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The emergency department physician is the critical link between the patient and the diagnostic tests, including radiographs, that are ordered. This article provides information on common radiographic errors to help clinicians improve their accuracy, confidence and subsequent patient care.
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The telemetry rhythm strip shown in the Figure was obtained from a 67-year-old woman who presented with heart failure. A permanent pacemaker had been implanted a number of years earlier. Interpret the tracing initially by looking only at lead MCL1. How does the addition of a second simultaneously recorded lead (lead II) help in your interpretation? How many findings can you identify on this two-lead telemetry tracing? (Hint: Some of these findings are very subtle.)
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Neuroleptic malignant syndrome is a disease process usually occurring in patients who use neuroleptic agents; classically, it is characterized by altered mental status, muscular rigidity, fever, and
autonomic instability.
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In this study, investigators conducted a large, international, randomized controlled clinical trial (as a part of the CREATE trial) to determine the effect of glucose-insulin-potassium infusion on mortality in patients presenting with acute ST-segment elevation MI.
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With our aging population, emergency medicine practitioners increasingly will face the challenges of care for the elderly in the emergency department. A new report from the Centers for Disease Control and Prevention notes that visits to U.S. EDs reached a record high in 2003 and attributes this rise to increased use by adults, especially those ages 65 and older. Elderly patients have higher risks for presenting to the ED.
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Public health officials from the California Department of Health Services have recognized epidemics of three types of Clostridium-associated diseases: wound botulism, necrotizing soft-tissue infections, and tetanus. These emerging infections and intoxications have been associated with the use of contaminated black tar heroin, an association known as "the clostridial connection."
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This is a retrospective study of consecutive head injury patients admitted to a single Level 1 trauma center.
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The purpose of this study was to evaluate the incidence of hip fractures presenting to the emergency department with negative initial radiographs.
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New drugs are constantly added to the market, many of them legal. Many new drugs with abuse potential are often called “legal highs,” as they are not banned by the federal government or states. Also, products may be labeled “not for human consumption” to avoid the label of illegal. The European Monitoring Center for Drugs and Addiction Europol says 41 new drugs entered the market in 2010. The legal status of the more familiar recreational substances has encouraged users to seek newer options that offer the advantages of being legal, less expensive, less contaminated with adulterants, more readily available, or with more desirable pharmacological effects.
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How do you deal with patients who request parenteral opioids for exacerbation of chronic pain and then want refills of their potent analgesics on discharge? If you are like me, painfully, often with frustration and hostility; this issue should therefore be of interest.
J. Stephan Stapczynski, MD, Editor
