Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Aug 2023
ReviewPrognosis of Cardiac Arrest-Peri-arrest and Post-arrest Considerations.
There has been only a small improvement in survival and neurologic outcomes in patients with cardiac arrest in recent decades. Type of arrest, length of total arrest time, and location of arrest alter the trajectory of survival and neurologic outcome. In the post-arrest phase, clinical markers such as blood markers, pupillary light response, corneal reflex, myoclonic jerking, somatosensory evoked potential, and electroencephalography testing can be used to help guide neurological prognostication. Most of the testing should be performed 72 hours post-arrest with special considerations for longer observation periods in patients who underwent TTM or who had prolonged sedation and/or neuromuscular blockade.
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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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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.