Heparin-induced anaphylactoid reaction associated with heparin-induced thrombocytopenia in the ED.

Although rare, heparin-induced anaphylactic and anaphylactoid reactions have been previously described in the literature. We present a case of a patient who presented to the emergency department with dyspnea and was subsequently diagnosed with an acute pulmonary venous thromboembolism. Shortly after being started on intravenous unfractionated heparin, she developed sudden cardiovascular collapse leading to a cardiopulmonary arrest. She was successfully resuscitated and, after further diagnostic evaluation, was found to have developed a heparin-induced anaphylactoid reaction.

Ethics curriculum for emergency medicine graduate medical education.

BACKGROUND: Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. OBJECTIVE: This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. DISCUSSION: Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. CONCLUSION: The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution.

Racial and ethnic disparities in the emergency department: a public health perspective.

This article discusses racial and ethnic disparities from a public health perspective, specifically why they threaten to impede the efforts to improve the nation's health. The authors (1) provide background information, including a review of the Institute of Medicine report on health care disparities; (2) describe the racial and ethnic compositions of the individuals in the emergency department setting from the perspective of both the patient and health care provider; (3) discuss the most prevalent disease presentations to the emergency department that are likely to have racial and ethnic disparities; and (4) give conclusions and general recommendations on how to address disparities in emergency health care.