3,288 results match your criteria Emergency Medicine[Journal]


Strategies for improving physician documentation in the emergency department: a systematic review.

BMC Emerg Med 2018 Oct 25;18(1):36. Epub 2018 Oct 25.

Department of Psychiatry, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N4N1, Canada.

Background: Physician chart documentation can facilitate patient care decisions, reduce treatment errors, and inform health system planning and resource allocation activities. Although accurate and complete patient chart data supports quality and continuity of patient care, physician documentation often varies in terms of timeliness, legibility, clarity and completeness. While many educational and other approaches have been implemented in hospital settings, the extent to which these interventions can improve the quality of documentation in emergency departments (EDs) is unknown. Read More

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http://dx.doi.org/10.1186/s12873-018-0188-zDOI Listing
October 2018

Man vs machine in emergency medicine - a study on the effects of manual and automatic vital sign documentation on data quality and perceived workload, using observational paired sample data and questionnaires.

BMC Emerg Med 2018 Dec 13;18(1):54. Epub 2018 Dec 13.

Department of Learning, Informatics, Management and Ethics, Health Informatics Centre, 171 77, Stockholm, Sweden.

Background: Emergency medicine is characterized by a high patient flow where timely decisions are essential. Clinical decision support systems have the potential to assist in such decisions but will be dependent on the data quality in electronic health records which often is inadequate. This study explores the effect of automated documentation of vital signs on data quality and workload. Read More

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http://dx.doi.org/10.1186/s12873-018-0205-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293611PMC
December 2018

Admission rates in emergency departments in Geneva during tennis broadcasting: a retrospective study.

BMC Emerg Med 2018 Dec 13;18(1):56. Epub 2018 Dec 13.

Division of Primary Care, Department of Community Medicine, Primary and Emergency Care, Geneva University Hospitals, 1205, Geneva, Switzerland.

Background: Literature provides mixed results regarding the influence of large-scale sporting events on emergency department attendance. To contribute to the research on the subject, we sought to evaluate whether the broadcasting of major tennis tournaments, one of the most popular sports in Switzerland, has an impact on patient admission rates in emergency units in Geneva including 1) type of match 2) the role of a Swiss player, 3) degree of triage, 4) reason of attendance and 5) age of patients.

Methods: Admission rates between periods with tennis matches regarding the semi-finals and finals of 3 major tennis tournaments were compared to equivalent periods without matches from May 2013 to August 2017. Read More

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http://dx.doi.org/10.1186/s12873-018-0209-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293595PMC
December 2018

Public knowledge of emergency medicine in Beirut, Lebanon.

BMC Emerg Med 2018 Dec 13;18(1):55. Epub 2018 Dec 13.

Department of Internal Medicine, Clinical Research Institute, Residency Research Program, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Introduction: To examine the public's level of knowledge and expectations of Emergency Medicine (EM) in Beirut, Lebanon.

Methods: A nested cross-sectional study was conducted exploring participants' knowledge and expectations of EM; the skillset, role and scope of practice of the emergency physician, and the dynamics of the Emergency Department (ED).

Results: A majority understand EM physicians perform minor procedures (83%), have specialized training (79%) and that they should be treated by a specialized EM physician (74%). Read More

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http://dx.doi.org/10.1186/s12873-018-0204-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293540PMC
December 2018

Hypoglycemia secondary to factitious hyperinsulinism in a foster care adolescent - a case report of munchausen syndrome in a community hospital emergency department setting.

BMC Emerg Med 2018 Dec 11;18(1):53. Epub 2018 Dec 11.

Northeast Georgia Medical Center Barrow, 316 N Broad St, Winder, GA, 30680, USA.

Background: Factitious disorder causing hypoglycemia is a psychiatric condition in which patients deliberately use blood sugar lowering medications to cause severe symptoms for the purposes of hospitalization or other primary gains.

Case Presentation: We report a case of factitious hypoglycemia in a 19-year-old foster care adolescent female who presented to the Emergency Department with recurrent hypoglycemic episodes, to the degree that the patient required large amounts of dextrose and further management by intensive care unit hospitalization. Further inquiry revealed that the patient intentionally injected herself with large doses of insulin for the purposes of seeking hospital admission. Read More

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http://dx.doi.org/10.1186/s12873-018-0208-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288932PMC
December 2018

Trajectories of early secondary insults correlate to outcomes of traumatic brain injury: results from a large, single centre, observational study.

BMC Emerg Med 2018 Dec 5;18(1):52. Epub 2018 Dec 5.

