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Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the EmergencyDepartment via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. The patient was upgraded to the ICU for closer monitoring. looked at consecutive patients with PE, ACS, or neither.
Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the EmergencyDepartment (ED). 2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). Am J Emerg Med. Am J Emerg Med.
A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergencydepartment after an episode of syncope while standing in line at a grocery store. Moreover, the Queen is only supposed to be used with a high pretest probability of ACS/OMI.
She presented to the emergencydepartment after a couple of days of chest discomfort. Ischemia from ACS causing the chest discomfort, with VT another consequence (or coincidence)? The pacing rate was increased without clinical improvement and the patient was transferred to the ICU for closer monitoring/treatment.
Despite the risk of hypotension and bradycardia, propofol has been shown in the ICU setting to be a safe and effective monotherapy intubation agent for hemodynamically unstable patients (19). References: Heffner AC et al. Incidence and factors associated with cardiac arrest complicating emergency airway management. J Emerg Med.
It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergencydepartment (ED). After developing encephalopathy and hypoxemic respiratory failure, the patient was transferred to the ICU. Ann Emerg Med. JAMA Intern Med.
They found NO difference in drain failure rates ( 11% pigtail vs 13% chest tube P=0.74), total daily volume drained or length of ICU stay between groups. Interim results presented earlier this year show that REBOA performed within the EmergencyDepartment increased mortality. c) Or, do both? Trauma Surg Acute Care Open.
The NIHSS cutoff that predicts outcomes is 4 points higher in AC compared with PC infarctions. All patients who receive thrombolytics for ischemic stroke should be admitted to a neurosurgical, neurologic, or medical ICU for management and monitoring, as this is shown to decrease mortality and length of stay. Arch Neurol. ResearchGate.
One of the most hair-raising presentations to the emergencydepartment (ED) can be massive hemoptysis with respiratory failure. He is the founder and host of Emergency Medicine Cases podcast and website. References Deshwal H, Sinha A, Mehta AC. The emergencydepartment evaluation and management of massive hemoptysis.
Bupe Allergy Buprenorphine induction has been the mainstay of emergencydepartment treatment of opioid use disorder for more than a decade [11, 12]. DOI: Papudesi BN, Malayala SV, Regina AC. Emergencydepartment–initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial.
In this situation, an ABG should be obtained periodically for correlation, though this is more relevant for the intensive care unit (ICU) setting than in routine ED care (5, 9). Correlation and agreement between arterial and venous blood gas analysis in patients with hypotension-an emergencydepartment-based cross-sectional study.
10 Although this is not the same pathophysiology seen in ACS from an acute plaque rupture leading to coronary artery occlusion, patients can have relatively abrupt coronary ischemia causing ACS due to acute, concentric vessel narrowing. A 63-year-old man presents to the emergencydepartment for dyspnea on exertion.
J Emerg Med. Goodman AD, Got CJ, Weiss AC. Clinical spectrum of rhabdomyolysis presented to pediatric emergencydepartment. Int J Emerg Med. He has no medical problems. He sustained a crush injury to his left leg and a prolonged extraction time. He is agitated and reporting significant pain. Critical Care.
This single-centre academic urban institution in the United States (US) undertook a 10-year retrospective observational study of paediatric intubation and bougie use in their emergencydepartment (ED). Garabon JJW, Gunz AC, Ali A, Lim R. Prehosp Emerg Care. 468 paediatric patients were intubated in this timeframe.
Am J Emerg Med. Chinawa JM, Ubesie AC, Chukwu BF, Ikefuna AN, Emodi IJ. Intranasal fentanyl and discharge from the emergencydepartment among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. C or 100.4 mg/kg, max 0.4 2022 Aug;58:235244. Am J Hematol.
Disposition is often admission to an intensive care unit (ICU) setting. Further management and resuscitation were required, and she had a lengthy ICU stay of 21 days until she was extubated. Parenteral organophosphorus poisoning in a rural emergencydepartment: a case report. Airway management should not be delayed.
Opioids do not cause ACS but they can exacerbate hypoxia in patients with ACS. A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergencydepartment. Mechanical or non-invasive ventilation : children with ACS may require ventilatory support.
Paper: Alwang AK, Law AC, Klings ES, Cohen RT, Bosch NA. The characteristics that were significantly different between the LR and NS exposure groups race, organ dysfunction at presentation, ICU admission, hemoglobin SS genotype, discharge year, and hydroxyurea use were appropriately included as confounders in the TMLE analysis.
84 All patients with severe malaria need inpatient admission, ideally to the intensive care unit (ICU). link] Hummell AC, Cummings M. HIV Prevention and Treatment: The Evolving Role of the EmergencyDepartment. Ann Emerg Med. Use of Medical Interpreters in the EmergencyDepartment.; 2022;37(1):41-49.
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