-
The daily practice of emergency medicine involves life and death decisions. While training in emergency medicine focuses on life-saving procedures and medications, dying patients often seek care in the ED for symptom relief, psychosocial support, or a variety of other reasons. Education, experience, communication, and compassion can improve the emergency physicians ability to deliver medical care near the end of life that will serve to relieve suffering, improve communication of the patients preferences and goals of medical treatment, and improve overall care of the patient and family.
-
Children who present with a history of foreign body ingestion frequently offer both a diagnostic and management challenge to the emergency medicine physician. Esophageal foreign bodies can result in significant injury to or the death of a child. What follows is a review of the literature on the subject of esophageal foreign bodies in children.
-
Influenza takes an enormous toll on humanity with respect to mortality, hospitalization, and medically attended illness. Despite the licensure of antiviral medications, immunization is the best control measure of influenza. Because patients eligible for influenza vaccine frequent EDs, health care providers working in this arena should offer the vaccine or appropriately recommend and refer patients following current guidelines to sites where the vaccine is obtainable.
-
In recent years, the analysis of complex system errors, such as medical errors occurring in the ED, has changed from simply labeling and punishing individuals to understanding the underlying systems that contribute to medical error. In this issue of Emergency Medicine Specialty Reports, error in the ED and its contributing factors will be discussed, as well as steps to develop a culture of safety.
-
This article focuses on specific populations presenting with abdominal pain to the ED and their specific or unique diagnoses. The pediatric, elderly, pregnant, and immunocompromised patients are special populations that pose a particular challenge to clinicians. These high-risk groups often present atypically, and serious conditions can be missed or misdiagnosed. This article discusses unusual diagnoses that often present with abdominal pain as one of the main symptoms.
-
This second and final part of a series covers the topics of differential diagnosis that must be considered when a patient presents with symptoms consistent with PE, treatment, and considerations for prevention of this disease state.
-
Optimizing outcomes in patients with acute coronary syndrome requires matching patients with strategies that will produce the best results in specific clinical subgroups. Identifying those patients with ST elevation myocardial infarction (STEMI) who represent ideal candidates for fibrinolysis, and who are likely to have outcomes that are at least as favorable as they would have with percutaneous interventions, has become an area of intense focus among cardiologists and emergency physicians. Significant improvements in patient outcomes will be made when patients are managed according to their institutional capabilities, with the understanding that prompt thrombolysis in the setting of STEMI is fundamental to optimal patient care. This article, the second in a two-part series, provides a practical, evidence-based approach to comprehensive management of this patient population.
-
In this second part of our two-part series, the SCMARTI (Selection of Cephalosporins, Macrolides, and AFQs for Respiratory Tract Infections) Consensus Panel presents recommendations for antimicrobial therapy in acute bacterial exacerbations of chronic bronchitis, along with a comprehensive treatment table to guide therapy in the emergency department and outpatient setting.
-
Part I of this two-part series on respiratory diseases covered two viral infections, severe acute respiratory syndrome and influenza. Part II focuses on a bacterial infection, community-acquired pneumonia.
-
Emergency Medicine Reports received a 2004 First Place award in the Best Single-Topic Newsletter category from the Newsletter and Electronic Publishers Foundation for the two-part article on immigrant medicine published Feb. 10 and Feb. 24, 2003. The authors of the winning article are Mary Meyer, MD, Danica Barron, MD, and Carter Clements, MD. The article was edited by Gideon Bosker, MD, and Shelly Morrow Mark.
