The American journal of emergency medicine
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An emergency physician (EP) is often the first provider to evaluate, resuscitate, and manage a critically ill patient. Over the past two decades, the annual hours of critical care delivered in emergency departments across the United States has dramatically increased. During the period from 2006 to 2014, the extent of critical care provided in the emergency department (ED) to critically ill patients increased approximately 80%. ⋯ As a result, it is imperative for the EP to be knowledgeable about recent developments in resuscitation and critical care medicine, so that the critically ill ED patient care receive current evidence-based care. These articles have been selected based on the authors review of key critical care, resuscitation, emergency medicine, and medicine journals and their opinion of the importance of study findings as it pertains to the care of the critically ill ED patient. Topics covered in this article include cardiac arrest, post-cardiac arrest care, rapid sequence intubation, mechanical ventilation, fluid resuscitation, cardiogenic shock, transfusions, and sepsis.
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Randomized Controlled Trial
Clinical predictors of endotracheal intubation in patients presenting to the emergency department with angioedema.
The objective of this study is to identify predictors of airway compromise among patients presenting to the emergency department with angioedema in order to develop and validate a risk score to augment clinician gestalt regarding need for intubation. ⋯ A simple scoring algorithm may aid in predicting angioedema patients at high and low risk for intubation. External validation of this score is necessary before wide-spread adoption of this decision aid.
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Spontaneous bladder rupture, while rare, carries a high risk of morbidity and mortality if left untreated. Here, we describe a case report of spontaneous bladder rupture in a patient initially presenting with foley malfunction. Despite foley replacement, the patient continued to endorse abdominal pain and clinically deteriorate, thus raising our suspicion for possible bladder rupture. Recognizing and understanding the different variations of spontaneous bladder rupture is paramount for timely appropriate intervention.