Emergency medicine clinics of North America
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Filoviruses, including Ebola virus, are associated with outbreaks of severe febrile illness with high fatality rates in humans. The 2014 outbreak of Ebola virus in West Africa is by far the largest outbreak in history and the first to spread to highly populated urban areas. The potential for such an epidemic to spread beyond Africa through international travel has raised concern in the world community as well as in American and international health agencies. This article presents background information, personal and public protective strategies, and treatment recommendations for emergency physicians.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEmergency Department Evaluation and Treatment of the Shoulder and Humerus.
Shoulder injuries are among the most common musculoskeletal complaints seen in US emergency departments (EDs). ED evaluation of the shoulder must account for the broad range of potential fracture patterns seen in the clavicle, scapula, and humerus. ⋯ Dislocation of the shoulder is frequently seen, and the ED physician must be skilled in several reduction techniques to optimize a successful reduction. An understanding of when orthopedic consultation is appropriate and when patients can be dispositioned with timely follow-up are integral to complete patient recovery.
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Emerg. Med. Clin. North Am. · May 2015
ReviewOrthopedic Emergencies: A Practical Emergency Department Classification (US-VAGON) in Pelvic Fractures.
Trauma is one of the leading causes of death before the age of 40 years and approximately 5% of patients with trauma who require hospital admission have pelvic fractures. This article updates the emergency department classification of pelvic fractures first described in 2000. This information is of practical value to emergency physicians in identifying the potential vascular, genitourinary, gastrointestinal, orthopedic, and neurologic complications and further assists them in the initial evaluation and treatment of patients with pelvic fractures.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEvaluation and Treatment of Acute Back Pain in the Emergency Department.
Back pain is a common presenting complaint to the emergency department. The key to proper evaluation is a history and physical examination focused on determining if any red flags for serious disease are present. ⋯ No diagnostic testing is required. For patients with red flags, a focused history and examination in conjunction with diagnostic laboratory tests and imaging determine whether the patient has an emergent condition such as herniated disc, epidural compression, or spinal infection.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEmergency Department Evaluation and Treatment of Acute Hip and Thigh Pain.
Although the incidence of hip fractures is decreasing, the overall prevalence continues to increase because of an aging population. People older than 65 suffer fractures at a rate of 0.6% per year--2% per year for persons older than 85. ⋯ Additionally, the emergency physician must consider entities such as avascular necrosis, compartment syndrome, and muscular disruption. This article reviews patterns and complications of acute hip and thigh injuries and clinically relevant diagnostic, anesthetic, and treatment options that facilitate timely, appropriate, and effective emergency department management.