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Necrotizing Soft Tissue Infections
AbstractPurpose of ReviewThe review discusses necrotizing soft tissue infections, including clinical manifestations, diagnosis and management.Recent FindingsThere has been an effort towards developing scoring systems to aid in the diagnosis of necrotizing soft tissue infections and this article reviews those in addition to their applicability. These scoring systems should primarily be used to aid in diagnosis and are not effective at ruling out necrotizing infections. Recent reviews regarding optimal antibiotics and IVIG are also discussed.SummaryNecrotizing soft tissue infections are challenging to diagnosis as they often...
Source: Current Emergency and Hospital Medicine Reports - February 1, 2019 Category: Emergency Medicine Source Type: research

Anticoagulation Levels and Bleeding After Emergency Department Extracorporeal Cardiopulmonary Resuscitation
AbstractPurpose of ReviewWe aimed to describe bleeding events associated with extracorporeal cardiopulmonary resuscitation (eCPR) using two institutional heparin protocols. In addition, we discuss current barriers to optimal anticoagulation in this critical population.Recent FindingsPatients initiated on venoarterial membrane oxygenation (VA-ECMO) are at risk of bleeding and thrombosis; both conditions can lead to severe morbidity or mortality. Intravenous heparin is the preferred form of anticoagulation for VA-ECMO. Prior studies have found elevated activated partial thromboplastin time (aPTT) may be an independent risk f...
Source: Current Emergency and Hospital Medicine Reports - January 19, 2019 Category: Emergency Medicine Source Type: research

Spine Pain Management
AbstractPurpose of ReviewSpine pain is one of the most common complaints presenting to the emergency department and represents significant healthcare cost. Evaluation and workup of these patients can be difficult, and a proper history and physical exam will minimize unnecessary tests.Recent FindingsNontraumatic spine pain is most often idiopathic or related to muscle or ligamentous strain. Although musculoskeletal mechanisms are most commonly responsible, there are very rarely, but importantly, life-threatening conditions which present as spine pain, and these must be ruled out. The presence of neurologic deficit renders a...
Source: Current Emergency and Hospital Medicine Reports - October 29, 2018 Category: Emergency Medicine Source Type: research

Intravenous and Oral Hyperammonemia Management
AbstractPurpose of ReviewHyperammonemia have significant morbidity and mortality. In this paper, we reviewed the latest research and evidence of both conventional and upcoming oral or intravenous treatments.Recent FindingsNew updates on the role of oral agents such as rifaximin, PEG, probiotics, glycerol phenylbutyrate, and zinc supplements in the management of both chronic hyperammonemia and overt hepatic encephalopathy have been discussed in this review. We discussed the recent findings on the role of branched-chain amino acids in patients with cirrhosis.SummaryRifaximin role has expanded as mono or combination therapy i...
Source: Current Emergency and Hospital Medicine Reports - October 2, 2018 Category: Emergency Medicine Source Type: research

Review of the Novel Agents for Hepatitis C Infection in the Emergency Department
AbstractPurpose of ReviewThe purpose of the study is to provide health care providers with general overview of the novel treatment strategies for patients infected with hepatitis C virus (HCV), monitoring for drug interactions, and dose modification in patients with renal impairment.Recent FindingsThe rapidly increasing demand for HCV infection treatment and the side effects associated with ribavirin (RBV) and peginterferon regimens led to the development of the novel direct acting antivirals (DAAs) and are RBV/peginterferon-free treatment in most cases. Several combinations, RBV-free regimens with different durations of t...
Source: Current Emergency and Hospital Medicine Reports - September 10, 2018 Category: Emergency Medicine Source Type: research

Updates on Sexually Transmitted Infections: Gonorrhea, Chlamydia, and Syphilis Testing and Treatment in the Emergency Department
AbstractPurpose of ReviewThis review describes current guidelines and research on screening, diagnostics, and treatment for sexually transmitted infections (STIs) seen in the emergency department (ED).Recent FindingsMany studies support less invasive testing for STIs, which in turn would encourage increased screening. The diagnosis of pelvic inflammatory disease (PID) is currently based on clinical findings and further research is needed to improve diagnostic accuracy. Current antibiotic treatment guidelines are based on numerous studies. Drug-resistant gonorrhea is an issue worldwide and alternative treatments are current...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2018 Category: Emergency Medicine Source Type: research

