Emergency
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Evidence-based Management of Atrial Fibrillation in the Emergency Department
This article provides an overview of atrial fibrillation (AF) and evidence-based guidance on controversial aspects of AF workup and management in the emergency department. The evidence is provided to help safely reduce unnecessary testing and expand the emergency provider’s management armamentarium to include electrical and pharmacologic conversion in recent-onset AF patients.
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Respiratory Distress in Pediatric Patients
Respiratory diseases are common in pediatrics, and providers need to have an in-depth knowledge of the presentation, diagnostic approach, and therapeutic options to optimize outcomes.
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ECMO vs. Prone Position in ARDS: The Curious Rejection of Evidence-based Practice
Despite credible evidence from a large, randomized, controlled trial and numerous meta-analyses demonstrating improved outcomes, prone position is seldom attempted prior to initiating extracorporeal membrane oxygenation to treat severe acute respiratory distress syndrome.
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Critical Illness-related Corticosteroid Insufficiency: What’s New?
For critically ill patients with sepsis, septic shock, acute respiratory distress syndrome, and major trauma, a multispecialty task force of 16 international experts developed evidence-based recommendations for the diagnosis of corticosteroid insufficiency and use of corticosteroids in the ICU.
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A Perspective on PEEP at 50 Years
Fifty years ago, positive end-expiratory pressure (PEEP) was introduced as an effective technique for improving oxygenation in patients with large intrapulmonary shunt, the hallmark of acute respiratory distress syndrome (ARDS). Although PEEP remains the primary means for stabilizing oxygenation in ARDS, consensus on how to approach setting it remains elusive. This is a narrative review on how our understanding and approach to PEEP has evolved over the past half century.
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ED Malpractice Claims Allege Failure to Obtain Translator
According to one expert: “An entire case can be brought around one inadvertent slip-up."
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Will Antibiotics for Appendicitis Become Standard of Care for ED?
Antibiotics instead of surgery is a reasonable approach for some patients with early uncomplicated appendicitis, according to the authors of a recent study; however, it is not the standard of care.
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Plaintiff Attorney Could Depict ‘Early Adopters’ of New ED Treatment Approaches as Reckless
New treatment approaches may be good options for a particular ED patient, but a bad outcome can trigger malpractice litigation alleging the standard of care was violated.
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Untwisting the Myths: A Medicolegal Review of Testicular Torsion
Testicular torsion (TT) is a urologic emergency with potentially devastating consequences and costs for providers and patients alike. With an annual incidence of approximately 4.5 per 100,000 males aged 1-25 years, TT is an uncommon medical condition, yet is the third most common cause of medical malpractice suit in this demographic. Because of varying presentations and physical exam findings, along with diagnostic imaging subject to individual interpretation, ED providers may miss this time-sensitive diagnosis.
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Community Hospital Uses Mobile App to Improve Communications, Accelerate Throughput
To improve communications between EMS providers and the ED, The Valley Hospital in Ridgewood, NJ, adopted an app that enables prehospital providers to notify the ED electronically that a patient is on the way, along with any key clinical information. The approach replaces the need for phone or radio notifications, which can tie up ED-based staff or get missed when the ED is busy.