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Emergency Medicine Clinics of North America

https://read.qxmd.com/read/38641401/frontiers-in-emergency-department-infectious-disease-management
#1
EDITORIAL
Bradley W Frazee, Michael S Pulia, Christopher M Colbert
No abstract text is available yet for this article.
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641400/infectious-disease-emergencies
#2
EDITORIAL
Amal Mattu
No abstract text is available yet for this article.
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641399/managing-antimicrobial-resistance-in-the-emergency-department
#3
REVIEW
Julianne Yeary, Larissa Hacker, Stephen Y Liang
(Basic awareness and understanding of antimicrobial resistance and prevailing mechanisms can aid emergency physicians in providing appropriate care to patients with infections due to a multidrug-resistant organism (MDRO). Empiric treatment of MDRO infections should be approached with caution and guided by the most likely pathogens based on differential diagnosis, severity of the illness, suspected source of infection, patient-specific factors, and local antibiotic susceptibility patterns. Newer broad-spectrum antibiotics should be reserved for critically ill patients where there is a high likelihood of infection with an MDRO...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641398/optimizing-antimicrobial-stewardship-in-the-emergency-department
#4
REVIEW
Julia Sapozhnikov, Fritzie S Albarillo, Michael S Pulia
Antibiotic stewardship is a core component of emergency department (ED) practice and impacts patient safety, clinical outcomes, and public health. The unique characteristics of ED practice, including crowding, time pressure, and diagnostic uncertainty, need to be considered when implementing antibiotic stewardship interventions in this setting. Rapid advances in pathogen detection and host response biomarkers promise to revolutionize the diagnosis of infectious diseases in the ED, but such tests are not yet considered standard of care...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641397/coronavirus-disease-2019-past-present-and-future
#5
REVIEW
Charlotte Page Wills, Berenice Perez, Justin Moore
Severe acute respiratory syndrome coronavirus 2 is one of the most impactful diseases experienced in the past century. While the official national health emergency concluded in May of 2023, coronavirus disease 2019 (COVID-19) continues to mutate. As the summer of 2023, all countries were experiencing a new surge of cases from the EG.5 Omicron variant. Additionally, a new genetically distinct Omicron descendant BA2.86 had been detected in multiple countries including the United States. This article seeks to offer lessons learned from the pandemic, summarize best evidence for current management of patients with COVID-19, and give insights into future directions with this disease...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641396/the-intersection-of-substance-use-disorders-and-infectious-diseases-in-the-emergency-department
#6
REVIEW
Erik S Anderson, Bradley W Frazee
Substance use disorders (SUDs) intersect clinically with many infectious diseases, leading to significant morbidity and mortality if either condition is inadequately treated. In this article, we will describe commonly seen SUDs in the emergency department (ED) as well as their associated infectious diseases, discuss social drivers of patient outcomes, and introduce novel ED-based interventions for co-occurring conditions. Clinicians should come away from this article with prescriptions for both antimicrobial medications and pharmacotherapy for SUDs, as well as an appreciation for social barriers, to care for these patients...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641395/communicable-disease-screening-and-human-immunodeficiency-virus-prevention-in-the-emergency-department
#7
REVIEW
Douglas A E White, Rachel E Solnick
Emergency departments (ED) provide care to populations with high rates of communicable diseases, like HIV, hepatitis C virus, and syphilis. For many patients, the ED is their sole entry point into the healthcare system and they do not routinely access screening and prevention services elsewhere. As such, the ED can serve an important public health role through communicable disease identification, treatment, and prevention. In this article, we examine national recommendations, peer-reviewed literature, and expert consensus to provide cutting edge strategies for implementing communicable infectious disease screening and prevention programs into routine ED care...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641394/sexually-transmitted-infections-in-the-emergency-department
#8
REVIEW
Rachel E Solnick, Laura Hernando López, Patricia Mae Martinez, Jason E Zucker
As the United States faces a worsening epidemic of sexually transmitted infections (STIs), emergency departments (EDs) play a critical role in identifying and treating these infections. The growing health inequities in the distribution and disproportionate impact of STIs add to the urgency of providing high-quality sexual health care through the ED. Changes in population health are reflected in the new Centers for Disease Control recommendations on screening, diagnostic testing, and treatment of STIs. This review covers common, as well as and less common or emerging STIs, and discusses the state-of-the-art guidance on testing paradigms, extragenital sampling, and antimicrobial treatment and prevention of STIs...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641393/fever-and-rash
#9
REVIEW
Richard Diego Gonzales Y Tucker, Aravind Addepalli
Infectious causes of fever and rash pose a diagnostic challenge for the emergency provider. It is often difficult to discern rashes associated with rapidly progressive and life-threatening infections from benign exanthems, which comprise the majority of rashes seen in the emergency department. Physicians must also consider serious noninfectious causes of fever and rash. A correct diagnosis depends on an exhaustive history and head-to-toe skin examination as most emergent causes of fever and rash remain clinical diagnoses...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641392/tick-borne-diseases
#10
REVIEW
Wesley Eilbert, Andrew Matella
Ticks are responsible for the vast majority of vector-borne illnesses in the United States. The number of reported tick-borne disease (TBD) cases has more than doubled in the past 20 years. The majority of TBD cases occur in warm weather months in individuals with recent outdoor activities in wooded areas. The risk of contracting a TBD is also highly dependent on geographic location. Between 24 and 48 hours of tick attachment is required for most disease transmission to occur. Only 50% to 70% of patients with a TBD will recall being bitten by a tick, and TBDs are often initially misdiagnosed as a viral illness...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641391/diabetic-foot-infections-in-the-emergency-department
#11
REVIEW
Bradley W Frazee
Diabetic foot infection (DFI) is among the most common diabetic complications requiring hospitalization. Prompt emergency department diagnosis and evidence-based management can prevent eventual amputation and associated disability and mortality. Underlying neuropathy, arterial occlusion, immune dysfunction, and hyperglycemia-associated dehydration and ketoacidosis can all contribute to severity and conspire to make DFI diagnosis and management difficult. Serious complications include osteomyelitis, necrotizing infection, and sepsis...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641390/orthopedic-articular-and-periarticular-joint-infections
#12
REVIEW
Pim Jetanalin, Yanint Raksadawan, Pholaphat Charles Inboriboon
Acute nontraumatic joint pain has an extensive differential. Emergency physicians must be adept at identifying limb and potentially life-threatening infection. Chief among these is septic arthritis. In addition to knowing how these joint infections typically present, clinicians need to be aware of host and pathogen factors that can lead to more insidious presentations and how these factors impact the interpretation of diagnostic tests.
