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  • Dizziness

    Few chief complaints cause more apprehension and dread for emergency physicians than dizziness. It is a common condition seen in the emergency department, is understood poorly, and has potentially malignant etiologies. Dizziness cannot be measured. It can mean different things to different patients and is often difficult to precisely characterize. Unfortunately, it is the ability to obtain a precise history and perform an exacting examination that allows a diagnosis to be made and appropriate treatment instituted. This article examines some of the different causes of dizziness, how they can be differentiated via history and physical examination, and their appropriate treatments and dispositions.
  • Maxillofacial Injuries: Imaging, Management, and Disposition

    The authors discuss radiographic imaging, specific management of different types of commonly seen injuries, and appropriate consultation and disposition of patients who have sustained maxillofacial trauma.
  • Spinal Epidural Abscess

    Patients with spinal epidural abscess may be normothermic and have normal WBC counts. Urgent surgery was more likely to be offered to patients presenting with neurologic deficits than with pain alone. Patients treated without early surgery were significantly more likely to deteriorate and suffer poor outcomes.
  • Emergency Medicine Specialty Reports: Informed Consent for Emergency Procedures

    Barriers to the informed consent process may exist among emergency patients, including impaired decisional capacity, impaired cognition, language barriers, illiteracy, insufficient time and communication, and numerous others. Because of the inherent vulnerability of ED patients, particular attention should be paid to addressing barriers to adequate informed consent, and steps should be taken to ensure adequate delivery of information, understanding of the proposed intervention and its risks and benefits, and voluntariness of the informed consent.
  • JCAHO warns: Look out for surveyor impostors

    Its 3 a.m., and a well-dressed man and woman approach the triage nurse with official-looking clipboards in hand. They claim to be surveyors from the Joint Commission on Accreditation of Healthcare Organizations, and they demand to be shown your medication storage areas.
  • JCAHO’s safety goals — Clock is ticking, will your ED be compliant?

    ED nurses will face even greater responsibility for compliance under the 2006 National Patient Safety Goals just unveiled by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
  • Cost-Saving Tip

    Overworked ED nurses at McKay-Dee Hospital Center in Ogden, UT, were frustrated with spending hours looking through charts to figure out charges for procedures.
  • Are you sedating agitated psychiatric patients safely?

    A man walks into your ED screaming at the top of his lungs and waving his arms wildly. Its clear that sedation is needed, but the safety of this patient and the ED staff is very much at risk.
  • Pediatric Corner

    An 8-year-old boy with a fractured arm was grimacing in pain when he arrived at the ED at Childrens Healthcare of Atlanta. Nurses quickly learned about his love for dinosaurs, cars, and superheroes and talked to him about his interests.
  • Learn new ways to treat, monitor septic patients

    This is the second of a two-part series on care of sepsis patients in the ED. This month, we cover educational strategies for emergency nurses regarding practice changes to comply with new guidelines. Last month, we covered new approaches for assessment and intervention in the ED.