J Emerg Med
-
A 12-month prospective study was undertaken to observe current practice and to determine if a Glasgow Coma Scale (GCS) of 8 or less on admission is a useful parameter to predict the need for airway protection in poisoning. For the period of September 1988 to August 1989, there were 414 admissions for poisoning with 3 fatalities (0.7%). A total of 41 patients (10%) were assessed by attending physicians as requiring airway protection. ⋯ Further analysis showed that the presence or absence of a gag reflex added nothing to the GCS for the prediction of probability for intubation. In conclusion, an initial GCS of 8 or less was found to be a useful guideline for intubation. However, it should be used in conjunction with the clinical context.
-
This article presents guidelines for interactions with consultant physicians by emergency physicians. The political aspects of dealing with consultant physicians often are not stressed in emergency medicine training programs and little has been written in the emergency medicine literature on this topic. Practicing maintenance of good relations with consultant physicians can make work in the emergency department more enjoyable for all concerned, and probably contributes to better overall patient care.
-
Electrocardiography can be a useful screening and diagnostic tool for children seen in an Emergency Department setting. This article reviews the technical aspects of electrocardiography in children and offers an approach to interpretation. Normal values for ECGs in children are presented in tabular format. Electrocardiographic features of several specific conditions are discussed.
-
The off-service rotation in Neurosurgery is included in some programs training emergency medicine residents. It may also be offered as an elective. ⋯ We have addressed this problem by developing a written curricula containing subject content listing, objectives, and references for the Neurosurgery off-service rotation for emergency medicine residents. This is the 23rd in a series of objectives for off-service rotations for emergency medicine residents.
-
Ketotic hypoglycemia (KH) is recognized in the pediatric literature as the most common cause of childhood hypoglycemia. Since the first manifestation of the syndrome is classically that of new onset seizures, initial emergency department presentation is likely. We describe a representative case and emphasize the importance of routine serum glucose and urine ketone measurements in young children with new onset seizures.