School of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy.

Background: Secondary insults (SI), such as hypotension, hypoxia, and intracranial hypertension frequently occur after traumatic brain injury (TBI), and have a strong impact on patients' clinical outcomes. The aim of this study is to examine the trajectories of SI from the early phase of injury in the prehospital setting to hospital admission in a cohort of TBI patients.

Methods: This is a retrospective, observational, single centre study on consecutive patients admitted from 1997 to 2016 to the Neuro Intensive Care Unit (NICU) at San Gerardo Hospital, in Monza, Italy. Read More

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http://dx.doi.org/10.1186/s12873-018-0197-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280374PMC
December 2018
1 Read

Ear measurement of temperature is only useful for screening for fever in an adult emergency department.

BMC Emerg Med 2018 Dec 3;18(1):51. Epub 2018 Dec 3.

Emergency Department, Sygehus Sønderjylland, Kresten Philipsensvej 15, 6200, Aabenraa, Denmark.

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. Read More

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https://bmcemergmed.biomedcentral.com/articles/10.1186/s1287
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http://dx.doi.org/10.1186/s12873-018-0202-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276133PMC
December 2018
2 Reads

Management of acute coronary syndrome in emergency departments: a cross sectional multicenter study (Tunisia).

BMC Emerg Med 2018 Dec 3;18(1):50. Epub 2018 Dec 3.

Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.

Background: We aimed to describe diagnosed acute coronary syndrome (ACS) and its care management and outcomes in emergency departments (EDs) and to determine related cardiovascular risk factors (CVRFs).

Methods: We conducted a cross sectional multicenter study that included 1173 adults admitted to EDs for acute chest pain (ACP) in 2015 at 14 sites in Tunisia. Data included patients' baseline characteristics, diagnosis, treatment and output. Read More

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https://bmcemergmed.biomedcentral.com/articles/10.1186/s1287
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http://dx.doi.org/10.1186/s12873-018-0201-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276213PMC
December 2018
2 Reads

Potential benefits of triage for the trauma patient in a Kenyan emergency department.

BMC Emerg Med 2018 Nov 29;18(1):49. Epub 2018 Nov 29.

Center for Disaster Medicine and Traumatology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

Background: Improved trauma management can reduce the time between injury and medical interventions, thus decreasing morbidity and mortality. Triage at the emergency department is essential to ensure prioritization and timely assessment of injured patients. The aim of the present study was to investigate how a lack of formal triage system impacts timely intervention and mortality in a sub-Saharan referral hospital. Read More

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http://dx.doi.org/10.1186/s12873-018-0200-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267912PMC
November 2018

Predictive value of quick surgical airway assessment for trauma (qSAT) score for identifying trauma patients requiring surgical airway in emergency room.

BMC Emerg Med 2018 Nov 29;18(1):48. Epub 2018 Nov 29.

Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

Background: A surgical airway is usually unpredictable in trauma patients. The aim of this study was to develop a predictable scoring system to determine the need for a surgical airway by using a database from a large multicenter trauma registry.

Methods: We obtained data from the nationwide trauma registry in Japan for adult blunt trauma patients who were intubated in the emergency department. Read More

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http://dx.doi.org/10.1186/s12873-018-0203-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267875PMC
November 2018
4 Reads

Application of the emergency medical services trigger tool to measure adverse events in prehospital emergency care: a time series analysis.

BMC Emerg Med 2018 Nov 26;18(1):47. Epub 2018 Nov 26.

Department: Improvement Capability, Institution: Institute for Healthcare Improvement, Cambridge, USA.

Background: Emergency Care has previously been identified as an area of significant concern regarding the prevalence of Adverse Events (AEs). However, the majority of this focus has been on the in-hospital setting, with little understanding of the identification and incidence of AEs in the prehospital environment.

Method: The early development and testing of Emergency Medical Services (EMS) specific triggers for the identification of AEs and Harm has been previously described. Read More

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http://dx.doi.org/10.1186/s12873-018-0195-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258398PMC
November 2018

Sonographic guided hydrostatic saline enema reduction of childhood intussusception: a prospective study.

BMC Emerg Med 2018 Nov 21;18(1):46. Epub 2018 Nov 21.

Department of Surgery, Obafemi Awolowo University, P. O. BOX 5538, Ile-Ife, Osun State, Nigeria.

