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While human immunodeficiency virus (HIV) infection no longer carries the death sentence it once did, it still carries an enormous cost both in terms of financial burden for treatment as well as the social and medical issues associated with long-term disease.
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I see many patients brought by EMS from motor vehicle collisions and ground level falls. The majority arrive with a rigid cervical collar placed by the EMTs or paramedics because of neck pain or a concern about possible cervical spine injury based on the mechanism of injury. If the patient did not have initial pain, most will have developed pain by the time of arrival because of their placement in a rigid cervical collar and on a hard backboard.
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Almost every emergency physician I know has missed a case of hypoglycemia in their career. I have. I have also been practicing long enough to have used "Dextrostix." Remember using them? Remember some of the values you obtained?
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Stroke remains a leading cause of death, but the disability associated with a stroke can be devastating and costly. In past decades, little could be done to reduce the morbidity and mortality of stroke. But over the past decade, use of thrombolytics by specialized stroke centers has reduced the morbidity of survivors. However, the reduction of morbidity comes at a cost of an increase in intracerebral hemorrhage, often associated with death.
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This issue is the second of a two-part discussion of cervical spine injuries.
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Approximately one in five of children evaluated in the emergency department (ED) are physically abused. Emergency physicians (EPs) have a responsibility to consider abuse in the differential of every injured child.
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Penetrating abdominal trauma (PAT) has the potential to be a devastating injury and ranks in the top 15 causes of death for all ages. This article will define the problem of PAT and review the initial management, including the ability to identify, resuscitate, and initiate treatment in patients with unstable PAT prior to their transfer to the operating room (OR).
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Even though the admission handoff has occurred, the "boarded" ED patient is often still managed by the admitting emergency physician (EP) or another ED attending physician many hours after the shift has ended, warns Uwe G. Goehlert, MD, MPH, an ED attending physician at Northwestern Medical Center in St. Albans, VT, and principal of Goehlert & Associates in South Burlington, VT.
