Current Emergency and Hospital Medicine Reports 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.Monitoring Biomarkers in Patients Receiving Neprilysin Inhibitors
AbstractPurpose of ReviewTo understand the role of neprilysin inhibition in the management of chronic heart failure with reduced ejection fraction (HFrEF) and review effects of neprilysin inhibition on concentrations of natriuretic peptides and other biomarkers.Recent FindingsNeprilysin inhibition improves cardiovascular outcomes in patients with chronic HFrEF. As bioactive natriuretic peptides are degraded by neprilysin, treatment with sacubitril/valsartan results in an increase in concentrations of atrial natriuretic peptide (ANP), B-type natriuretic peptide (BNP), and C-type natriuretic peptide (CNP). In contrast, nepri...
Source: Current Emergency and Hospital Medicine Reports - February 13, 2018 Category: Emergency Medicine Source Type: research
The Safe and Successful Management of Acute Pain in the Infant and Young Child
AbstractPurpose of ReviewThe purpose of this review is to assist clinicians in making evidence-based pharmacologic choices for treating pain in children. Pain is one of the most common reasons patients present to an Emergency Department. Determining the most appropriate way to control pain is a challenge in adults, but is even more difficult when treating infants and small children because of their increased risk of complications related to treatment. Historically, children with pain were treated less often and less aggressively than adults for a variety of reasons. Better tools for assessment and improved management guide...
Source: Current Emergency and Hospital Medicine Reports - February 13, 2018 Category: Emergency Medicine Source Type: research
Ularitide in Acute Heart Failure
AbstractPurpose of ReviewThis review article will summarize the currently available data for ularitide in acute decompensated heart failure (ADHF).Recent FindingsHospitalization for ADHF represents a key prognostic event in the time course of many patients with HF. It is associated with a high risk for rehospitalization (~ 50% at 6 months) and 1-year mortality rate (~ 30%).SummaryThere is an unmet need for agents that will improve symptoms and outcomes for clinical outcomes in ADHF. Several agents with vasodilating properties have been studied in this population, but there is limited data demonstrating definitive eff...
Source: Current Emergency and Hospital Medicine Reports - February 9, 2018 Category: Emergency Medicine Source Type: research
Difficult Relationships: Patients, Providers, and Systems
AbstractPurpose of ReviewPerspectives on difficult patients have evolved substantially over the years; this paper exams some of the recent developments and trends in literature on this topic.Recent FindingsConflict between providers and their patients was once seen as the fault of the patient; more recently, models have evolved to look at how provider behavior and attitudes as well as systems of care can play a significant role in creating —and, hopefully—defusing such conflict. Conflicts may be informal or escalate to formal complaints; monitoring and remediating both can play a significant role in mitigating exposure...
Source: Current Emergency and Hospital Medicine Reports - February 5, 2018 Category: Emergency Medicine Source Type: research
Outpatient Treatment of Pulmonary Embolism: a Practical Guide
AbstractPurpose of ReviewPulmonary embolism (PE) is an ever increasing diagnosis in the emergency department.Recent FindingsTraditionally, all patients with PE were admitted to the hospital; however, with the advent of higher resolution CT scanners, more PEs of questionable clinical significance are being diagnosed. This phenomenon coupled with the emerging evidence of the safety of non-warfarin oral anticoagulants for outpatient management suggests that an alternative approach is both timely and appropriate. This paper reviews the growing body of literature supporting outpatient treatment of select patients with low risk ...
Source: Current Emergency and Hospital Medicine Reports - December 21, 2017 Category: Emergency Medicine Source Type: research
Safe and Rational Use of Analgesics: Non-Opioid Analgesics Alternatives to the Use of Narcotics in Emergency Pain Management
AbstractPurpose of ReviewClinicians in every setting have been charged with relief of pain as part of their mission as providers. Pain relief has been listed as one of the drivers of patient satisfaction and, in many settings, of reimbursement. Manyhealth care practitioners equate aggressive pain relief with administration of narcotic analgesia. Given the scourge ofnarcotic addiction, and evidence that many patients started on narcotic analgesics in the emergency setting will still betaking narcotics one year later, and may die from narcotic addiction or overdose, the possibility of providing pain reliefwithout the use of ...
Source: Current Emergency and Hospital Medicine Reports - November 9, 2017 Category: Emergency Medicine Source Type: research
The Needle-Less Treatment of Pain and Anxiety in the Pediatric Patient
AbstractPurpose of ReviewWe recognize the possibility of a needle stick can be an overwhelming fear for a child. We seek to review the needle-less options available to medical personnel for the treatment of pain and anxiety in children.Recent FindingsWe found that many new needle-less options exist for the treatment of pain and anxiety. Pharmacological measures, beyond the oral and enteral routes of medication administration, include intra-nasal and topical routes. Non-pharmacological treatments, including distraction techniques and oral sucrose for infants, are increasingly being recognized as viable treatments as the sci...
Source: Current Emergency and Hospital Medicine Reports - November 4, 2017 Category: Emergency Medicine Source Type: research
Evidence-Based Medicine and the Art of Medicine
AbstractPurpose of ReviewEvidence-based medicine since its inception offered the potential for increased use of effective interventions and consequently a potential to improve quality of care and to reduce health care costs.Recent FindingsOne great accomplishment of the evidence-based medicine movement has been a renewed focus on the scientific process and the development of systematic reviews and meta-analysis that condense the best evidence available. However, the well-being and goals of the patient are at the center of patient-physician and at the core of the clinical decision-making process.SummaryEvidence-based medici...
