{"title":"Emergency department management of knee pain.","authors":"Vanica Guignard, John Kiel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Knee pain is a common presenting complaint in the emergency department, and although the major etiologies are overuse and degenerative, inflammatory and infectious causes must be ruled out. This issue reviews the potential causes of knee pain from the history and physical examination, symptom location based differential, clinical clues, and special testing strategies. Evidence on the uses of x-ray and ultrasound for diagnostic imaging is reviewed. For suspected infectious causes, procedures for palpation-guided and ultrasound-guided arthrocentesis are outlined. Treatment strategies are summarized, with evidence on the effectiveness of weight loss, physical therapy, orthotics, medication therapies, joint injections, and nerve blocks considered.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"27 3","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of mild traumatic brain injury in the emergency department.","authors":"Micelle Haydel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>With almost 2.9 million people in the United States seeking medical attention for head trauma each year,1 emergency clinicians face the critical task of efficiently and accurately identifying those with potentially life-threatening intracranial trauma. Due to the heterogeneity of patients, there is no one-size- fits-all approach to managing patients with suspected mild traumatic brain injury. This issue of Emergency Medicine Practice: Trauma EXTRA! reviews clinical guidelines, challenges in care for patients at extremes of ages, and strategies for managing patients with bleeding disorders or those taking anticoagulants or antiplatelet agents. Indications for imaging are also discussed, as well as which patients are at increased risk for intracranial injury and post-concussive syndrome. Management of patients with mild traumatic brain injury includes neurosurgery consultation, hospital admission for further observation, repeat imaging, or discharge home with careful discharge instructions.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"27 Suppl 2","pages":"1-46"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erin D'Agostino, Miguel Reyes-Zaragoza, Matthew Siket
{"title":"Management of traumatic intracranial hemorrhage in the emergency department.","authors":"Erin D'Agostino, Miguel Reyes-Zaragoza, Matthew Siket","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although there is a large body of existing research on traumatic intracranial hemorrhage, there are few clear and consistent recommendations that have emerged. Appropriate management is guided by an understanding of the pathophysiology of traumatic brain injury as well as by clinical observation and radiographic assessment. This review provides a comprehensive analysis of the literature and recommendations based on the best available evidence, including expeditious management of critically elevated intracranial pressure and acquisition of follow-up studies.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"27 2","pages":"1-32"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alkali exposure: an evidence-based approach to diagnosis and treatment.","authors":"Sukhshant Atti, Jessica Behrndt, Alicia Hereford","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Alkali caustic exposures can occur in the workplace with industrial chemicals, or in the home with common household products. These exposures, whether accidental or intentional, create risk for death or acute injury, such as airway compromise and esophageal or gastric perforation, as well as long-term complications such as stricture formation. Swift diagnosis and grading of these injuries will guide management options and are essential to reduce morbidity and mortality in these patients. This issue reviews the evidence on emergency department management of alkali caustic exposures, with a focus on decontamination, resuscitation, and appropriate disposition.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"27 1","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abdominal pain: update on emergency department management of appendicitis and diverticulitis.","authors":"Liza Hartofilis, John K Riggins","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Abdominal pain is one of the most common presenting complaints to the emergency department, and appendicitis and diverticulitis are common causes. Intra-abdominal infections have historically been managed with admission to the hospital, antibiotics, and surgical interventions, and best-practice pathways are an important part of quality programs. Advances in diagnostics and management, supported with outcome data, are impacting care pathways. This review provides an update on best practices related to the management of appendicitis and diverticulitis, with the goal of improving patient care, minimizing risk, and maximizing the patient experience.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"26 10","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abigail La Nou, Smitesh Padte, Mustafa Sajjad Cheema, Sindhura Tadisetty, Rahul Kashyap
{"title":"Drugs of addiction and stroke: diagnostic and treatment challenges in the emergency department.","authors":"Abigail La Nou, Smitesh Padte, Mustafa Sajjad Cheema, Sindhura Tadisetty, Rahul Kashyap","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Drugs of addiction have been associated with an increased risk of both hemorrhagic and ischemic stroke. While the mechanisms that increase stroke risk are well recognized for the most commonly used substances, there is limited evidence to guide the management and treatment of stroke in the setting of concurrent substance use disorder. This review presents a comprehensive approach to evaluation and management of stroke in patients with substance use disorders. Identification of concurrent drug intoxication and guidelines for drug screening in stroke patients are discussed, along with standardized treatment strategies to improve care and outcomes in these patients.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"26 Suppl 9","pages":"1-39"},"PeriodicalIF":0.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Elder abuse and neglect: making the diagnosis and devising a treatment plan in the emergency department.","authors":"Nicole Cimino-Fiallos","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The prevalence of elder abuse and neglect is trending upward among American seniors, but physician reports of suspected maltreatment are not keeping pace. The most important step in management of elder abuse and neglect is making the diagnosis and reporting the suspicions to Adult Protective Services. This review presents a systematic approach for emergency department diagnosis of elder abuse and neglect, including a thorough history and physical examination combined with the use of standardized validated screening tools. To better assess and treat victims of suspected abuse, physicians can also employ a multidisciplinary team or recruit available resources in the hospital and the community, such as case managers, social workers, and primary care providers to create safety plans for at-risk elders.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"26 9","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Emergency department management of patients with complications of dialysis.","authors":"Hemang Acharya, Sabrina M Tennant, Kathleen Yip","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the United States, more than 450,000 patients are on dialysis due to end-stage renal disease. Compared to the general population, these patients account for a disproportionate number of emergency department visits due to higher rates of infection and cardiovascular complications, as well as issues unique to the process of dialysis itself, such as vascular access problems and dialysis disequilibrium syndrome. This issue describes the pathophysiology arising from hemodialysis and peritoneal dialysis-related complications, as well as the evaluation and initial treatment within the emergency department, based on best available evidence.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"26 7","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Managing emergency department patients with opioid use disorder.","authors":"Corey S Hazekamp, Dana Sacco","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As the United States continues to grapple with the opioid crisis, emergency clinicians are on the front lines of managing patients with opioid use disorder. This issue reviews tools and best practices in emergency department management of patients with opioid overdose and opioid withdrawal, and how substance use history will inform treatment planning and disposition. As growing evidence shows that medications for opioid use disorder (MOUD)- buprenorphine, methadone, and naltrexone-can have lasting impacts on patients' addiction recovery, strategies for assessing patient readiness for MOUD and overcoming barriers to emergency department initiation of these medications are reviewed. Newer approaches to buprenorphine dosing (high-dose, low-dose, home induction, and long-acting injectable dosing) are also reviewed.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"26 6","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141072049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current concepts in ketamine therapy in the emergency department.","authors":"Reuben J Strayer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ketamine has been in use since its development as a dissociative anesthetic in the 1960s, but it was largely confined to the operating theater or austere environments until used by emergency physicians to facilitate painful procedures in children. As the unique effects of ketamine across its dose-response curve were understood, new applications emerged. In low doses, ketamine has found an important role alongside or instead of opioids in the management of severe pain, and methods to slow its absorption allow higher, more effective doses while attenuating psychoperceptual effects. Ketamine's unique anesthetic properties have inspired its use as an induction agent for intubation without a paralytic and for the rapid, safe control of dangerously agitated patients. Emerging uses for ketamine in acute care include treatment for status epilepticus and alcohol withdrawal syndrome; however, its most important rising indication may be as an emergency treatment of depression and suicidality.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"26 5","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}