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Humans vs. Machines: Mechanical Compression Devices and Their Appropriate Application in the Management of Cardiac Arrest
AbstractPurpose of ReviewThis paper reviews the published literature on mechanical compression devices compared to manual compressions to provide clinicians with an overview of the implementation and efficacy.Recent FindingsThe 2020 American Heart Association guidelines now recommend mechanical compression devices under certain circumstances, prompting further discussion of the benefits and risks. Pre-clinical studies have shown marked advantages in organ perfusion and cerebral blood flow with external chest compression provided by mechanical devices when compared to manual compression. However, clinical reports have provi...
Source: Current Emergency and Hospital Medicine Reports - October 20, 2023 Category: Emergency Medicine Source Type: research

Kawasaki Disease: Recent Diagnostics, Treatment, and Predictors for Treatment Failure and Coronary Artery Involvement
AbstractPurpose of ReviewKawasaki disease (KD) is a medium vessel vasculitis in pediatric patients with a predilection for coronary artery involvement. The disease can be complete or incomplete but generally consists of a fever longer than 5  days, bilateral conjunctivitis, rash, edema, cervical adenopathy, and mucosal involvement. Mainstay of therapy includes IV immunoglobulin and aspirin. The goal of this article is to identify recent research that focuses on the newest diagnostic tools, predictive factors for coronary involvement, a nd treatment failure, as well as the most recent literature on treatment.Recent Finding...
Source: Current Emergency and Hospital Medicine Reports - October 19, 2023 Category: Emergency Medicine Source Type: research

Central Retinal Artery Occlusion
AbstractPurpose of ReviewThis review aims to provide a comprehensive overview of emergency department management of central retinal artery occlusion (CRAO). It examines common presentations, etiologies, workup, and various treatment options with their evidence.Recent FindingsThere is limited research on CRAO. Most treatment methods and guidelines are based on observational literature, case series, retrospective studies, and expert opinion. Many of the treatments available to the emergency provider have limited success. More advanced treatments with hyperbaric therapy or thrombolytics are becoming more established.SummaryWo...
Source: Current Emergency and Hospital Medicine Reports - September 11, 2023 Category: Emergency Medicine Source Type: research

Long-Covid and Pain: Pathophysiology and Management
AbstractPurpose of ReviewSince its origin on December 12, 2019, SARS-CoV-2 has shaken the globe, and while pandemic restrictions have lifted, many individuals who survived the acute viral infection continue to suffer chronically from complications for months and even years.Recent FindingsThe physiologic, multi-organ complications related to this viral infection can be severe. The ongoing symptoms of SAR-CoV-2 extending beyond 4 weeks are referred to as Long-Covid, with the most common complaints being related to pain. As the pathophysiology continues to be investigated, the current hypothesis is that the angiotensin-conver...
Source: Current Emergency and Hospital Medicine Reports - September 6, 2023 Category: Emergency Medicine Source Type: research

Coccidioidomycosis Update and Review
AbstractPurpose of ReviewCoccidioidomycosis is a nationally notifiable fungal infection with mandatory reporting in 26 states and the District of Colombia. Identifying patients at risk for coccidioidomycosis infection, ordering appropriate testing, and understanding criteria for pharmacologic treatment are important to management of the disease.Recent FindingsCases of coccidioidomycosis are increasing. Surveillance studies show significant diagnostic delay and frequent mistreatment with antibiotics in both endemic areas, and especially when travel acquired cases present in non-endemic states. Studies of physician practice ...
Source: Current Emergency and Hospital Medicine Reports - September 2, 2023 Category: Emergency Medicine Source Type: research

Geriatric Injury: A Contemporary Review of Patterns, Prevention, and Treatment
AbstractPurpose of ReviewAdults 65  years and older represent a rapidly growing population in the USA and worldwide. Today, 16.8% of the US population is over 65, with an estimate that 20% of Americans will be over 65 by 2030. This review analyzes the complexities involved with preventing and managing geriatric injury.Recent FindingsGeriatric injury represents nearly 50% of all traumas, with ground-level falls and motor vehicle crashes being the most common mechanisms, resulting in predictable injury patterns. Conscientious medical and surgical management from the emergency department to discharge and beyond is paramount,...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2023 Category: Emergency Medicine Source Type: research

The Role of Albumin in the Resuscitation of Hypotensive Patients
AbstractPurpose of ReviewAlbumin is a colloid used in fluid resuscitation, with intrinsic physiologic properties that make it ideal to use for certain hypotensive patients. Despite this, its indications for use in this context are the source of much debate. This review aims to provide an overview of the history of albumin, explain its rise and fall in popularity, and identify situations where use of albumin may be beneficial over other forms of fluid resuscitation.Recent FindingsThe use of albumin dropped significantly in 1998 after a review article was published suggesting that it was harmful to use in critically ill pati...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2023 Category: Emergency Medicine Source Type: research

Hypertonic Saline in the Critically Ill: A Review of Indications, Routes, and Dosing
AbstractPurpose of ReviewIn this article, we review the use of hypertonic saline (HTS) for FDA-approved indications, namely treatment of hyponatremia and elevated intracranial pressure (ICP), as well as the routes of administration appropriate for infusion.Recent FindingsThough society guidelines for treating hyponatremia have not recently changed, new data is emerging that supports the use of bolus-based HTS treatment regimens. HTS is at least as effective as mannitol for lowering elevated ICP from cerebral edema and is also now the preferred hyperosmolar treatment in patients with intracranial hemorrhage (ICH) and trauma...
Source: Current Emergency and Hospital Medicine Reports - September 1, 2023 Category: Emergency Medicine Source Type: research

