Jonathan A Edlow, Christopher Carpenter, Murtaza Akhter, Danya Khoujah, Evie Marcolini, William J Meurer, David Morrill, James G Naples, Robert Ohle, Rodney Omron, Sameer Sharif, Matt Siket, Suneel Upadhye, Lucas Oliveira J E Silva, Etta Sundberg, Karen Tartt, Simone Vanni, David E Newman-Toker, Fernanda Bellolio
This third Guideline for Reasonable and Appropriate Care in the Emergency Department (GRACE-3) from the Society for Academic Emergency Medicine is on the topic adult patients with acute dizziness and vertigo in the emergency department (ED). A multidisciplinary guideline panel applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence and strength of recommendations regarding five questions for adult ED patients with acute dizziness of less than 2 weeks' duration...
May 2023: Academic Emergency Medicine
Danya Khoujah, James G Naples, Lucas Oliveira J E Silva, Jonathan A Edlow, Danielle J Gerberi, Christopher R Carpenter, Fernanda Bellolio
BACKGROUND: Canalith repositioning maneuvers (such as the Epley maneuver) are recommended by specialty guidelines for management of benign paroxysmal positional vertigo (BPPV) yet are frequently underutilized in the emergency department (ED). METHODS: We conducted a systematic review of systematic reviews to summarize the evidence of Epley maneuver for the treatment of posterior canal (pc) BPPV in any setting. We included systematic reviews of randomized controlled trials (RCTs) that compared Epley to control in adult patients with pc-BPPV...
April 26, 2023: Academic Emergency Medicine
Shiro Gonai, Daisuke Yoneoka, Takahiro Miyoshi, Katharina da Silva Lopes
STUDY OBJECTIVE: To review closed reduction methods for anterior shoulder dislocation and perform the first comprehensive comparison of the individual methods in terms of success rate, pain, and reduction time. METHODS: We searched MEDLINE, PubMed, EMBASE, Cochrane, and for randomized controlled trials registered until December 31, 2020. We performed a pairwise and network meta-analysis using a Bayesian random-effects model. Two authors independently performed screening and risk-of-bias assessment...
April 2023: Annals of Emergency Medicine
Velina Tzankova, Werner J Becker, Tommy L H Chan
No abstract text is available yet for this article.
January 30, 2023: Canadian Medical Association Journal: CMAJ
Velina Tzankova, Werner J Becker, Tommy L H Chan
No abstract text is available yet for this article.
February 6, 2023: Canadian Medical Association Journal: CMAJ
Natasha L Larivée, Jacob B Michaud, Keigan M More, Jo-Anne Wilson, Karthik K Tennankore
It is well established that an elevated potassium level (hyperkalemia) is associated with a risk of adverse events including morbidity, mortality and healthcare system cost. Hyperkalemia is commonly encountered in many chronic conditions including kidney disease, diabetes and heart failure. Furthermore, hyperkalemia may result from the use of renin-angiotensin-aldosterone system inhibitors (RAASi), which are disease-modifying treatments for these conditions. Therefore, balancing the benefits of optimizing treatment with RAASi while mitigating hyperkalemia is crucial to ensure patients are optimally treated...
December 12, 2022: Cardiology and Therapy
Jason T Yarter, Justin Racht, Kevin S Michels
Orbital compartment syndrome is a rare but serious condition most commonly as a result of traumatic retrobulbar hemorrhage and must be treated quickly to avoid ischemic damage to the optic nerve and retina. While the previously accepted standard of care for management of this condition has been lateral canthotomy with inferior cantholysis, this procedure can be challenging for physicians to perform given the rarity of the condition and that patients are frequently in significant pain often with significant periocular edema...
February 2023: American Journal of Emergency Medicine
Joëlla H Hopman, Juliette A L Santing, Kelly A Foks, Rolf J Verheul, Christien M van der Linden, Crispijn L van den Brand, Korné Jellema
INTRODUCTION: A computerized tomography (CT) scan is an effective test for detecting traumatic intracranial findings after mild traumatic brain injury (mTBI). However, a head CT is costly, and can only be performed in a hospital. OBJECTIVE: To determine if the addition of plasma S100B to clinical guidelines could lead to a more selective scanning strategy without compromising safety. METHODS: We conducted a single center prospective cohort study at the emergency department...
