RESUMO
Due to a miscommunication during the process of transferring this manuscript from our editorial team to Production, the Members of the American College of Emergency Physicians Clinical Policies Committee (Oversight Committee) were not properly indexed in PubMed. This has now been corrected online. The publisher would like to apologize for any inconvenience caused.
Assuntos
Serviço Hospitalar de Emergência , Política de Saúde , Transtornos Mentais/diagnóstico , Doença Aguda , Adulto , Tratamento de Emergência/métodos , Tratamento de Emergência/tendências , Medicina Baseada em Evidências , Antagonistas de Aminoácidos Excitatórios/uso terapêutico , Humanos , Ketamina/uso terapêutico , Transtornos Mentais/terapia , Guias de Prática Clínica como Assunto , Medição de Risco/métodosRESUMO
This clinical policy from the American College of Emergency Physicians is an update of the 2004 clinical policy on the critical issues in the evaluation of adult patients presenting to the emergency department with acute blunt abdominal trauma. A writing subcommittee reviewed the literature as part of the process to develop evidence-based recommendations to address 4 key critical questions: (1) In a hemodynamically unstable patient with blunt abdominal trauma, is ultrasound the diagnostic modality of choice? (2) Does oral contrast improve the diagnostic performance of computed tomography (CT) in blunt abdominal trauma? (3) In a clinically stable patient with isolated blunt abdominal trauma, is it safe to discharge the patient after a negative abdominal CT scan result? (4) In patients with isolated blunt abdominal trauma, are there clinical predictors that allow the clinician to identify patients at low risk for adverse events who do not need an abdominal CT? Evidence was graded and recommendations were based on the available data in the medical literature related to the specific clinical question.
Assuntos
Traumatismos Abdominais/diagnóstico , Ferimentos não Penetrantes/diagnóstico , Traumatismos Abdominais/diagnóstico por imagem , Adulto , Meios de Contraste/administração & dosagem , Meios de Contraste/uso terapêutico , Serviço Hospitalar de Emergência , Hemodinâmica , Humanos , Alta do Paciente , Sistemas Automatizados de Assistência Junto ao Leito , Tomografia Computadorizada por Raios X , Ultrassonografia , Ferimentos não Penetrantes/diagnóstico por imagemAssuntos
Serviço Hospitalar de Emergência , Fibrinolíticos/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Ativador de Plasminogênio Tecidual/uso terapêutico , Fibrinolíticos/administração & dosagem , Fibrinolíticos/efeitos adversos , Humanos , Infusões Intravenosas , Acidente Vascular Cerebral/diagnóstico , Tempo , Ativador de Plasminogênio Tecidual/administração & dosagem , Ativador de Plasminogênio Tecidual/efeitos adversosRESUMO
This clinical policy from the American College of Emergency Physicians focuses on critical issues concerning the management of adult patients presenting to the emergency department (ED)with community-acquired pneumonia. It is an update of the 2001 clinical policy for the management and risk stratification of adult patients presenting to the ED with community-acquired pneumonia. A subcommittee reviewed the current literature to derive evidence-based recommendations to help answer the following questions: (1) Are routine blood cultures indicated in patients admitted with community-acquired pneumonia? (2) In adult patients with community-acquired pneumonia without severe sepsis, is there a benefit in mortality or morbidity from the administration of antibiotics within aspecific time course? The evidence was graded and recommendations were given based on the strength of evidence.