Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Feb 1999
ReviewEvaluation of the patient with sore throat, earache, and sinusitis: an evidence based approach.
Sore throat, earache, and sinusitis are common presenting complaints in the emergency department, and all fall within the top ten in the United States. These complaints usually have a benign course but rarely can be a symptom of a serious disease process. This article provides an evidence-based review of the literature regarding the diagnosis of pharyngitis, otitis media, and sinusitis.
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The diagnosis of acute scrotal pain can be difficult. The most common causes include torsion of a testicular appendage, epididymitis, and testicular torsion, which account for 85% to 90% of all cases. ⋯ Diagnostic accuracy without delay is required to avoid the loss of testicular function in testicular torsion cases and to avoid unnecessary surgery in other cases. A thorough understanding of the key clinical features of each entity, coupled with an understanding of the appropriate use of perfusion imaging studies, will equip the emergency physician with the tools to accomplish this task.
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Dizziness is a common but difficult symptom to evaluate because, due to its subjective nature, it is virtually impossible to measure objectively. In essence, dizziness means different things to different people. ⋯ After taking a detailed history, the clinician should perform a thorough physical examination with emphasis on determining whether the dizziness is vestibular or nonvestibular in origin. Patient disposition is determined by the prognosis of the underlying cause and the presence of support mechanisms.
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Penetrating neck trauma can pose significant diagnostic and therapeutic challenges for emergency physicians. Factors contributing to these problems are complex anatomy, proximity of vital structures, and potential for rapid deterioration of airway, vascular, or neurologic injuries. ⋯ This review focuses on the key components of the history and physical examinations that allow for an assessment of the severity and type of structures involved. In addition, current methods of airway management, as well as ways to manage penetrating neck trauma efficiently and cost effectively, are discussed.
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Proper management of the pediatric trauma patient involves most of the components contained within standard trauma protocols. By paying strict attention to the anatomical and physiological differences among the pediatric population, the clinician will be assured the best outcomes. This article outlines the fundamentals of proper management of pediatric trauma patients.