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Emergency Medicine Practice

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https://www.readbyqxmd.com/read/30070813/points-pearls-cannabinoids-emerging-evidence-in-use-and-abuse
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/29634896/jaundice-in-the-emergency-department-meeting-the-challenges-of-diagnosis-and-treatment-digest
#9
Todd Taylor, Matthew Wheatley, Nachi Gupta, Jeffrey Nusbaum
There are approximately 52,000 visits a year to emergency departments for patients presenting with jaundice. While many of these patients will not have immediately life-threatening pathology, it is essential that the emergency clinician understands the pathophysiology of jaundice, as this will guide the appropriate workup to detect critical diagnoses. Patients who present with jaundice could require intravenous antibiotics, emergent surgery, and, in severe cases, organ transplantation. This issue will focus on the challenge of evaluating and treating the jaundiced patient in the ED using the best available evidence from the literature...
April 2, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29617550/calculated-decisions-acetaminophen-overdose-and-n-acetylcysteine-nac-dosing
#10
Scott Lucyk
No abstract text is available yet for this article.
April 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29617548/calculated-decisions-king-s-college-criteria-for-acetaminophen-toxicity
#11
Vincent Nguyen
No abstract text is available yet for this article.
April 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29565526/jaundice-in-the-emergency-department-meeting-the-challenges-of-diagnosis-and-treatment
#12
Todd Taylor, Matthew Wheatley
There are approximately 52,000 visits a year to emergency departments for patients presenting with jaundice. While many of these patients will not have immediately life-threatening pathology, it is essential that the emergency clinician understands the pathophysiology of jaundice, as this will guide the appropriate workup to detect critical diagnoses. Patients who present with jaundice could require intravenous antibiotics, emergent surgery, and, in severe cases, organ transplantation. This issue will focus on the challenge of evaluating and treating the jaundiced patient in the ED using the best available evidence from the literature...
April 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29489309/calculated-decisions-rads-radiologist%C3%A2-s-score-for-smoke-inhalation-injury
#13
Pujan H. Patel
No abstract text is available yet for this article.
March 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29489308/calculated-decisions-abbreviated-injury-score-ais-for-inhalation-injury
#14
Pujan H. Patel
No abstract text is available yet for this article.
March 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29489307/emergency-department-management-of-smoke-inhalation-injury-in-adults-digest
#15
Karalynn Otterness, Christine Ahn, Jeffrey Nusbaum, Nachi Gupta
Smoke inhalation injury portends increased morbidity and mortality in fire-exposed patients. Upper airway thermal burns, inflammation from lower airway irritants, and systemic effects of carbon monoxide and cyanide can contribute to injury. A standardized diagnostic protocol for inhalation injury is lacking, and management remains mostly supportive. Clinicians should maintain a high index of suspicion for concomitant traumatic injuries. Diagnosis is mostly clinical, aided by bronchoscopy and other supplementary tests...
March 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29489306/emergency-department-management-of-smoke-inhalation-injury-in-adults
#16
Karalynn Otterness, Christine Ahn
Smoke inhalation injury portends increased morbidity and mortality in fire-exposed patients. Upper airway thermal burns, inflammation from lower airway irritants, and systemic effects of carbon monoxide and cyanide can contribute to injury. A standardized diagnostic protocol for inhalation injury is lacking, and management remains mostly supportive. Clinicians should maintain a high index of suspicion for concomitant traumatic injuries. Diagnosis is mostly clinical, aided by bronchoscopy and other supplementary tests...
March 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29388754/emergency-department-management-of-patients-with-thermal-burns-digest
#17
Juliana Tolles, Nachi Gupta, Jeffrey Nusbaum
Thermal burn injuries are a significant cause of morbidity and mortality worldwide. In addition to treatment of the burns, emergency clinicians must assess for inhalation injury, exposure to toxic gases, and related traumatic injuries. Priorities for emergency resuscitation include stabilization of airway and breathing, intravenous fluid administration, pain control, and local wound care. Special populations, including children and pregnant women, require additional treatment considerations. Referral to specialized burn care for select patients is necessary to improve long-term outcomes...
February 1, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29369586/emergency-department-management-of-patients-with-thermal-burns
#18
Juliana Tolles
Thermal burn injuries are a significant cause of morbidity and mortality worldwide. In addition to treatment of the burns, emergency clinicians must assess for inhalation injury, exposure to toxic gases, and related traumatic injuries. Priorities for emergency resuscitation include stabilization of airway and breathing, intravenous fluid administration, pain control, and local wound care. Special populations, including children and pregnant women, require additional treatment considerations. Referral to specialized burn care for select patients is necessary to improve long-term outcomes...
February 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29369604/calculated-decisions-parkland-formula-for-burns
#19
David Zodda
No abstract text is available yet for this article.
January 25, 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29363928/managing-patients-with-oncologic-complications-in-the-emergency-department-digest
#20
David Wacker, Michael T McCurdy, Jeffrey Nusbaum, Nachi Gupta
As the prevalence of cancer continues to increase in the general population and improvements in cancer treatment prolong survival, the incidence of patients presenting to the emergency department with oncologic complications will, similarly, continue to rise. This issue reviews 3 of the more common presentations of oncology patients to the emergency department: metastatic spinal cord compression, tumor lysis syndrome, and febrile neutropenia. Signs and symptoms of these conditions can be varied and nonspecific, and may be related to the malignancy itself or to an adverse effect of the cancer treatment...
January 22, 2018: Emergency Medicine Practice
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