Browse Emergency Medicine General Articles by Topic

Can Occurrence of Delirium be Predicted by Elevated Proinflammatory Cytokines?

This observational study of 224 ICU patients who had serial measurements of C-reactive protein found an association between elevated initial levels and development of delirium.

What Makes an ICU Consultation ‘High Quality’?

From interviews, seven key factors were identified that characterized a high-quality consultation.

Efficacy of Continuous EEG Monitoring in Critical Care Units

Utilization of continuous EEG monitoring in mechanically ventilated patients in the ICU was associated with a reduction in hospital mortality without sigificantly affecting hospital costs or length of stay.

Integrating Nurse Practitioners into the Critical Care Team

Nurse practitioners (NP) have been involved in the care of critically ill patients since the late 1980s. Today, multiple universities and colleges offer NP preparation with specialization in a variety of areas.

Obesity in Trauma Care

MONOGRAPH: The authors review the implications of obesity for acute care physicians who manage trauma.

An Evidence-Based Extubation Bundle Improved Care Outcomes in Mechanically Ventilated Brain-Injured Patients

Implementation of an evidence-based extubation-readiness bundle was associated with a decrease in mechanical ventilation days and pneumonia in brain-injured patients.

CME Instructions/Questions

Practical Management of the Suicidal Patient in the Emergency Department

Recently The Joint Commission created a new standard, which calls for the identification of ED patients who are suicidal. This is based, in part, on the fact that a significant proportion of patients who die by suicide are seen in the ED in the months prior to their suicide. However, many of these patients are seen for non-mental health reasons.

Kawasaki Disease

Kawasaki disease, first described by Dr. Tomisaku Kawasaki in 1967, is a self-limited systemic inflammatory vasculitis characterized by fever and a variety of mucocutaneous manifestations. Surpassing rheumatic heart disease, it is now the leading cause of acquired cardiac disease in children.

Massive Transfusion: Part II

There are several relatively new adjuvant treatments for patients with massive hemorrhage. Of these, TXA is most widely recommended. It is inexpensive and has been shown to reduce mortality when given within three hours of injury. A new test, viscoelastic hemostatic assay, identifies the patient's stage of coagulability and fibrinogen status. The result of the test is a curve, which can help determine the need for fibrinogen, clotting factors, and platelets. Massive transfusion is an independent predictor of increased mortality, increased infection rate, SIRS, andmulti-organ failure. Complications of massive transfusion include acid/base derangement, electrolyte abnormalities (particularly hyperkalemia with rapid infusion), immune system changes, acute lung injury, and fluid overload.