Emergency medicine clinics of North America
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Trauma to the eye represents approximately 3% of all emergency department visits in the United States. Rapid assessment and examination following trauma to the eye is crucial. ⋯ This article describes the aspects of the eye examination that merit special attention in the case of trauma. It then discusses the eye injuries most likely to be seen in the emergency department and their appropriate treatment.
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Neuro-ophthalmologic disorders arise from all areas of the neuro-ophthalmologic tract. They may be expressed simply as loss of vision or double vision, or as complex syndromes or systemic illnesses, depending on the location and type of lesion. Problems may occur anywhere along the visual pathway, including the brainstem, cavernous sinus, subarachnoid space, and orbital apex, and may affect adjacent structures also. A firm understanding of the neuroanatomy and neurophysiology of the eye is essential to correct diagnosis.
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This article is a review of the anatomy of the eye and its surrounding tissues. A working knowledge of the functional anatomy of the eye will aid the emergency physician in performing a thorough yet efficient physical examination of the eye. A goal-directed physical examination of the eye will allow the emergency physician to attempt to identify (or exclude) visionthreatening disease processes and facilitate communication with the ophthalmologist.
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In 2005, the American Heart Association updated the guidelines for newborn and pediatric resuscitation. These changes are now being taught in the current Basic Life Support and Pediatric Advanced Life Support classes. This article reviews the pertinent new changes in caring for the critically ill child.
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Metabolic diseases can vary as much in clinical presentation as they can in classification, and neonates and infants frequently present with symptoms similar to those seen with other emergencies. Vomiting, alterations in neurologic status, and feeding difficulties are the most prominent features of metabolic emergencies. This article discusses the recognition and management of specific disorders, including diabetic ketoacidosis, congenital adrenal hyperplasia, inborn errors of metabolism, and thyrotoxicosis. Also highlighted are specific laboratory entities, including hypoglycemia, hyponatremia, and metabolic acidosis.