Current Emergency and Hospital Medicine Reports Current Emergency and Hospital Medicine Reports RSS feedThis 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.

Disposition Decisions for Psychiatric Patients Presenting to the Emergency Department
This article reviews the thought process and risk stratification modalities that should be considered when determining disposition selection in emergency rooms without readily available psychiatric services. Although the SPI rating scale and the CTRS provide some guidance in this decision, ER providers should also consider psychosocial factors, collateral information, and judgment. (Source: Current Emergency and Hospital Medicine Reports)
Source: Current Emergency and Hospital Medicine Reports - April 27, 2017 Category: Emergency Medicine Source Type: research

Identification, Assessment, and Management of Suicide Risk in Emergency Departments: Significant Updates in Research and Practice
AbstractPurpose of ReviewIt is estimated that emergency departments (EDs) could prevent 5% of all suicide attempts and 8% of suicide deaths, making EDs a critical setting in which to identify individuals at risk for suicide and to intervene to mitigate the risk. The goal of this review was to detail recent advances in the identification, assessment, and management of suicide risk in emergency medicine and to provide best practice recommendations for these processes.Recent FindingsAdvances in caring for patients who present to EDs with suicide risk include improved workflows and tools for ED providers to identify, assess, a...
Source: Current Emergency and Hospital Medicine Reports - April 18, 2017 Category: Emergency Medicine Source Type: research

Takotsubo Cardiomyopathy vs. Acute Coronary Syndrome in the Emergency Department Setting: a Review of Diagnostic Criteria and Outcomes
AbstractPurpose of ReviewThe purpose of this article is to review the Mayo Clinic criteria for diagnosis, differential diagnoses, epidemiology, pathogenesis, imaging, treatment, and prognosis for this condition.Recent FindingsTakotsubo cardiomyopathy (TCMP) often poses a diagnostic dilemma in the emergency department (ED) and in the intensive care unit (ICU) setting. TCMP is virtually indistinguishable from acute coronary syndrome (ACS).SummaryFurther research is needed to study the pathogenesis of this condition and to investigate whether genetic or serologic markers could be used to identify individuals at risk for this ...
Source: Current Emergency and Hospital Medicine Reports - April 10, 2017 Category: Emergency Medicine Source Type: research

Entresto (Sacubitril/Valsartan): Angiotensin Receptor Neprilysin Inhibition for Treating Heart Failure
AbstractPurpose of ReviewHeart failure is a major and growing public health problem throughout the world. Sacubitril/valsartan is a new medication with proven benefit in chronic heart failure with reduced ejection fraction. In order to use it most effectively, a thorough understanding of this medication is essential for providers.Recent FindingsRecent evidence demonstrates a significant improvement in mortality and heart failure hospitalizations and an acceptable side effect profile with sacubitril/valsartan in patients with heart failure and reduced ejection fraction. The most frequent adverse reaction is hypotension, whi...
Source: Current Emergency and Hospital Medicine Reports - April 6, 2017 Category: Emergency Medicine Source Type: research

Medications to Avoid in Acute Decompensated Heart Failure
AbstractPurpose of ReviewThe goal of this chapter is to educate physicians and practitioners of medicine on agents to avoid when managing patients with acute decompensated heart failure (ADHF). Through this review, we will offer explanations as to why it is necessary to refrain from the usage of certain medications, with the goal of providing optimal health care.Recent FindingsThe latest research reveals several classes of medications which should be used with caution or not at all in patients with ADHF.SummaryWe found that vasodilators (like ACE inhibitors) present the risk of hypotension, while beta- and calcium channel ...
Source: Current Emergency and Hospital Medicine Reports - April 4, 2017 Category: Emergency Medicine Source Type: research

The Use of Nitrates in the Management of Acute Heart Failure in the Emergency Department: a Review
AbstractPurpose of ReviewNitrates represent a frequently used group of medications in the management of hypertensive patients in acute heart failure. Despite its longevity, usage of this medication seems to be guided chiefly by expert opinion, with relatively few trials involving interventions in the emergency department. This review seeks to define more precisely the role of nitrates in the emergency department by discussing some of the more compelling research that exists on the topic in addition to their biochemistry and current guidelines.Recent FindingsMore recent explorations have demonstrated various benefits to reg...
Source: Current Emergency and Hospital Medicine Reports - April 3, 2017 Category: Emergency Medicine Source Type: research

Morphine in Acute Pulmonary Oedema Treatment
AbstractPurpose of ReviewWe will review the pharmacodynamics and clinical outcomes of morphine therapy for pulmonary oedema.Recent FindingsBoth animal and human studies demonstrate that morphine has vasodilatory properties. The effect on pulmonary hemodynamics seems to be neutral and possibly adverse on ventilation. Morphine, along with furosemide and nitrates, is routinely used to treat cardiogenic pulmonary oedema. Clinical data on the safety and efficacy of morphine for cardiogenic pulmonary oedema are scarce; however, morphine use has been correlated with increased rates of ICU admission and mechanical ventilation. Eur...
Source: Current Emergency and Hospital Medicine Reports - April 1, 2017 Category: Emergency Medicine Source Type: research

Emerging Trends in Health Care Costs and Reimbursement for Heart Failure
AbstractPurpose of ReviewEscalating costs threaten to destabilize the US health care system. This review evaluates the overall economic burden of heart failure in the USA and new payment models that attempt to address rising costs.Recent FindingsThe aging population and improved outcomes with innovative treatments for heart failure are likely to result in a continued increasing economic burden. Recent cost estimates and economic models suggest that prior studies might have substantially underestimated the total costs related to heart failure. CMS is leading the efforts to design alternative payment systems that shift from ...
Source: Current Emergency and Hospital Medicine Reports - April 1, 2017 Category: Emergency Medicine Source Type: research

