Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · May 2023
ReviewEmergency Medicine Considerations in the Transgender Patient.
Transgender patients are at high risk for poor health outcomes and many harbor fear of healthcare settings secondary to prior discrimination, perceived sensationalism, clinician unfamiliarity, and unwanted exams. It is essential to approach transgender patients without judgement and with empathy. Asking open ended questions with explanation as to why your questions are pertinent to their specific care will help create rapport and trust. Through a basic working knowledge of terminology, types of hormone therapy, non-surgical techniques, garments, and surgical procedures typically encountered by such patients, and their respective potential side effects and complications, clinicians can provide quality care to transgender patients.
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The physiologic changes in pregnancy predispose the pregnant patient to a variety of potential cardiovascular complications. In this article, we discuss the major cardiovascular disorders of pregnancy and their management, highlight specific diagnostic challenges, and discuss new developments in the field. Topics covered in this article include venous thromboembolism, acute myocardial infarction, peripartum cardiomyopathy, and aortic dissection.
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Emerg. Med. Clin. North Am. · May 2023
ReviewEmergency Gynecologic Considerations in the Older Woman.
As women mature through menopause, they will experience normal physiologic changes that can contribute to emergency complaints specific to this patient population. Reviewing the expected physiologic changes of menopause and correlating these normal processes to the development of specific pathologic conditions offers a framework for emergency physicians and practitioners to use when evaluating older women for breast, genitourinary, and gynecologic symptoms.
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Pregnancy is a time of tremendous physiologic change and vulnerability. At any point, symptoms and complications can prompt the need for emergency care, and these can range from minor to life-threatening. ⋯ To optimally care for these patients, it is paramount to be aware of the unique physiologic changes that occur during pregnancy. The focus of this review is to discuss illnesses unique to pregnancy and additional aspects of resuscitation that must be considered when caring for a critically ill pregnant patient.
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Emerg. Med. Clin. North Am. · May 2023
ReviewSpontaneous and Complicated Therapeutic Abortion in the Emergency Department.
Pregnancy-related emergency department visits are common in the United States. Although typically managed safely in the outpatient setting, patients with spontaneous abortion may also present with life-threatening hemorrhage or infection. ⋯ Surgical management of complicated therapeutic abortion is similar to that of spontaneous abortion. The dramatic changes in the legal status of abortion in the United States may have significant influence on the incidence of complicated therapeutic abortion, and we encourage emergency physicians to familiarize themselves with the diagnosis and management of these conditions.