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Managing acute cardiac valvular emergencies in the emergency department. 急诊科处理急性心脏瓣膜急症。
Emergency medicine practice Pub Date : 2022-08-01
Adam Sigal, Stephanie Costa
{"title":"Managing acute cardiac valvular emergencies in the emergency department.","authors":"Adam Sigal, Stephanie Costa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Valvular heart disease is becoming more prevalent as the United States' population ages, with aortic and mitral valves most commonly affected. Complications, including syncope, heart failure, dyspnea, and chest pain, can arise from slow progression of stenosis and regurgitation, though acute regurgitation from an ischemic or traumatic event can be life-threatening. Patients with valvular disease may present with cardiogenic shock, and vasoactive agent treatment will depend on determination of the valvular etiology. This issue reviews aortic and mitral valvular disease as potential causes of a patient's emergency department presentation, including history, diagnostic testing, and physical examination findings that can help guide treatment.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"24 8","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40525090","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
Management of allergic reactions and anaphylaxis in the emergency department. 急诊科过敏反应和过敏反应的处理。
Emergency medicine practice Pub Date : 2022-07-01
Andrea Zeke, Amita Sudhir
{"title":"Management of allergic reactions and anaphylaxis in the emergency department.","authors":"Andrea Zeke,&nbsp;Amita Sudhir","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An acute allergic reaction is a rapid-onset, IgE-mediated hypersensitivity reaction. Although it is most commonly caused by food, insect stings, and medications, there are many additional causes. Symptoms can range from mild urticaria and swelling, to abdominal cramping, to respiratory collapse. Anaphylaxis and anaphylactic shock are the most severe, life-threatening forms of allergic reaction, with fast onset and decompensation, requiring urgent airway monitoring and support. This issue reviews the current evidence on managing allergy and anaphylaxis with epinephrine, and reviews the evidence on corticosteroids, antihistamines, and other adjunctive therapies. Guidelines are reviewed to offer assistance with grading of symptoms, which can help determine treatment and disposition. Biphasic reactions and allergic reactions caused by alpha-gal, scombroid poisoning, and Kounis syndrome are also reviewed.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"24 7","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40296286","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 adults with infectious meningitis and encephalitis. 成人感染性脑膜炎和脑炎的急诊科管理。
Emergency medicine practice Pub Date : 2022-04-01 Epub Date: 2022-04-02
Andrew N Hogan, C Reece Brockman II, Amanda Santa Maria
{"title":"Emergency department management of adults with infectious meningitis and encephalitis.","authors":"Andrew N Hogan,&nbsp;C Reece Brockman II,&nbsp;Amanda Santa Maria","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Infectious meningitis and encephalitis are often life-threatening illnesses, though prompt workup and targeted treatment can greatly reduce morbidity and mortality. Although presentation of central nervous system infection can sometimes be subtle, this issue focuses on evidence-based strategies for identifying combinations of signs and symptoms to narrow the diagnosis. Identifying meningitis versus encephalitis; bacterial versus viral, fungal, or iatrogenic causes; and providing prompt empiric antimicrobials and appropriate diagnostic testing are key to management. Cerebrospinal fluid testing findings are outlined to help determine a potential cause for symptoms, along with blood and serum testing options. International society guidelines and evidence regarding the need for computed tomography prior to lumbar puncture are presented, which can help reduce unnecessary imaging. Disposition criteria are expanded to help determine whether a patient can go home, or the level of hospital care that will be required for those admitted.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"24 4","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312914","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
Managing Postpartum Complications in the Emergency Department. 急诊部产后并发症的处理。
Emergency medicine practice Pub Date : 2022-03-01
Nicole Yuzuk, Joseph Bove, Riddhi Desai
{"title":"Managing Postpartum Complications in the Emergency Department.","authors":"Nicole Yuzuk,&nbsp;Joseph Bove,&nbsp;Riddhi Desai","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Postpartum patients may present to the emergency department with complaints ranging from minor issues, requiring only patient education and reassurance, to severe, life-threatening complications that require prompt diagnosis and multidisciplinary consultation and management. At times, vague presentations or overlapping conditions can make it difficult for the emergency clinician to recognize an emergent condition and initiate proper treatment. This issue reviews the major common emergencies that present in postpartum patients, by chief complaint, including hemorrhage, infection, pre-eclampsia, eclampsia, headache, and cardiopulmonary conditions, and reviews the most recent evidence and guidelines.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"24 3","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39821971","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 asthma exacerbations. 急性哮喘发作的急诊科管理。
Emergency medicine practice Pub Date : 2022-02-01
Steven M Hochman, Anthony Catapano, Arsalan Shawl, Brandon Somwaru
