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With advances in diagnostic modalities and shunting procedures, children with hydrocephalus now do amazingly well. Unfortunately, not only do these children get common childhood illnesses, but they also may develop life-threatening complications from their shunting devices that have very similar clinical presentations to common childhood diseases. To effectively and efficiently manage these children, the emergency physician must have a clear understanding of the technology used and of the potential risks and complications that may develop.
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With their variable and unpredictable results, bites and stings can be vexing for the ED physician to assess and treat. The purpose of this paper is to provide an overview for treatment of the most important bites and stings encountered in the United States. Due to the popularity of the exotic pet trade, some non-native species now commonly held in captivity in private homes in the United States also will be discussed, especially when specific anti-venom is available.
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Given the importance of acute bacterial rhinosinusitis (ABRS), a commonly encountered outpatient infection, this article attempts to outline in evidence-based detail what the authors conclude to be optimal, risk-stratified, empiric treatment recommendations. In addition, this review identifies key clinical findings, resistance patterns, risk factors, coexisting conditions, and other clinical triggers supporting referral of patients with ABRS to an otolaryngologist for more invasive i.e., multimodal surgical and more intensive antimicrobial management strategies.
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This issue is the second installment of a two-part series on evaluation and management of sexual assault in the emergency department. Part I of the series covered initial ED care, physical exam, and evidence collection. This issue will cover laboratory analysis, pharmacotherapy, disposition, follow-up, documentation, and court testimony.
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