Source: Current Emergency and Hospital Medicine Reports - October 28, 2017 Category: Emergency Medicine Source Type: research
The Opioid Epidemic
AbstractThe opioid epidemic is the most devastating drug crisis in American history. More than 28,000 deaths each year are attributed to opioid use (Rudd et al., MMWR Morb Mortal Wkly Rep.2016;65:1445 –1452). Death rates now approach those of AIDS during the 1990s, double that from cocaine overdoses and exceed those from car accidents. The epidemic has hit nearly every demographic, regardless of race, economic status, or age. While heroin deaths occur in younger patients, fatal opioid overdoses are more likely to happen in middle age, and the rate of hospitalizations for the geriatric patient with opioid-related issues h...
Source: Current Emergency and Hospital Medicine Reports - October 24, 2017 Category: Emergency Medicine Source Type: research
The Triage Process for Behavioral Emergencies
AbstractPurpose of ReviewThis review describes methods used by Emergency Departments (EDs) to identify patients with mental health problems. It additionally reviews their ease of use, statistical validity and the effects of their use on the attitudes of patients and ED personnel.Recent FindingsMultiple interventions including additional screening tools, consultation-liaison support, and increased education for triage nurses have been studied. The majority of studies evaluated scales for general mental health concerns, as well as those specifically targeted for suicide, depression, anxiety, and substance abuse.SummaryAll th...
Source: Current Emergency and Hospital Medicine Reports - October 19, 2017 Category: Emergency Medicine Source Type: research
Intravenous Acetaminophen
AbstractPurpose of ReviewAcetaminophen (paracetamol, APAP) is the most commonly prescribed analgesic for the treatment of acute pain. It is also the most commonly prescribed analgesic and antipyretic for children. There has been extensive clinical use of acetaminophen in nonparenteral forms (e.g., oral or rectal) for over six decades and over 20 years of clinical experience outside the USA with the intravenous (IV) use of acetaminophen.Recent FindingsIn the USA, IV acetaminophen was approved by the Food and Drug Administration in November 2010. Studies indicate that IV acetaminophen is as effective for acute pain relief ...
Source: Current Emergency and Hospital Medicine Reports - October 18, 2017 Category: Emergency Medicine Source Type: research
Patient Safety and Risk Management in the Treatment of Pain
AbstractPurpose of ReviewTreating patients with severe, nonmalignant pain can be challenging, and with so many options for pain management, one should evaluate the risks and benefits of each treatment. Opioid pain medications are very potent analgesics and should be considered for severe pain in certain cases, but it is important to weight the risks and benefits of prescribing and to document this reasoning clearly to avoid confusion and misunderstanding. Opioids carry a risk of abuse and diversion, as well as side effects of respiratory depression, constipation, nausea, and others. There are recommended precautions to tak...
Source: Current Emergency and Hospital Medicine Reports - October 6, 2017 Category: Emergency Medicine Source Type: research
What Hospitalists Need to Know About Quality Improvement
AbstractPurpose of ReviewThe purpose of this review is to discuss quality improvement in the roles of Hospitalists.Recent FindingsHealthcare has seen two parallel evolutions in the field over the last 2 decades; the first being the integration of industrial quality improvement methodologies into healthcare with the aim of reducing cost and improving quality of care. At the same time, the inpatient care model has shifted with the development and significant growth of the hospitalist profession.SummaryHospitalists are physicians dedicating their sole practice to the care of hospitalized patients, and merging this knowledge w...
Source: Current Emergency and Hospital Medicine Reports - July 25, 2017 Category: Emergency Medicine Source Type: research
Closing the Clinical Knowledge Gap: Achieving Collaborative Nursing Education Between Hospitalists and Nurses
AbstractPurpose of ReviewIncreased collaboration between physicians and nurses may translate into improved patient outcomes. We explored the feasibility of an innovative educational program for nurses taught by physicians in their own medical team. It was designed as 15-min sessions on five relevant clinical topics imparted during nurses ’ shift change. We assessed confidence at dealing with conditions included in education sessions, knowledge on topics and subjective general impressions, and perceived barriers.Recent FindingsWe found that nurses reported increased confidence at dealing with the conditions included in th...
Source: Current Emergency and Hospital Medicine Reports - July 18, 2017 Category: Emergency Medicine Source Type: research
Serelaxin in the Treatment of Acute Heart Failure in the Emergency Department
AbstractPurpose of the ReviewThe aim of this paper is to review the historical perspective for the need for new agents in the treatment of acute heart failure that may impact morbidity and mortality. Also, the purpose is to introduce serelaxin and discuss how it may play a role in the treatment for acute heart failure, in particular in the emergency department.Recent FindingsProspective, randomized trials in acute heart failure are limited. No single intervention or treatment in acute heart failure has improved mortality. However, registry data show that rapid treatment for acute heart failure produces better outcomes. Ser...
Source: Current Emergency and Hospital Medicine Reports - April 29, 2017 Category: Emergency Medicine Source Type: research
