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Pulmonary Embolism

For emergency physicians, acute pulmonary embolism (PE) provides a particularly complex diagnostic challenge. It has been estimated that 650,000 to 900,000 individuals annually suffer a fatal or nonfatal acute pulmonary embolism.¹ While the classic textbook clinical presentation is well known, it is insufficiently accurate and precise in the timely diagnosis of an acute PE. In addition, many patients presenting with seemingly typical exacerbations of their underlying cardiopulmonary disease or other chronic illness may be masking symptoms of an undiagnosed acute pulmonary embolism.² The high acuity coupled with the unreliable clinical presentation led to the development of several clinical tools, laboratory diagnostics, and radiographical studies to increase the clinician’s diagnostic power. This article we will review the Geneva Score and Wells Criteria, as well as the Kline and PERC rules. In addition, it will discuss special patient populations and diagnostic modalities for treating pulmonary emboli.

Insulin: A Primer

With the continued development of “smarter” pumps, the management of one of the most common chronic conditions is becoming safer and more effective.

Emergency Psychiatry Update

This issue of Emergency Medicine Reports will review several changes in the recently released Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) — i.e., specifically those changes most relevant to emergency physicians. We also provide an update on some of the newest medications for depression.

An Update on Sepsis Clinical Research: Impact on ED Management

The authors review the ups and downs of several landmark sepsis studies from the past 15 years. Their findings are reaffirming and powerful.

Complications of Tubes and Lines: Part I

Emergency physicians are often required to adeptly manage patients with unique and challenging clinical problems. This is a two-part paper to provide the emergency physician with a clear, concise review of troubleshooting tubes and lines. Part I will deal with central venous catheters and tracheostomies. A later edition will deal with feeding and nephrostomy tubes.

The Lethargic Child

Stedman's medical dictionary defines lethargy as a "relatively mild impairment of consciousness resulting in reduced alertness and awareness; this condition has many causes but is ultimately due to generalized brain dysfunction."

Updates in ENT Emergencies: Tales from the Trenches

Life-threatening ear, nose, and throat (ENT) emergencies can present to any emergency department (ED) at any hour of the day or night.

Short-Course Antibiotic Therapy

The duration of antimicrobial therapy for common infections has been a subject of debate and investigation for decades. During this time, there has been a general trend toward shorter duration treatments, particularly in the area of urinary and genital tract infections.

Cardioprotection in the Emergency Department: Part II

In this article, the authors discuss the "less sexy" aspects ACS mangement, those agents and treatments that have either a long history of use in ACS patients or are still too new to judge.

Skin and Soft-Tissue Infections

This report begins with discussion of the most superficial lesions and progresses through the skin and soft tissue to the deeper and systemic disease processes.

Emergency Medicine Reports

Articles