Public awareness of the symptoms of stroke has increased the frequency of emergency department visits by patients with this complex chief complaint. Often, subtle symptoms may or may not represent a cerebral infarct. This issue of ED Legal Letter will review the diagnosis, management, and follow-up of patients with both transient ischemic attack and cerebral vascular accidents. Appropriate diagnosis and treatment will prevent subsequent permanent disability and potential litigation.
Children who present with a history of foreign body ingestion frequently offer both a diagnostic and management challenge to the emergency medicine physician. Esophageal foreign bodies can result in significant injury to or the death of a child. What follows is a review of the literature on the subject of esophageal foreign bodies in children.
The daily practice of emergency medicine involves life and death decisions. While training in emergency medicine focuses on life-saving procedures and medications, dying patients often seek care in the ED for symptom relief, psychosocial support, or a variety of other reasons. Education, experience, communication, and compassion can improve the emergency physicians ability to deliver medical care near the end of life that will serve to relieve suffering, improve communication of the patients preferences and goals of medical treatment, and improve overall care of the patient and family.
With the media currently focused on vaccine shortages, the emergency physician must be prepared to rationally and scientifically explain diagnostic and therapeutic approaches in children with influenza. The author of this article prepares the ED physician to confidently face the 2004-2005 influenza season.
