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ER Dogma

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521 papers 1000+ followers ER dogma
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
Caitlin R Dean, Manjeet Shemar, Gillian A U Ostrowski, Rebecca C Painter
No abstract text is available yet for this article.
November 30, 2018: BMJ: British Medical Journal
Christian Backer Mogensen, Malene Bue Vilhelmsen, Johanne Jepsen, Lilian Keene Boye, Maiken Hjuler Persson, Florence Skyum
BACKGROUND: A new generation of ear thermometers with preheated tips and several measurements points should allow a more precise temperature measurement. The aim of the study was to evaluate if the ear temperature measured by this ear thermometer can be used to screen for fever and whether the thermometer is in agreement with the rectal temperature and if age, use of hearing devices or time after admission influences the temperature measurements. METHODS: Open cross-sectional clinical single site study patients, > 18 years old, who were acutely admitted to the short stay unit at the ED...
December 3, 2018: BMC Emergency Medicine
Risa B Burns, C Christopher Smith, Robert H Shmerling, Anjala Tess
Gout is the most common form of inflammatory arthritis. In 2012, the American College of Rheumatology (ACR) issued a guideline, which was followed in 2017 by one from the American College of Physicians (ACP). The guidelines agree on treating acute gout with a corticosteroid, nonsteroidal anti-inflammatory drug, or colchicine and on not initiating long-term urate-lowering therapy (ULT) for most patients after a first gout attack and in those whose attacks are infrequent (<2 per year). However, they differ on treatment of both recurrent gout and problematic gout...
December 4, 2018: Annals of Internal Medicine
Corey Heitz, Justin Morgenstern, Christopher Bond, William K Milne
Ketamine has been studied as an alternative to opioids for acute pain in the emergency department setting. This review compares the effectives of intravenous ketamine at a dose of <0.5mg/kg to opioids for acute pain in adult patients. Measurements were taken within 60 minutes of administration. Ketamine was found to have similar effectiveness to opioids. Increased, but short-lived, side effects were seen with ketamine.
November 27, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Matthew James Reed
Syncope is a common reason for ED attendance and it presents a major management challenge with regard to the appropriate workup and disposition. Nearly 50% of patients are admitted, and for many this is unnecessary; clinical decision rules have not proven to decrease unnecessary admissions. The European Society of Cardiology has recently developed guidance for managing syncope in the ED. This article highlights the key steps in evaluating syncope in the ED, factors involved in determining risk of a cardiac cause, and considerations for admission, observation or discharge...
November 23, 2018: Emergency Medicine Journal: EMJ
Jeremiah S Hinson, Diego A Martinez, Stephanie Cabral, Kevin George, Madeleine Whalen, Bhakti Hansoti, Scott Levin
STUDY OBJECTIVE: Rapid growth in emergency department (ED) triage literature has been accompanied by diversity in study design, methodology, and outcome assessment. We aim to synthesize existing ED triage literature by using a framework that enables performance comparisons and benchmarking across triage systems, with respect to clinical outcomes and reliability. METHODS: PubMed, EMBASE, Scopus, and Web of Science were systematically searched for studies of adult ED triage systems through 2016...
November 20, 2018: Annals of Emergency Medicine
Lorna M Gibson, Laura Paul, Francesca M Chappell, Malcolm Macleod, William N Whiteley, Rustam Al-Shahi Salman, Joanna M Wardlaw, Cathie L M Sudlow
OBJECTIVES: To determine prevalence and types of potentially serious incidental findings on magnetic resonance imaging (MRI) in apparently asymptomatic adults, describe factors associated with potentially serious incidental findings, and summarise information on follow-up and final diagnoses. DESIGN: Systematic review and meta-analyses. DATA SOURCES: Citation searches of relevant articles and authors' files in Medline and Embase (from inception to 25 April 2017)...
November 22, 2018: BMJ: British Medical Journal
Anne Robinson
No abstract text is available yet for this article.
November 20, 2018: BMJ: British Medical Journal
Sally Liang
Influenza is an acute respiratory infection that imposes a heavy burden on society. The illness itself usually lasts a few days but the residual symptoms of cough and malaise can last for weeks. In addition, it can cause complications such as otitis media, pneumonia, secondary bacterial pneumonia, exacerbations of chronic respiratory disease, bronchiolitis, febrile seizures, Reye's syndrome, and myocarditis.1 Vaccines have been developed in attempt to minimize the effects of influenza. However, given the yearly antigenic changes of the virus, a new vaccine has to be developed, produced, and administered to the population every year...
November 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Scott J Adams, Paul S Babyn, Alanna Danilkewich
No abstract text is available yet for this article.
