Investigators discovered a more than twofold increase in cases of acute HIV during the COVID-19 pandemic as part of an ED-based screening program at UChicago Medicine. The cause of the increase remains unknown, but it underscores the importance of screening despite the fact the pandemic has strained all resources.
The Acute Stroke or Transient Ischemic Attack Treated with Ticagrelor and ASA for Prevention of Stroke and Death (THALES) study was designed to test the hypothesis that 30-day treatment with ticagrelor and aspirin would be superior to aspirin alone in reducing the risk of subsequent stroke or death in patients who had a non-cardioembolic ischemic stroke or transient ischemic attack.
A recent advance in ischemic stroke treatment is the mobile stroke unit, an ambulance outfitted with specialized equipment, computed tomography for brain imaging, and a specialized team with a stroke neurologist available either onboard or via telemedicine. Intravenous thrombolytics can be administered at the scene with the patient on the ambulance.
Opioid therapy can be an effective form of pain management in the ED for acute painful conditions. The risk of addiction and abuse should be considered in every case. Alternatives to opioid therapy include systemic agents, such as acetaminophen, NSAIDs, lidocaine, alpha agonists, anticonvulsants, ketamine, corticosteroids, and local and regional anesthesia.
This article will review psychosis within myriad differentials and discuss the potential workup and medication options for the management of these patients to help equip the emergency provider with the tools necessary to care for this unique population.