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ER Dogma

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459 papers 500 to 1000 followers ER dogma
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
https://www.readbyqxmd.com/read/29781559/hot-off-the-press-sgem-215-aortic-dissection-love-will-tear-us-apart
#1
Corey Heitz, Justin Morgenstern, Christopher Bond, William K Milne
This systematic review provides an assessment of the diagnostic accuracy of various historical, physical, and clinical examination features for aortic dissection. 9 articles were included, with moderate to high heterogeneity. Limitations to general practice include risk of selection bias and partial verification bias. Risk scores were included, but their use is not recommended at this time. This article is protected by copyright. All rights reserved.
May 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29759531/biphasic-anaphylaxis-a-review-of-the-literature-and-implications-for-emergency-management
#2
REVIEW
Ali Pourmand, Chelsea Robinson, Wahab Syed, Maryann Mazer-Amirshahi
BACKGROUND: The biphasic reaction is a feared complication of anaphylaxis management in the emergency department (ED). The traditional recommended ED observation time is 4-6 h after complete resolution of symptoms for every anaphylaxis patient. However, there has been great controversy regarding whether this standard of care is evidence-based. METHODS: Articles were selected using a PubMed, MEDLINE search for the keywords "biphasic anaphylaxis", yielding 155 articles...
May 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29724572/what-signs-increase-the-likelihood-of-acute-aortic-dissection
#3
EDITORIAL
Nicholas Chien, Paul E Casey, Michael Gottlieb
No abstract text is available yet for this article.
April 30, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29691305/application-of-outpatient-cardiac-testing-among-emergency-department-patients-with-syncope
#4
Olivia G Cook, Muhammad A Mukarram, Soo-Min Kim, Kirtana Arcot, Marie-Joe Nemnom, Monica Taljaard, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVES: 2.6% of ED syncope patients will suffer cardiac serious adverse events (SAEs) within 30 days of disposition, and outpatient cardiac testing can improve patient safety. The objective is to determine whether outpatient cardiac testing for ED syncope patients is being appropriately ordered after discharge. To this end, we describe the proportion of high-risk and non-high (low and medium)-risk ED syncope patients as per the Canadian Syncope Risk Score (CSRS) who have a SAE after ED discharge, and the proportion referred for outpatient cardiac testing...
April 24, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29636295/concussion-diagnoses-among-adults-presenting-to-three-canadian-emergency-departments-missed-opportunities
#5
Brian H Rowe, Leeor Eliyahu, Justin Lowes, Lindsay A Gaudet, Jeremy Beach, Martin Mrazik, Garnet Cummings, Donald Voaklander
OBJECTIVES: Patients with concussion commonly present to the emergency department (ED) for assessment. Misdiagnosis of concussion has been documented in children and likely impacts treatment and discharge instructions. This study aimed to examine diagnosis of concussion in a general adult population. METHODS: Patients >17years old presenting meeting the World Health Organization's definition of concussion were recruited in one academic (Hospital 1) and two community (Hospitals 2 and 3) EDs in a Canadian city...
March 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29615439/physician-follow-up-and-long-term-use-of-evidence-based-medication-for-patients-with-hypertension-who-were-discharged-from-an-emergency-department-a-prospective-cohort-study
#6
Clare L Atzema, Bing Yu, Michael J Schull, Cynthia A Jackevicius, Noah M Ivers, Douglas S Lee, Paula Rochon, Peter C Austin
BACKGROUND: More than 25% of the population has hypertension. The number of patients seeking care for hypertension in emergency departments has increased by more than 60% in the last decade, with less than 10% of these patients subsequently admitted to hospital. Managing physicians recommend early follow-up to patients who are discharged from the emergency department, but there is a paucity of literature assessing the impact or timing of follow-up on patient outcomes. METHODS: Using a population-based cohort design, we included patients more than 65 years of age who were discharged from an Ontario emergency department with a primary diagnosis of hypertension between 2007 and 2014...
April 3, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29605393/differentiating-tonsil-cancer-from-benign-tonsillar-hypertrophy
#7
Eelam A Adil, Genevieve Medina, Michael J Cunningham
No abstract text is available yet for this article.
March 28, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29532807/acute-management-of-croup-in-the-emergency-department
#8
Oliva Ortiz-Alvarez
Croup is one of the most common causes of upper airway obstruction in young children. It is characterized by sudden onset of barky cough, hoarse voice, inspiratory stridor and respiratory distress caused by upper airway inflammation secondary to a viral infection. Published guidelines for the diagnosis and treatment of croup advise using steroids as the mainstay treatment for all children who present to emergency department (ED) with croup symptoms. Dexamethasone, given orally as a single dose at 0.6 mg/kg, is highly efficacious in treating croup symptoms...
June 2017: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29110977/clinical-mimics-an-emergency-medicine-focused-review-of-syncope-mimics
#9
Diana K Coleman, Brit Long, Alex Koyfman
BACKGROUND: Syncope is an event that causes a transient loss of consciousness (LOC) secondary to global cerebral hypoperfusion. The transient nature of the event can make diagnosis in the emergency department (ED) difficult, as symptoms have often resolved by time of initial presentation. The symptoms and presentation of syncope are similar to many other conditions, which can lead to difficulty in establishing a diagnosis in the ED. OBJECTIVE: This review evaluates patients presenting with a history concerning for possible syncope, mimics of syncope, and approach to managing syncope mimics...
January 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29540384/nonsuicidal-self-injury-in-an-adolescent-patient
#10
Tina Hu, William Watson
No abstract text is available yet for this article.