Devices Used in the Treatment of Tension Pneumothorax
AbstractPurpose of ReviewThis review will describe pathophysiology, current emergency department (ED) treatment strategies, and novel devices used in the management of acute tension pneumothorax.Recent FindingsTraditional decompression success rates for the treatment of acute tension pneumothorax utilizing a standard 5-cm angiocatheter are inadequate in many cases. Novel devices and anatomical approaches have recently been developed to improve upon the rate of successful decompression and treatment.SummaryRecent studies have shown greater success in emergent decompression of acute tension pneumothorax at the 4th or 5th int...
Source: Current Emergency and Hospital Medicine Reports - August 10, 2023 Category: Emergency Medicine Source Type: research

Geriatric Injury: A Contemporary Review of Patterns, Prevention, and Treatment
AbstractPurpose of ReviewAdults 65  years and older represent a rapidly growing population in the USA and worldwide. Today, 16.8% of the US population is over 65, with an estimate that 20% of Americans will be over 65 by 2030. This review analyzes the complexities involved with preventing and managing geriatric injury.Recent FindingsGeriatric injury represents nearly 50% of all traumas, with ground-level falls and motor vehicle crashes being the most common mechanisms, resulting in predictable injury patterns. Conscientious medical and surgical management from the emergency department to discharge and beyond is paramount,...
Source: Current Emergency and Hospital Medicine Reports - August 5, 2023 Category: Emergency Medicine Source Type: research

Recognizing and Managing Idiopathic Intracranial Hypertension in the Emergency Department
AbstractPurpose of ReviewThis review covers evaluation and Emergency Department (ED) management of patients with symptoms consistent with idiopathic intracranial hypertension (IIH), along with reviewing new proposed mechanisms and treatments for the disease.Recent FindingsNew imaging techniques can provide evidence to support the clinical diagnosis of IIH, including MRI and bedside ultrasound. Recent studies suggest novel metabolic mechanisms and possible treatments for IIH.SummaryIn the Emergency Department, clinicians should keep IIH on their differential in patients with headache and/or papilledema and work patients up ...
Source: Current Emergency and Hospital Medicine Reports - August 4, 2023 Category: Emergency Medicine Source Type: research

Mpox in the Emergency Department
AbstractPurpose of ReviewThis paper provides a comprehensive review of mpox for emergency medicine providers. Despite the disease existing in endemic regions for decades, substantial knowledge gaps remain. This review covers the diagnosis, treatment, and prevention of mpox.Recent FindingsSince the 2022 outbreak began, there have been more than 80,000 cases of mpox. The disease manifests as a rash in most cases. Diagnosis is challenging due to the great variability in rash presentation and similarity with other cutaneous diseases, however, PCR testing can confirm mpox. Antiviral therapies are available under a compassionate...
Source: Current Emergency and Hospital Medicine Reports - June 22, 2023 Category: Emergency Medicine Source Type: research

The Role of Albumin in the Resuscitation of Hypotensive Patients
AbstractPurpose of ReviewAlbumin is a colloid used in fluid resuscitation, with intrinsic physiologic properties that make it ideal to use for certain hypotensive patients. Despite this, its indications for use in this context are the source of much debate. This review aims to provide an overview of the history of albumin, explain its rise and fall in popularity, and identify situations where use of albumin may be beneficial over other forms of fluid resuscitation.Recent FindingsThe use of albumin dropped significantly in 1998 after a review article was published suggesting that it was harmful to use in critically ill pati...
Source: Current Emergency and Hospital Medicine Reports - June 16, 2023 Category: Emergency Medicine Source Type: research

Mammalian Bites: Infection Prevention and Management
This article reviews approaches to the evaluation and treatment of patients with mammalian bites presenting to the Emergency Department with an emphasis on infectious complication prevention and management.Recent FindingsRecent studies questioned the wisdom of leaving all bite wounds open, while reinforcing extreme caution with primary closure of wounds in areas of the body where infection development is likelier and more consequential. Nuances have also emerged as far as prophylactic antibiotics are concerned.SummaryOnce an initial trauma assessment and stabilization have been completed in the patient with an animal bite,...
Source: Current Emergency and Hospital Medicine Reports - June 10, 2023 Category: Emergency Medicine Source Type: research

Hypertonic Saline in the Critically Ill: A Review of Indications, Routes, and Dosing
AbstractPurpose of ReviewIn this article, we review the use of hypertonic saline (HTS) for FDA-approved indications, namely treatment of hyponatremia and elevated intracranial pressure (ICP), as well as the routes of administration appropriate for infusion.Recent FindingsThough society guidelines for treating hyponatremia have not recently changed, new data is emerging that supports the use of bolus-based HTS treatment regimens. HTS is at least as effective as mannitol for lowering elevated ICP from cerebral edema and is also now the preferred hyperosmolar treatment in patients with intracranial hemorrhage (ICH) and trauma...
Source: Current Emergency and Hospital Medicine Reports - June 8, 2023 Category: Emergency Medicine Source Type: research