Background: The management of childhood intussusception in our sub-region is still via surgical intervention. Currently, the gold standard of treatment is non-operative reduction. We sought to assess the suitability of hydrostatic (saline) reduction of intussusception in children in our institution. Read More

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http://dx.doi.org/10.1186/s12873-018-0196-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249894PMC
November 2018
1 Read

Provision of post-crash first aid by traffic police in Dar es Salaam, Tanzania: a cross-sectional survey.

BMC Emerg Med 2018 Nov 20;18(1):45. Epub 2018 Nov 20.

Umeå University, Umeå, Sweden.

Background: The availability of prehospital trauma care is an important means of reducing serious injuries and fatalities associated with road traffic injuries (RTIs). Lay responders such as traffic police play an important role in the provision of prehospital trauma care to RTI victims, especially where there is no established prehospital care system. Therefore, the objective of the present study was to investigate knowledge, self-reported practice, and attitudes toward post-crash first aid among traffic police officers in Tanzania. Read More

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http://dx.doi.org/10.1186/s12873-018-0199-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247529PMC
November 2018

Utility and effectiveness of the Scandinavian guidelines to exclude computerized tomography scanning in mild traumatic brain injury - a prospective cohort study.

BMC Emerg Med 2018 Nov 20;18(1):44. Epub 2018 Nov 20.

Clinic of Orthopedic Surgery, Akershus University Hospital, Lørenskog, Norway.

Background: In 2013 the Scandinavian Neurotrauma Committee (SNC) published updated guidelines for the initial management of minimal, mild and moderate traumatic head injuries (MTHI) that included serum analysis of protein S100B as a marker for brain tissue damage. This study reviews the effectiveness of the new guidelines in a clinical setting.

Methods: For all patients admitted to Akershus University Hospital (AHUS) from June 30th 2014 to December 15th 2014 with MTHI a separate form was filled in recording the time, indication and result of any S100B sampling and/or head computer tomography (CT) examinations. Read More

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http://dx.doi.org/10.1186/s12873-018-0193-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245911PMC
November 2018
4 Reads

Erratum.

Authors:

Emerg Med Clin North Am 2019 Feb;37(1):xv

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http://dx.doi.org/10.1016/j.emc.2018.10.001DOI Listing
February 2019
1 Read

Ear, Nose, and Throat Emergencies.

Emerg Med Clin North Am 2019 Feb;37(1):xiii-xiv

Clinical Emergency Medicine, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USA. Electronic address:

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http://dx.doi.org/10.1016/j.emc.2018.10.002DOI Listing
February 2019
1 Read

Ears, Nose, and Throat Emergencies.

Authors:
Amal Mattu

Emerg Med Clin North Am 2019 Feb;37(1):xi-xii

Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA. Electronic address:

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http://dx.doi.org/10.1016/j.emc.2018.10.003DOI Listing
February 2019

Infections of the Neck.

Emerg Med Clin North Am 2019 Feb;37(1):95-107

Department of Emergency Medicine, Loma Linda University School of Medicine, 11234 Anderson Street MC A-108, Loma Linda, CA 92354, USA. Electronic address:

Infection of the neck is a relatively common emergency department complaint. If not diagnosed and managed promptly, it may quickly progress to a life-threatening infection. These infections can result in true airway emergencies that may require fiberoptic or surgical airways. Read More

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http://dx.doi.org/10.1016/j.emc.2018.09.003DOI Listing
February 2019
4 Reads

Dental Emergencies.

Emerg Med Clin North Am 2019 Feb;37(1):81-93

Department of Emergency Medicine, Norwalk Hospital, 34 Maple Street, Norwalk, CT 06850, USA.

Dental emergencies present frequently to the emergency department and urgent care centers. Trauma to the teeth includes fractures, luxations, and avulsions, which can be reduced in most cases. Avulsed primary teeth should never be replaced. Read More

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http://dx.doi.org/10.1016/j.emc.2018.09.008DOI Listing
February 2019
3 Reads

Infections of the Oropharynx.

Authors:
Matthew R Klein

Emerg Med Clin North Am 2019 Feb;37(1):69-80

Department of Emergency Medicine, Northwestern University, 211 East Ontario - Suite 300, Chicago, IL 60611, USA. Electronic address:

This article reviews the presentation, diagnosis, and management of common and "can't miss" infections of the oropharynx, including streptococcal pharyngitis, infectious mononucleosis, peritonsillar abscess, retropharyngeal abscess, and epiglottitis. Read More

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http://dx.doi.org/10.1016/j.emc.2018.09.002DOI Listing
February 2019
2 Reads

Soft Tissue Disorders of the Mouth.

