Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Nov 2010
ReviewThe emergency department evaluation, management, and treatment of back pain.
Back pain is one of the most common symptom-related complaints for visits to primary care physicians and is the most common musculoskeletal complaint that results in visits to the emergency department (ED). With recent national health care initiatives moving toward universal coverage, an increasing number of patients with common complaints such as back pain will visit the ED. The first goal of ED assessment of patients with back pain is to evaluate for potentially dangerous causes that, if not promptly recognized, could result in significant morbidity and mortality. This article focuses on the essential elements of an efficient and effective evaluation, management and treatment of patients with back pain in the ED, with special emphasis on epidural abscess, epidural compression syndrome, malignancy, spinal stenosis, and back pain in children.
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Emerg. Med. Clin. North Am. · Nov 2010
ReviewEmergency orthogeriatrics: concepts and therapeutic alternatives.
Multidisciplinary orthogeriatric care can enhance prompt ED diagnosis, optimal pre- and postoperative care, and functional recovery in older adults with bony injuries. Emergency care providers should be cognizant of prevalent geriatric syndromes including delirium and standing level falls to minimize fracture-related morbidity. Recognizing the implications of aging physiology, acute care physicians should be aware of effective alternatives to analgesia, procedural sedation, and definitive imaging to promote early surgical management and postoperative recovery.
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The emergency provider (EP) must be aware of the anatomy of the leg, ankle, and foot. The varied presentation of common injuries must be recognized as well as the unique presentations of uncommon injuries. ⋯ In some cases, emergent orthopedic consultation is required. Potential complications associated with these injuries must be anticipated and avoided if possible.