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Child Maltreatment and Neglect
Emergency medicine clinicians are mandated reporters, legally, which obligates clinicians to report any behavior suspicious for child maltreatment to local authorities. Pediatric patients often present to the emergency department with concern for physical injury and other pervasive complaints. In some cases, these injuries are nonaccidental. To appropriately advocate and protect children from further physical and emotional trauma, it is important for clinicians to recognize the signs and symptoms of child maltreatment and sexual abuse. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - June 10, 2021 Category: Emergency Medicine Authors: Riham Mazen Alwan, Nisa S. Atigapramoj Source Type: research

High-Risk Medicolegal Conditions in Pediatric Emergency Medicine
The top 5 reasons for pediatric malpractice are cardiac or cardiorespiratory arrest, appendicitis, disorder of male genital organs, encephalopathy, and meningitis. Malpractice is most likely to result from an “error in diagnosis.” Claims involving a “major permanent injury” were more likely to pay out money, but of all claims, only 30% result in a monetary pay out. Consideration of “high-risk misses” may help to direct a history, examination, testing, and discharge instructions. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - June 9, 2021 Category: Emergency Medicine Authors: Michael B. Weinstock, Heath Jolliff Source Type: research

Pediatric Hematologic and Oncologic Emergencies
This article presents a review of the most commonly encountered pediatric hematologic and oncologic complications that emergency physicians and providers need to know. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - June 9, 2021 Category: Emergency Medicine Authors: Kathleen Stephanos, Sarah B. Dubbs Source Type: research

Pediatric Fever
Pediatric fever is a common complaint in children. The most common cause is self-limited viral infection. However, neonates and young infants are evaluated and treated differently than older, vaccinated, and clinically evaluable children. Neonates should be admitted to the hospital, young infants in the second month of life may be risk stratified, and those deemed low risk on testing may be sent home with close follow-up. Children older than 2  months may be evaluated clinically for signs of bacterial infection that require intervention. Urinary tract infections cause more than 90% of serious bacterial illness in children...
Source: Emergency Medicine Clinics of North America - June 9, 2021 Category: Emergency Medicine Authors: Emily Rose Source Type: research

Ear, Nose, Throat
This article provides the emergency physician with the tools needed to decipher between the mundane and the critical, variations in presentation, and their emergent management. All of them require early recognition for any airway compromise or obstruction in order to avoid serious complications. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - June 9, 2021 Category: Emergency Medicine Authors: Mahsa Akhavan Source Type: research

New Designer Drugs
This article discusses the opioid epidemic and several emerging opioids, including buprenorphine, loperamide, fentanyl, fentanyl derivatives, and others. Kratom, a plant occasionally used for opiate detoxification, along with the sedatives etizolam and phenibut, will be discussed. Lastly, this article discusses the phenethylamines and marijuana. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - June 9, 2021 Category: Emergency Medicine Authors: Michael Levine, Frank Lovecchio Source Type: research

Technology-Dependent Children
There are a growing number of medically complex children with implanted devices. Emergency physicians with a basic knowledge of these devices can troubleshoot and fix many of the issues that may arise. Recognition of malfunction of these devices can reduce morbidity and mortality among this special population. In this article, we review common issues that may arise in children with gastrostomy tubes, central nervous system shunts, cochlear implants, and vagal nerve stimulators. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - June 9, 2021 Category: Emergency Medicine Authors: Alamelu Natesan, Solomon Behar Source Type: research

Big Tests in Little People
This article presents the literature about 4 common blood tests and examines the clinical applications of each. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - June 8, 2021 Category: Emergency Medicine Authors: Jennifer Guyther, Lauren Cantwell Source Type: research

Geriatric Trauma
This article outlines common presentations of trauma in geriatric patients, with consideration to baseline physiologic function and patterns of injury that may be more prevalent in geriatric populations. Additionally, the article explores specific evidence-based management practices, the significance of trauma team and geriatrician involvement, and disposition decisions. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 14, 2021 Category: Emergency Medicine Authors: Drew Clare, Korie L. Zink Source Type: research

Chronic Brain Failure
Chronic brain failure, also known as dementia or major neurocognitive disorder, is a syndrome of progressive functional decline characterized by both cognitive and neuropsychiatric symptoms. It can be conceptualized like other organ failure syndromes and its impact on quality of life can be mitigated with proper treatment. Dementia is a risk factor for delirium, and their symptoms can be similar. Patients with dementia can present with agitation that can lead to injury. Logic and reason are rarely successful when attempting to redirect someone with advanced dementia. Interactions that offer a sense of choice are more likel...
Source: Emergency Medicine Clinics of North America - April 14, 2021 Category: Emergency Medicine Authors: James P. Wolak Source Type: research

Cardiopulmonary Emergencies in Older Adults
Older adults are susceptible to serious illnesses, including atrial fibrillation, congestive heart failure, pneumonia, and pulmonary embolism. Atrial fibrillation is the most common arrhythmia in this age group and can cause complications such as thromboembolic events and stroke. Congestive heart failure is the most common cause of hospital admission and readmission in the older adult population. Older adults are at higher risk for pulmonary embolism because of age-related changes and comorbidities. Pneumonia is also prevalent and is one of the leading causes of death. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 14, 2021 Category: Emergency Medicine Authors: Rebecca Theophanous, Wennie Huang, Luna Ragsdale Source Type: research

Disaster Diagnoses in Geriatric Patients with Abdominal Pain
This article explores the evaluation and management of several important causes of abdominal pain in geriatric patients with an emphasis on high-risk presentations. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 14, 2021 Category: Emergency Medicine Authors: Ryan Spangler, Sara Manning Source Type: research

Preface
We are excited to bring you this geriatric-focused issue of Emergency Medicine Clinics of North America. The authors have done a thorough job of interpreting the literature and distilling important concepts so you can be prepared for your next shift (or hospital meeting). While education in our field correctly trains us for the next trauma or airway disaster, the realities of our shifts are often quite different. Chief complaints that fill our days often include “weak and dizzy,” “fall,” “confusion,” “dementia with behaviors,” and so forth. (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 14, 2021 Category: Emergency Medicine Authors: Robert S. Anderson, Phillip D. Magidson, Danya Khoujah Source Type: research

Emergencies in the Older Adult
EMERGENCY MEDICINE CLINICS OF NORTH AMERICA (Source: Emergency Medicine Clinics of North America)
Source: Emergency Medicine Clinics of North America - April 14, 2021 Category: Emergency Medicine Authors: Robert S. Anderson, Phillip D. Magidson, Danya Khoujah Source Type: research

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Source: Emergency Medicine Clinics of North America - April 14, 2021 Category: Emergency Medicine Source Type: research