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Whether a bite or sting results in an anaphylactic reaction, impressive local effects, or a life-threatening systemic reaction, the emergency physician must be able to institute appropriate and effective treatment. Emergency physicians also must be able to recognize clinical envenomation patterns, since some critically ill patients may not be able to convey the details of the attack. Since all areas of the country are represented in the envenomation statistics, all emergency physicians should be familiar with identification and stabilization of envenomated patients and know what resources are available locally for further management of these often complicated patients.
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The potential of chemical warfare agents should be of overwhelming concern to civilian emergency physicians and prehospital providers. As General Pershing warned after World War I, the effect is so deadly to the unprepared that we can never afford to neglect the question.
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Pulmonary artery catheters (PACS) are widely used in critically ill patients. Proponents of the catheter, introduced into the clinical arena more than 30 years ago, argue that physiologic data provided by the use of the PAC permit clinicians to target treatment and improve patient outcomes.
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Sepsis and its consequences are common causes of death in the United States. Detection of infection and its proper treatment are essential for survival in all patients, but especially those in the ICU.
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Low intensity warfarin therapy effectively prevents recurrent venous thromboembolism, according to a recent study in the New England Journal of Medicine.
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Bispectral index (BIS) monitoring has received a generally favorable reception since its formal introduction at the American Association of Critical Care Nurses National Teaching Institute and Critical Care Exposition last spring.
