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Delivering Bad News in the Emergency Department

Clear, timely communication during critical events can significantly reduce long-term psychological distress in families, underscoring that how providers communicate in the emergency department can be as impactful as the medical care delivered.

Opioid Use Disorder in the ED: A Case-Based Approach

The emergency department (ED) is a critical touchpoint for identifying, initiating, and linking patients with opioid use disorder (OUD) to ongoing care.

Emerging Infectious Diseases

Emerging infectious diseases may be defined as infectious diseases that are either new to a specific population or that are rapidly increasing in both incidence and geographic range. As the front line for healthcare, emergency physicians should be aware of the potential threats developing around the globe, as well as the constant threat that emerging infectious diseases pose to public health. This article will detail seven of the most threatening emerging infectious diseases in terms of increasing spread, severity, and lethality.

The Seasonal Surge: Influenza in the ED

Influenza outbreaks occur each year, with their nature and extent largely determined by the virus’s glycoprotein structure and antigenic properties. These outbreaks typically occur during the winter months and can confer high morbidity to the general patient population. Increased mortality rates are seen in children younger than 5 years of age, older adults, and those with chronic comorbid medical conditions.

Clinical Approach to Pediatric Shoulder Injuries

Pediatric shoulder injuries are a significant concern because of the high participation of youth in sports and physical activities. Understanding the unique aspects of pediatric shoulder anatomy, injury mechanisms, clinical presentation, and evidence-based management is essential for optimizing outcomes and facilitating safe return to sport and daily activities in pediatric populations.

Diabetic Emergencies

Although diabetes affects various organ systems and complicates other disease processes, pure diabetic emergencies include diabetic ketoacidosis, hyperosmolar hyperglycemic syndrome, euglycemic diabetic ketoacidosis, and severe hypoglycemia. These emergencies often are precipitated in a patient with known diabetes but frequently can be the initial presentation in someone with undiagnosed diabetes. It is essential for ED providers to understand the pathophysiology, clinical features, workup, and management of these conditions, since they can be fatal, as they often were before the availability of insulin.

Evaluation and Management of Abnormal Uterine Bleeding in Nonpregnant Patients: A Detailed Review

Vaginal bleeding in the nonpregnant patient may be due to various etiologies, including structural abnormalities, dysfunctional bleeding, disorders of menstruation, trauma, or coagulopathy. Emergency department assessment and management includes a thorough history and physical examination, stabilization, diagnostic studies, treatment, and appropriate disposition.

Movement Disorder Emergencies: Serotonin Syndrome and Neuroleptic Malignant Syndrome

Serotonin syndrome and neuroleptic malignant syndrome are both potentially life-threatening conditions caused by medications. They present with altered mental status, autonomic dysfunction, and neuromuscular abnormalities. Despite overlapping features, they differ in etiology, pathophysiology, clinical presentation, and treatment.

Wrist and Finger Dislocations

Injuries to the wrist and fingers, although frequently overshadowed in polytrauma care, demand precise assessment and timely intervention to prevent long-term functional impairment. In this issue, the authors provide a thorough and clinically focused review of these often-complex dislocations, emphasizing both anatomical understanding and evidence-based management strategies relevant to emergency medicine providers.

An Approach to Palliative Care in the Emergency Department

Emergency physicians play a critical role in recognizing the need for and initiating early palliative care interventions, often at the most pivotal moments in a patient’s illness. By addressing symptoms such as dyspnea, pain, nausea, and constipation early and effectively, and by guiding conversations around goals of care, emergency providers can greatly enhance the quality of life for patients with serious or terminal illnesses.