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Emergency Medicine Practice

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https://read.qxmd.com/read/30707538/calculated-decisions-ottawa-subarachnoid-hemorrhage-rule
#1
Rachel Kwon
The Ottawa subarachnoid hemorrhage rule is used to rule out subarachnoid hemorrhage in patients with headache.
February 1, 2019: Emergency Medicine Practice
https://read.qxmd.com/read/30707533/points-pearls-evaluation-and-management-of-life-threatening-headaches-in-the-emergency-department
#2
David Zodda, Gabrielle Procopio, Amit Gupta, Nachi Gupta, Jeffrey Nusbaum
Headache is the fourth most common reason for emergency department encounters, accounting for 3% of all visits in the United States. Though troublesome, 90% are relatively benign primary headaches --migraine, tension, and cluster headaches. The other 10% are secondary headaches, caused by separate underlying processes, with vascular, infectious, or traumatic etiologies, and they are potentially life-threatening. This issue details the important pathophysiologic features of the most common types of life-threatening headaches, the key historical and physical examination information emergency clinicians must obtain, the red flags that cannot be missed, and the current evidence for best-practice testing, imaging, treatment, and disposition...
February 1, 2019: Emergency Medicine Practice
https://read.qxmd.com/read/30676714/evaluation-and-management-of-life-threatening-headaches-in-the-emergency-department
#3
David Zodda, Gabrielle Procopio, Amit Gupta
Headache is the fourth most common reason for emergency department encounters, accounting for 3% of all visits in the United States. Though troublesome, 90% are relatively benign primary headaches --migraine, tension, and cluster headaches. The other 10% are secondary headaches, caused by separate underlying processes, with vascular, infectious, or traumatic etiologies, and they are potentially life-threatening. This issue details the important pathophysiologic features of the most common types of life-threatening headaches, the key historical and physical examination information emergency clinicians must obtain, the red flags that cannot be missed, and the current evidence for best-practice testing, imaging, treatment, and disposition...
February 2019: Emergency Medicine Practice
https://read.qxmd.com/read/30592592/points-pearls-first-trimester-pregnancy-emergencies-recognition-and-management
#4
Ryan Pedigo, Jeffrey Nusbaum, Nachi Gupta
Timely management of patients presenting to the ED while in their first trimester of pregnancy can improve outcomes for both the patient and the fetus. Common obstetric problems encountered include vaginal bleeding and miscarriage, ectopic pregnancy and pregnancy of undetermined location, and nausea and vomiting of pregnancy, including hyperemesis gravidarum. Optimal diagnostic approaches and management strategies are covered, including which antiemetics are safe to give in pregnancy. Common nonobstetric problems include asymptomatic bacteriuria, urinary tract infections including pyelonephritis, and acute appendicitis...
January 1, 2019: Emergency Medicine Practice
https://read.qxmd.com/read/30570248/first-trimester-pregnancy-emergencies-recognition-and-management
#5
Ryan Pedigo
Timely management of patients presenting to the ED while in their first trimester of pregnancy can improve outcomes for both the patient and the fetus. Common obstetric problems encountered include vaginal bleeding and miscarriage, ectopic pregnancy and pregnancy of undetermined location, and nausea and vomiting of pregnancy, including hyperemesis gravidarum. Optimal diagnostic approaches and management strategies are covered, including which antiemetics are safe to give in pregnancy. Common nonobstetric problems include asymptomatic bacteriuria, urinary tract infections including pyelonephritis, and acute appendicitis...
January 2019: Emergency Medicine Practice
https://read.qxmd.com/read/30525346/points-pearls-influenza-diagnosis-and-management-in-the-emergency-department
#6
Al Giwa, Chinwe Ogedegbe, Charles G. Murphy, Nachi Gupta, Jeffrey Nusbaum
Emergency clinicians must be aware of the current diagnostic and therapeutic recommendations for influenza and the available resources to guide management. This comprehensive review outlines the classification of influenza viruses, influenza pathophysiology, the identification of high-risk patients, and the importance of vaccination. Seasonal variations of influenza are discussed, as well as the rationale for limiting testing during periods of high prevalence. Differences between strains of influenza are discussed, as well as the challenges in achieving optimal vaccine effectiveness...
December 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30476430/influenza-diagnosis-and-management-in-the-emergency-department
#7
REVIEW
A L Giwa, Chinwe Ogedegbe, Charles G Murphy
Emergency clinicians must be aware of the current diagnostic and therapeutic recommendations for influenza and the available resources to guide management. This comprehensive review outlines the classification of influenza viruses, influenza pathophysiology, the identification of high-risk patients, and the importance of vaccination. Seasonal variations of influenza are discussed, as well as the rationale for limiting testing during periods of high prevalence. Differences between strains of influenza are discussed, as well as the challenges in achieving optimal vaccine effectiveness...
