Assuntos
Serviço Hospitalar de Emergência , Rabdomiólise/diagnóstico , Rabdomiólise/terapia , Diagnóstico Diferencial , Testes Diagnósticos de Rotina , Medicina de Emergência Baseada em Evidências , Hidratação , Predisposição Genética para Doença , Hospitalização , Humanos , Manitol/uso terapêutico , Terapia de Substituição Renal , Rabdomiólise/genética , Bicarbonato de Sódio/uso terapêutico , Inibidores de Simportadores de Cloreto de Sódio e Potássio/uso terapêuticoAssuntos
Betacoronavirus , Infecções por Coronavirus , Transmissão de Doença Infecciosa/prevenção & controle , Medicina de Emergência/normas , Controle de Infecções/normas , Pandemias , Pneumonia Viral , COVID-19 , Tomada de Decisão Clínica , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Medicina de Emergência/tendências , Humanos , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Pneumonia Viral/transmissão , SARS-CoV-2RESUMO
Sexually transmitted diseases are a growing threat to public health, but are often underrecognized, due to the often nonspecific (or absent) signs and symptoms, the myriad diseases, and the possibility of co-infection. Emergency clinicians play a critical role in improving healthcare outcomes for both patients and their partners. Optimizing the history and physical examination, ordering appropriate testing, and prescribing antimicrobial therapies, when required, will improve outcomes for men, women, and pregnant women and their babies. This issue reviews the latest evidence in the diagnosis and treatment of sexually transmitted diseases, focusing on efficient and safe strategies to optimize outcomes. [Points & Pearls is a digest of Emergency Medicine Practice.]
Assuntos
Serviço Hospitalar de Emergência , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Diagnóstico Diferencial , Feminino , Humanos , Masculino , GravidezRESUMO
Blunt cardiac injury describes a range of cardiac injury patterns resulting from blunt force trauma to the chest. Due to the multitude of potential anatomical injuries blunt force trauma can cause, the clinical manifestations may range from simple ectopic beats to fulminant cardiac failure and death. Because there is no definitive, gold-standard diagnostic test for cardiac injury, the emergency clinician must utilize an enhanced index of suspicion in the clinical setting combined with an evidence-based diagnostic testing approach in order to arrive at the diagnosis. This review focuses on the clinical cues, diagnostic testing, and clinical manifestations of blunt cardiac injury as well as best-practice management strategies. [Points & Pearls is a digest of Emergency Medicine Practice.]
Assuntos
Serviço Hospitalar de Emergência , Contusões Miocárdicas/diagnóstico , Contusões Miocárdicas/terapia , Diagnóstico Diferencial , HumanosRESUMO
Headache is the fourth most common reason for emergency department encounters, accounting for 3% of all visits in the United States. Though troublesome, 90% are relatively benign primary headaches --migraine, tension, and cluster headaches. The other 10% are secondary headaches, caused by separate underlying processes, with vascular, infectious, or traumatic etiologies, and they are potentially life-threatening. This issue details the important pathophysiologic features of the most common types of life-threatening headaches, the key historical and physical examination information emergency clinicians must obtain, the red flags that cannot be missed, and the current evidence for best-practice testing, imaging, treatment, and disposition. [Points & Pearls is a digest of Emergency Medicine Practice.]
Assuntos
Transtornos da Cefaleia/terapia , Adulto , Encefalopatias/diagnóstico , Estado Terminal , Diagnóstico Diferencial , Diagnóstico por Imagem/métodos , Serviço Hospitalar de Emergência , Tratamento de Emergência/métodos , Feminino , Transtornos da Cefaleia/diagnóstico , Transtornos da Cefaleia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico/métodos , Exame Físico/métodos , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/terapia , Gravidez , Punção Espinal/métodosRESUMO
Timely management of patients presenting to the ED while in their first trimester of pregnancy can improve outcomes for both the patient and the fetus. Common obstetric problems encountered include vaginal bleeding and miscarriage, ectopic pregnancy and pregnancy of undetermined location, and nausea and vomiting of pregnancy, including hyperemesis gravidarum. Optimal diagnostic approaches and management strategies are covered, including which antiemetics are safe to give in pregnancy. Common nonobstetric problems include asymptomatic bacteriuria, urinary tract infections including pyelonephritis, and acute appendicitis. This article also reviews the various imaging modalities available for pregnant patients and reviews the risks of ionizing radiation as well as various contrast media.[Points & Pearls is a digest of Emergency Medicine Practice.]
Assuntos
Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapia , Primeiro Trimestre da Gravidez , Aborto Espontâneo/diagnóstico , Aborto Espontâneo/terapia , Adulto , Apendicite/diagnóstico , Apendicite/terapia , Diagnóstico Diferencial , Feminino , Humanos , Hiperêmese Gravídica/diagnóstico , Hiperêmese Gravídica/terapia , Gravidez , Gravidez Ectópica/diagnóstico , Gravidez Ectópica/terapia , Infecções Urinárias/diagnóstico , Infecções Urinárias/terapiaRESUMO
Electrical injuries can be caused by exposure to current from low-voltage and high-voltage sources as well as lightning strikes, and the circumstances of the exposure will dictate management strategies. Human tissues have varying resistance characteristics and susceptibility to damage, so injuries may be thermal, electrical, and/or mechanical, potentially causing burns, thrombosis, tetany, falls, and blast injury. This issue reviews the types of trauma seen with electrical injury and how body systems can be affected by occult or delayed effects, and the optimal evidence-based resuscitation and management strategies associated with each. [Points & Pearls is a digest of Emergency Medicine Practice.]
Assuntos
Traumatismos por Eletricidade/diagnóstico , Traumatismos por Eletricidade/terapia , Serviço Hospitalar de Emergência , Diagnóstico Diferencial , Medicina Baseada em Evidências , HumanosRESUMO
Sepsis is a common and life-threatening condition that requires early recognition and swift initial management. Diagnosis and treatment of sepsis and septic shock are fundamental for emergency clinicians, and include knowledge of clinical and laboratory indicators of subtle and overt organ dysfunction, infection source control, and protocols for prompt identification of the early signs of septic shock. [Points & Pearls is a digest of Emergency Medicine Practice.]