Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Aug 2010
ReviewDiagnosis and evaluation of syncope in the emergency department.
With a careful history, physical examination, and directed investigation, physicians can determine the likely cause of syncope in more than 50% and perhaps up to 80% of patients. Understanding the cause of syncope allows clinicians to determine the disposition of high- and low-risk patients. ⋯ This article reviews the diagnosis and ED work-up of syncope, the different classifications of syncope, and prognosis. The use of specific decision rules in risk stratification and syncope in the pediatric population are discussed in another article.
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Emerg. Med. Clin. North Am. · Aug 2010
ReviewTwenty per hour: altered mental state due to ethanol abuse and withdrawal.
This article discusses the physiology and clinical syndromes involved in ethanol absorption, intoxication, and withdrawal, with special emphasis on the evidentiary backing for common treatments, as well as some discussion of the medicolegal sequelae of treatment of ethanol abusers in the emergency department.
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Emerg. Med. Clin. North Am. · Aug 2010
ReviewDelirium in the older emergency department patient: a quiet epidemic.
Delirium is defined as an acute change in cognition that cannot be better accounted for by a preexisting or evolving dementia. This form of organ dysfunction commonly occurs in older patients in the emergency department (ED) and is associated with a multitude of adverse patient outcomes. ⋯ Once delirium is diagnosed, the ED evaluation should focus on searching for the underlying cause. Infection is one of the most common precipitants of delirium, but multiple causes may exist concurrently.
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Emerg. Med. Clin. North Am. · Aug 2010
Review Case ReportsPediatric syncope: cases from the emergency department.
Pediatric syncope is a common presentation in the emergency department. Most causes are benign, but an evaluation must exclude rare life-threatening disorders. The lack of objective findings can pose a challenge. This case-based review emphasizes the importance of a detailed history and physical examination with electrocardiogram in determining high-risk patients.
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Emerg. Med. Clin. North Am. · Aug 2010
Review Case ReportsThe mental status examination in emergency practice.
A systematic approach to assessing mental status in the emergency department is key to identifying alterations in mental status and to directing diagnostic testing and management. After initial stabilization of the patient, it is critical to assess a patient's alertness, attention, and cognition, and perform a brief psychiatric assessment to fully evaluate a patient with mental status changes. This article offers an approach to allow better management of a patient with altered mental status.