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Dermatologic complaints commonly are seen in emergency medicine and may pose a diagnostic dilemma for the clinician. Although a detailed understanding of all dermatologic conditions is beyond the scope of practice of emergency physicians, recognition of categories of disease, particularly emergent conditions, is essential. Knowledge of basic disease lesions, patterns, diagnostic tests, and emergent management is crucial to the appropriate treatment of patients with cutaneous disease. This article presents an organized approach to the diagnosis and management of cutaneous conditions, including brief discussions of selected dermatologic complaints.
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This study found no evidence that the use of narcotics or benzodiazepines to treat discomfort after the withdrawal of life support hastens death in critically ill patients at our center. Clinicians should strive to control patient symptoms in this setting and should document the rationale for escalating drug doses.
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The Department of Health and Human Services (HHS) has placed a draft influenza preparedness and response plan on its web site. This detailed document provides useful advice about health care system guidance on staffing, infection control, and strategies to limit transmission of infection within health care institutions.
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A Crackdown on Importation of Drugs; FDA Actions.
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Based on emerging evidence, there are increased efforts around the world to maintain strict glycemic control in non-diabetic critically ill patients. Management of hyperglycemia through the use of insulin protocols is a new standard in critical care. Several protocols have been evaluated and reported in the literature.
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This prospective multicenter observational study demonstrates that patients with do-not-intubate (DNI) status who receive non-invasive positive pressure ventilation (NPPV) for respiratory failure have high hospital mortality. Presence of cough, being awake, or having a primary diagnosis of COPD or CHF, is associated with improved outcome.
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Emergency personnel care for innumerable victims of domestic violence. None of these victims are more vulnerable than the infants who have been abused by their caretakers. Although signs of abuse sometimes can be very apparent, this months article reminds emergency clinicians that we must be alert to more subtle signs of abuse that can be indicators of substantial injury to infants. Though the presenting complaints and histories may be inaccurate or frankly deceptive, the physical and diagnostic findings of infants with shaken baby syndrome will assist in identifying these victims of domestic abuse.
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