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641389/optimizing-diagnosis-and-management-of-community-acquired-pneumonia-in-the-emergency-department
#13
REVIEW
Katherine M Hunold, Elizabeth Rozycki, Nathan Brummel
Pneumonia is split into 3 diagnostic categories: community-acquired pneumonia (CAP), health care-associated pneumonia, and ventilator-associated pneumonia. This classification scheme is driven not only by the location of infection onset but also by the predominant associated causal microorganisms. Pneumonia is diagnosed in over 1.5 million US emergency department visits annually (1.2% of all visits), and most pneumonia diagnosed by emergency physicians is CAP.
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/38641388/the-diagnosis-and-treatment-of-adult-urinary-tract-infections-in-the-emergency-department
#14
REVIEW
Robert Redwood, Kimberly C Claeys
Emergency medicine has been called the art of "making complicated clinical decisions with limited information." This description is particularly relevant in the case of diagnosis and treatment of urinary tract infections (UTIs). Although common, UTIs are often challenging to diagnose given the presence of non-specific signs and symptoms and over-reliance on laboratory findings. This review provides an interdisciplinary interpretation of the primary literature and practice guidelines, with a focus on diagnostic and antimicrobial stewardship in the emergency department...
May 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/37977757/essentials-of-psychiatric-and-behavioral-emergencies
#15
EDITORIAL
Eileen F Baker, Catherine A Marco
No abstract text is available yet for this article.
February 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/37977756/psychiatric-and-behavioral-emergencies
#16
EDITORIAL
Amal Mattu
No abstract text is available yet for this article.
February 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/37977755/schizophrenia-and-emergency-medicine
#17
REVIEW
Ryan E Lawrence, Adam Bernstein
Schizophrenia is a chronic condition characterized by positive symptoms (auditory hallucinations, delusion), negative symptoms (avolition, social withdrawal), and disorganized thoughts/behaviors. Although the pathophysiology is incompletely understood, several neurobiological mechanisms have been proposed. Treatment usually involves antipsychotic medication as well as psychotherapy and supportive services. When evaluating patients in the emergency department, acute safety considerations are paramount. Patients should be assessed for suicide risk, violence risk, inability to care for self, and the risk of being the victim of a crime...
February 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/37977754/physiologic-effects-of-substance-use
#18
REVIEW
Brian Patrick Murray, Emily Anne Kiernan
Physiologic and psychological effects of substance use are common occurrences. They may be the proximate purpose of the exposure or related to an unintended complication. Acute short-term exposure effects may not be the same as long-term effects. These effects are mediated by different receptors they act on and the homeostatic changes that occur due to repeat exposure. We review in this article the physiologic and psychological effects from exposure to commonly encountered drugs, ethanol, sedative hypnotics, cocaine, amphetamines, marijuana, opioids, nicotine, hydrocarbons (halogenated and non-halogenated), and nitrous oxide...
February 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/37977753/substance-use-disorder
#19
REVIEW
Kaitlyn R Swimmer, Stephen Sandelich
Substance use disorders (SUDs) present a challenge in the emergency department (ED) setting. This article provides an overview of SUDs, their clinical assessment, legal considerations in drug testing, diagnosis, and treatment approaches. SUDs are prevalent and coexist with mental health disorders, necessitating comprehensive evaluation and management. Clinical assessment involves screening tools, substance use history, and identification of comorbidities. Diagnosis relies on a thorough evaluation of substance abuse patterns and associated medical conditions...
February 2024: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/37977752/hyperactive-delirium-with-severe-agitation
#20
REVIEW
Brian Springer
Hyperactive delirium with severe agitation is a clinical syndrome of altered mental status, psychomotor agitation, and a hyperadrenergic state. The underlying pathophysiology is variable and often results from sympathomimetic abuse, psychiatric disease, sedative-hypnotic withdrawal, and metabolic derangement. Patients can go from a combative state to periarrest with little warning. Safety of the patient and of the medical providers is paramount and the emergency department should be prepared to manage these patients with adequate staffing, restraints, and pharmacologic sedatives...
February 2024: Emergency Medicine Clinics of North America
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