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Emergency Medicine

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42 papers 25 to 100 followers
https://www.readbyqxmd.com/read/29776516/tactical-emergency-medicine-support
#1
EDITORIAL
(no author information available yet)
No abstract text is available yet for this article.
June 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#2
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/29212634/intravenous-n-acetylcysteine-for-acetaminophen-toxicity
#3
Alyssa N Fixl, Robert M Woods, Katelyn Dervay
No abstract text is available yet for this article.
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29358490/understanding-cardiac-troponin-part-2-early-rule-out-of-acute-coronary-syndrome
#4
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
https://www.readbyqxmd.com/read/28792873/acute-respiratory-distress-syndrome
#5
REVIEW
B Taylor Thompson, Rachel C Chambers, Kathleen D Liu
New England Journal of Medicine, Volume 377, Issue 6, Page 562-572, August 2017.
August 10, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28174217/diagnosis-and-treatment-of-hyponatremia-compilation-of-the-guidelines
#6
REVIEW
Ewout J Hoorn, Robert Zietse
Hyponatremia is a common water balance disorder that often poses a diagnostic or therapeutic challenge. Therefore, guidelines were developed by professional organizations, one from within the United States (2013) and one from within Europe (2014). This review discusses the diagnosis and treatment of hyponatremia, comparing the two guidelines and highlighting recent developments. Diagnostically, the initial step is to differentiate hypotonic from nonhypotonic hyponatremia. Hypotonic hyponatremia is further differentiated on the basis of urine osmolality, urine sodium level, and volume status...
May 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#7
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise nonspecific features based on an understanding of the underlying pathophysiological characteristics. Although echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiological diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (eg, tachycardia, peripheral vasoconstriction), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/28800865/anaphylaxis
#8
REVIEW
Daniel LoVerde, Onyinye I Iweala, Ariana Eginli, Guha Krishnaswamy
Anaphylaxis is a systemic, life-threatening disorder triggered by mediators released by mast cells and basophils activated via allergic (IgE-mediated) or nonallergic (non-IgE-mediated) mechanisms. It is a rapidly evolving, multisystem process involving the integumentary, pulmonary, gastrointestinal, and cardiovascular systems. Anaphylaxis and angioedema are serious disorders that can lead to fatal airway obstruction and culminate in cardiorespiratory arrest, resulting in hypoxemia and/or shock. Often, these disorders can be appropriately managed in an outpatient setting; however, these conditions can be severe enough to warrant evaluation of the patient in the ED and in some cases, hospitalization, and management in an ICU...
February 2018: Chest
https://www.readbyqxmd.com/read/26419625/atrial-fibrillation-in-heart-failure-what-should-we-do
#9
REVIEW
Dipak Kotecha, Jonathan P Piccini
Heart failure (HF) and atrial fibrillation (AF) are two conditions that are likely to dominate the next 50 years of cardiovascular (CV) care. Both are increasingly prevalent and associated with high morbidity, mortality, and healthcare cost. They are closely inter-related with similar risk factors and shared pathophysiology. Patients with concomitant HF and AF suffer from even worse symptoms and poorer prognosis, yet evidence-based evaluation and management of this group of patients is lacking. In this review, we evaluate the common mechanisms for the development of AF in HF patients and vice versa, focusing on the evidence for potential treatment strategies...
December 7, 2015: European Heart Journal
https://www.readbyqxmd.com/read/29239753/the-use-of-intranasal-analgesia-for-acute-pain-control-in-the-emergency-department-a-literature-review
#10
REVIEW
Billy Sin, Jennifer Wiafe, Christine Ciaramella, Luis Valdez, Sergey M Motov
BACKGROUND: Traditional routes for administration of pain medications include oral (PO), intravenous (IV), or intramuscular routes (IM). When these routes are not feasible, the intranasal (IN) route may be considered. The objectives of this evidence-based review were: to review the literature which compared the safety and efficacy of IN analgesia to traditional routes and to determine if IN analgesia should be considered over traditional routes for acute pain control in the ED. METHODS: The MEDLINE and EMBASE databases from July 1970 to July 2017 were searched...
February 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29273246/asthma
#11
REVIEW
Alberto Papi, Christopher Brightling, Søren E Pedersen, Helen K Reddel
Asthma-one of the most common chronic, non-communicable diseases in children and adults-is characterised by variable respiratory symptoms and variable airflow limitation. Asthma is a consequence of complex gene-environment interactions, with heterogeneity in clinical presentation and the type and intensity of airway inflammation and remodelling. The goal of asthma treatment is to achieve good asthma control-ie, to minimise symptom burden and risk of exacerbations. Anti-inflammatory and bronchodilator treatments are the mainstay of asthma therapy and are used in a stepwise approach...
