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If youre an ED manager considering a career in health care consulting, the first thing you should do is examine your skill set to see if theres even a fit.
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Treatments for Acute Migraine; Statin Therapy for ACS Patients; The Correct Dosing for Onychomycosis; FDA Actions
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While children typically have a lower severity of illness than their adult counterparts during visits to the emergency department (ED), they also present with some of the most serious illnesses. Furthermore, there are a wide range of possible illnesses with potentially devastating outcomes for children. Unfortunately, the relative rarity of critically ill or injured children means that clinical experience potentially may be lacking or even atrophied over time.
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As if communication with young children was not challenging enough, the child presenting with an altered mental status (AMS) is an exceptional opportunity for testing one's sleuthing ability. The reality is that we see far more adults with AMS than we do children. Consequently, we might be tempted for just a moment to doubt our abilities.
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By Ronald M. Perkin, MD, MA
Professor and Chairman, Department of Pediatrics, Brody School of Medicine at East Carolina University; Chairman, Committee on Physician Health, Pitt County Memorial Hospital, Greenville, NC; and Jay Weaver, JD, EMT-P, Attorney, Private Practice; Adjunct Faculty, Northeastern University, Boston.
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Difficult airway is a broad term that unfortunately encompasses many clinical situations and their potential management options. Airway management difficulties can be divided into those that are predicted and those that are unexpected. They also can require immediate attention (emergent) or be stable (non-emergent). Difficulty can arise at any stage of airway management. Development of a standardized airway assessment and approach to management allows the physician to provide better patient care. Optimal care requires skill in assessing the situation, knowledge of equipment, and finally, how to use it successfully.
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Once the diagnosis of alcohol withdrawal syndrome is confirmed, the treatment of the life-threatening sequelae must be swift. For many years, the pharmacologic agent of choice to treat AWS has been quite controversial. Benzodiazepines, antiepileptic agents, ethanol, and barbiturates have all been the preferred drug at one time or another. In recent years, benzodiazepines have come to the forefront as the drug class of choice, although some agents may offer advantages over others. Several guidelines have been developed to aid the emergency medicine practitioner select the most effective and efficient therapy. This review outlines, in systematic detail, the full range of AWS and risk-directed interventions shown to improve clinical outcomes in AWS.
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Although the exact number of children that sustain hand and wrist injuries is unknown, there have been many studies conducted in the United States and abroad during the past 10 years that provide valuable information regarding common mechanisms of injury, frequently sustained injury patterns, and injury patterns suspicious for abuse that may be of benefit in the care and treatment of the general pediatric population. The authors of this article provide a comprehensive review of pediatric hand and wrist injuries with a special emphasis on the unique aspects of management.
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