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The evaluation and diagnosis of the child with a limp can be challenging for the emergency physician. The authors review common causes for the acutely limping child, with special attention to those etiologies that need emergent or urgent intervention and referral. Additionally, the authors offer clinical and historical clues to help decipher the cause.
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In part II of this two-part series, the Antibiotic Therapy in Bacterial Sinusitis (ATBS) Clinical Consensus Panel outlines risk-directed strategies for management of patients with acute bacterial rhinosinusitis. Outlining specific symptomatic, historical, and host criteria that prompt empiric antibiotic therapy, and a sequencing strategy for antimicrobial drug selection, this review provides practical, evidence-based strategies for patient management.
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Drug-seeking behaviors are commonplace in emergency departments. Many physicians have faced patients with multiple alleged allergies to narcotics who are asking for a medication that the physician never would have initially thought of prescribing, whose medications were stolen, and who become angry, threatening, and agitated upon refusal to refill the stolen prescription. This article defines various terms used in the drug-seeking literature, provides an overview of drug-seeking behaviors, and proposes some techniques to manage these patients both at the individual and at the institutional levels.
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Hypertensive disorders of pregnancy range from chronic pre-existing disease to life-threatening conditions such as HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) and eclampsia. They often represent a continuum from bad to worse. The emergency department physician is likely to evaluate a pregnant patient for many conditions unrelated to the pregnancy itself, and knowledge of abnormalities that warrant further assessment and follow-up is essential.
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