Emergency
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Surge of HIV Patients Present to EDs, Leaders Call for Expanded Screening
Investigators discovered a more than twofold increase in cases of acute HIV during the COVID-19 pandemic as part of an ED-based screening program at UChicago Medicine. The cause of the increase remains unknown, but it underscores the importance of screening despite the fact the pandemic has strained all resources.
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EDs Administer Monoclonal Antibody Therapy to High-Risk COVID-19 Patients
Clinicians can use new monoclonal antibody therapies to treat high-risk patients presenting with mild to moderate COVID-19 symptoms. However, despite the promise to depress viral loads, logistical and other challenges continue to stand in the way of larger-scale use. Still, some EDs are trying the therapeutics, with promising results.
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COVID-19 Affected U.S. Life Expectancy: How Bad Is It?
The pandemic dinged the average, but the latest data do not tell the whole story.
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Reversal of Direct Oral Anticoagulants
Given the growing use of direct oral anticoagulants, particularly in the elderly population, it is important as an emergency physician to be well versed on the methods of emergent reversal of these agents in the bleeding patient.
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One Dose, Lower Temps May Suffice for Pfizer/BioNTech COVID-19 Vaccine
Encouraging new data emerge regarding storage, administration requirements.
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Pressure Support Compared to T-Piece Trial: What Is the Optimal Strategy?
Post-hoc analysis of a multicenter, randomized clinical trial among adults receiving at least 24 hours of mechanical ventilation who were ready for ventilator weaning revealed that the use of pressure support significantly increased the proportion of patients successfully extubated compared to T-piece.
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Management of the Cardiac Surgery Patient
The goal of this review is to provide an evidence-based narrative for the management of post-operative patients who have coronary artery bypass graft surgery and heart valve repair/replacement surgeries.
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Frail Older Patients Receiving Higher-Intensity End-of-Life Care
There is an opportunity for targeted interventions for all older patients, especially frail older adults, undergoing emergency general surgery to establish better prognostic understanding and discuss advance care planning before hospital discharge.
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Routine Ethics Consults Helpful if ECMO Is Considered
When a patient is placed on extracorporeal membrane oxygenation (ECMO), usually emergently, families have begun to face the gravity of the situation. Suddenly, ECMO offers new hope. Even though the primary team explains ECMO will be a time-limited trial and a bridge to recovery, transplant, or device, many families remain focused only on the possibility of hope.
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Febrile and First-Time Seizures
The sudden appearance of COVID-19 has created an additional challenge to the evaluation of children with "flu-like" symptoms. This article compares and contrasts influenza and coronavirus and provides a critical update on a timely topic.