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Emergency Medicine Clinics of North America

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https://www.readbyqxmd.com/read/30297012/here-to-stay-infectious-diseases-in-emergency-medicine
#1
EDITORIAL
Stephen Y Liang, Rachel L Chin
No abstract text is available yet for this article.
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297011/infectious-disease-emergencies
#2
EDITORIAL
Amal Mattu
No abstract text is available yet for this article.
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297010/infection-prevention-for-the-emergency-department-out-of-reach-or-standard-of-care
#3
REVIEW
Stephen Y Liang, Madison Riethman, Josephine Fox
The emergency department (ED) presents unique challenges to infection control and prevention. Hand hygiene, transmission-based precautions, environmental cleaning, high-level disinfection and sterilization of reusable medical devices, and prevention of health care-associated infections (catheter-associated urinary tract infection, ventilator-associated pneumonia, central line-associated bloodstream infection) are key priorities in ED infection prevention. Effective and sustainable infection prevention strategies tailored to the ED are necessary and achievable...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297009/antimicrobial-stewardship-in-the-emergency-department
#4
REVIEW
Michael Pulia, Robert Redwood, Larissa May
The emergency department (ED) is the hub of the US health care system. Acute infectious diseases are frequently encountered in the ED setting, making this a critical setting for antimicrobial stewardship efforts. Systems level and behavioral stewardship interventions have demonstrated success in the ED setting but successful implementation depends on institutional support and the presence of a physician champion. Antimicrobial stewardship efforts in the ED should target high-impact areas: antibiotic prescribing for nonindicated respiratory tract conditions, such as bronchitis and sinusitis; overtreatment of asymptomatic bacteriuria; and using two antibiotics (double coverage) for uncomplicated cases of cellulitis or abscess...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297008/infectious-diseases-after-hydrologic-disasters
#5
REVIEW
Stephen Y Liang, Nicole Messenger
Hydrologic disasters, including hurricanes, tsunamis, and severe flooding, have been associated with infectious diseases, particularly among vulnerable and displaced populations in resource-poor settings. Skin and soft tissue infections, gastrointestinal infections, respiratory infections, zoonotic infections, and vector-borne diseases each present unique threats to human health in this setting. Increased emergency physician awareness of these infectious diseases and their diagnosis and management helps optimize medical care for survivors after a hydrologic disaster and safeguard the health of disaster responders...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297007/biothreat-agents-and-emerging-infectious-disease-in-the-emergency-department
#6
REVIEW
Amesh A Adalja
The challenges faced by the emergency physician with recognizing and treating category A biothreat agents and emerging infectious disease are summarized and reviewed.
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297006/approach-to-transplant-infectious-diseases-in-the-emergency-department
#7
REVIEW
Diana Zhong, Stephen Y Liang
The emergency department (ED) is an increasingly important site of care for patients who have undergone solid organ transplantation or hematopoietic cell transplantation. It is paramount for emergency physicians to recognize infections early on, obtain appropriate diagnostic testing, initiate empirical antimicrobial therapy, and consider specialty consultation and inpatient admission when caring for these patients. This review provides emergency physicians with an approach to the assessment of transplant patients' underlying risk for infection, formulation of a broad differential diagnosis, and initial management of transplant infectious disease emergencies in the ED...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297005/infectious-disease-emergencies-in-oncology-patients
#8
REVIEW
Lauren Cantwell, Jack Perkins
Oncology patients are a unique patient population in the emergency department (ED). Malignancy and associated surgical, chemotherapeutic, or radiation therapies put them at an increased risk for infection. The most ominous development is neutropenic fever, which happens often and may not present with signs or symptoms other than fever. A broad differential diagnosis is essential when considering infectious disease pathology in both neutropenic and non-neutropenic oncology patients in the ED.