February 24, 2018: Lancet
https://www.readbyqxmd.com/read/29307766/methamphetamine-use-and-heart-failure-prevalence-risk-factors-and-predictors
#12
John R Richards, Brian N Harms, Amanda Kelly, Samuel D Turnipseed
OBJECTIVES: To compare methamphetamine users who develop heart failure to those who do not and determine predictors. METHODS: Patients presenting over a two-year period testing positive for methamphetamine on their toxicology screen were included. Demographics, vital signs, echocardiography and labs were compared between patients with normal versus abnormal B-type natriuretic peptide (BNP). RESULTS: 4407 were positive for methamphetamine, 714 were screened for heart failure, and 450 (63%) had abnormal BNP...
January 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29290508/the-emergency-medicine-evaluation-and-management-of-the-patient-with-cirrhosis
#13
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Cirrhosis is a significant cause of death in the U.S. and has a variety of causes, most commonly Hepatitis C and alcohol. Liver fibrosis and nodule formation result in significant complications due to portal system hypertension. There are several deadly complications emergency physicians must consider. OBJECTIVE OF THE REVIEW: Provide an evidence-based update for the resuscitation of decompensating cirrhotic patients and an overview of cirrhosis complications...
April 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29325062/st-segment-elevation-myocardial-infarction-the-new-esc-guidelines
#14
Thomas F Lüscher
No abstract text is available yet for this article.
January 7, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29331270/severe-beta-blocker-and-calcium-channel-blocker-overdose-role-of-high-dose-insulin
#15
Karan Seegobin, Satish Maharaj, Ansuya Deosaran, Pramod Reddy
A 54-year-old female presented after taking an overdose of an unknown amount of hydrochlorothiazide, doxazocin, atenolol and amlodipine. She was initially refractory to treatment with conventional therapy (intravenous fluids, activated charcoal, glucagon 5 mg followed with glucagon drip, calcium gluconate 10%, and atropine). Furthermore, insulin at 4 U/kg was not effective in improving her hemodynamics. Shortly after high dose insulin was achieved with 10 U/kg, there was dramatic improvement in hemodynamics resulting in three of five vasopressors being weaned off in 8 h...
April 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29332232/prone-position-in-ards-a-simple-maneuver-still-underused
#16
EDITORIAL
Davide Chiumello, Silvia Coppola, Sara Froio
No abstract text is available yet for this article.
February 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29347874/adjunctive-glucocorticoid-therapy-in-patients-with-septic-shock
#17
RANDOMIZED CONTROLLED TRIAL
Balasubramanian Venkatesh, Simon Finfer, Jeremy Cohen, Dorrilyn Rajbhandari, Yaseen Arabi, Rinaldo Bellomo, Laurent Billot, Maryam Correa, Parisa Glass, Meg Harward, Christopher Joyce, Qiang Li, Colin McArthur, Anders Perner, Andrew Rhodes, Kelly Thompson, Steve Webb, John Myburgh
BACKGROUND: Whether hydrocortisone reduces mortality among patients with septic shock is unclear. METHODS: We randomly assigned patients with septic shock who were undergoing mechanical ventilation to receive hydrocortisone (at a dose of 200 mg per day) or placebo for 7 days or until death or discharge from the intensive care unit (ICU), whichever came first. The primary outcome was death from any cause at 90 days. RESULTS: From March 2013 through April 2017, a total of 3800 patients underwent randomization...
March 1, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/27147888/assessing-inhalation-injury-in-the-emergency-room
#18
REVIEW
Shinsuke Tanizaki
Respiratory tract injuries caused by inhalation of smoke or chemical products are related to significant morbidity and mortality. While many strategies have been built up to manage cutaneous burn injuries, few logical diagnostic strategies for patients with inhalation injuries exist and almost all treatment is supportive. The goals of initial management are to ensure that the airway allows adequate oxygenation and ventilation and to avoid ventilator-induced lung injury and substances that may complicate subsequent care...
2015: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/17400077/management-of-burn-wounds-in-the-emergency-department
#19
REVIEW
Rubén Gómez, Leopoldo C Cancio
This article makes some introductory comments on the histology of the skin and the pathophysiology of burn injury as these topics pertain to the estimation of the depth of the burn injury. The definition of a major burn and the salient points of its treatment are covered. In addition, some general comments are made about several special injuries for which burn center referral usually is sought. Finally, guidance is given in the selection and treatment of patients who have burns that may be treated on an outpatient basis...
February 2007: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28662832/vascular-causes-of-syncope-an-emergency-medicine-review
#20
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Syncope is a common emergency department (ED) complaint, accounting for 2% of visits annually. A wide variety of etiologies can result in syncope, and vascular causes may be deadly. OBJECTIVE: This review evaluates vascular causes of syncope and their evaluation and management in the ED. DISCUSSION: Syncope is defined by a brief loss of consciousness with loss of postural tone and complete, spontaneous recovery without medical intervention...
September 2017: Journal of Emergency Medicine
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