The most frequent vascular-related violations specifically involved lack of vascular specialist availability. Developing specialist networks and maintaining adequate call coverage can help improve patient access to emergency services.
It is unclear whether the claims involved IV infiltration, thrombophlebitis, pain caused by multiple sticks, or inadvertent arterial placement. Prevention efforts might include procedural training, integration of ultrasound in IV placement, or escalation of patients with difficult access to providers who specialize in IV access.
This postmortem study of multiple sclerosis (MS) patients evaluated the presence and pathological significance of extracranial systemic and cerebral small vessel disease in patients with MS compared to healthy controls. MS patients had less systemic vascular disease and more small vessel disease in the brain compared to controls.
Part I of this series discussed etiology, initial field management, and emergency department evaluation of penetrating extremity trauma. This article will cover the mangled extremity, recognizing and managing vascular injuries, imaging approach, and emergency department management of these injuries.
In a cohort of 15,480 adults with diabetes, there was no significant difference in the risk of serious vascular events when comparing supplementation with 1 g of omega-3 fatty acid vs. an olive oil placebo.
Penetrating extremity trauma is a potentially devastating injury that must be identified and managed expeditiously. Early hemorrhage control may be life-saving. This two-part article comprehensively addresses the approach and management of penetrating extremity trauma, highlighting controversies and advances.
Although many cases of extremity pain are the result of mild, self-limited issues, ischemia and gangrene are catastrophic causes of pain that initially can present with nondescript findings. To limit tissue loss and optimize patient outcomes, emergency physicians must be able to distinguish benign limb pain from the earliest stages of high-risk, life- and limb-threatening disease.