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This article will review and dispute some commonly held beliefs about dogma in the practice of emergency medicine.
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Few chief complaints cause more apprehension and dread for emergency physicians than dizziness. It is a common condition seen in the emergency department, is understood poorly, and has potentially malignant etiologies. Dizziness cannot be measured. It can mean different things to different patients and is often difficult to precisely characterize. Unfortunately, it is the ability to obtain a precise history and perform an exacting examination that allows a diagnosis to be made and appropriate treatment instituted. This article examines some of the different causes of dizziness, how they can be differentiated via history and physical examination, and their appropriate treatments and dispositions.
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The authors discuss radiographic imaging, specific management of different types of commonly seen injuries, and appropriate consultation and disposition of patients who have sustained maxillofacial trauma.
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Barriers to the informed consent process may exist among emergency patients, including impaired decisional capacity, impaired cognition, language barriers, illiteracy, insufficient time and communication, and numerous others. Because of the inherent vulnerability of ED patients, particular attention should be paid to addressing barriers to adequate informed consent, and steps should be taken to ensure adequate delivery of information, understanding of the proposed intervention and its risks and benefits, and voluntariness of the informed consent.
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The purpose of this meta-analysis was to assess the efficacy of subglottic secretion drainage in preventing ventilator-associated pneumonia (VAP). Dezfulian and colleagues performed a comprehensive analysis of randomized trials that have compared subglottic secretion drainage with a standard endotracheal tube care in mechanically ventilated patients.
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This observational study from a university-affiliated, urban, tertiary hospital in Toledo, OH, retrospectively reviewed the records of 840 patients admitted to various ICUs to determine if the time to first visit by a physician had an effect on a number of clinically relevant outcomes.
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Care of the critically ill pregnant patient poses unique challenges. The normal physiology of a pregnant patient differs considerably from that of a non-pregnant patient and these differences may affect many aspects of routine care: resuscitation, mechanical ventilation, choice of drugs and use of diagnostic studies are some examples.