December 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30383348/points-pearls-electrical-injuries-in-the-emergency-department-an-evidence-based-review
#8
Joshua Gentges, Christoph Schieche, Jeffrey Nusbaum, Nachi Gupta
Electrical injuries can be caused by exposure to current from low-voltage and high-voltage sources as well as lightning strikes, and the circumstances of the exposure will dictate management strategies. Human tissues have varying resistance characteristics and susceptibility to damage, so injuries may be thermal, electrical, and/or mechanical, potentially causing burns, thrombosis, tetany, falls, and blast injury. This issue reviews the types of trauma seen with electrical injury and how body systems can be affected by occult or delayed effects, and the optimal evidence-based resuscitation and management strategies associated with each...
November 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30358379/electrical-injuries-in-the-emergency-department-an-evidence-based-review
#9
REVIEW
Joshua Gentges, Christoph Schieche
Electrical injuries can be caused by exposure to current from low-voltage and high-voltage sources as well as lightning strikes, and the circumstances of the exposure will dictate management strategies. Human tissues have varying resistance characteristics and susceptibility to damage, so injuries may be thermal, electrical, and/or mechanical, potentially causing burns, thrombosis, tetany, falls, and blast injury. This issue reviews the types of trauma seen with electrical injury and how body systems can be affected by occult or delayed effects, and the optimal evidence-based resuscitation and management strategies associated with each...
November 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30280868/points-pearls-updates-and-controversies-in-the-early-management-of-sepsis-and-septic-shock
#10
Faheem Guirgis, Lauren Page Black, Elizabeth L DeVos, Nachi Gupta, Jeffrey Nusbaum
Sepsis is a common and life-threatening condition that requires early recognition and swift initial management. Diagnosis and treatment of sepsis and septic shock are fundamental for emergency clinicians, and include knowledge of clinical and laboratory indicators of subtle and overt organ dysfunction, infection source control, and protocols for prompt identification of the early signs of septic shock. [Points & Pearls is a digest of Emergency Medicine Practice.]
October 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30280854/calculated-decisions-qsofa-quick-sofa-score-for-sepsis
#11
Kamal Medlej
The qSOFA score identifies patients with suspected infection who are at high risk for in-hospital mortality outside of the intensive care unit.
October 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30280853/calculated-decisions-sequential-organ-failure-assessment-sofa-score
#12
Kamal Medlej
The SOFA score predicts mortality risk for patients in the intensive care unit based on lab results and clinical data.
October 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30252228/updates-and-controversies-in-the-early-management-of-sepsis-and-septic-shock
#13
Faheem Guirgis, Lauren Page Black, Elizabeth L DeVos
Sepsis is a common and life-threatening condition that requires early recognition and swift initial management. Diagnosis and treatment of sepsis and septic shock are fundamental for emergency clinicians, and include knowledge of clinical and laboratory indicators of subtle and overt organ dysfunction, infection source control, and protocols for prompt identification of the early signs of septic shock. This issue is a structured review of the literature on the management of sepsis, focusing on the current evidence, guidelines, and protocols...
October 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30183239/calculated-decisions-glasgow-coma-scale
#14
Daniel Runde
The Glasgow Coma Scale (GCS) estimates coma severity based on eye, verbal, and motor criteria.
October 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30183238/calculated-decisions-bastion-classification-of-lower-limb-blast-injuries
#15
Jennie Kim, Travis Polk
The Bastion Classification criteria stratify explosionrelated lower limb injuries into 5 categories to guide treatment.
September 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30183237/calculated-decisions-blast-lung-injury-severity-score
#16
Jennie Kim, Travis Polk
The Blast Lung Injury Severity Score stratifies primary blast lung injuries into 3 categories to guide ventilator treatment.
September 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30183234/calculated-decisions-focused-assessment-with-sonography-for-trauma-fast
#17
Jennie Kim, Morgan Schellenberg, Kenji Inaba
Focused Assessment with Sonography for Trauma (FAST) predicts the presence of pericardial or intra-abdominal injury after penetrating or blunt trauma.
September 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30183233/cacluated-decisions-tash-trauma-associated-severe-hemorrhage-score
#18
Graham Walker, Rachel Kwon
The TASH Score predicts the need for massive transfusion based on clinical and laboratory data.
September 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30179413/points-pearls-emergency-department-management-of-north-american-snake-envenomations
#19
Sophia Sheikh, Patrick Leffers, Jeffrey Nusbaum, Nachi Gupta
There are approximately 10,000 emergency department visits in the United States for snakebites every year, and one-third of those involve venomous species. Venomous North American indigenous snakes include species from the Crotalinae (pit vipers) and Elapidae (coral snakes) subfamilies. Treatment relies on supportive care, plus antivenom for select cases. While certain principles of management are widely accepted, controversies exist with regard to prehospital use of pressure immobilization, antivenom use, coagulation testing after copperhead envenomation, and fasciotomy...
September 1, 2018: Emergency Medicine Practice
https://read.qxmd.com/read/30179411/calculated-decisions-antivenom-dosing-algorithm
#20
Stephen A. Harding
The Antivenom Dosing Algorithm specifies the manifestations of Crotalinae (pit viper, formerly known as Crotalidae) snake envenomation that necessitate aggressive management.
September 1, 2018: Emergency Medicine Practice
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