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Emergency Medicine Practice

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https://www.readbyqxmd.com/read/30280868/points-pearls-updates-and-controversies-in-the-early-management-of-sepsis-and-septic-shock
#1
Faheem Guirgis, Lauren Page Black, Elizabeth L DeVos, Nachi Gupta, Jeffrey Nusbaum
Sepsis is a common and life-threatening condition that requires early recognition and swift initial management. Diagnosis and treatment of sepsis and septic shock are fundamental for emergency clinicians, and include knowledge of clinical and laboratory indicators of subtle and overt organ dysfunction, infection source control, and protocols for prompt identification of the early signs of septic shock. [Points & Pearls is a digest of Emergency Medicine Practice.]
October 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30280854/calculated-decisions-qsofa-quick-sofa-score-for-sepsis
#2
Kamal Medlej
The qSOFA score identifies patients with suspected infection who are at high risk for in-hospital mortality outside of the intensive care unit.
October 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30280853/calculated-decisions-sequential-organ-failure-assessment-sofa-score
#3
Kamal Medlej
The SOFA score predicts mortality risk for patients in the intensive care unit based on lab results and clinical data.
October 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30252228/updates-and-controversies-in-the-early-management-of-sepsis-and-septic-shock
#4
Faheem Guirgis, Lauren Page Black, Elizabeth L DeVos
Sepsis is a common and life-threatening condition that requires early recognition and swift initial management. Diagnosis and treatment of sepsis and septic shock are fundamental for emergency clinicians, and include knowledge of clinical and laboratory indicators of subtle and overt organ dysfunction, infection source control, and protocols for prompt identification of the early signs of septic shock. This issue is a structured review of the literature on the management of sepsis, focusing on the current evidence, guidelines, and protocols...
October 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30183239/calculated-decisions-glasgow-coma-scale
#5
Daniel Runde
The Glasgow Coma Scale (GCS) estimates coma severity based on eye, verbal, and motor criteria.
October 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30183238/calculated-decisions-bastion-classification-of-lower-limb-blast-injuries
#6
Jennie Kim, Travis Polk
The Bastion Classification criteria stratify explosionrelated lower limb injuries into 5 categories to guide treatment.
September 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30183237/calculated-decisions-blast-lung-injury-severity-score
#7
Jennie Kim, Travis Polk
The Blast Lung Injury Severity Score stratifies primary blast lung injuries into 3 categories to guide ventilator treatment.
September 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30183234/calculated-decisions-focused-assessment-with-sonography-for-trauma-fast
#8
Jennie Kim, Morgan Schellenberg, Kenji Inaba
Focused Assessment with Sonography for Trauma (FAST) predicts the presence of pericardial or intra-abdominal injury after penetrating or blunt trauma.
September 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30183233/cacluated-decisions-tash-trauma-associated-severe-hemorrhage-score
#9
Graham Walker, Rachel Kwon
The TASH Score predicts the need for massive transfusion based on clinical and laboratory data.
September 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30179413/points-pearls-emergency-department-management-of-north-american-snake-envenomations
#10
Sophia Sheikh, Patrick Leffers, Jeffrey Nusbaum, Nachi Gupta
There are approximately 10,000 emergency department visits in the United States for snakebites every year, and one-third of those involve venomous species. Venomous North American indigenous snakes include species from the Crotalinae (pit vipers) and Elapidae (coral snakes) subfamilies. Treatment relies on supportive care, plus antivenom for select cases. While certain principles of management are widely accepted, controversies exist with regard to prehospital use of pressure immobilization, antivenom use, coagulation testing after copperhead envenomation, and fasciotomy...
September 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30179411/calculated-decisions-antivenom-dosing-algorithm
#11
Stephen A. Harding
The Antivenom Dosing Algorithm specifies the manifestations of Crotalinae (pit viper, formerly known as Crotalidae) snake envenomation that necessitate aggressive management.
September 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30130010/emergency-department-management-of-north-american-snake-envenomations
#12
Sophia Sheikh, Patrick Leffers
There are approximately 10,000 emergency department visits in the United States for snakebites every year, and one-third of those involve venomous species. Venomous North American indigenous snakes include species from the Crotalinae (pit vipers) and Elapidae (coral snakes) subfamilies. Treatment relies on supportive care, plus antivenom for select cases. While certain principles of management are widely accepted, controversies exist with regard to prehospital use of pressure immobilization, antivenom use, coagulation testing after copperhead envenomation, and fasciotomy...
September 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30070813/points-pearls-cannabinoids-emerging-evidence-in-use-and-abuse
#13
Mollie Williams, Nachi Gupta, Jeffrey Nusbaum
Despite current legal and medical controversies surrounding cannabinoids, it is a fact that emergency departments are seeing an increasing number of patients presenting with symptoms associated with the use of these drugs. This review outlines the pathophysiology of cannabinoids, the potential clinical findings associated with their use, and the current evidence for best-practice management of patients who present to the emergency department with signs of acute intoxication and chronic use. Differences between natural and synthetic cannabinoids are discussed, along with the latest evidence for diagnosing and managing patients presenting with the intractable vomiting of cannabinoid hyperemesis syndrome...
