RESUMO
Emergency medicine physicians aim to stabilize or restore vital functions, establish diagnosis, initiate specific treatments and adequately orientate patients. This year, new evidences have improved our knowledge about diagnostic strategy for patients with acute non traumatic headache, treatment of acute atrial fibrillation and outpatient management of acute pulmonary embolism. Reducing injection pain of local anesthetics, reducing irradiation by using alternative diagnostic tools in appendicitis suspicion, and identification of trauma patients who benefit from tranexamic acid administration are other illustrations of the efforts to improve efficacy, safety and comfort in the management of emergency patients.
Assuntos
Apendicite , Fibrilação Atrial , Traumatismos Craniocerebrais , Medicina de Emergência/tendências , Cefaleia , Hemorragia Subaracnóidea/diagnóstico por imagem , Doença Aguda , Assistência Ambulatorial , Anisóis/uso terapêutico , Antifibrinolíticos/uso terapêutico , Apendicite/diagnóstico por imagem , Fibrilação Atrial/terapia , Traumatismos Craniocerebrais/diagnóstico , Eletrocardiografia Ambulatorial , Emergências , Serviço Hospitalar de Emergência , Medicina Baseada em Evidências , Cefaleia/etiologia , Humanos , Guias de Prática Clínica como Assunto , Embolia Pulmonar/terapia , Pirrolidinas/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Hemorragia Subaracnóidea/complicações , Síncope/diagnóstico , Tomografia Computadorizada por Raios X , Ácido Tranexâmico/uso terapêutico , Ultrassonografia , Ferimentos e Lesões/tratamento farmacológicoRESUMO
Geriatric patients presenting to the ED are at high risk of mortality as well as of cognitive or functional decline. Thus, ED is an ideal spot for interventions that can improve their outcome. In this article, we summarize six recent studies, regarding the utilization of prognostic evaluation scores in geriatric patients presenting to the ED, adverse drug reactions, the significance of elevated troponin in patients who have remained on the ground after a fall, the rationale of performing head CT in patients without focal neurologic findings after a fall, the ideal treatment of a proximal femoral fracture and the excessive use of urinary catheters in the ED.
Assuntos
Serviço Hospitalar de Emergência , Acidentes por Quedas , Idoso , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Fraturas do Colo Femoral/diagnóstico , Humanos , Hemorragia Intracraniana Traumática/diagnóstico , Prognóstico , Troponina/sangue , Cateterismo UrinárioRESUMO
Usefulness of a predictive score in subarachnoid hemorrhage diagnosis Nearly half of the patients with non-traumatic subarachnoid hemorrhage (SAH) present with no neurological signs, inducing clinical underestimation of the gravity of their affection. As the outcome of aneurismal SAH is highly dependant on the initial neurological status and the recurrence of untreated hemorrhagic events, these neurologically intact patients stand to suffer the most from delayed diagnosis. Although there is currently no validated predictive score that reliably identifies SAH-induced headache, a combination of clinical criteria derived from a cohort of sudden-onset headache patients should allow risk stratification and identification of those patients requiring further investigation.