Emerg Med Clin North Am 2019 Feb;37(1):55-68

Department of Emergency Medicine, University of Colorado School of Medicine, Denver, CO, USA. Electronic address:

Soft tissue disorders of the mouth encompass a wide expanse of pathophysiology. This article focuses on the identification, etiology, management, and complications of common infectious processes (candidiasis, dental caries, and herpes labialis), inflammatory lesions (sialolithiasis, oral lichen planus, and aphthous ulcer), and benign entities (bony tori and mucocele). Read More

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http://dx.doi.org/10.1016/j.emc.2018.09.006DOI Listing
February 2019
8 Reads

Sinusitis Update.

Emerg Med Clin North Am 2019 Feb;37(1):41-54

Department of Emergency Medicine, Division of International EM Stony Brook University (SUNY), 101 Nicholls Road, HSC Level 4, Stony Brook, NY 11794, USA.

Rhinosinusitis affects many pediatric patients as well as 1 in 6 adults in any given year, resulting in ambulatory care, pediatric, and emergency department visits. Uncomplicated rhinosinusitis requires no imaging or testing and does not require antibiotic treatment. Using strict clinical diagnostic criteria may minimize unnecessary antibiotics. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183009
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http://dx.doi.org/10.1016/j.emc.2018.09.007DOI Listing
February 2019
8 Reads

Epistaxis.

Emerg Med Clin North Am 2019 Feb;37(1):29-39

Division of Emergency Medicine, University of Utah, 30 North 1900 East, Room 1C26, Salt Lake City, UT 84132, USA.

Most anterior epistaxis originates primarily from the Kiesselbach plexus, whereas posterior epistaxis is less common and originates from branches of the sphenopalatine artery. Risk factors include local trauma, foreign body insertion, substance abuse, neoplasms, inherited bleeding diatheses, or acquired coagulopathies. Assessment of airway, breathing, and circulation precedes identification of bleeding source, pain control, and achieving hemostasis. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183009
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http://dx.doi.org/10.1016/j.emc.2018.09.005DOI Listing
February 2019
4 Reads

The Diagnosis and Management of Facial Bone Fractures.

Emerg Med Clin North Am 2019 Feb;37(1):137-151

Department of Emergency Medicine, Northwestern Medicine, Northwestern University Feinberg School of Medicine, 259 East Erie, Suite 1300, Chicago, IL 60611, USA; Department of Medicine, Northwestern Medicine, Northwestern University Feinber School of Medicine, 259 East Erie Street, Suite 1300, Chicago, IL 60611, USA; Department of Orthopaedic Surgery, Northwestern Medicine, Northwestern University Feinberg School of Medicine, 259 East Erie Street, Suite 1300, Chicago, IL 60611, USA; Department of Orthopaedic Surgery, 259 East Erie Street, Suite 1300, Chicago, IL 60611, USA. Electronic address:

Appropriate medical care for a patient with a facial fracture can not only optimize aesthetic outcomes but also prevent the potential morbidity and mortality of delayed treatment. In this article, we focus on the clinical presentations, physical examination findings, diagnostic imaging, consultations, and follow-up that patients with facial fractures need related to their emergency department management. Specifically, we address the nuances of evaluating frontal, orbital, nasal, maxillofacial, and mandibular fractures. Read More

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http://dx.doi.org/10.1016/j.emc.2018.09.012DOI Listing
February 2019
4 Reads

Traumatic Injuries of the Ear, Nose and Throat.

Emerg Med Clin North Am 2019 Feb;37(1):131-136

Emergency Medicine, Alameda Health System, Highland Hospital, 1411 East 31st, Oakland, CA 94602, USA. Electronic address:

This article reviews the presentation, diagnosis, and management of common traumatic injuries of the ear, nose, and throat, including laryngeal trauma, auricular and septal hematomas, and tympanic membrane rupture. Read More

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http://dx.doi.org/10.1016/j.emc.2018.09.011DOI Listing
February 2019
1 Read

Foreign Bodies of the Ear, Nose and Throat.

Authors:
Leslie C Oyama

Emerg Med Clin North Am 2019 Feb;37(1):121-130

Department of Emergency Medicine, UC San Diego, 200 West Arbor Drive, MC 8676, San Diego, CA 92103-8676, USA. Electronic address:

Foreign bodies to the ear, nose, and throat often can be managed in the emergency department, particularly if the patient offers a history consistent with foreign body and is calm and compliant with the examination and removal attempts. Tips for success include analgesia, adequate visualization, immobilization of the patient's head, dexterity and experience level of the provider, and minimizing attempts at removal. It is critical to recognize the risks involved with certain retained objects (button batteries or sharp objects) and when to call a consultant to help facilitate safe, successful removal of objects to the ear, nose, and throat. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183009
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http://dx.doi.org/10.1016/j.emc.2018.09.009DOI Listing
February 2019
2 Reads

Peripheral Vertigo.