Cardiac Implantable Electric Devices: Indications and Complications
AbstractPurpose of ReviewAs the evidence base for cardiac implantable electric devices (CIED), which include pacemakers, defibrillators, and devices with both functionalities, continues to expand, so does the rate of usage in patients with chronic heart failure (CHF), atrial fibrillation (AF), or both. Given that no medical intervention is ever free from complications and unintended consequences, it is expected that patients will present to the Emergency Department (ED) for unscheduled, acute care secondary to CIED complications. In this article, we will examine first the indications for CIED placement in patients with chr...
Source: Current Emergency and Hospital Medicine Reports - March 31, 2017 Category: Emergency Medicine Source Type: research

Management of Chronic Pulmonary Obstructive Disease: a Review of Long Acting Beta 2 Agonists
AbstractPurpose of ReviewUse of inhaled aerosols allows selective treatment of the lungs by achieving high drug concentrations in the airways while minimizing systemic effects. Inhaled long acting beta 2 agonists (ILAB) produce a more rapid onset of action than oral delivery and are convenient and safe for the most patients. Chronic obstructive pulmonary disease (COPD) is a respiratory disease that causes progressive symptoms of breathlessness, cough, and mucus buildup. It is the sixth most common cause of death worldwide and is associated with significant healthcare costs.Recent FindingsILAB have demonstrated to be very e...
Source: Current Emergency and Hospital Medicine Reports - March 28, 2017 Category: Emergency Medicine Source Type: research

Criteria for Sepsis: Systemic Inflammatory Response Syndrome (SIRS) and Quick Sepsis-Related Organ Dysfunction Assessment (QSOFA)
AbstractPurpose of ReviewVarious definitions and scoring systems for sepsis were available but none of them was perfect due to the incomplete knowledge of sepsis syndrome pathobiology. Sepsis is a collection of diseases described mainly by systemic host response to infection. An international consensus first defined sepsis in 1991 and was later updated in 2001. Definitions of sepsis, severe sepsis, and septic shock remained the same for two decades. The systemic inflammatory response syndrome (SIRS) criteria were used widely in hospitals to identify sepsis. The third international consensus definitions for sepsis and septi...
Source: Current Emergency and Hospital Medicine Reports - March 6, 2017 Category: Emergency Medicine Source Type: research

Hypercalcemia in Inpatient Setting: Diagnostic Approach and Management
AbstractPurpose of ReviewHypercalcemia is commonly seen as a chronic disorder which can be effectively managed in the outpatient world. Acute decompensation of hypercalcemia is a condition that needs urgent evaluation and treatment, otherwise, can become life-threatening. In majority of cases, hyperparathyroidism and malignancy are the causes.Recent FindingsThorough history and examination can provide us clues to delineate the cause of hypercalcemia. PTH is the mainstay blood testing that can point us further towards the diagnostic approach. This evaluation is usually done while the patient is being treated to lower down C...
Source: Current Emergency and Hospital Medicine Reports - February 28, 2017 Category: Emergency Medicine Source Type: research

Prescribing Naloxone: Managing and Preventing Opioid-Related Overdoses
AbstractPurpose of ReviewRising opioid overdoses are a nationwide problem. This review aims to educate health care professionals on the various naloxone nasal formulations that are available.Recent FindingsNational data confirms a significant increase in opioid overdoses and a need for all health care professionals to recognize the importance of dispensing naloxone when indicated. With four options available (two intranasal and two intramuscular), naloxone may be dispensed with or without a prescription in many states.SummaryBeing aware of the current formulations and offering naloxone prescriptions to patients at risk are...
Source: Current Emergency and Hospital Medicine Reports - February 13, 2017 Category: Emergency Medicine Source Type: research

A Change of Heart: the New Era of Heart Failure Management
AbstractPurpose of ReviewThis review provides in-depth insight into the recently published literature surrounding two new heart failure therapies, sacubitril/valsartan and ivabradine.Recent FindingsSignificant literature has emerged in the last few years supporting the use of both sacubitril/valsartan and ivabradine in patients with chronic heart failure. Both agents were recently approved and included in the 2016 American College of Cardiology, American Heart Association, and Heart Failure Society of America (ACC/AHA/HFSA) Focused Update on New Pharmacological Therapy for Heart Failure.SummarySacubitril/valsartan was foun...
Source: Current Emergency and Hospital Medicine Reports - January 29, 2017 Category: Emergency Medicine Source Type: research

Diagnosis and Management of Acute Adrenal Insufficiency in the Hospitalized Patient
AbstractPurpose of ReviewThis manuscript attempts to simplify the manner of diagnosing adrenal insufficiency.Recent FindingsWith the ever increasing age of the patient population, along with their comorbidities, readers should be aware of how to diagnose acute adrenal insufficiency promptly. More often than not, resident physicians as well as clinicians struggle to diagnose and treat adrenal insufficiency in a timely manner, as diagnostic testing is time dependent.SummaryThe time sensitive nature of the co-cosyntropin testing, which is difficult to implement even as an in-patient by nurses/phlebotomist secondary to nursing...
Source: Current Emergency and Hospital Medicine Reports - January 23, 2017 Category: Emergency Medicine Source Type: research