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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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The emergency physician (EP) and nurse often may encounter patients with the chief complaint of eye pain or visual problems. Generally, the diagnosis easily is obtained and quickly treated. Unfortunately, a subset of patients will present with an illness that threatens permanent vision loss or impairment. EPs must have a broad differential diagnosis and structured approach in evaluating these patients to ensure appropriate diagnosis and treatment.
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In the constantly shifting landscape of drug resistance, antibiotic options, and pharmacoeconomic considerations, urinary tract infection continues to be one of the most frequently diagnosed conditions in patients presenting to the emergency department.
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Recently, the Centers for Medicare and Medicaid Services proposed several changes to EMTALA that attempt to clarify hospital and physician duties. Undoubtedly, this new legislation will have an impact upon the care of emergency patients and the emergency physicians caring for them.
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The emergency department physician can be an advocate for the appropriate use of antibiotics in children by becoming familiar with the pathogenesis of common ENT infections and the latest treatment guidelines for some of these entities. This article reviews common ENT infections, diagnostic criteria, and treatment options.