March 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29530658/systemic-antibiotics-for-the-treatment-of-skin-and-soft-tissue-abscesses-a-systematic-review-and-meta-analysis
#11
REVIEW
Michael Gottlieb, Joshua M DeMott, Marilyn Hallock, Gary D Peksa
STUDY OBJECTIVE: The addition of antibiotics to standard incision and drainage is controversial, with earlier studies demonstrating no significant benefit. However, 2 large, multicenter trials have recently been published that have challenged the previous literature. The goal of this review was to determine whether systemic antibiotics for abscesses after incision and drainage improve cure rates. METHODS: PubMed, the Cumulative Index of Nursing and Allied Health Literature, Scopus, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all randomized controlled trials comparing adjuvant antibiotics with placebo in the treatment of drained abscesses, with an outcome of treatment failure assessed within 21 days...
March 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29478864/management-of-acute-kidney-injury-core-curriculum-2018
#12
Peter K Moore, Raymond K Hsu, Kathleen D Liu
Acute kidney injury (AKI) is a heterogeneous disorder that is common in hospitalized patients and associated with short- and long-term morbidity and mortality. When AKI is present, prompt workup of the underlying cause should be pursued, with specific attention to reversible causes. Measures to prevent AKI include optimization of volume status and avoidance of nephrotoxic medications. Crystalloids are preferred over colloids for most patients, and hydroxyethyl starches should be avoided. Volume overload in the setting of AKI is associated with adverse outcomes, so attention should be paid to overall fluid balance...
February 22, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29399531/deep-vein-thrombosis-pathogenesis-diagnosis-and-medical-management
#13
REVIEW
Jonathan Stone, Patrick Hangge, Hassan Albadawi, Alex Wallace, Fadi Shamoun, M Grace Knuttien, Sailendra Naidu, Rahmi Oklu
Deep vein thrombosis (DVT) is a major preventable cause of morbidity and mortality worldwide. Venous thromboembolism (VTE), which includes DVT and pulmonary embolism (PE), affects an estimated 1 per 1,000 people and contributes to 60,000-100,000 deaths annually. Normal blood physiology hinges on a delicate balance between pro- and anti-coagulant factors. Virchow's Triad distills the multitude of risk factors for DVT into three basic elements favoring thrombus formation: venous stasis, vascular injury, and hypercoagulability...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28924481/euglycemic-diabetic-ketoacidosis-a-diagnostic-and-therapeutic-dilemma
#14
Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru, Jeffrey Pradeep Raj
Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29437127/kawasaki-disease
#15
Mary Beth F Son, Jane W Newburger
No abstract text is available yet for this article.
February 2018: Pediatrics in Review
https://www.readbyqxmd.com/read/29452747/accuracy-of-clinician-practice-compared-with-three-head-injury-decision-rules-in-children-a-prospective-cohort-study
#16
Franz E Babl, Ed Oakley, Stuart R Dalziel, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, John A Cheek, Yuri Gilhotra, Jeremy Furyk, Jocelyn Neutze, Susan Donath, Stephen Hearps, Charlotte Molesworth, Louise Crowe, Silvia Bressan, Mark D Lyttle
STUDY OBJECTIVE: Three clinical decision rules for head injuries in children (Pediatric Emergency Care Applied Research Network [PECARN], Canadian Assessment of Tomography for Childhood Head Injury [CATCH], and Children's Head Injury Algorithm for the Prediction of Important Clinical Events [CHALICE]) have been shown to have high performance accuracy. The utility of any of these in a particular setting depends on preexisting clinician accuracy. We therefore assess the accuracy of clinician practice in detecting clinically important traumatic brain injury...
February 13, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29404597/cellulitis-and-soft-tissue-infections
#17
Rachel Bystritsky, Henry Chambers
Cellulitis and soft tissue infections are a diverse group of diseases that range from uncomplicated cellulitis to necrotizing fasciitis. Management of predisposing conditions is the primary means of prevention. Cellulitis is a clinical diagnosis and thus is made on the basis of history and physical examination. Imaging may be helpful for characterizing purulent soft tissue infections and associated osteomyelitis. Treatment varies according to the type of infection. The foundations of treatment are drainage of purulence and antibiotics, the latter targeted at the infection's most likely cause...
February 6, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29395765/emergency-medicine-considerations-in-atrial-fibrillation
#18
REVIEW
Brit Long, Jennifer Robertson, Alex Koyfman, Kurian Maliel, Justin R Warix
BACKGROUND: Atrial fibrillation (AF) is an abnormal heart rhythm which may lead to stroke, heart failure, and death. Emergency physicians play a role in diagnosing AF, managing symptoms, and lessening complications from this dysrhythmia. OBJECTIVE: This review evaluates recent literature and addresses ED considerations in the management of AF. DISCUSSION: Emergency physicians should first assess patient clinical stability and evaluate and treat reversible causes...
January 30, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29371217/managing-migraine-in-pregnancy
#19
Sheba Jarvis, Pooja Dassan, Catherine Nelson Piercy
No abstract text is available yet for this article.
January 25, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29358490/understanding-cardiac-troponin-part-2-early-rule-out-of-acute-coronary-syndrome
#20
Edward Carlton, Richard Body
Chest pain of suspected cardiac origin is a very common emergency department presentation. Over the past decade, there has been an exponential growth in strategies that promote blood sampling at earlier and earlier time points after presentation to facilitate the rule out of acute coronary syndrome.In part 2 of this series, we examine key concepts from the recent literature with the aim of improving clinicians' understanding of the rule-out strategies available to them and provide a structured overview of strategies that facilitate discharge with blood testing over <3 hours...
March 2018: Emergency Medicine Journal: EMJ
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