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Emergency Medicine Clinics of North America

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https://www.readbyqxmd.com/read/30037451/the-heme-onc-tidal-wave-are-you-prepared
#1
EDITORIAL
Colin G Kaide, Sarah B Dubbs
No abstract text is available yet for this article.
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037450/hematologic-and-oncologic-emergencies
#2
EDITORIAL
Amal Mattu
No abstract text is available yet for this article.
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037449/the-oncologic-emergency-medicine-fellowship
#3
REVIEW
Michael G Purcell, Imad El Majzoub
The United States cancer population is growing and is projected to grow further. The current cancer population has a high rate of emergency department admission. Further training about oncologic emergencies may be needed and would ideally strive to care for the whole patient, including sequelae of the malignancy, progressive disease, symptom control, adverse effects of treatment, and palliative care. The James Cancer Hospital at The Ohio State University Wexner Medical Center and The University of Texas MD Anderson Cancer Center fellowship training programs in oncologic emergency medicine are described...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037448/the-cancer-emergency-department-the-ohio-state-university-james-cancer-center-experience
#4
REVIEW
Luca R Delatore
In 2015, The James Cancer Hospital's Emergency Department (ED) opened at The Ohio State University Wexner Medical Center's ED. Careful planning was undertaken to assure that the needs of patients with cancer would be addressed. Strong relationships between experts in hematology, oncology, and emergency medicine were built to maximize the positive impact. Ongoing reevaluation of operational needs facilitates optimal patient flow, resource use, and opportunities to build and develop new resources. The results are evident in improved patient satisfaction in the cancer ED and a much smoother flow of patients into the system...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037447/emergency-medicine-evaluation-and-management-of-anemia
#5
REVIEW
Brit Long, Alex Koyfman
Anemia is a common condition and is diagnosed on laboratory assessment. It is defined by abnormally low hemoglobin concentration or decreased red blood cells. Several classification systems exist. Laboratory markers provide important information. Acute anemia presents with symptoms owing to acute blood loss; chronic anemia may present with worsening fatigue, dyspnea, lightheadedness, or chest pain. Specific treatments depend on the underlying anemia and etiology. Iron is an alternative treatment for patients with microcytic anemia owing to iron deficiency...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037446/rapid-fire-acute-blast-crisis-hyperviscosity-syndrome
#6
REVIEW
Geremiha Emerson, Colin G Kaide
Emergency providers are likely to encounter patients with acute and chronic leukemias. In some cases, the first presentation to the emergency department may be for symptoms related to blast crisis and leukostasis. Making a timely diagnosis and consulting a hematologist can be life saving. Presenting symptoms are caused by complications of bone marrow infiltration and hyperleukocytosis with white blood cell counts over 100,000. Presentations may include fatigue (anemia), bleeding (thrombocytopenia), shortness of breath, and/or neurologic symptoms owing to hyperleukocytosis and subsequent leukostasis...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037445/anticoagulation-reversal
#7
REVIEW
Erica M Simon, Matthew J Streitz, Daniel J Sessions, Colin G Kaide
Today a variety of anticoagulants and antiplatelet agents are available on the market. Given the propensity for bleeding among patients prescribed these medications, the emergency medicine physician must be equipped with a working knowledge of hemostasis, and anticoagulant and antiplatelet reversal. This article reviews strategies to address bleeding complications occurring secondary to warfarin, low-molecular-weight heparin, and direct oral anticoagulant therapy.
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037444/rapid-fire-superior-vena-cava-syndrome
#8
REVIEW
Shelly Zimmerman, Matthew Davis
Superior vena cava syndrome occurs from obstruction of the superior vena cava. The most common cause is malignancy. Small cell lung cancer and non-Hodgkin lymphoma are the most frequent culprits. Intravascular devices associated with thrombus are becoming more common causes. Classic symptoms include edema, plethora, and distended veins of the face, neck, and chest; shortness of breath; cough; headache; and hoarseness. Treatment in the emergency department is mostly supportive, with head elevation, oxygen, and steroids...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037443/rapid-fire-sickle-cell-disease
#9
REVIEW
Michael Porter
Emergency providers are likely to encounter sickle cell disease-related emergencies. The pathophysiology of emergent complaints are usually related to either an acute anemia or a vasoocclusive crisis. Differentiating between the two is the first step in the workup. Anemic crises must then be differentiated by the source. Vasoocclusive crises must be appropriately treated with aggressive pain management, gentle hydration, and other appropriate adjuncts. Early recognition and treatment are key in providing excellent emergency care to those with sickle cell disease...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037442/rapid-fire-pericardial-effusion-and-tamponade
#10
REVIEW
Akilesh P Honasoge, Sarah B Dubbs
One of the most common causes of pericardial effusion in the Western world is malignancy. Emergency physicians must maintain vigilance in suspecting pericardial effusion and tamponade in patients with known or suspected malignancy who present with tachycardia, dyspnea, and hypotension. Diagnosis can be expedited by key physical examination, electrocardiogram, and sonographic findings. Unstable or crashing patients with tamponade must undergo emergent pericardiocentesis for removal of fluid and pressure to restore cardiac output...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037441/rapid-fire-hypercalcemia
#11
REVIEW
Angela Irene Carrick, Holly Briann Costner
Hypercalcemia is commonly encountered in the clinical setting and requires identification by the clinician to avoid disastrous patient outcomes. The 2 most common causes are malignancy and hyperparathyroidism. The underlying cause for hypercalcemia may be readily known at presentation or may require further investigation. After identification, acuity of treatment will depend on severity of calcium level and symptoms. In the emergency setting, intravenous hydration with isotonic fluids is the treatment mainstay...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037440/rapid-fire-central-nervous-system-emergencies
#12
REVIEW
Sarah B Dubbs, Akilesh P Honasoge
Neurologic complications are unfortunately common in oncology patients, with many presenting to the emergency department for diagnosis and management. This case-based review provides a brief overview of the key points in pathophysiology, diagnosis, and management of 2 oncologic central nervous system emergencies: malignant spinal cord compression and intracranial mass.