January 2, 2023: Brain Injury
Gabrielle Trépanier, Guylaine Laguë, Marie Victoria Dorimain
OBJECTIVES: Patients leaving against medical advice (AMA) can be distressing for emergency physicians trying to navigate the medical, social, psychological, and legal ramifications of the situation in a fast-paced and chaotic environment. To guide physicians in fulfilling their obligation of care, we aimed to synthesize the best approaches to patients leaving AMA. METHODS: We conducted a scoping review across various fields of work, research context and methodology to synthesize the most relevant strategies for emergency physicians attending patients leaving AMA...
January 2023: CJEM
Jeffrey J Perry, David E Newman-Toker, Robert Ohle
No abstract text is available yet for this article.
November 2022: CJEM
A O'Connor, J R Abbas, H McNeill
The One Minute Preceptor (OMP) model of teaching has an important role to play during the COVID-19 pandemic. It's quick and easy to learn and can be applied to any clinical setting. By responding directly to a student's needs, and building on the knowledge they already hold, the OMP is able to offer relevant and opportunistic teaching that the learner can immediately apply. Finally, the OMP can be taught in under two hours meaning medical staff not used to regularly teaching can develop the confidence to offer high quality educational interventions...
2022: Acute Medicine
Ariel Hendin, Erin Rosenberg, Hans Rosenberg
No abstract text is available yet for this article.
June 2022: CJEM
Volker Musahl, Ian D Engler, Ehab M Nazzal, Jonathan F Dalton, Gian Andrea Lucidi, Jonathan D Hughes, Stefano Zaffagnini, Francesco Della Villa, James J Irrgang, Freddie H Fu, Jon Karlsson
Clinical evaluation and management of anterior cruciate ligament (ACL) injury is one of the most widely researched topics in orthopedic sports medicine, giving providers ample data on which to base their practices. The ACL is also the most commonly treated knee ligament. This study reports on current topics and research in clinical management of ACL injury, starting with evaluation, operative versus nonoperative management, and considerations in unique populations. Discussion of graft selection and associated procedures follows...
January 2022: Knee Surgery, Sports Traumatology, Arthroscopy
Sophie Ramsden, Lauren Beals
A short-cut review of the available medical literature was carried out to establish whether elbow immobilisation is required after closed reduction of a distal radial fracture. After abstract review, six papers were found to answer this clinical question using the detailed search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that elbow immobilisation is not required.
March 2022: Emergency Medicine Journal: EMJ
George Mastoras, Sara H Gray
No abstract text is available yet for this article.
September 2021: CJEM
Kevin H Phan, John G Anderson, Donald R Bohay
Outpatient orthopedic surgery is gradually becoming the standard across the country, as it has been found to significantly lower costs without compromising patient care. Peripheral nerve blocks (PNBs) are largely what have made this transition possible by providing patients excellent pain control in the immediate postoperative period. However, with the increasing use of PNBs, it is important to recognize that they are not without complications. Although rare, these complications can cause patients a significant amount of morbidity...
July 2021: Orthopedic Clinics of North America
Kamel S Kamel, Mitchell L Halperin
We discuss the use of urine electrolytes and urine osmolality in the clinical diagnosis of patients with fluid, electrolytes, and acid-base disorders, emphasizing their physiological basis, their utility, and the caveats and limitations in their use. While our focus is on information obtained from measurements in the urine, clinical diagnosis in these patients must integrate information obtained from the history, the physical examination, and other laboratory data.
May 2021: KI Reports
Kathryn Hawk, Jason Hoppe, Eric Ketcham, Alexis LaPietra, Aimee Moulin, Lewis Nelson, Evan Schwarz, Sam Shahid, Donald Stader, Michael P Wilson, Gail D'Onofrio
The treatment of opioid use disorder with buprenorphine and methadone reduces morbidity and mortality in patients with opioid use disorder. The initiation of buprenorphine in the emergency department (ED) has been associated with increased rates of outpatient treatment linkage and decreased drug use when compared to patients randomized to receive standard ED referral. As such, the ED has been increasingly recognized as a venue for the identification and initiation of treatment for opioid use disorder, but no formal American College of Emergency Physicians (ACEP) recommendations on the topic have previously been published...
September 2021: Annals of Emergency Medicine
Aleksandar Trajkovski, Eddy Lang
No abstract text is available yet for this article.
May 2021: CJEM
Derek K Chu, Paul Oykhman, Gordon L Sussman
No abstract text is available yet for this article.
April 6, 2021: Canadian Medical Association Journal: CMAJ
2021-04-10 14:04:53
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