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From October 2003 to Jan. 9, 2004, the Centers for Disease Control and Prevention received reports of 93 influenza-associated deaths among children younger than 18 years. The demands the annual flu season places on emergency department and urgent care facilities and the voracity of the current years epidemic have overwhelmed many physicians.
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The Centers for Disease Control and Prevention note that fractures were the fourth-leading cause of injury-related emergency department visits in 2000, accounting for 3.8 million visits. Patients may develop serious and life-threatening complications of orthopedic trauma. Because signs and symptoms of these complications may not be readily apparent when patients present, emergency physicians and nurses need to be cognizant of high-risk presentations. This months issue focuses on these high-risk presentations, including open fractures, compartment syndromes, malignancies, and septic joints.
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Stroke is the third leading cause of death in the United States, surpassed only by heart diseases and malignant neoplasms. Part 1 of this series will cover the differential diagnosis of stroke, stroke mimics, and risk factors and prevention. Part II will cover the physical examination, laboratory investigations, imaging, and treatment of stroke.
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This article will review the current literature about blast injuries. Explosions have the potential to cause multi-system injuries involving multiple patients simultaneously. The potential mechanisms of injury, early signs of these injuries, and the natural course of the problems caused by explosive blasts will be discussed.
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Low back pain is a frequent patient complaint in the emergency department. In fact, the same patients may visit the ED repetitively with the same complaint. It is easy to be assuaged into thinking that these patients are merely seeking drugs, but to make that assumption can lead a clinician to miss the cauda equina syndrome and may result in a malpractice action if efforts are not taken to identify any new symptoms and signs in a patient with low back pain. This issue provides the reader with a solid understanding of diagnosing and caring for patients with cauda equina syndrome in the ED and the medicolegal issues that arise from failing to diagnose and appropriately treat these patients.
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Part II of this two-part series focuses on facial nerve palsies and oropharyngeal infections. The authors present a systematic approach to differential diagnosis and identification of etiologic agents responsible for such conditions as peritonsillar abscess, epiglottitis, and pharyngeal infections. Radiographic and bacteriologic findings are emphasized, and appropriate antibiotic therapy is presented. The authors have provided treatment tables that direct emergency practitioners toward outcome-effective therapy.
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Parts I and II of this series discussed general facial wound repair, forehead and scalp trauma, eye trauma, nasal trauma, and midface fractures. This third and final part of the series covers mandible, mouth, ear, and pediatric trauma.
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