding the physiologic changes to the woman throughout the course of pregnancy. Ultimately, trauma management is best approached by prioritizing maternal resuscitation...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940374/hypertensive-disorders-of-pregnancy
#7
REVIEW
R Gentry Wilkerson, Adeolu C Ogunbodede
The 4 categories of hypertensive disorders of pregnancy are chronic hypertension, gestational hypertension, preeclampsia-eclampsia, and chronic hypertension with superimposed preeclampsia. These disorders are among the leading causes of maternal and fetal morbidity and mortality. Proper diagnosis in the emergency department is crucial in order to initiate appropriate treatment to reduce the potential harm to the mother and the fetus. Prompt management should be undertaken when the blood pressure is greater than 160/110 mm Hg or there are other severe features such as acute kidney injury, elevated liver function tests, severe abdominal pain, pulmonary edema, and central nervous system disturbances...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940373/postdelivery-emergencies
#8
REVIEW
Natasha Wheaton, Aws Al-Abdullah, Tyler Haertlein
This article covers a high-risk time in a woman's life, the period just after delivery of her baby. There are large variations in complication rates across various groups in the United States. Many women seek care in the emergency department for routine and more serious postpartum pathologies. Emergency physicians should be well versed in common and life-threatening complications of delivery. The specific pathologies discussed in this article include lactation in the emergency department, postpartum hemorrhage, amniotic fluid embolism, endometritis, and mastitis...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940372/late-pregnancy-and-postpartum-emergencies
#9
REVIEW
Natasha Wheaton, A Al-Abdullah, Tyler Haertlein
The period just after delivery is a high-risk period for women with associated morbidity and even mortality. There are large variations in complication rates across various groups in the United States. This article covers complications commonly encountered in the emergency department in late pregnancy and the early postpartum period. It specifically addresses postpartum depression, peripartum cardiomyopathy, and the late pregnant or postpartum patient presenting with headache or neurologic complaints. Emergency physicians should be well versed in common and life-threatening postpartum pathologies...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940371/precipitous-labor-and-emergency-department-delivery
#10
REVIEW
Joelle Borhart, Kathryn Voss
A precipitous delivery can be among the most stressful events an emergency physician encounters. The physician must assess 2 patients (mother and fetus) and be prepared to manage a variety of complications that may arise during delivery. A majority of precipitous deliveries result in good outcomes for both mother and baby, but emergency physicians must be prepared to manage feared complications, such as tight nuchal cords, shoulder dystocia, and breech presentation. An understanding of the labor process as well as advanced planning can help decrease the stress and chaos inherent to any precipitous delivery...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940370/vaginal-bleeding-in-late-pregnancy
#11
REVIEW
Janet S Young, Lindsey M White
Bleeding in late-term pregnancy can present as an innocuous start to parturition or a catastrophic maternal-fetal hemorrhage masked by the physiologic adaptations of pregnancy. The emergency management of late-term bleeding can be challenging, especially when providing stabilizing care in a limited-resource environment. Early recognition of life-threatening vaginal bleeding, potential causes, and emergency management of maternal-fetal distress is reviewed. Maternal resuscitation with balanced versus targeted blood products replacement is presented for low-resource versus high-resource environments...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940369/complications-of-assisted-reproductive-technology
#12
REVIEW
SueLin M Hilbert, Stephanie Gunderson
Although only accounting for a small percentage of infants born in the United States each year, assisted reproductive technology (ART) has become a more common means of conception since the first in vitro fertilization baby was born in 1978. An understanding of the ART process, medications, and complications is becoming essential for emergency medicine practice. Much of the surveillance data focuses on ART complications that are likely to be less relevant in the acute care setting, but ovarian hyperstimulation syndrome, ectopic pregnancy, and ovarian torsion are 3 diagnoses with high potential morbidity and mortality that emergency physicians should not miss...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940368/complications-in-early-pregnancy
#13
REVIEW
Elizabeth Pontius, Julie T Vieth
Early in pregnancy women frequently experience nausea, vomiting, and vaginal bleeding. Nausea and vomiting can be mild, managed by dietary modifications and medications, or severe, requiring intravenous fluids and medications. Care should be used when selecting medications for nausea to avoid additional side effects or potential harm to the developing fetus. When evaluating vaginal bleeding in early pregnancy, ectopic pregnancy must be ruled out. If an intrauterine pregnancy is seen, threatened miscarriage should be considered and the patient appropriately counseled...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940367/acute-pelvic-pain
#14
REVIEW
Kayla Dewey, Cory Wittrock
Acute pelvic pain has gynecologic and nongynecologic causes, and distinguishing between them can be difficult in the emergency department. Ovarian cysts, adnexal torsion, and pelvic inflammatory disease are conditions that emergency physicians must be able to identify. Pelvic pathologic condition can be readily assessed with ultrasound but has significant limitations. Adnexal torsion can occur despite normal vasculature on ultrasound with Doppler; patients with significant pain or risk factors may require exploratory laparotomy...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940366/genital-complaints-at-the-extremes-of-age
#15
REVIEW
Sara Manning
Variations in estrogen levels across a woman's lifetime lead to important changes in genital physiology and pathophysiology. Low estrogen states like menopause and the prepubertal period share important physiologic changes, including more friable, dry, and inelastic mucosa that is prone to irritation, injury, and infection. These and other factors lead to unique gynecologic pathologic conditions encountered at the extremes of age. Age-specific pathologic conditions and differences in examination techniques are discussed...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940365/sexually-transmitted-diseases-in-the-emergency-department
#16
REVIEW
Camiron L Pfennig
Sexually transmitted diseases (STDs) continue to be underrecognized leading to devastating health and economic consequences. Emergency clinicians play an important role in diagnosing and managing STDs and in improving health care outcomes for both the patient and their partners. In addition, antibiotic resistance and emerging infections continue to challenge providers in clinical practice. This review focuses on the cause, history, physical examination, diagnostic studies, and treatment strategies for bacterial vaginosis, chlamydia, genital herpes, gonorrhea, human papillomavirus, granuloma inguinale, Lymphogranuloma Venereum, Mycoplasma genitalium, syphilis, and trichomoniasis...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30940364/the-patient-with-non-pregnancy-associated-vaginal-bleeding
#17
REVIEW
Pamela L Dyne, Teri Anne Miller
Abnormal uterine bleeding (AUB) unrelated to pregnancy affects 20% to 30% of women at some point in life and is a common emergency department (ED) and urgent care (UC) presentation. AUB is a complex condition with extensive terminology, broad differential diagnosis, and numerous treatment options, yet few published evidence-based guidelines. In the ED or UC setting most affected patients are often more frustrated than acutely ill. These factors can make for a challenging patient encounter in the EC/UC setting...
May 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30454786/erratum
#18
(no author information available yet)
No abstract text is available yet for this article.
February 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30454785/ear-nose-and-throat-emergencies
#19
EDITORIAL
Laura J Bontempo, Jan Shoenberger
No abstract text is available yet for this article.
February 2019: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/30454784/ears-nose-and-throat-emergencies
#20
EDITORIAL
Amal Mattu
No abstract text is available yet for this article.
February 2019: Emergency Medicine Clinics of North America
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