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  • Special Feature: Neuroleptic Malignant Syndrome

    Neuroleptic malignant syndrome is a disease process usually occurring in patients who use neuroleptic agents; classically, it is characterized by altered mental status, muscular rigidity, fever, and autonomic instability.
  • GIK Infusion Ineffective in Acute MI

    In this study, investigators conducted a large, international, randomized controlled clinical trial (as a part of the CREATE trial) to determine the effect of glucose-insulin-potassium infusion on mortality in patients presenting with acute ST-segment elevation MI.
  • Elderly patients in the ED: Be wise in their care

    With our aging population, emergency medicine practitioners increasingly will face the challenges of care for the elderly in the emergency department. A new report from the Centers for Disease Control and Prevention notes that visits to U.S. EDs reached a record high in 2003 and attributes this rise to increased use by adults, especially those ages 65 and older. Elderly patients have higher risks for presenting to the ED.
  • The Clostridial Connection

    Public health officials from the California Department of Health Services have recognized epidemics of three types of Clostridium-associated diseases: wound botulism, necrotizing soft-tissue infections, and tetanus. These emerging infections and intoxications have been associated with the use of contaminated black tar heroin, an association known as "the clostridial connection."
  • Prehospital Intubation with Neuromuscular Blockade: The Pendulum Swings Again?

    This is a retrospective study of consecutive head injury patients admitted to a single Level 1 trauma center.
  • MRI Finds Hip or Pelvic Fractures After Initial Negative Plain X-rays

    The purpose of this study was to evaluate the incidence of hip fractures presenting to the emergency department with negative initial radiographs.
  • Drugs of Abuse 2012 Update

    New drugs are constantly added to the market, many of them legal. Many new drugs with abuse potential are often called “legal highs,” as they are not banned by the federal government or states. Also, products may be labeled “not for human consumption” to avoid the label of illegal. The European Monitoring Center for Drugs and Addiction Europol says 41 new drugs entered the market in 2010. The legal status of the more familiar recreational substances has encouraged users to seek newer options that offer the advantages of being legal, less expensive, less contaminated with adulterants, more readily available, or with more desirable pharmacological effects.
  • Strategies to Improve Opioid Prescribing

    How do you deal with patients who request parenteral opioids for exacerbation of chronic pain and then want refills of their potent analgesics on discharge? If you are like me, painfully, often with frustration and hostility; this issue should therefore be of interest. J. Stephan Stapczynski, MD, Editor
  • Unavailable Specialist = Legal Woes for EPs

    In one case that was eventually settled, an on-call specialist admitted making no effort to come in promptly, stating that traffic would be untenable for an hour because it was near the end of a Chicago Bulls playoff, recalls Tom Scaletta, MD, FAAEM, chair of the ED at Edward Hospital in Naperville, IL, and the emergency physician (EP) quoted the specialist verbatim to make it clear why a transfer was initiated.
  • Hospital Boasts on ED Care Could Come Up During Suit

    Your hospitals public relations staff may jump at the chance to advertise that patients can expect to see a doctor within 30 minutes in your ED, but claims such as this could easily backfire if a lawsuit involves this issue.