Authors:
Rodney Omron

Emerg Med Clin North Am 2019 Feb;37(1):11-28

Department of Emergency Medicine, Johns Hopkins Medical School, Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, USA. Electronic address:

This article summarizes the systematic assessment of the dizzy patient who presents with peripheral vertigo. It demonstrates the steps and tests necessary using the Triage-Timing-Trigger-Test (Triage + TiTraTe) method to accurately diagnose the underlying most probable cause while ruling out life-threatening causes. Using video support and just-in-time infographics, it demonstrates the Dix-Hallpike, Semont, Epley, and HINTS maneuvers. Read More

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http://dx.doi.org/10.1016/j.emc.2018.09.004DOI Listing
February 2019
1 Read

Tracheostomy Emergencies.

Emerg Med Clin North Am 2019 Feb;37(1):109-119

Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.

Tracheostomy is a common procedure for long-term airway management. Although the overall complication rate is greater than 50%, the incidence of serious complications is low. These serious complications can, however, lead to significant morbidity and mortality and it is incumbent on the emergency provider to be prepared to deal with such tracheostomy-related emergencies. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183009
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http://dx.doi.org/10.1016/j.emc.2018.09.010DOI Listing
February 2019
6 Reads

Infections of the Ear.

Emerg Med Clin North Am 2019 Feb;37(1):1-9

Department of Emergency Medicine, Kaiser Permanente, 4647 Zion Avenue, San Diego, CA 92120, USA. Electronic address:

Infections of the ear are a common presentation to an acute care environment. In this article, the authors aim to summarize the most common presentations, and diagnostic and treatment options for typical infections of the ear. This article is geared toward the emergency physician, urgent care provider, and primary care provider who will likely be the initial evaluating and treating provider to assist them in determining what treatment modalities can be managed in a clinic and what needs to be referred for admission or specialty consultation. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183008
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http://dx.doi.org/10.1016/j.emc.2018.09.001DOI Listing
February 2019
4 Reads

Comparison of the use of comprehensive point-of-care test panel to conventional laboratory process in emergency department.

BMC Emerg Med 2018 Nov 19;18(1):43. Epub 2018 Nov 19.

Emergency Medicine, University of Helsinki and Department of Emergency Medicine and Services, Helsinki University Hospital, Haartmaninkatu 4, PL 340, 00029, Helsinki, Finland.

Background: In this study, we hypothesized that point of care testing (POCT) would reduce length of stay (LOS) in emergency department (ED) when compared to central laboratory testing and be a factor in patient discharge destination.

Methods: A single centre observational study was performed in ED non-ambulatory patients. Blood testing was performed either with POC instruments for blood gases and chemistry panel, full blood count, and CRP, or at central laboratory, or as a combination of both. Read More

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http://dx.doi.org/10.1186/s12873-018-0198-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6245706PMC
November 2018

Seasonal prevalence of hyponatremia in the emergency department: impact of age.

BMC Emerg Med 2018 Nov 15;18(1):41. Epub 2018 Nov 15.

Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan.

Background: Hyponatremia is one of the most commonly encountered electrolyte disorders in emergency department (ED). Seasonal fluctuations of the prevalence of hyponatremia has been reported. We investigated the impact of age on the seasonal prevalence of hyponatremia in the emergency department in Japan. Read More

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http://dx.doi.org/10.1186/s12873-018-0182-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238288PMC
November 2018
1 Read

Creative adapting in a fluid environment: an explanatory model of paramedic decision making in the pre-hospital setting.

BMC Emerg Med 2018 Nov 15;18(1):42. Epub 2018 Nov 15.

Alberta Health Services, Seventh Street Plaza, 14th Floor, North Tower, 10030 - 107 Street NW, Edmonton, Alberta, T5J 3E4, Canada.

Background: Paramedics work in a highly complex and unpredictable environment which is characterized by ongoing decision-making. Decisions made by paramedics in the prehospital setting have implications for patient safety, transport, treatment, and health resource utilization. The objective of this study was; a) to understand how paramedics conduct decision-making in the field, and b) to develop a grounded theory of paramedic decision-making in the prehospital setting. Read More

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https://bmcemergmed.biomedcentral.com/articles/10.1186/s1287
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http://dx.doi.org/10.1186/s12873-018-0194-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238402PMC
November 2018
5 Reads

Pain score, desire for pain treatment and effect on pain satisfaction in the emergency department: a prospective, observational study.

