Current Emergency and Hospital Medicine Reports 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.

Assessing Pain in the ED Including the Use of Pain Scales (Such as OSBD, FLACC, VRS, NRS, CRS, and Oucher)
Abstract Pain is a common presenting complaint in pediatric emergency departments (EDs). In 2001 the Joint Commission for Healthcare Organizations (JCAHO) set standards for pain assessment and management that have become important quality indicators. These Joint Commission standards led EDs to treat pain as a “fifth vital sign” to be measured and addressed. JCAHO left the details of pain assessment metrics to the facilities, thus no single scale has been recommended as the standard of care in pediatrics. Self-reported pain severity scales are considered ideal, but young and cognitively impaired childr...
Source: Current Emergency and Hospital Medicine Reports - February 16, 2016 Category: Emergency Medicine Source Type: research

Non-pharmacologic Management of Pain and Anxiety in the Pediatric Patient
Abstract Minimizing pain and anxiety is imperative to a child and parent’s emergency department and hospital encounter. While various pharmacologic agents are available and widely used, they are not without risks. We discuss a variety of preparation, non-pharmacologic, and minimal pharmacologic strategies as alternatives or adjuncts to decrease pain and anxiety associated with medical encounters and procedures in children. (Source: Current Emergency and Hospital Medicine Reports)
Source: Current Emergency and Hospital Medicine Reports - February 12, 2016 Category: Emergency Medicine Source Type: research

An Evidence-Based Approach to Medical Clearance of Psychiatric Patients in the Emergency Department
Abstract Medical clearance of psychiatric patients is the process whereby emergency physicians (EP) screen for medical causes of psychiatric symptoms as well as incidental comorbid illnesses in order to appropriately dispose the patient to either a medical or psychiatric unit. There is much disagreement between EPs and psychiatrists regarding the extent of workup required. It is universally accepted that an adequate history and physical exam, including complete vital signs, mental status exam, and neurological exams are crucial to this process. However, several components of the H&P, particularly the ...
Source: Current Emergency and Hospital Medicine Reports - October 29, 2015 Category: Emergency Medicine Source Type: research

The Agitated Patient in the Emergency Department
Abstract A 32-year-old male with a past history of paranoid schizophrenia and methamphetamine use presents to the emergency department requesting help. He is vague in his requests for help and seems paranoid about staff harming him. He is not taking his psychiatric medication. He is directable in triage, but after being placed into a room begins to escalate. By the time the physician and nurse go to see him, he attempts to strike the physician. He is talking loudly and breaks a portable computer. Security must be called immediately to the bedside. (Source: Current Emergency and Hospital Medicine Reports)
Source: Current Emergency and Hospital Medicine Reports - October 12, 2015 Category: Emergency Medicine Source Type: research

Child and Adolescent Emergency Psychiatry: A Review of Recent Developments
Abstract Child and adolescent emergency psychiatry is an important but often isolated field. Borrowing from or integrating with emergency psychiatry, emergency medicine, and pediatric emergency medicine, this field has struggled to develop a robust research agenda. Despite these challenges, the past several years have seen many significant developments. Paralleling adult research, extensive medical screening and clearance for children and adolescents is now shown to be unproductive. Bullying, especially online bullying, and targeting of sexual minority youth are increasingly recognized as a risk for suici...
Source: Current Emergency and Hospital Medicine Reports - October 8, 2015 Category: Emergency Medicine Source Type: research

Deadly Behavioral Emergencies
This article delves into five medical emergencies, based on cases, that may initially present with a behavioral chief complaint. Delirium, neuroleptic malignant syndrome, serotonin syndrome, anticholinergic toxicity, and thyrotoxicosis are detailed and basic treatments are noted. (Source: Current Emergency and Hospital Medicine Reports)
Source: Current Emergency and Hospital Medicine Reports - September 25, 2015 Category: Emergency Medicine Source Type: research

Difficult Patient Encounters: Medical Education and Modern Approaches
Abstract One might expect the physician–patient encounter to routinely be a rewarding experience. The patient needs help with a medical problem; the physician provides relief for that medical problem. However, conflict within these encounters continues to arise. Though research indicates physicians, medical systems, and patients contribute to potential conflict, medical education and practice provides limited guidance to physicians how to recognize and avoid these exhausting and sometimes confrontational experiences. (Source: Current Emergency and Hospital Medicine Reports)
Source: Current Emergency and Hospital Medicine Reports - September 19, 2015 Category: Emergency Medicine Source Type: research

Models of Psychiatric Emergency Care
This article discusses the most prominent models of psychiatric crisis care and compares the pros and cons of each, with additional focus on the newest and most innovative approaches. (Source: Current Emergency and Hospital Medicine Reports)
Source: Current Emergency and Hospital Medicine Reports - September 15, 2015 Category: Emergency Medicine Source Type: research

