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Specialty: Emergency Medicine
Condition: Pain

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Total 103 results found since Jan 2013.

Looking Past Dementia Reveals Hidden Life Threats
Conclusion Acute delirium is commonly underdiagnosed, and can be masked by chronic alterations in cognition and mentation. Delirium has many causes, and can be assessed using the acronym DELIRIUM. The most common presentations suggesting delirium over dementia are short-term memory loss, rapid fluctuation in condition, acute alteration, and a condition present that may be responsible for delirium. Management includes searching for causes of acute alteration in mental status, negating environmental factors of delirium, and—only when necessary—reducing the patient’s threat to themselves or providers by using butyrophen...
Source: JEMS Special Topics - August 13, 2018 Category: Emergency Medicine Authors: Joseph K. Mesches, NRP, FP-C Tags: Exclusive Articles Patient Care Source Type: news

Transporting Patients to Appropriate Receiving Destinations
Conclusion EMS is in a position to be the initiator of specialty center destination. In large cities with multiple hospitals, EMS should transport patients to the closest, most appropriate facility based on patient condition, even if this requires passing a closer facility. Where there are hospitals with multiple specialty services, EMS may be asked to activate a specific team, such as the stroke or cardiac team. In rural communities, EMS can communicate with the local hospital and by letting the hospital know of patient condition, help start the interfacility transport process from the field....
Source: JEMS Special Topics - July 19, 2018 Category: Emergency Medicine Authors: Dennis Edgerly, MEd, EMT-P Tags: Exclusive Articles Columns Operations Source Type: news

Not Just Acid Reflux: The Need to Think Worst First
Discussion Heart disease is the leading cause of death in the United States.1 This year, 720,000 Americans will have a new coronary event—defined as first hospitalized myocardial infarction (MI) or coronary heart disease death—and around 335,000 will have a recurrent event. Approximately 35% of people who experience a coronary event in a given year and around 14% of patients who have an acute coronary syndrome will die from it.1 Roughly 60% of patients with an acute coronary syndrome are transported to the emergency department via ambulance.2–4. Up to one-third of patients experiencing an MI may not complain of chest...
Source: JEMS Special Topics - January 13, 2019 Category: Emergency Medicine Authors: Stephen Sanko, MD, FACEP Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news

Using Benchmark Data as a Launching Point for Quality Improvement in EMS
EMS agencies strive to provide the best possible care and contribute to positive patient outcomes. To ensure a high level of care, many agencies implement quality improvement programs; choosing a place to start for a quality improvement initiative, however, can seem overwhelming, with so many important conditions like cardiac arrest, sepsis, stroke, overdoses, etc. With limited time and resources, it’s necessary to concentrate efforts on measures that matter and are likely to make an impact. A great place to start with quality improvement efforts is where the gold standard is known and the frequency of events isn’t rar...
Source: JEMS Operations - February 20, 2019 Category: Emergency Medicine Authors: Remle Crowe, PhD, NREMT Tags: Exclusive Articles Operations Top Story Source Type: news

Missed Serious Neurologic Conditions in Emergency Department Patients Discharged With Nonspecific Diagnoses of Headache or Back Pain
ConclusionA small proportion of ED patients discharged with nonspecific diagnoses of headache or back pain returned with a serious neurologic condition or inhospital death within 30 days.
Source: Annals of Emergency Medicine - February 22, 2019 Category: Emergency Medicine Source Type: research

Improving the Care of Individuals With Sickle Cell Disease in the Emergency Department Using a Quality Improvement Framework: The Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS)
Sickle cell disease (SCD) is a severe chronic disease that leads to premature mortality caused by serious complications of the disease such as acute chest syndrome, stroke, and sepsis. Patients presenting to the emergency department (ED) with pain due to vaso-occlusive crisis (VOC) are at a higher risk for complications, making it imperative that emergency nurses, nurse practitioners, and physicians are knowledgeable about SCD and understand the other associated complications besides VOC. Because of the complexity of disease and misperceptions about SCD among ED nurses, physicians, and nurse practitioners, a quality improv...
Source: Advanced Emergency Nursing Journal - July 1, 2019 Category: Emergency Medicine Tags: PROCEDURAL COLUMN Source Type: research

