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To improve patient survival, the emergency physician (EP) must be knowledgeable about current concepts and controversies in the management of patients in shock. No longer can one simply rely on the presence of traditional clinical markers of shock to make the diagnosis. New and innovative monitoring techniques, as well as continually evolving treatment algorithms, are at the forefront of shock research. This article will educate and update the EP on current and future trends in the management of patients in shock. Equipped with this information, the EP more effectively can identify patients in shock, administer the latest evidence-based treatment, and ultimately improve patient outcome.
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"EMTALA: The Essential Guide to Compliance" from Thomson American Health Consultants, publisher of Emergency Medicine Reports, explains how the changes to EMTALA will affect emergency departments and off-campus clinics.
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The emergency physician is faced with a wide variety of acute respiratory emergencies in daily practice. Noninvasive ventilation (NIV), a means of delivering positive pressure ventilation without the use of an endotracheal tube, is a powerful therapeutic tool in the hands of an informed physician. This article will delineate the physiology of NIV. It will provide guidelines for initiation, weaning, and possible complications of NIV. It also will highlight current research in the topic.
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Emergency department physicians must be vigilant to accurately assess,
rapidly stabilize, and appropriately transport a severely injured
patient to the level of trauma care the patient requires. Instead of
viewing missed injuries as occurrences that result from inexperience or
incompetence, strategies to minimize the occurrence of missed injuries
and the resulting consequences are needed. All aspects of a trauma
system must work together to improve patient care.
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Although cervical spine injuries are uncommon in children, a missed or
delayed diagnosis may have devastating consequences for the patient. A
thorough understanding of normal pediatric anatomy, injury patterns,
and children who are at increased risk for injury is critical for the
physician caring for the acutely injured child.
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Pediatric athletic head injuries are a significant problem, especially for emergency medicine physicians. The dedication of many young athletes to performance and their avoidance of restrictions makes it imperative that ED physicians recognize and give appropriate recommendations to parents and coaches of young athletes. The cumulative damage that may result from repetitive minor head trauma is not recognized by the majority of athletes, and the ED physician has the burden of conveying these potential risks to the family. This article provides a comprehensive review of sports-related head injuries and recommendations on grading of concussions, imaging, and the safe return of the athlete to competition.