July 2016: Canadian Family Physician Médecin de Famille Canadien
Shannon O'Donnell, Darrell H S Tan, Mark W Hull
The incidence of HIV infections in Canada has increased yearly since 2014. New cases of HIV have resulted almost exclusively from non-occupational exposures, including sexual contact and needle sharing. Appropriate HIV post-exposure prophylaxis is under-prescribed to patients who present to the emergency department after a high-risk exposure. In November of 2017, a Canadian guideline on HIV pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) was published. The guideline presents a standardized, evidence-based approach to assessing risk for HIV transmission and prescribing HIV prophylaxis...
November 20, 2018: CJEM
Edward C Jauch, Christine A Holmstedt
No abstract text is available yet for this article.
November 9, 2018: Annals of Emergency Medicine
Daniel S Kowalsky, Allan B Wolfson
Post-herpetic neuralgia is a painful condition of persistent chronic pain following acute reactivation of varicella zoster virus. The review defines PHN as persisting or recurring pain at the site of shingles at least one month after the onset of the acute rash. The incidence of shingles increases with age, almost doubling in each decade after 50 years of age. Of these cases, roughly 20% go on to develop PHN, with age again being the strongest risk factor.1 The pain of PHN is frequently debilitating and can significantly affect quality of life...
November 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Tim Montrief, Alex Koyfman, Brit Long
INTRODUCTION: Acute liver failure (ALF) remains a high-risk clinical presentation, and many patients require emergency department (ED) management for complications and stabilization. OBJECTIVE: This narrative review provides an evidence-based summary of the current data for the emergency medicine evaluation and management of ALF. DISCUSSION: While ALF remains a rare clinical presentation, surveillance data suggest an overall incidence between 1 and 6 cases per million people every year, accounting for 6% of liver-related deaths and 7% of orthotopic liver transplants (OLT) in the U...
October 22, 2018: American Journal of Emergency Medicine
H S Rosman, S Patel, S Borzak, G Paone, K Retter
STUDY OBJECTIVES: Aortic dissection generally is an acute catastrophe. Rapid diagnosis is critical. We hypothesized that the quality of history taking contributes to the accuracy of diagnosis in patients with dissection. DESIGN: Retrospective chart review of 83 patients, whose diagnosis of aortic dissection was confirmed by autopsy, surgery, CT scan, echocardiogram, or angiogram. The quality of the initial history was reviewed using predetermined criteria. The physicians' initial clinical impressions were recorded...
September 1998: Chest
Prabath C A M Lodewijks, Diyar Delawi, Thomas L Bollen, Gawein R Dijkhuis, Nienke Wolterbeek, Jacco A C Zijl
PURPOSE: To describe the validity and inter- and intra-observer reliability of the lateral femoral notch sign (LFNS) as measured on conventional radiographs for diagnosing acute anterior cruciate ligament (ACL) injury. METHODS: Patients (≤ 45 years) with a traumatic knee injury who underwent knee arthroscopy and had preoperative radiographs were retrospectively screened for this case-control study. Included patients were assigned to the ACL injury group (n = 65) or the control group (n = 53) based on the arthroscopic findings...
October 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Krista Brucker, Carter Duggan, Joseph Niezer, Kyle Roseberry, Helen Le-Niculescu, Alexander B Niculescu, Jeffrey A Kline
BACKGROUND: Emergency departments (ED) are the first line of evaluation for patients at risk and in crisis, with or without overt suicidality (ideation, attempts). Currently employed triage and assessments methods miss some of the individuals who subsequently become suicidal. The Convergent Functional Information for Suicidality (CFI-S) 22-item checklist of risk factors, which does not ask directly about suicidal ideation, has demonstrated good predictive ability for suicidality in previous studies in psychiatrict patients but has not been tested in the real-world setting of EDs...
October 30, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Shannon M Fernando, Alexandre Tran, Wei Cheng, Bram Rochwerg, Monica Taljaard, Venkatesh Thiruganasambandamoorthy, Kwadwo Kyeremanteng, Jeffrey J Perry
OBJECTIVE: The HEART score has been proposed for emergency department (ED) prediction of major adverse cardiac events (MACE). We sought to summarize all studies assessing the prognostic accuracy of the HEART score for prediction of MACE in adult ED patients presenting with chest pain. METHODS: We searched MEDLINE, PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews from inception through May 2018 and included studies using the HEART score for the prediction of short-term MACE in adult patients presenting to the ED with chest pain...
October 29, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Mieke L van Driel, Sophie Scheire, Laura Deckx, Philippe Gevaert, An De Sutter
No abstract text is available yet for this article.
October 10, 2018: BMJ: British Medical Journal
Christina L Shenvi, Timothy F Platts-Mills
No abstract text is available yet for this article.
October 1, 2018: Annals of Emergency Medicine
2018-10-07 15:59:54
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