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In part II of this two-part series, the Antibiotic Therapy in Bacterial Sinusitis (ATBS) Clinical Consensus Panel outlines risk-directed strategies for management of patients with acute bacterial rhinosinusitis. Outlining specific symptomatic, historical, and host criteria that prompt empiric antibiotic therapy, and a sequencing strategy for antimicrobial drug selection, this review provides practical, evidence-based strategies for patient management.
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Drug-seeking behaviors are commonplace in emergency departments. Many physicians have faced patients with multiple alleged allergies to narcotics who are asking for a medication that the physician never would have initially thought of prescribing, whose medications were stolen, and who become angry, threatening, and agitated upon refusal to refill the stolen prescription. This article defines various terms used in the drug-seeking literature, provides an overview of drug-seeking behaviors, and proposes some techniques to manage these patients both at the individual and at the institutional levels.
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Hypertensive disorders of pregnancy range from chronic pre-existing disease to life-threatening conditions such as HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) and eclampsia. They often represent a continuum from bad to worse. The emergency department physician is likely to evaluate a pregnant patient for many conditions unrelated to the pregnancy itself, and knowledge of abnormalities that warrant further assessment and follow-up is essential.
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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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Some 20 trials dedicated to the pursuit of more rapid and more complete reperfusion have been published in the last few years, and sorting through the literature can be dizzying. The following article will highlight the major recent developments in AMI reperfusion therapy. It will accent which of the many therapeutic options currently are considered acceptable, and present treatment guidelines for the emergency physician faced with the patient who presents to the emergency department with acute ST elevation MI.
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The emergency physician plays a key role in the management of HIV. Emergency physicians encounter all phases of the illness, from counseling patients on safe sex practices to treating the medical complications of chronic immunosuppression. Despite all of the recent advances, HIV infection and AIDS remain challenging and continually evolving diseases. In this issue of Emergency Medicine Specialty Reports, the authors provide a comprehensive update on the diagnosis and clinical management of HIV infection and its complications.
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Part I of this two-part series on stroke covered the differential diagnosis, risk factors, and prevention of stroke. This second and final part in the series will focus on the physical examination, laboratory investigations, imaging, and treatment of stroke.