BMC Emerg Med 2018 Nov 8;18(1):40. Epub 2018 Nov 8.

Department of Emergency Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Background: Pain management in the Emergency Department has often been described as inadequate, despite proven benefits of pain treatment protocols. The aim of this study was to investigate the effectiveness of our current pain protocol on pain score and patient satisfaction whilst taking the patients' wishes for analgesia into account.

Methods: We conducted a 10-day prospective observational study in the Emergency Department. Read More

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http://dx.doi.org/10.1186/s12873-018-0189-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225652PMC
November 2018

Reduction in the IL-6 level at 24 h after admission to the intensive care unit is a survival predictor for Vietnamese patients with sepsis and septic shock: a prospective study.

BMC Emerg Med 2018 Nov 6;18(1):39. Epub 2018 Nov 6.

International University of Health and Welfare, Tokyo, Japan.

Background: Sepsis and septic shock are common problems in intensive care units (ICUs). The mortality of patients with sepsis or septic shock is high. We investigated if reduction in the serum concentration of the cytokines tumor necrosis factor α, interleukin (IL)-6 and IL-10, and the rate of change in the IL-6 level at 24 h after ICU admission were survival predictors for patients with sepsis and septic shock in a Vietnamese population. Read More

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https://bmcemergmed.biomedcentral.com/articles/10.1186/s1287
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http://dx.doi.org/10.1186/s12873-018-0191-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219151PMC
November 2018
4 Reads

Autosomal dominant polycystic kidney disease and minimal trauma: medical review and case report.

BMC Emerg Med 2018 Nov 1;18(1):38. Epub 2018 Nov 1.

Department of Emergency Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.

Background: Blunt abdominal trauma in the setting of polycystic kidney disease is still scantly described in the literature and management guidelines of such patients are not well-established.

Case Presentation: The authors herein present a case of hypovolemic shock secondary to segmental renal artery bleed in a 75-year-old man with polycystic kidney disease after minimal blunt abdominal trauma, who underwent successful selective arterial embolization, and provide a thorough review of similar cases in the literature, while shedding the light on important considerations when dealing with such patients.

Conclusions: It is important to suspect renal injury in patients with pre-existing renal lesions irrespective of the mechanism of injury; and, vice-versa to suspect an underlying abnormality in patients with a clinical deterioration that's out of proportion to the mechanism of injury. Read More

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https://bmcemergmed.biomedcentral.com/articles/10.1186/s1287
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http://dx.doi.org/10.1186/s12873-018-0192-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211544PMC
November 2018
2 Reads

Evaluation of public awareness, knowledge and attitudes towards basic life support: a cross-sectional study.

BMC Emerg Med 2018 10 29;18(1):37. Epub 2018 Oct 29.

Faculty of Nursing, Applied Science Private University, Amman, Jordan.

Background: Out-of-hospital cardiac arrest is a major cause of mortality worldwide. When basic life support techniques are implemented quickly, the chance of survival is doubled. Therefore, this study evaluated public awareness, knowledge and attitudes towards basic life support in Jordan. Read More

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https://bmcemergmed.biomedcentral.com/articles/10.1186/s1287
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http://dx.doi.org/10.1186/s12873-018-0190-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206630PMC
October 2018
1 Read

High time to omit oxygen therapy in ST elevation myocardial infarction.

BMC Emerg Med 2018 10 20;18(1):35. Epub 2018 Oct 20.

Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.

Supplemental oxygen (O) therapy in patients with chest pain has been a cornerstone in the treatment of suspected myocardial infarction (MI). Recent randomized controlled trials have, however, shown that supplemental O therapy has no positive nor negative effects on cardiovascular functions, mortality, morbidity or pain in normoxic patients with suspected MI and foremost patients with ST Elevation Myocardial Infarction (STEMI). O therapy in normoxic STEMI patients should therefore be omitted. Read More

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https://bmcemergmed.biomedcentral.com/articles/10.1186/s1287
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http://dx.doi.org/10.1186/s12873-018-0187-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196022PMC
October 2018
7 Reads

Prior CT imaging history for patients who undergo whole-body CT for acute traumatic injury and are discharged home from the emergency department.

BMC Emerg Med 2018 10 16;18(1):34. Epub 2018 Oct 16.