Key Performance Measures in the Management of Patients with Asthma
Abstract Asthma affects over 22 million people in the United States and leads to more than 497,000 hospital admissions annually. Given this significant healthcare burden, asthma is often the focus of quality improvement initiatives. An important part of any of these initiatives is the use of performance or quality measures to track progress. Currently there are at least 40 asthma-specific measures in use. Of these 40, the National Quality Forum endorses nine measures. In addition to these measures, there are several others of importance due to regulatory and reimbursement considerations. (Source: Current ...
Source: Current Emergency and Hospital Medicine Reports - July 18, 2015 Category: Emergency Medicine Source Type: research

Controversies in the Care of the Acute Asthmatic in the Prehospital and Emergency Department Environments
Abstract Asthma is an episodic disease of the airways characterized by inflammation and constriction of the bronchi. It has a significant societal impact with over 25 million persons affected in the United States alone and annually accounts for approximately 3300 deaths in the US. Standard therapy for acute severe asthma is effective for most patients, but controversies exist surrounding the care of the impending or actual respiratory failure patient. Non-invasive positive pressure ventilation has been effective in multiple case reports, but lacks large trial evidence to support its use. Intravenous ketam...
Source: Current Emergency and Hospital Medicine Reports - July 1, 2015 Category: Emergency Medicine Source Type: research

Management of Status Asthmaticus
Abstract Status asthmaticus (SA) is a severe and life-threatening asthma exacerbation that requires aggressive treatment. First-line treatment entails continuous treatment of nebulized short-acting β-receptor agonists and intravenous (IV) steroid administration. This review article focuses on the current literature supporting the use of these medications as well as other treatment modalities such as inhaled anticholinergics, parenteral β-agonists, IV magnesium, and IV ketamine. We also explore the utility methylxanthines, volatile anesthetics, nitric oxide, antibiotics, IV fluids, and mucolytics in trea...
Source: Current Emergency and Hospital Medicine Reports - June 27, 2015 Category: Emergency Medicine Source Type: research

Update on New Treatments for Idiopathic Pulmonary Fibrosis
Abstract Idiopathic pulmonary fibrosis (IPF) is a chronic disorder that results in significant declines in respiratory function and a high mortality rate only a few years after diagnosis. Medical management of IPF has been attempted with various types of medications, such as immunosuppressants, anticoagulants, endothelin receptor antagonists, and anti-inflammatory drugs with less than conclusive results. However, with the approval of nintedanib and pirfenidone following the IMPULSIS-1, IMPULSIS-2, and ASCEND data, there is hope that medical therapy may be able to slow the progression of IPF and decrease t...
Source: Current Emergency and Hospital Medicine Reports - June 16, 2015 Category: Emergency Medicine Source Type: research

Review of Current Pneumococcal Vaccine Guidelines
Abstract Pneumococcal vaccination has been associated with a decline in the infectious disease burden caused by Streptococcus pneumoniae since it was incorporated into routine vaccination schedules for adults and children. In 2014, the Centers for Disease Control and Prevention updated its recommendations to include a single dose of a 13-valent pneumococcal conjugate vaccine for adults ≥65 years. The pediatric recommendations remain unchanged. This paper reviews the current vaccine recommendations for adults and children. (Source: Current Emergency and Hospital Medicine Reports)
Source: Current Emergency and Hospital Medicine Reports - June 16, 2015 Category: Emergency Medicine Source Type: research

Management of Bleeding Complications in Patients Taking Direct Oral Anticoagulants at a Large Tertiary Academic Medical Center
Abstract Direct oral anticoagulants (DOACs) offer a fixed-dose alternative to warfarin for stroke prevention in patients with atrial fibrillation. However, there is minimal evidence to guide the management of bleeding in patients taking a DOAC. We retrospectively evaluated the acute management of major bleeding in this patient population at a large, tertiary academic medical center. We evaluated various strategies of management including dialysis, transfusions, pharmacologic agents, surgical intervention, and reinitiation of anticoagulation. We also assessed length of intensive care unit and hospit...
Source: Current Emergency and Hospital Medicine Reports - June 13, 2015 Category: Emergency Medicine Source Type: research

Current Influenza Vaccine Options for 2014
Abstract Influenza is a virus that causes significant morbidity and mortality in the United States each year. There are multiple vaccine formulations available that can help prevent or decrease the burden of influenza. The Advisory Committee on Immunization Practices (ACIP) recommends that everyone ≥6 months of age receive the influenza vaccine prior to the start of influenza season each year unless contraindicated to help prevent influenza and the spread of infection. The ACIP has developed the best practice guidelines to help assist patients, and providers select the vaccine that will offer the great...
Source: Current Emergency and Hospital Medicine Reports - June 9, 2015 Category: Emergency Medicine Source Type: research