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297004/management-of-human-immunodeficiency-virus-in-the-emergency-department
#9
REVIEW
Mercedes Torres, Siamak Moayedi
Over the past 30 years, significant advances have transformed the landscape of human immunodeficiency virus (HIV) care in the emergency department. Diagnosis and management of HIV has improved, resulting in a decline in the incidence of acquired immunodeficiency syndrome (AIDS)-defining infections. Advances in pharmacology have led to fewer serious medication toxicities and more tolerable regimens. Emergency providers have played an increasingly important role in HIV screening and diagnosis of acute infection...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297003/management-of-patients-with-sexually-transmitted-infections-in-the-emergency-department
#10
REVIEW
SueLin M Hilbert, Hilary E L Reno
Sexually transmitted infections (STI) are very common infections in the United States. Most patients with STIs are evaluated and treated in primary care settings; however, many also present to the Emergency Department (ED) for initial care. Management of STIs in the ED includes appropriate testing and treatment per CDC Sexually Transmitted Diseases Treatment Guidelines. Although most patients with STIs are asymptomatic or may only exhibit mild symptoms, serious complications from untreated infection are possible...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297002/musculoskeletal-infections-in-the-emergency-department
#11
REVIEW
Daniel C Kolinsky, Stephen Y Liang
Bone and joint infections are potentially limb-threatening or even life-threatening diseases. Emergency physicians must consider infection when evaluating musculoskeletal complaints, as misdiagnosis can have significant consequences. Patients with bone and joint infections can have heterogeneous presentations with nonspecific signs and symptoms. Staphylococcus aureus is the most commonly implicated microorganism. Although diagnosis may be suggested by physical examination, laboratory testing, and imaging, tissue sampling for Gram stain and microbiologic culture is preferable, as pathogen identification and susceptibility testing help optimize long-term antibiotic therapy...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297001/skin-and-soft-tissue-infections-in-the-emergency-department
#12
REVIEW
Amelia Breyre, Bradley W Frazee
This article covers the diagnosis and treatment of skin and soft tissue infections commonly encountered in the emergency department: impetigo, cutaneous abscesses, purulent cellulitis, nonpurulent cellulitis, and necrotizing skin and soft tissue infections. Most purulent infections in the United States are caused by methicillin-resistant Staphylococcus aureus. For abscesses, we emphasize the importance of incision and drainage. Nonpurulent infections are usually caused by streptococcal species and initial empiric antibiotics need not cover methicillin-resistant Staphylococcus aureus...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30297000/emergency-department-approach-to-the-patient-with-suspected-central-nervous-system-infection
#13
REVIEW
Rupal Jain, Wan-Tsu W Chang
Central nervous system (CNS) infections require early recognition and aggressive management to improve patient survival and prevent long-term neurologic sequelae. Although early detection and treatment are important in many infectious syndromes, CNS infections pose unique diagnostic and therapeutic challenges. The nonspecific signs and symptoms at presentation, lack of characteristic infectious changes in laboratory and imaging diagnostics, and closed anatomic and immunologically sequestered space each present challenges to the emergency physician...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30296999/the-emergency-department-diagnosis-and-management-of-urinary-tract-infection
#14
REVIEW
Brit Long, Alex Koyfman
Urinary tract infection (UTI) is a common infection seen in the emergency department. The spectrum of UTI includes simple versus complicated infection and lower versus upper UTI. No one history or examination finding is definitive for diagnosis. Testing often includes urinalysis and/or urine dipstick, and several pitfalls may occur in interpretation. Urine cultures should be obtained in complicated or upper UTIs but not simple and lower tract UTIs, unless a patient is pregnant. Imaging often is not required...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30296998/community-acquired-pneumonia
#15
REVIEW
Ashley C Rider, Bradley W Frazee
Community-acquired pneumonia is one of the most common infections seen in emergency department patients. There is a wide spectrum of disease severity and viral pathogens are common. After a careful history and physical examination, chest radiographs may be the only diagnostic test required. The first step in management is risk stratification, using a validated clinical decision rule and serum lactate, followed by early antibiotics and fluid resuscitation when indicated. Antibiotics should be selected with attention to risk factors for multidrug-resistant respiratory pathogens...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30296997/infective-endocarditis
#16
REVIEW
Elaine Yang, Bradley W Frazee
Infective endocarditis (IE) is an uncommon infection of cardiac valves associated with bacteremia. It increasingly affects elderly patients with chronic disease and artificial cardiac devices. The presentation, however, remains subtle and varied, with nonspecific symptoms ranging from those resembling a mild viral infection to septic shock and multiorgan failure. IE carries potential to cause significant morbidity and mortality through its impact on cardiac function and from embolic complications. Blood cultures prior to antibiotics and obtaining prompt echocardiography are key diagnostic steps, followed by proper selection of empiric antibiotics and, in many cases, collaboration with infectious disease, cardiology, and cardiothoracic surgery specialists...
November 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/30037451/the-heme-onc-tidal-wave-are-you-prepared
#17
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
#18
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
#19
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
#20
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
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