Department of Acute Care Surgery, Trauma & Surgical Critical Care, CHRISTUS Spohn Hospital, Corpus Christi, TX, USA.

Background: Recurrent CT imaging is believed to significantly increase lifetime malignancy risk. We previously reported that high acuity, admitted trauma patients who received a whole-body CT in the emergency department (ED) had a history of prior CT imaging in 14% of cases. The primary objective of this study was to determine the CT imaging history for trauma patients who received a whole-body CT but were ultimately deemed safe for discharge directly home from the ED. Read More

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https://bmcemergmed.biomedcentral.com/articles/10.1186/s1287
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http://dx.doi.org/10.1186/s12873-018-0186-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192200PMC
October 2018
3 Reads

Here to Stay: Infectious Diseases in Emergency Medicine.

Emerg Med Clin North Am 2018 Nov;36(4):xvii-xviii

Department of Emergency Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco School of Medicine, 1001 Potrero Avenue, Suite 6A, San Francisco, CA 94110-1377, USA. Electronic address:

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183007
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http://dx.doi.org/10.1016/j.emc.2018.08.001DOI Listing
November 2018
3 Reads

Infectious Disease Emergencies.

Authors:
Amal Mattu

Emerg Med Clin North Am 2018 Nov;36(4):xv-xvi

Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA. Electronic address:

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183007
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http://dx.doi.org/10.1016/j.emc.2018.08.002DOI Listing
November 2018
2 Reads

Infection Prevention for the Emergency Department: Out of Reach or Standard of Care?

Emerg Med Clin North Am 2018 Nov 6;36(4):873-887. Epub 2018 Sep 6.

Infection Prevention, Barnes-Jewish Hospital, Mailstop 90-75-593, 4590 Children's Place, St Louis, MO 63108, USA.

The emergency department (ED) presents unique challenges to infection control and prevention. Hand hygiene, transmission-based precautions, environmental cleaning, high-level disinfection and sterilization of reusable medical devices, and prevention of health care-associated infections (catheter-associated urinary tract infection, ventilator-associated pneumonia, central line-associated bloodstream infection) are key priorities in ED infection prevention. Effective and sustainable infection prevention strategies tailored to the ED are necessary and achievable. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183006
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http://dx.doi.org/10.1016/j.emc.2018.06.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203442PMC
November 2018
19 Reads

Antimicrobial Stewardship in the Emergency Department.

Emerg Med Clin North Am 2018 Nov 6;36(4):853-872. Epub 2018 Sep 6.

Department of Emergency Medicine, University of California Davis, 4150 V Street, Suite 2100, Sacramento, CA 95817, USA.

The emergency department (ED) is the hub of the US health care system. Acute infectious diseases are frequently encountered in the ED setting, making this a critical setting for antimicrobial stewardship efforts. Systems level and behavioral stewardship interventions have demonstrated success in the ED setting but successful implementation depends on institutional support and the presence of a physician champion. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183006
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http://dx.doi.org/10.1016/j.emc.2018.06.012DOI Listing
November 2018
3 Reads

Infectious Diseases After Hydrologic Disasters.

Emerg Med Clin North Am 2018 Nov 6;36(4):835-851. Epub 2018 Sep 6.

Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO, USA.

Hydrologic disasters, including hurricanes, tsunamis, and severe flooding, have been associated with infectious diseases, particularly among vulnerable and displaced populations in resource-poor settings. Skin and soft tissue infections, gastrointestinal infections, respiratory infections, zoonotic infections, and vector-borne diseases each present unique threats to human health in this setting. Increased emergency physician awareness of these infectious diseases and their diagnosis and management helps optimize medical care for survivors after a hydrologic disaster and safeguard the health of disaster responders. Read More

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http://dx.doi.org/10.1016/j.emc.2018.07.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195322PMC
November 2018
1 Read

Biothreat Agents and Emerging Infectious Disease in the Emergency Department.

Authors:
Amesh A Adalja

Emerg Med Clin North Am 2018 Nov 6;36(4):823-834. Epub 2018 Sep 6.

Johns Hopkins Center for Health Security, Bloomberg School of Public Health, Johns Hopkins University, 601 E. Pratt Street, Baltimore, MD 21202, USA. Electronic address:

The challenges faced by the emergency physician with recognizing and treating category A biothreat agents and emerging infectious disease are summarized and reviewed. Read More

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http://dx.doi.org/10.1016/j.emc.2018.06.011DOI Listing
November 2018
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Approach to Transplant Infectious Diseases in the Emergency Department.