Evaluation of Nonfatal Strangulation in Alert Adults
ConclusionAlert, strangled patients had a low rate of injuries. All patients with neck injuries had concerning findings besides neck pain; specifically, GCS score less than 15 or dysphagia. Our findings suggest, but do not prove, that a selective imaging strategy is safe in alert patients after strangulation findings besides neck pain.
Source: Annals of Emergency Medicine - October 5, 2019 Category: Emergency Medicine Source Type: research

High-Risk Chief Complaints III
A careful history and thorough physical examination are necessary in patients presenting with acute neurologic dysfunction. Patients presenting with headache should be screened for red-flag criteria that suggest a dangerous secondary cause warranting imaging and further diagnostic workup. Dizziness is a vague complaint; focusing on timing, triggers, and examination findings can help reduce diagnostic error. Most patients presenting with back pain do not require emergent imaging, but those with new neurologic deficits or signs/symptoms concerning for acute infection or cord compression warrant MRI. Delay to diagnosis and tr...
Source: Emergency Medicine Clinics of North America - April 24, 2020 Category: Emergency Medicine Authors: Danielle E. Smith, Matthew S. Siket Source Type: research

Diagnosis and management of acute aortic syndromes in the emergency department
AbstractAcute aortic syndromes (AASs) are deadly cardiovascular emergencies involving the thoracic aorta. AASs are relatively rare conditions, have unspecific signs and symptoms (including truncal pain, syncope, neurologic deficit and limb ischemia) and require contrast-enhanced tomography angiography (CTA) of the chest and abdomen for conclusive diagnosis and subsequent therapeutic planning. In the Emergency Department (ED), most patients with potential signs/symptoms of AASs are finally found affected by other alternative diagnoses. Hence, misdiagnosis and delayed diagnosis of AASs are major concerns. In critically ill p...
Source: Internal and Emergency Medicine - April 30, 2020 Category: Emergency Medicine Source Type: research

Lung apical findings in coronavirus disease (COVID-19) infection on neck and cervical spine CT
ConclusionLung apical findings on cervical spine or neck CTs consistent with COVID-19 infection are common and may be encountered on neuroimaging performed for non-respiratory indications. For these patients, the emergency radiologist may be the first physician to suspect underlying COVID-19 infection.
Source: Emergency Radiology - July 20, 2020 Category: Emergency Medicine Source Type: research

Neurologic Emergencies
I ’ll bet that if you ask most emergency physicians about which organ system’s emergencies cause them the most angst, it would be the neurologic system. Neurologic emergencies are the epitome of the proverbial “needle in a haystack.” For example, the overwhelming majority of cases of headache, back pain, weakness, and dizziness turn out to be a haystack of benign causes. Our job in the emergency department is to find those rare needles...the subarachnoid hemorrhage, the spinal infection, the stroke, or the vertebral dissection.
Source: Emergency Medicine Clinics of North America - November 4, 2020 Category: Emergency Medicine Authors: Amal Mattu Tags: Foreword Source Type: research

Patient Care Falters as COVID-19 Devastates L.A. County (CA) Hospitals
Soumya Karlamangla, Rong-Gong Lin II, Luke Money Los Angeles Times (MCT) Los Angeles County’s healthcare system was buckling Wednesday under the unprecedented surge of COVID-19 patients, with bodies piling up at morgues and medical professionals resorting to increasingly desperate measures as they brace for conditions to worsen in the coming weeks. With hospitals overwhelmed by patients and no outlet valve available, doctors, nurses and paramedics are being forced to make wrenching choices about who gets care and at what level. “No one would believe this is in the United States,” ...
Source: JEMS Patient Care - December 31, 2020 Category: Emergency Medicine Authors: JEMS Staff Tags: Coronavirus News News Feed California EMS Hospital Paramedic Source Type: news