Annals of emergency medicine
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Treatment of infectious diseases comprises a large part of emergency medicine practice. The management of infectious diseases in the emergency department is often different than in other settings because of the types of infectious presentations and the frequent necessity of empiric treatment decisions. This paper examines the new antimicrobials and their role for the treatment of infections in the ED.
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Polyarteritis nodosa is a vasculitic disease commonly involving coronary arteries, mesenteric arteries, kidneys, muscles, and vasa nervorum. Central nervous system involvement in polyarteritis nodosa is unusual and tends to occur later in the course of disease. ⋯ Her evaluation led to a diagnosis of polyarteritis nodosa. We present what may be the first published case report of polyarteritis nodosa presenting as acute bilateral visual loss.
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The present epidemic of tuberculosis has increased the risk of transmission of tuberculosis to health care workers in general and emergency department staff in particular, who often treat patients with tuberculosis before their diagnosis. The purpose of this study was to determine the risk of tuberculosis exposure among the nursing and physician staff of an urban ED. ⋯ As measured by self-reported PPD status, a high rate of exposure to tuberculosis has been observed among the ED staff at Harbor-UCLA Medical Center. The highest rate of PPD conversion has been noted most recently, suggesting that there has been a significant increase in staff exposure to tuberculosis during 1992 and the beginning of 1993. Systematic monitoring of PPD conversion rates among ED staff is necessary to determine the adequacy of ED respiratory isolation procedures during the current tuberculosis epidemic.
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In May 1993, the appearance of critically ill patients with unexplained respiratory distress was noted in the Four Corners area formed by New Mexico, Arizona, and Colorado. This epidemic was ultimately linked to a hantavirus, an emerging pathogen. ⋯ Emerging infections that are important to emergency physicians are discussed. Recommendations that focus on disaster management and prevention of the spread of an unknown pathogen are developed.
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Practice Guideline Guideline
Definition of emergency medicine. American College of Emergency Physicians.