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Evidence-based management of pulmonary embolism in the emergency department. 急诊肺栓塞的循证管理。
Emergency medicine practice Pub Date : 2023-08-01
Alfred Sacchetti, Michael Driscoll
{"title":"Evidence-based management of pulmonary embolism in the emergency department.","authors":"Alfred Sacchetti,&nbsp;Michael Driscoll","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients with pulmonary emboli present both diagnostic and therapeutic challenges to the emergency clinician, because initial symptoms can be variable and overlap with other medical conditions. This issue reviews treatment options for patients with pulmonary emboli based on risk stratification scores of low, intermediate-low, intermediate-high, and high risk classifications. The evidence on laboratory testing and imaging is presented, as well as treatment strategies that include anticoagulation, thrombolytics, and mechanical or surgical thrombectomy. Management decisions regarding pregnancy and COVID-19 are discussed, as well as considerations for outpatient treatment of low-risk patients.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 8","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9867675","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}
引用次数: 0
Emergency department management of acute intracerebral hemorrhage. 急性脑出血的急诊处理。
Emergency medicine practice Pub Date : 2023-07-20
Dana Klavansky, Nicole Davis, Cappi Lay
{"title":"Emergency department management of acute intracerebral hemorrhage.","authors":"Dana Klavansky,&nbsp;Nicole Davis,&nbsp;Cappi Lay","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute intracerebral hemorrhage accounts for only a small portion of all stroke presentations, but often leads to a high rate of morbidity and mortality. The presentation of patients with ICH is often similar to other stroke patients and requires rapid recognition, imaging, and evaluation. Treatment begins in the emergency department and focuses on correction of abnormal coagulopathies, blood pressure reduction, emergent treatment of intracranial hypertension, and recognition of those in need of urgent surgical decompression. Patients should be admitted to capable critical care units, with expertise in neurocritical care if available. This review presents evidence-based recommendations for the emergency department identification and management of patients with ICH.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 Suppl 7","pages":"1-41"},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9930552","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}
引用次数: 0
Diagnosing and treating pericarditis and myocarditis in the emergency department. 急诊心包炎、心肌炎的诊断与治疗。
Emergency medicine practice Pub Date : 2023-07-01
Morgan McGuire, Warren Harvey, Tucker Brady, Alexandre D Nguyen
{"title":"Diagnosing and treating pericarditis and myocarditis in the emergency department.","authors":"Morgan McGuire,&nbsp;Warren Harvey,&nbsp;Tucker Brady,&nbsp;Alexandre D Nguyen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pericarditis and myocarditis represent a challenging set of diseases to diagnose and treat. These diseases typically present with chest pain and dyspnea in previously healthy young people, often in the weeks following a viral illness, including COVID-19. Nonetheless, the etiologies can be very diverse, including infectious, noninfectious, drug-induced, and autoimmune causes. This review focuses on the evaluation, diagnosis, and management of emergency department patients presenting with pericarditis and myocarditis and summarizes current guidelines and best-practice medical management strategies in order to avoid potential life-threatening cardiac complications.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 7","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9684790","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}
引用次数: 0
Hypertensive emergencies: guidelines and best-practice recommendations. 高血压急症:指南和最佳做法建议。
Emergency medicine practice Pub Date : 2023-06-01
Ari B Davis, Kyle Hughes, Jonathan Pun, Scott Goldstein
{"title":"Hypertensive emergencies: guidelines and best-practice recommendations.","authors":"Ari B Davis,&nbsp;Kyle Hughes,&nbsp;Jonathan Pun,&nbsp;Scott Goldstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Due to a variety of demographic and public health factors, the number of emergency department visits related to hypertensive emergencies has increased dramatically in recent decades, making it imperative that clinicians clearly understand the current treatment guidelines and definitions for the spectrum of hypertensive disease. This issue reviews current evidence on identifying and managing hypertensive emergencies and the differences between expert opinions on diagnosing and managing these emergencies. Clear protocols differentiating patients with hypertension from patients with hypertensive emergencies are needed to appropriately manage this patient population.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 6","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9497503","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}
引用次数: 0
Emergency department management of gastrointestinal foreign body ingestion. 胃肠异物误食的急诊科处理。
Emergency medicine practice Pub Date : 2023-05-01
James C Crosby
{"title":"Emergency department management of gastrointestinal foreign body ingestion.","authors":"James C Crosby","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are over 150,000 reports to American Poison Centers every year due to foreign body ingestions, and many patients will be directed to emergency departments for evaluation and management. This comprehensive review evaluates the current literature related to gastrointestinal foreign body diagnosis and management. A discussion of the utility of various imaging modalities is presented, along with a description of high-risk ingestions and the evidence behind society guidelines and management strategies. Finally, controversies in the management of esophageal impactions are reviewed, including the use of glucagon.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 5","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9420939","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}
引用次数: 0
Evaluation and management of intimate partner violence in the emergency department. 急诊部门亲密伴侣暴力的评估和管理。
Emergency medicine practice Pub Date : 2023-04-20
