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HIV Testing in the Emergency Department
AbstractPurpose of ReviewThis review explores data from the past 5 years with regard to HIV testing and diagnosis in the emergency department, as well downstream linkage to care and several adjuvant approaches. We offer perspectives on futures directions for care.Recent FindingsThere are many approaches to HIV testing in the ED. The largest overarching question is that of testing strategies (universal vs targeted, opt in vs out), where data is mixed and there is a lack of randomized control trials. Other studies address different aspects of ED testing, including where to integrate testing into ED workflow, and supplement...
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

Infections in the Injection Drug Abuser
AbstractPurpose of ReviewIntravenous drug abuse (IVDA) represents a significant economic, social, and health burden to society and is one of the most dangerous ways to administer a drug, and medical management often falls on the shoulders of the emergency department provider. This review seeks to provide an update on the etiology, common infectious agents, and treatment modalities specific to IV drug abuse.Recent FindingsIV drug use conveys serious health hazards and in particular cutaneous, soft tissue, and systemic infections. Illicit drug use carries with it social stigma, and patients may be reluctant to admit to using...
Source: Current Emergency and Hospital Medicine Reports - August 29, 2018 Category: Emergency Medicine Source Type: research

Management of Cancer Pain
This article seeks to provide an update on the current knowledge and concepts in cancer pain management with an attempt to provide practical education for use in the emergency room.Recent FindingsPain presents in various ways, manifesting as either nociceptive or neuropathic types. Classification systems such as the DN4 questionnaire and the Zubrod scoring system have been established in an attempt to provide guidelines for the evaluation and treatment of cancer-associated pain and provide a quick and efficient way to evaluate pain in the ER setting and to guide treatment.SummaryThere are many options for pain control in t...
Source: Current Emergency and Hospital Medicine Reports - August 22, 2018 Category: Emergency Medicine Source Type: research

Challenges Encountered in the Emergency Department in the Unimmunized Pediatric Population
AbstractPurpose of ReviewThis review discusses unimmunized pediatric patients and the unique circumstances surrounding their evaluation and management in the emergency department in an era where many established guidelines are based on the assumption of a vaccinated patient.Recent FindingsWhile there have been increasing outbreaks of vaccine preventable diseases, there have been no recent significant studies or recommendations made to alter the evaluation and management of an non-vaccinated pediatric patient.SummaryGiven increasing vaccine hesitancy, it is prudent to be vigilant during the evaluation of an unimmunized pedi...
Source: Current Emergency and Hospital Medicine Reports - August 22, 2018 Category: Emergency Medicine Source Type: research

A Review of Triple Therapy in Acute Coronary Syndromes
AbstractPurpose of ReviewThis review provides a summary of the new literature surrounding the concomitant use of anticoagulation with direct oral anticoagulants (DOACs) and antiplatelet agents following acute coronary syndromes (ACS) and percutaneous intervention (PCI).Recent FindingsThe American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA) and the American College of Chest Physicians (CHEST) provide weak recommendations for clinical situations in which patients require anticoagulation and dual antiplatelet therapy with aspirin and a P2Y12 inhibitor, also known as triple ther...
Source: Current Emergency and Hospital Medicine Reports - August 9, 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 - August 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 - July 17, 2018 Category: Emergency Medicine Source Type: research

Medical Management of Pain in the Emergency Setting Without Narcotics: Current Status and Future Options
This article elucidates current pharmacologic options regarding analgesia in the emergency setting, with some possible future options. (Source: Current Emergency and Hospital Medicine Reports)
Source: Current Emergency and Hospital Medicine Reports - July 13, 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 - July 13, 2018 Category: Emergency Medicine Source Type: research