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Cognitive Effects of Estrogen Therapy; Vitamin Therapy and Restenosis; Echinacea and the Common Cold; Effects of Paxil in Children Under 18; FDA Actions.
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Ventilator-associated pneumonia (vap) is nosocomial pneumonia occurring in a mechanically ventilated patient > 48 hours after intubation. It is categorized as early-onset (defined by most experts as 48-96 hours after intubation) and late-onset (> 2-96 hours after intubation): these differ with respect to responsible bacterial agents as well as outcomes. With an estimated incidence of 8-28% of intensive care unit (ICU) patients, or 13-35 cases per 1000 ventilator-days, VAP is common.
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This meta-analysis of clinical trials of steroids in septic shock demonstrates that whereas short-term, high-dose administration actually worsens survival, giving lower doses for a longer period hastens shock resolution and improves survival.
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This issue reviews the current status of SARS, influenza, and community-acquired pneumonia, providing essential information for emergency physicians and recommendations at a time when the therapeutic landscape for management of patients constantly is evolving.
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Heres help from a new bookRisk Management and Ethics in Pediatric Emergency Care.
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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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Endorsed by a multi-disciplinary panel of clinical experts, the Year 2004 ATBS Clinical Consensus Report primarily is directed toward physicians faced with the challenge of managing patients with acute bacterial rhinosinusitis in the primary care, emergency, and urgent care settings. The ultimate goal is to provide a concise, practical, and clinically relevant schemata for day-to-day patient management in which evidence can be put into practice to optimize clinical outcomes.
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The topic of pediatric traumatic brain injury (TBI) is extensive, and the majority of information is very familiar to the practicing emergency department physician. The author discusses two areas of controversy patient selection for imaging and an update on management strategies for children with TBI.
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Public awareness of the symptoms of stroke has increased the frequency of emergency department visits by patients with this complex chief complaint. Often, subtle symptoms may or may not represent a cerebral infarct. This issue of ED Legal Letter will review the diagnosis, management, and follow-up of patients with both transient ischemic attack and cerebral vascular accidents. Appropriate diagnosis and treatment will prevent subsequent permanent disability and potential litigation.