Hyperbaric Oxygen Therapy and Utilization in Infectious Disease
AbstractPurpose of ReviewThis review explores the multiple infectious processes in which the Undersea and Hyperbaric Medicine Society recommends hyperbaric oxygen as an adjunct to standard treatment to determine the benefit of including hyperbaric oxygen in standard treatment protocols.Recent FindingsWhile the utilization of hyperbaric oxygen (HBO) has been shown to improve outcomes, there is limited research comparing it to other therapies. There are numerous case reports and retrospective analyses of the use of HBO as adjunctive treatment, but randomized control trials are glaringly absent from recent literature.SummaryT...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2018 Category: Emergency Medicine Source Type: research

Emerging Infectious Diseases: a Review
AbstractPurpose of ReviewThis review highlights some of the recent concerning emerging infectious diseases, a number of them specifically that the World Health Organization has categorized as priorities for research.Recent FindingsEmerging and reemerging infectious diseases account for significant losses in not only human life, but also financially. There are a number of contributing factors, most commonly surrounding human behavior, that lead to disease emergence. Zoonoses are the most common type of infection, specifically from viral pathogens. The most recent emerging diseases in the USA areEmergomyces canadensis, the H...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2018 Category: Emergency Medicine Source Type: research

Stethoscope as a Vector for Infectious Disease
AbstractPurpose of ReviewTo discuss the current status of the stethoscope as a vector for infection and possible interventions to promote stethoscope disinfection.Recent FindingsAnywhere from 70 to 100% of stethoscopes are contaminated after a physical examination with bacterial counts of stethoscopes comparable to those of the physician ’s dominant hand. Disinfection with alcohol agents can reduce the number of pathogens and risk of transmission, which is recommended by guidelines. However, only 0–11% of healthcare providers disinfected their stethoscope before patient contact and 0–24% disinfected after the contact...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2018 Category: Emergency Medicine Source Type: research

Advocating For Pediatric Rapid Response Worldwide
AbstractPurpose of ReviewGeneral pediatricians have been involved for decades in bringing health to the world ’s children with preventive and public health interventions. Building on this, this article seeks to explore the necessary concepts and components that would facilitate a rapid response for critically ill or injured pediatric patients to become a life-saving reality for all children.Recent FindingsIt has been shown that emergency care can be done practically, cost-effectively, and is necessary to save the lives of children who will, just like children in the USA, suffer from critical illness and injury as a matte...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2018 Category: Emergency Medicine Source Type: research

Select Advances in Infectious Disease Chemotherapy: Review for Emergency Department Practitioners
This article provides the emergency department clinicians with a summary of novel antimicrobials and their relevance to the practice of clinical and emergency medicine, as well as highlighting recent research into the topic. (Source: Current Emergency and Hospital Medicine Reports)
Source: Current Emergency and Hospital Medicine Reports - September 1, 2018 Category: Emergency Medicine Source Type: research

Emergency Department Management of Acute Bacterial Skin and Soft Tissue Infections
AbstractPurpose of ReviewAcute skin infections are a common Emergency Department presentation. Changes in microbial resistance to antibiotics have resulted in changes in management of these infections. This paper seeks to highlight these changes in management of cellulitis and abscesses with the new emergence of methicillin-resistantStaphylococcal aureus.Recent FindingsSoft tissue infections are most commonly caused byStreptococcus andStaphylococcus but other microbes are present in specific environments and can cause infections when patients are exposed. Simple cellulitis can be treated with beta lactams; however, purulen...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2018 Category: Emergency Medicine Source Type: research

Accuracy of Medication Safety Report Severity Level Among Disciplines at a Tertiary Academic Medical Center
The objective of our analysis was to determine whether differences exist in the accuracy of reporter estimated incident severity level. This is a retrospective, quality assurance analysis of medication safety reports. Information collected included the total number of medication safety reports, reporter roles, reported severity level, and actual severity level. Accuracy of reporter severity was determined based on the difference between reported compared to the actual severity scored for each incident.Recent FindingsFour hundred forty-nine were included in the analysis. Reports were most commonly entered by nurses (71.3%) ...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2018 Category: Emergency Medicine Source Type: research