Emerg Med Clin North Am 2018 Nov 6;36(4):811-822. Epub 2018 Sep 6.

Division of Emergency Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8072, St Louis, MO 63110, USA; Division of Infectious Diseases, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St Louis, MO 63110, USA. Electronic address:

The emergency department (ED) is an increasingly important site of care for patients who have undergone solid organ transplantation or hematopoietic cell transplantation. It is paramount for emergency physicians to recognize infections early on, obtain appropriate diagnostic testing, initiate empirical antimicrobial therapy, and consider specialty consultation and inpatient admission when caring for these patients. This review provides emergency physicians with an approach to the assessment of transplant patients' underlying risk for infection, formulation of a broad differential diagnosis, and initial management of transplant infectious disease emergencies in the ED. Read More

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http://dx.doi.org/10.1016/j.emc.2018.06.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237280PMC
November 2018
1 Read

Infectious Disease Emergencies in Oncology Patients.

Emerg Med Clin North Am 2018 Nov 6;36(4):795-810. Epub 2018 Sep 6.

Department of Emergency Medicine, Virginia Tech Carilion School of Medicine, 1 Riverside Circle, 4th Floor, Roanoke, VA 24014, USA. Electronic address:

Oncology patients are a unique patient population in the emergency department (ED). Malignancy and associated surgical, chemotherapeutic, or radiation therapies put them at an increased risk for infection. The most ominous development is neutropenic fever, which happens often and may not present with signs or symptoms other than fever. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183006
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http://dx.doi.org/10.1016/j.emc.2018.06.009DOI Listing
November 2018
4 Reads

Management of Human Immunodeficiency Virus in the Emergency Department.

Emerg Med Clin North Am 2018 Nov 6;36(4):777-794. Epub 2018 Sep 6.

Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, Sixth Floor, Suite 200, Baltimore, MD 21201, USA.

Over the past 30 years, significant advances have transformed the landscape of human immunodeficiency virus (HIV) care in the emergency department. Diagnosis and management of HIV has improved, resulting in a decline in the incidence of acquired immunodeficiency syndrome (AIDS)-defining infections. Advances in pharmacology have led to fewer serious medication toxicities and more tolerable regimens. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183006
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http://dx.doi.org/10.1016/j.emc.2018.06.008DOI Listing
November 2018
2 Reads

Management of Patients with Sexually Transmitted Infections in the Emergency Department.

Emerg Med Clin North Am 2018 Nov 6;36(4):767-776. Epub 2018 Sep 6.

Division of Infectious Disease, Washington University in St. Louis, Campus Box 8051, 4523 Clayton Avenue, St Louis, MO 63110, USA. Electronic address:

Sexually transmitted infections (STI) are very common infections in the United States. Most patients with STIs are evaluated and treated in primary care settings; however, many also present to the Emergency Department (ED) for initial care. Management of STIs in the ED includes appropriate testing and treatment per CDC Sexually Transmitted Diseases Treatment Guidelines. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183005
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http://dx.doi.org/10.1016/j.emc.2018.06.007DOI Listing
November 2018
3 Reads

Musculoskeletal Infections in the Emergency Department.

Emerg Med Clin North Am 2018 Nov 6;36(4):751-766. Epub 2018 Sep 6.

Division of Emergency Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8072, St Louis, MO 63110, USA; Division of Infectious Diseases, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8051, St Louis, MO 63110, USA. Electronic address:

Bone and joint infections are potentially limb-threatening or even life-threatening diseases. Emergency physicians must consider infection when evaluating musculoskeletal complaints, as misdiagnosis can have significant consequences. Patients with bone and joint infections can have heterogeneous presentations with nonspecific signs and symptoms. Read More

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http://dx.doi.org/10.1016/j.emc.2018.06.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214631PMC
November 2018
1 Read

Skin and Soft Tissue Infections in the Emergency Department.

Emerg Med Clin North Am 2018 Nov;36(4):723-750

Department of Emergency Medicine, Highland Hospital, 1411 East 31st Street, Oakland, CA 94602, USA. Electronic address:

This article covers the diagnosis and treatment of skin and soft tissue infections commonly encountered in the emergency department: impetigo, cutaneous abscesses, purulent cellulitis, nonpurulent cellulitis, and necrotizing skin and soft tissue infections. Most purulent infections in the United States are caused by methicillin-resistant Staphylococcus aureus. For abscesses, we emphasize the importance of incision and drainage. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338627183005
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http://dx.doi.org/10.1016/j.emc.2018.06.005DOI Listing
November 2018
2 Reads