Emergency medicine clinics of North America
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The treatment of pregnant patients with traumatic injuries requires knowledge of the fundamentals of general trauma management as well as the specific anatomic and physiologic changes brought about by pregnancy. This article provides a review of the spectrum of trauma prevention and treatment in pregnant women, from counseling strategies that can be used during any emergency department visit to a step-by-step evaluation protocol for patients with trauma during pregnancy and the severe injuries that might be encountered by providers during the treatment of these women, including maternal cardiopulmonary arrest and the perimortem cesarean section.
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First-trimester vaginal bleeding and abdominal pain are common complaints in the emergency department. The differential diagnosis is broad, ranging from benign conditions to life-threatening complications. This is a difficult topic because it is charged not only with immediate emotional connotations but also with potential long-term effects on the patient's ability to become pregnant again. This article reviews the presentation, diagnosis, and management of implantation bleeding, subchorionic hemorrhage, spontaneous abortion, ectopic pregnancy, heterotopic pregnancy, anembryonic pregnancy, hyperemesis gravidarum, gestational trophoblastic disease, and round ligament syndrome.
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Emerg. Med. Clin. North Am. · Aug 2012
ReviewTransient ischemic attack: reviewing the evolution of the definition, diagnosis, risk stratification, and management for the emergency physician.
A transient ischemic attack (TIA) is an episode of reversible neurologic deficit caused by temporary focal central nervous system hypoperfusion. TIA is a medical emergency. Because patients with TIA in the emergency department (ED) have a high risk for stroke within the next 48 hours, it is imperative for the clinician to recognize this golden opportunity to prevent a disabling stroke. This article reviews our conceptual understanding of TIA, its definition, diagnosis, ways to stratify stroke risk, the acute management and disposition in the ED, and the potential future role of diagnostic biomarkers.