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Specialty: Emergency Medicine
Condition: Pain
Therapy: Pain Management

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Total 31 results found since Jan 2013.

Not as Simple as Canker Sores
BY ​NANA P. MATSUMOTO, & DEREK MEEKS, DO​​A 16-year-old boy presented to a rural ED with a swollen jaw, painful blisters in the mouth, and earache for the past day. One week before, he had a fever with chills, sore throat, and dry coughs. He was not taking any medications, and his immunizations were up-to-date. He had a mild learning disorder but no significant past medical or surgical history.​An apthous ulcer, the most common and one of the earliest signs of Behçet's disease.The patient's vital signs were within normal limits, and his physical examination revealed anterior cervical lymphadenopathy, sinus con...
Source: The Case Files - October 11, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: research

A Pregnancy Complication to Look out for even after Pregnancy
​BY GREGORY TAYLOR, DO, & SHERIF G. EL-ALAYLI, DOA 30-year-old G5P3 presented to the ED with bilateral lower-extremity edema and headache for three days. She presented one week after an uncomplicated full-term vaginal delivery with an unremarkable pregnancy course and no prior requirement for antihypertensive therapy. The headache was described as achy to sharp, with associated photophobia. She also noted occasional vaginal spotting, which was common a few weeks after delivery. She denied any chest pain, shortness of breath, nausea or vomiting, abdominal pain, or any other symptoms. She admitted to occasional mild cr...
Source: The Case Files - August 28, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

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

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

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

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

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