Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · May 2014
ReviewCurrent Diagnosis and Treatment of Hyperglycemic Emergencies.
Diabetic ketoacidosis and hyperosmolar hyperglycemic state are the most feared complications of uncontrolled diabetes seen in emergency medicine. The treatment of both conditions must be tailored to individual patients and relies on aggressive fluid resuscitation, insulin replacement, and electrolyte management. ⋯ Improved understanding of the underlying pathophysiology and application of evidence-based guidelines have significantly improved prognosis and decreased mortality. The purpose of this article is to review the diagnosis, presentation, and emergency department management of diabetic ketoacidosis and hyperosmolar hyperglycemic state with an emphasis on current management and treatment guidelines.
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Emerg. Med. Clin. North Am. · May 2014
ReviewNeonatal Endocrine Emergencies: A Primer for the Emergency Physician.
The resuscitation principles of securing the airway and stabilizing hemodynamics remain the same in any neonatal emergency. However, stabilizing endocrine disorders may prove especially challenging. ⋯ Implementing routine screening tests worldwide and improving the accuracy of present tests remains the challenge for healthcare providers. With further study of these disorders and best treatment practices we can provide neonates presenting to the emergency department with the best possible outcomes.
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Although the altered mental status is a common presentation in the emergency department, altered mental status caused by endocrine emergencies is rare. The altered patient could have an endocrine cause that can quickly improve with appropriate diagnosis and interventions. When dealing with limited information and an obtunded patient, it is important to have a broad differential diagnosis, pick up on the physical examination findings, and evaluate laboratory abnormalities that could suggest an underlying endocrine emergency. This article outlines the findings and provides a description of altered patients with endocrine emergencies to facilitate the diagnosis and treatment in the emergency department.
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Emerg. Med. Clin. North Am. · May 2014
ReviewApproach to Metabolic Acidosis in the Emergency Department.
Acid-base disorders should be considered a process with the goal being to treat the patient and the underlying condition, not the numbers. A good understanding of the normal acid-base regulation in the body, as well as the most common derangements can prepare the emergency physician for this very common disorder that presents on every shift.
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Emerg. Med. Clin. North Am. · May 2014
ReviewCalcium, Magnesium, and Phosphate Abnormalities in the Emergency Department.
Derangements of calcium, magnesium, and phosphate are associated with increased morbidity and mortality. These minerals have vital roles in the cellular physiology of the neuromuscular and cardiovascular systems. This article describes the pathophysiology of these mineral disorders. It aims to provide the emergency practitioner with an overview of the diagnosis and management of these disorders.