Emergency Medicine - Adult and Pediatric
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The Opioid Minefield
The opioid epidemic has become not only a public health crisis, but also a political one. Legislative activity at the state and federal levels of government has reached a fever pitch, the ramifications of which certainly will affect the practice of emergency medicine.
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Airway Management in Trauma
The process of airway management has evolved considerably to include rapid sequence intubation (RSI), the use of various procedures, and sophisticated devices designed to assist in the placement of an endotracheal tube. This article summarizes the basic concepts of airway management, the technique of RSI, and post-intubation management in trauma patients.
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Advanced Imaging in Acute Ischemic Stroke
Any clinician who may have a role in the initial triage and management of these patients would be well-served to have an understanding of the currently available imaging modalities and techniques, and the applications of each in the evaluation of acute ischemic stroke.
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Targeted Management of Headaches for Emergency Physicians
Headaches are one of the most prevalent and disabling categories of disorders worldwide. Emergency healthcare providers are in a unique position to provide management of acute attacks, exclude emergent causes, educate patients, initiate some forms of preventive treatment, refer patients for appropriate outpatient workup and management of chronic headaches, and clarify and provide feedback regarding diagnostic criteria.
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Approach to Pediatric Eye Discharge and Periorbital Swelling
Eye problems, particularly conjunctivitis and periorbital swelling, are very common. The majority are managed easily, but more serious disease processes must be considered. Early recognition and prompt treatment of more serious etiologies, such as gonococcal conjunctivitis and herpes simplex virus, can prevent vision loss.
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Take Steam Out of Plaintiff’s Missed Fracture Claim
About 2% of minor trauma patients presenting to a Belgian ED leave with a missed diagnosis, according to a recent study. Of 56 minor trauma patients with missed diagnoses, the most frequently missed diagnoses were ankle, wrist, and foot fractures.
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Excessive ED Waits Are Trigger for Malpractice Lawsuits
EPs can expect wait times to become an issue in any litigation in which an ED patient was diagnosed with a time-sensitive disease process.
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Some Plaintiffs' ‘Experts’ Have Never Worked in ED
It’s never easy for an EP to listen to an expert witness testify that their care was negligent, but it’s harder to take coming from someone who hasn’t worked in an ED in many years — or ever.
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ECG Overload? EP Might Miss Subtle STEMI
It’s not uncommon for EPs to be presented with dozens of ECGs during a shift. The large number of ECGs performed at triage could lead to an unintended legal consequence: increasing the possibility of missed ST-elevation myocardial infarction (STEMI), especially those that are subtle or atypical presentations.
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Surprising New Data on Missed Acute Coronary Syndrome in EDs
Lack of “typical” symptoms cannot rule out acute coronary syndrome, and “atypical” symptoms should raise the EP’s index of suspicion, according to a recent review of the literature.