Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Feb 2003
ReviewDiagnosis of subarachnoid hemorrhage in the emergency department.
To decide which patients with headache ought to be evaluated for SAH, physicians should focus on specific elements of the patient history, such as onset, severity, and quality of the headache and associated symptoms. These questions should be asked and the responses documented for every patient with a headache. The physical examination should be compulsive with regard to vital signs, HEENT. and neurologic signs. ⋯ Physicians should understand the limitations of this diagnostic algorithm. In addition, the CSF should be carefully analyzed, including measuring the opening pressure. In patients whose CT scans and CSF analyses are normal, further testing is rarely indicated.
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Emerg. Med. Clin. North Am. · Feb 2003
ReviewPearls and pitfalls in the emergency department evaluation of abdominal pain.
Abdominal pain is a common complaint in the emergency department (ED), comprising approximately 5% of total visits. Although not typically serious, abdominal pain often presents many difficult situations for the clinician. ⋯ This article outlines the epidemiology of abdominal pain in patients who present to the ED, and provides guidelines pertinent to the evaluation of all patients. In addition, the article discusses the approach to abdominal pain of pelvic origin in women of reproductive age and abdominal pain in elderly individuals.
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Emerg. Med. Clin. North Am. · Feb 2003
ReviewManagement of lacerations in the emergency department.
The goals of wound management are simple: avoid infection and achieve a functional and aesthetically pleasing scar. This is achieved by reducing tissue contamination, debriding devitalized tissue, and restoring perfusion in poorly perfused wounds, in conjunction with a well-approximated skin closure.
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Airway control is one of the most critical interventions required for saving a life. It is essential that practitioners be as well trained as possible in the numerous techniques available to establish airway control. ⋯ Perhaps the most important aspect of advanced airway management is the ability to anticipate and prepare for the difficult airway. This article gives numerous options for the difficult airway situation.
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Emerg. Med. Clin. North Am. · Feb 2003
ReviewEvaluation and management of febrile infants in the emergency department.
Managing fever in pediatric patients has always been a high-risk aspect of emergency medicine, and this is especially true of infants. The task of correctly discerning "well" versus "ill" can be difficult for these patients because they cannot describe their symptoms and have not developed normal social behaviors. Recent studies, however, have greatly enhanced physicians' understanding of how best to manage these young patients. With this research comes an array of new recommendations for diagnosing and treating febrile infants, which can be incorporated into the practice of every emergency physician who cares for pediatric patients.