August 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/30020736/cannabinoids-emerging-evidence-in-use-and-abuse
#14
Molly V Williams
Despite current legal and medical controversies surrounding cannabinoids, it is a fact that emergency departments are seeing an increasing number of patients presenting with symptoms associated with the use of these drugs. This review outlines the pathophysiology of cannabinoids, the potential clinical findings associated with their use, and the current evidence for best-practice management of patients who present to the emergency department with signs of acute intoxication and chronic use. Differences between natural and synthetic cannabinoids are discussed, along with the latest evidence for diagnosing and managing patients presenting with the intractable vomiting of cannabinoid hyperemesis syndrome...
August 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29993207/points-pearls-emergency-department-management-of-dyspnea-in-the-dying-patient
#15
REVIEW
Ashley Shreves, Trevor R. Pour, Nachi Gupta, Jeffrey Nusbaum
Dyspnea is one of the most distressing symptoms experienced by dying patients, and it is a common reason for such patients to seek care in the emergency department. Many underlying disease states and acute illnesses cause shortness of breath at the end of life, and management tends to be symptomatic rather than diagnostic, particularly in those for whom comfort is the most important goal. Opioids are the most effective and widely studied agents available for palliation of dyspnea in this population, while adjuvant therapies such as oxygen, noninvasive positive pressure ventilation, and hand-held fans may also be used...
July 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29949707/emergency-department-management-of-dyspnea-in-the-dying-patient
#16
REVIEW
Ashley Shreves, Trevor R Pour
Dyspnea is one of the most distressing symptoms experienced by dying patients, and it is a common reason for such patients to seek care in the emergency department. Many underlying disease states and acute illnesses cause shortness of breath at the end of life, and management tends to be symptomatic rather than diagnostic, particularly in those for whom comfort is the most important goal. Opioids are the most effective and widely studied agents available for palliation of dyspnea in this population, while adjuvant therapies such as oxygen, noninvasive positive pressure ventilation, and hand-held fans may also be used...
July 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29906380/points-pearls-managing-shoulder-injuries-in-the-emergency-department-fracture-dislocation-and-overuse
#17
Richard Pescatore, Andrew Nyce, Nachi Gupta, Jeffrey Nusbaum
The complex structures of the shoulder can be injured by fracture, dislocation, and overuse, and correctly identifying and classifying injury is essential to avoiding pain, disability, and life- and limb-threatening complications. This issue presents a systematic approach to classifying shoulder injuries based on the mechanism of injury and clinical presentation, choosing appropriate imaging, and determining the best strategies for treatment, including reduction, surgical consultation, or outpatient referral...
June 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29771483/managing-shoulder-injuries-in-the-emergency-department-fracture-dislocation-and-overuse
#18
Richard Pescatore, Andrew Nyce
The complex structures of the shoulder can be injured by fracture, dislocation, and overuse, and correctly identifying and classifying injury is essential to avoiding pain, disability, and life- and limb-threatening complications. This issue presents a systematic approach to classifying shoulder injuries based on the mechanism of injury and clinical presentation, choosing appropriate imaging, and determining the best strategies for treatment, including reduction, surgical consultation, or outpatient referral...
June 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29717846/recognizing-and-managing-emerging-infectious-diseases-in-the-emergency-department-digest
#19
Ramón Millán, Deepti Thomas-Paulose, Daniel J Egan, Jeffrey Nusbaum, Nachi Gupta
With population shifts, increased travel, and climate change, the spread of emerging and re-emerging infections is increasing. Although encountering a patient with an emerging infection on any given emergency department shift is unlikely, missing a diagnosis could have profound consequences for the patient, healthcare workers, and the patient's close contacts. This review provides a framework to evaluate, diagnose, and treat a returning traveler with suspected Middle East respiratory syndrome, chikungunya virus, or Zika virus-3 recently emerged infections...
May 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29697919/recognizing-and-managing-emerging-infectious-diseases-in-the-emergency-department
#20
Ramón Millán, Deepti Thomas-Paulose, Daniel J. Egan
With population shifts, increased travel, and climate change, the spread of emerging and re-emerging infections is increasing. Although encountering a patient with an emerging infection on any given emergency department shift is unlikely, missing a diagnosis could have profound consequences for the patient, healthcare workers, and the patient's close contacts. This review provides a framework to evaluate, diagnose, and treat a returning traveler with suspected Middle East respiratory syndrome, chikungunya virus, or Zika virus-3 recently emerged infections...
May 2018: Emergency Medicine Practice
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