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037439/pediatric-oncologic-emergencies
#13
REVIEW
Kathleen Stephanos, Lindsey Picard
Pediatric patients with cancer, although rarely, do present to emergency departments for first-time diagnosis, as well as for complications of treatment. The presenting symptoms can be vague, so emergency physicians must maintain a high index of suspicion and be aware of guidelines to help direct appropriate care after an initial diagnosis. It is also necessary to know the complications of treatment. Although these patients often seek care in the institution where they receive treatment, many live far from these locations and may present to any emergency department in extremis...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037438/rapid-fire-tumor-lysis-syndrome
#14
REVIEW
Sarah B Dubbs
Tumor lysis syndrome (TLS) is a life-threatening oncologic emergency, characterized by a constellation of hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia. The spectrum ranges from patients who are asymptomatic to those who go into cardiac arrest and die. Prompt recognition and initiation of treatment by emergency physicians are key, especially in the early stages of the syndrome. This case-based review presents an overview of the key points in pathophysiology, diagnosis, and management of TLS that are key to emergency physicians...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037437/rapid-fire-infectious-disease-emergencies-in-patients-with-cancer
#15
REVIEW
Stephanie Charshafian, Stephen Y Liang
Patients with cancer can be immunocompromised because of their underlying malignancy as well as the medical therapies with which they are treated. Infections frequently present atypically and can be challenging to diagnose. The spectrum of infectious diseases encountered in patients receiving chemotherapy, hematopoietic stem cell transplant, and immunotherapy is broad depending on the depth of immunosuppression. Early recognition of infectious processes followed by appropriate diagnostic testing, imaging, and empiric antibiotic therapy in the emergency department are critical to providing optimal care and improving survival in this complex patient population...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037436/the-latest-cancer-agents-and-their-complications
#16
REVIEW
Sarah B Dubbs
The latest cancer agents, collectively known as cancer immunotherapy, have tremendously increased the armamentarium against cancer. Their targeted mechanisms seem ideal, but they do come with complications. As these therapies become more widespread, emergency physicians everywhere must be aware of the immune-related adverse events that can occur, and be ready to identify and coordinate treatment. This article provides the emergency physician with a brief introduction and overview of immunotherapy drugs and their complications...
August 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29622337/pediatric-emergencies-the-common-and-the-critical
#17
EDITORIAL
Sean M Fox, Dale P Woolridge
No abstract text is available yet for this article.
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29622336/pediatric-emergencies
#18
EDITORIAL
Amal Mattu
No abstract text is available yet for this article.
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29622335/pediatric-thoracic-trauma-recognition-and-management
#19
REVIEW
Stacy L Reynolds
Thoracic injuries account for less than one-tenth of all pediatric trauma-related injuries but comprise 14% of pediatric trauma-related deaths. Thoracic trauma includes injuries to the lungs, heart, aorta and great vessels, esophagus, tracheobronchial tree, and structures of the chest wall. Children have unique anatomic features that change the patterns of observed injury compared with adults. This review article outlines the clinical presentation, diagnostic testing, and management principles required to successfully manage injured children with thoracic trauma...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29622334/pediatric-major-head-injury-not-a-minor-problem
#20
REVIEW
Aaron N Leetch, Bryan Wilson
Traumatic brain injury is a highly prevalent and devastating cause of morbidity and mortality in children. A rapid, stepwise approach to the traumatized child should proceed, addressing life-threatening problems first. Management focuses on preventing secondary injury from physiologic extremes such as hypoxemia, hypotension, prolonged hyperventilation, temperature extremes, and rapid changes in cerebral blood flow. Initial Glasgow Coma Score, hyperglycemia, and imaging are often prognostic of outcome. Surgically amenable lesions should be evacuated promptly...
May 2018: Emergency Medicine Clinics of North America
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