The drowned patient represents a unique and difficult challenge. A wide range of physiologic insults may occur, making each management decision critical. This review describes the epidemiology, pathophysiology, critical actions, and prognostic factors the emergency physician must know to provide the best care for the drowned patient.
With trauma as the leading cause of death in children nationwide, pediatric abdominal trauma is a commonly encountered clinical situation in the emergency department (ED).
I remember when the Goldman myocardial infarction (MI) algorithm came out, quickly followed by a seven-button hand-held "calculator." It promised to reduce all decision-making regarding ED chest pain patients to seven yes or no questions. But when you looked into the mathematics, if you answered no or negative to all of the questions, it indicated a 4% chance of acute cardiac ischemia. So, what would you do with this information? Could you tell the patient that there was only a 4% chance of a heart attack, so it was OK to go home?