Gilberto A Salazar, Jo-Anna Palma, Maria Box, Davindeep Brar
{"title":"Evaluation and management of intimate partner violence in the emergency department.","authors":"Gilberto A Salazar,&nbsp;Jo-Anna Palma,&nbsp;Maria Box,&nbsp;Davindeep Brar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Intimate partner violence (IPV) and emergency medicine intersect when individuals experiencing IPV present to emergency departments for medical care, either on their own or when brought in by law enforcement authorities for medical evaluation and social services. Coordination of care is required, with particular attention paid to the sensitive nature of the patient's presentation and with an emphasis on trauma-informed care. Emergent medical needs must be balanced with concerns for the patient's emotional well-being and the need for advocacy and social services. This supplement reviews best practices and evidence-based recommendations for the evaluation and management of patients who have experienced IPV, with a focus on the considerations for traumatic injuries in these patients.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 Suppl 4","pages":"1-37"},"PeriodicalIF":0.0,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9385996","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}
引用次数: 0
An evidence-based approach to managing gunshot wounds in the emergency department. 急诊部门枪伤的循证管理方法
Emergency medicine practice Pub Date : 2023-04-01
Drew Clare, Samantha Baxley
{"title":"An evidence-based approach to managing gunshot wounds in the emergency department.","authors":"Drew Clare,&nbsp;Samantha Baxley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Education regarding ballistic injuries in the emergency department is sparse and may rarely be encountered if not training or practicing in a trauma center or a military wartime setting. This article provides a comprehensive review on the management of ballistic injuries in the emergency department, including how to assess and manage gunshot wounds, how to recognize when further imaging or evaluation is needed, and how to recognize when transfer to another facility is required. Algorithms are proposed for the management of gunshot wounds based on body part: head, neck, chest and abdomen, and extremities/soft tissue.</p><p><p></p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 4","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9161466","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}
引用次数: 0
Emergency department management of infective endocarditis-associated stroke. 感染性心内膜炎相关脑卒中的急诊处理。
Emergency medicine practice Pub Date : 2023-03-01
Lauren Gillespie, Natalie Kreitzer
{"title":"Emergency department management of infective endocarditis-associated stroke.","authors":"Lauren Gillespie,&nbsp;Natalie Kreitzer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Stroke in patients with endocarditis is a unique, highly morbid condition requiring a high index of suspicion for diagnosis. This issue reviews the historical and physical examination factors that can provide clues to the etiology. The workup of these patients, involving both infection-focused and stroke-focused laboratory testing and neuroimaging, is discussed. The mainstay of treatment is empiric antibiotics, as thrombolytics are contraindicated. Recent evidence regarding the use of mechanical thrombectomy in largevessel occlusion strokes is discussed, as well as surgical options and consultation strategies with stroke, neurocritical care, infectious disease, and neurosurgery teams.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 3","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10735516","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}
引用次数: 0
Diagnosis and management of blast injuries in the emergency department. 急诊科爆炸伤的诊断与处理。
Emergency medicine practice Pub Date : 2023-02-01
Tung-Lin Yuan, Navin Ariyaprakai
{"title":"Diagnosis and management of blast injuries in the emergency department.","authors":"Tung-Lin Yuan,&nbsp;Navin Ariyaprakai","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Managing patients with blast injuries can challenge emergency department operations, as patients can present in multiple waves, with occult or delayed injuries, and by personal transport, without standard prehospital care. Rapid and effective triage and evaluation includes approximation of blast proximity, determination of the category of blast - primary to quinary - and assessment of the body systems that are most likely to be injured from the type, location, and mechanism of the blast. This issue reviews the physics of the various types of explosions, how this affects the types of injuries that may be seen, and recommended treatments. Best-evidence recommendations are made for decision-making for observation, admission, or discharge.</p><p><p></p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 2","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10618711","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}
引用次数: 0
An evidence-based approach to emergency department patients at risk for posttraumatic stress disorder symptoms. 急诊病人创伤后应激障碍症状风险的循证方法
Emergency medicine practice Pub Date : 2023-01-01
Maria Lynn Pacella-LaBarbara, Enzo G Plaitano, Bernard P Chang
{"title":"An evidence-based approach to emergency department patients at risk for posttraumatic stress disorder symptoms.","authors":"Maria Lynn Pacella-LaBarbara,&nbsp;Enzo G Plaitano,&nbsp;Bernard P Chang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Approximately one-quarter of emergency department patients who are injured or experience medical emergencies will develop clinically significant posttraumatic stress disorder (PTSD) symptoms, which can evolve into PTSD. Emergency clinicians and rapid response teams (eg, trauma, cardiac, stroke) can play a critical role in recognizing symptoms of posttraumatic stress and providing early distress management techniques, screening, and referral to services that may mitigate the development of PTSD. This review summarizes the existing literature on psychological distress related to events that trigger the need for emergency care and synthesizes cutting-edge approaches that may impact patient outcomes.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"25 1","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10476546","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}
引用次数: 0
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