{"title":"Emergency department management of acute asthma exacerbations.","authors":"Steven M Hochman,&nbsp;Anthony Catapano,&nbsp;Arsalan Shawl,&nbsp;Brandon Somwaru","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Asthma is a disease of the airways characterized by inflammation, hyperresponsiveness, and bronchoconstriction. The diagnosis is primarily a clinical one, based on a focused history and physical examination, to differentiate from other entities such as heart failure, pneumonia, and pulmonary embolism. Radiographs, laboratory studies, and blood gases are not routinely recommended, except in atypical or refractory cases, or if there is diagnostic uncertainty. The cornerstone of acute asthma treatment includes short-acting beta agonists, anticholinergics, and systemic corticosteroids. This issue reviews the latest evidence in diagnostic and treatment strategies, including other pharmacologic treatments and newer management strategies to avoid intubation.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"24 2","pages":"1-32"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39854749","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 acute joint pain in the emergency department. 急诊科急性关节痛的诊断与处理。
Emergency medicine practice Pub Date : 2022-01-01
Rachel Sullivan
{"title":"Diagnosis and management of acute joint pain in the emergency department.","authors":"Rachel Sullivan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute monoarticular and polyarticular joint pain that results from infection, trauma, and autoimmune and inflammatory processes are a major cause of disability that is often preventable with early diagnosis and management. Septic arthritis presents a particular danger, with a high potential for morbidity and mortality. This issue presents an overview of the various types of acute joint pain that present to the emergency department, and outlines systematic, evidence-based strategies for diagnosis and treatment. Emerging infectious and reactive causes of arthritis, including Zika, chikungunya, and COVID-19 are reviewed. Best-practice recommendations for treatment and disposition based on diagnosis are highlighted.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"24 1","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39847199","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
Acute traumatic wounds: evaluation, cleansing, and repair in the ED. 急诊科的急性创伤:评估、清洗和修复。
Emergency medicine practice Pub Date : 2021-12-15
Stacey Barnes, Katrina D'Amore, Marco Propersi, Miguel Reyes
{"title":"Acute traumatic wounds: evaluation, cleansing, and repair in the ED.","authors":"Stacey Barnes,&nbsp;Katrina D'Amore,&nbsp;Marco Propersi,&nbsp;Miguel Reyes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Traumatic wounds are a common presentation in the emergency department. While most minor traumatic wounds and lacerations will heal well, appropriate management is required to preserve function and cosmesis as well as to prevent infection and other complications. This supplement reviews evidence-based recommendations for management of acute traumatic wounds, including evaluation, cleansing, anesthesia, selection of closure methods and materials, and post-repair instruction. Management of high-risk wounds and special considerations for the evaluation and repair of facial lacerations are also reviewed.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"23 Suppl 12","pages":"1-43"},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39805652","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
Thoracic aortic syndromes in the emergency department: recognition and management. 急诊科胸主动脉综合征的认识和处理。
Emergency medicine practice Pub Date : 2021-12-01
Anthony Hackett, Jonathan Stuart, Douglas L Robinson
{"title":"Thoracic aortic syndromes in the emergency department: recognition and management.","authors":"Anthony Hackett,&nbsp;Jonathan Stuart,&nbsp;Douglas L Robinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute aortic syndromes include aortic dissection, penetrating atherosclerotic ulcer, and intramural hematomas, but aortic dissection is the most common and the deadliest. This review summarizes the latest evidence on developing a differential for aortic dissection when common complaints, such as chest pain, abdominal pain, and syncope are also present. Recent evidence on the optimal uses of emergency department imaging studies and risk stratification tools are reviewed, along with special considerations in the management of penetrating atherosclerotic ulcer and intramural hematoma. Pharmacologic therapies for managing hemodynamic parameters and shock, and indications for operative intervention are also reviewed, along with cutting-edge diagnostic and treatment options on the horizon.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":" ","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39720594","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
Calculated decisions: Aortic Dissection Detection Risk Score (ADD-RS). 计算决策:主动脉夹层检测风险评分(ADD-RS)。
Emergency medicine practice Pub Date : 2021-12-01
Seth Crockford
{"title":"Calculated decisions: Aortic Dissection Detection Risk Score (ADD-RS).","authors":"Seth Crockford","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A review of the uses and evidence for the ADD-RS, which rules out aortic dissection.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"23 12","pages":"CD1-CD3"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9233314","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 rib fractures 急诊部对肋骨骨折的处理
Emergency medicine practice Pub Date : 2021-11-01
Patrick Maher
{"title":"Emergency Department management of rib fractures","authors":"Patrick Maher","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rib fractures resulting from blunt thoracic trauma are often associated with life-threatening complications of injury to cardiorespiratory systems. Given the risk for morbidity and mortality, the emergency clinician must be swift and thorough in diagnosing and managing these injuries. Society guidelines have been published to assist in determining best-practice approaches to pain control, imaging, and treatment. This issue reviews the recent studies and evidence for multimodal pain control, decision tools for diagnostic imaging, ventilatory support, and operative fixation. Scoring systems to determine disposition of patients are evaluated, with particular attention given to the special risks to the elderly patient.</p>","PeriodicalId":38728,"journal":{"name":"Emergency medicine practice","volume":"23 11","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39535298","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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