Acute Coronary Syndromes
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EMTALA Lawsuits Involving Psychiatric Patients Held in ED Rarely Successful
The risk of an Emergency Medical Treatment & Labor Act (EMTALA) lawsuit involving a patient with psychiatric illness is low, according to a recent study.1 If emergency physicians (EPs) perform appropriate medical screening examinations, the lawsuit is rarely successful. -
The Photosensitive Patient
A 65-year-old female presents to the emergency department with a chief complaint of a severe rash. The rash has been present for two weeks on her arms, neck, and scalp. It began while she was sitting on her porch one afternoon. She denies any associated fevers, chills, headache, or muscle ache. She denies any exposure to pets, new soaps, detergents, or lotions, and she denies recent travel.
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Pediatric Myocarditis
Myocarditis can at times be asymptomatic and has a varied presentation; consequentially, it often goes undiagnosed and its true incidence is unknown -
Emergency Ultrasound Part I: Pelvic Ultrasound and the First Trimester Patient
In this article and the succeeding two parts in this series, three distinctive applications of ultrasound in the ED will be discussed. The ability to perform a proficient and diagnostically effective ultrasound examination requires a judicious understanding of the underlying principles. -
Hyperbaric Oxygen for Carbon Monoxide Poisoning
The value of hyperbaric oxygen therapy for the treatment of CO-poisoned patients, and its ability to prevent long-term cognitive sequelae, has been debated for years among toxicology and hyperbaric experts. This study from the University of Utah addressed this difficult issue. -
Oral Vitamin K Lowers INR Faster than Subcutaneous Vitamin K
Crowther and associates tested the hypothesis that oral vitamin K would reduce high international normalized ratio values faster than subcutaneous vitamin K. -
Special Feature: Metabolic Alkalosis
A systematic approach with an understanding of the pathophysiology can help the clinician correctly diagnose and treat metabolic alkalosis, a condition that carries a high morbidity and mortality rate. -
Fibrinolysis in Acute MI and Hospital Revascularization Capability
In this retrospective study of the GUSTO-1 database, investigators compared clinical outcomes of more than 25,000 patients with acute myocardial infarction who were treated with fibrinolytic therapy in U.S. hospitals with and without coronary revascularization capability for percutaneous transluminal coronary angioplasty and coronary artery bypass grafting. -
Syncope Should Not Be Taken Lightly
The authors of this study in the New England Journal of Medicine evaluated participants enrolled in the Framingham Heart Study between 1971 and 1998 who reported syncopal events. -
ECG Review: Chest Pain and Lots of P Waves
The 12-lead ECG shown in the figure was obtained from a 55-year-old woman with new-onset chest pain. Many more P waves than QRS complexes are seen on the tracing. How would you interpret this ECG?