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While ED staff are well-versed in life-saving techniques, they are not as expert in making dying patients feel comfortable, asserts Tammie E. Quest, MD, assistant professor in the department of emergency medicine at Emory University in Atlanta.
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The widespread publicity surrounding the case of Terri Schiavo may have brought end-of-life issues to the forefront for the general public, but ED managers deal with these challenges on a daily basis. The proper way to treat these extremely ill patients in the ED whether or not they have a do-not-resuscitate (DNR) order is, like the Schiavo case, hardly cut and dried.
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In the past few years, new strategies in the management of sepsis have shown significant mortality benefits. This article addresses aspects regarding the management of sepsis, including appropriate fluid administration, medications, and other evidence-based strategies necessary for the treatment of septic patients in the emergency department. With the incorporation of these new practice strategies in addition to the guidelines published by the Surviving Sepsis Campaign, emergency physicians can contribute to a significant decrease in sepsis mortality in the years to come.
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Its the first of its kind: a course in difficult airway management using mannequin simulations that is required for all practicing emergency physicians at the University of Pittsburgh Medical Center, says Paul Phrampus, MD, FACEP, director of the course, assistant professor of emergency medicine in the department of emergency medicine, and assistant director of the Peter M. Winter Institute for Simulation, Education, and Research (WISER).
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Part I of this two-part series on bites and stings covered the diagnosis and management of mammalian bites and insect stings. Part II will examine the management of snake and reptile bites as well as bites and stings from marine animals.
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In this issue, the author provides some insight into the deposition process and some guidelines that will help the health care provider approach a deposition with equanimity.
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Infants younger than 28 days are challenging to the emergency department physician, who must be familiar with the normal variants and the subtle findings that may indicate a more serious underlying problem. The amazing physiologic changes that the newborn accomplishes following delivery may precipitate disaster if an underlying congenital problem exists. The astute ED physician is also familiar with particular high-risk times when critical diseases may present, such as cyanotic congenital heart disease, and has a heightened suspicion for these disease processes. This article provides a comprehensive overview of critical diseases that may present in the newborn period and strategies for their early detection and appropriate management.
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To adequately address the complexity and breadth of maxillofacial trauma, this article reviews the anatomy, recognition of common injury patterns, and initial stabilization. A second article will address specific injuries in detail, diagnostic imaging, definitive management, and appropriate consultation and disposition strategies.
